Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HIV WITH MAJOR RELATED CONDITION WITH CC

Facility

$43,990.63

Service Code	MSDRG 975
Min. Negotiated Rate	$13,394.58
Max. Negotiated Rate	$43,990.63
Rate for Payer: Aetna Commercial	$30,483.91
Rate for Payer: Aetna Medicare Advantage	$43,990.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,634.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,634.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,099.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,634.96
Rate for Payer: Cigna Commercial	$24,234.63
Rate for Payer: Cigna Medicare Advantage	$14,099.56
Rate for Payer: Clover Medicare Advantage	$13,394.58
Rate for Payer: EmblemHealth Commercial	$42,298.68
Rate for Payer: Humana Medicare Advantage	$14,522.55
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,099.56
Rate for Payer: Oxford Commercial	$17,417.75
Rate for Payer: UnitedHealthcare Commercial	$30,542.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,099.56
Rate for Payer: Wellcare Medicare Advantage	$14,099.56

HIV WITH MAJOR RELATED CONDITION WITH MCC

Facility

$95,414.40

Service Code	MSDRG 974
Min. Negotiated Rate	$29,052.46
Max. Negotiated Rate	$95,414.40
Rate for Payer: Aetna Commercial	$65,817.89
Rate for Payer: Aetna Medicare Advantage	$95,414.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67,922.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67,922.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$30,581.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67,922.12
Rate for Payer: Cigna Commercial	$54,008.60
Rate for Payer: Cigna Medicare Advantage	$30,581.54
Rate for Payer: Clover Medicare Advantage	$29,052.46
Rate for Payer: EmblemHealth Commercial	$91,744.62
Rate for Payer: Humana Medicare Advantage	$31,498.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$30,581.54
Rate for Payer: Oxford Commercial	$38,816.70
Rate for Payer: UnitedHealthcare Commercial	$68,066.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$30,581.54
Rate for Payer: Wellcare Medicare Advantage	$30,581.54

HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC

Facility

$31,310.88

Service Code	MSDRG 976
Min. Negotiated Rate	$9,533.76
Max. Negotiated Rate	$31,310.88
Rate for Payer: Aetna Commercial	$21,771.46
Rate for Payer: Aetna Medicare Advantage	$31,310.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,771.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,771.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10,035.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19,771.85
Rate for Payer: Cigna Commercial	$16,739.67
Rate for Payer: Cigna Medicare Advantage	$10,035.54
Rate for Payer: Clover Medicare Advantage	$9,533.76
Rate for Payer: EmblemHealth Commercial	$30,106.62
Rate for Payer: Humana Medicare Advantage	$10,336.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10,035.54
Rate for Payer: Oxford Commercial	$12,031.02
Rate for Payer: UnitedHealthcare Commercial	$21,096.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$10,035.54
Rate for Payer: Wellcare Medicare Advantage	$10,035.54

HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS

Facility

$9,489.75

Service Code	APR-DRG 8901
Min. Negotiated Rate	$9,303.68
Max. Negotiated Rate	$9,489.75
Rate for Payer: UnitedHealthcare Community & State	$9,303.68
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,489.75
Rate for Payer: Wellpoint Medicaid Managed Care	$9,303.68

HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS

Facility

$16,039.28

Service Code	APR-DRG 8903
Min. Negotiated Rate	$15,724.78
Max. Negotiated Rate	$16,039.28
Rate for Payer: UnitedHealthcare Community & State	$15,724.78
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,039.28
Rate for Payer: Wellpoint Medicaid Managed Care	$15,724.78

HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS

Facility

$9,990.26

Service Code	APR-DRG 8902
Min. Negotiated Rate	$9,794.37
Max. Negotiated Rate	$9,990.26
Rate for Payer: UnitedHealthcare Community & State	$9,794.37
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,990.26
Rate for Payer: Wellpoint Medicaid Managed Care	$9,794.37

HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS

Facility

$31,344.50

Service Code	APR-DRG 8904
Min. Negotiated Rate	$30,729.90
Max. Negotiated Rate	$31,344.50
Rate for Payer: UnitedHealthcare Community & State	$30,729.90
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$31,344.50
Rate for Payer: Wellpoint Medicaid Managed Care	$30,729.90

HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS

Facility

$10,143.46

Service Code	APR-DRG 8932
Min. Negotiated Rate	$9,944.57
Max. Negotiated Rate	$10,143.46
Rate for Payer: UnitedHealthcare Community & State	$9,944.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,143.46
Rate for Payer: Wellpoint Medicaid Managed Care	$9,944.57

HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS

Facility

$9,381.29

Service Code	APR-DRG 8931
Min. Negotiated Rate	$9,197.34
Max. Negotiated Rate	$9,381.29
Rate for Payer: UnitedHealthcare Community & State	$9,197.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,381.29
Rate for Payer: Wellpoint Medicaid Managed Care	$9,197.34

HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS

Facility

$14,106.34

Service Code	APR-DRG 8933
Min. Negotiated Rate	$13,829.75
Max. Negotiated Rate	$14,106.34
Rate for Payer: UnitedHealthcare Community & State	$13,829.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,106.34
Rate for Payer: Wellpoint Medicaid Managed Care	$13,829.75

HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS

Facility

$20,179.64

Service Code	APR-DRG 8934
Min. Negotiated Rate	$19,783.96
Max. Negotiated Rate	$20,179.64
Rate for Payer: UnitedHealthcare Community & State	$19,783.96
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,179.64
Rate for Payer: Wellpoint Medicaid Managed Care	$19,783.96

HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS

Facility

$18,956.61

Service Code	APR-DRG 8944
Min. Negotiated Rate	$18,584.91
Max. Negotiated Rate	$18,956.61
Rate for Payer: UnitedHealthcare Community & State	$18,584.91
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,956.61
Rate for Payer: Wellpoint Medicaid Managed Care	$18,584.91

HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS

Facility

$12,339.38

Service Code	APR-DRG 8943
Min. Negotiated Rate	$12,097.43
Max. Negotiated Rate	$12,339.38
Rate for Payer: UnitedHealthcare Community & State	$12,097.43
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,339.38
Rate for Payer: Wellpoint Medicaid Managed Care	$12,097.43

HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS

Facility

$8,730.16

Service Code	APR-DRG 8942
Min. Negotiated Rate	$8,558.98
Max. Negotiated Rate	$8,730.16
Rate for Payer: UnitedHealthcare Community & State	$8,558.98
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,730.16
Rate for Payer: Wellpoint Medicaid Managed Care	$8,558.98

HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS

Facility

$7,033.42

Service Code	APR-DRG 8941
Min. Negotiated Rate	$6,895.51
Max. Negotiated Rate	$7,033.42
Rate for Payer: UnitedHealthcare Community & State	$6,895.51
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,033.42
Rate for Payer: Wellpoint Medicaid Managed Care	$6,895.51

HIV WITH OR WITHOUT OTHER RELATED CONDITION

Facility

$44,077.92

Service Code	MSDRG 977
Min. Negotiated Rate	$13,421.16
Max. Negotiated Rate	$44,077.92
Rate for Payer: Aetna Commercial	$30,543.89
Rate for Payer: Aetna Medicare Advantage	$44,077.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,030.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,030.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,127.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33,030.62
Rate for Payer: Cigna Commercial	$23,721.87
Rate for Payer: Cigna Medicare Advantage	$14,127.54
Rate for Payer: Clover Medicare Advantage	$13,421.16
Rate for Payer: EmblemHealth Commercial	$42,382.62
Rate for Payer: Humana Medicare Advantage	$14,551.37
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,127.54
Rate for Payer: Oxford Commercial	$17,049.22
Rate for Payer: UnitedHealthcare Commercial	$29,896.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,127.54
Rate for Payer: Wellcare Medicare Advantage	$14,127.54

HLA A,B,C

Facility

$200.00

Service Code	HCPCS 81372
Hospital Charge Code	3038134
Hospital Revenue Code	310
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

HLA A,B,C

Facility

$200.00

Service Code	HCPCS 81372
Hospital Charge Code	3038134
Hospital Revenue Code	310
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$1,456.84
Rate for Payer: Aetna Commercial	$1,097.76
Rate for Payer: Aetna Medicare Advantage	$1,307.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,456.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,456.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$403.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,456.84
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: Cigna Medicare Advantage	$403.59
Rate for Payer: Clover Medicare Advantage	$383.41
Rate for Payer: EmblemHealth Commercial	$1,210.77
Rate for Payer: Humana Medicare Advantage	$415.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$403.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$322.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$403.59
Rate for Payer: Wellcare Medicare Advantage	$403.59
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

HLA A,B,C TYPING

Facility

$410.69

Service Code	HCPCS 86813
Hospital Charge Code	38476274
Hospital Revenue Code	302
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$209.36
Rate for Payer: Aetna Commercial	$157.76
Rate for Payer: Aetna Medicare Advantage	$187.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$58.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.36
Rate for Payer: Cigna Commercial	$205.34
Rate for Payer: Cigna Medicare Advantage	$58.00
Rate for Payer: Clover Medicare Advantage	$55.10
Rate for Payer: EmblemHealth Commercial	$174.00
Rate for Payer: Humana Medicare Advantage	$59.74
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$58.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.21
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$46.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$58.00
Rate for Payer: Wellcare Medicare Advantage	$58.00
Rate for Payer: Wellpoint Medicaid Managed Care	$10.88

HLA A,B,C TYPING

Facility

$410.69

Service Code	HCPCS 86813
Hospital Charge Code	38476274
Hospital Revenue Code	302
Min. Negotiated Rate	$61.60
Max. Negotiated Rate	$61.60
Rate for Payer: Qualcare PPO/HMO/WC	$61.60

HLA-A,B,C TYPING

Facility

$1,149.65

Service Code	HCPCS 86813
Hospital Charge Code	3009834
Hospital Revenue Code	302
Min. Negotiated Rate	$172.45
Max. Negotiated Rate	$172.45
Rate for Payer: Qualcare PPO/HMO/WC	$172.45

HLA-A,B,C TYPING

Facility

$1,149.65

Service Code	HCPCS 86813
Hospital Charge Code	3009834
Hospital Revenue Code	302
Min. Negotiated Rate	$30.47
Max. Negotiated Rate	$574.83
Rate for Payer: Aetna Commercial	$157.76
Rate for Payer: Aetna Medicare Advantage	$187.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$58.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.36
Rate for Payer: Cigna Commercial	$574.83
Rate for Payer: Cigna Medicare Advantage	$58.00
Rate for Payer: Clover Medicare Advantage	$55.10
Rate for Payer: EmblemHealth Commercial	$174.00
Rate for Payer: Humana Medicare Advantage	$59.74
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$58.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.89
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$46.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$58.00
Rate for Payer: Wellcare Medicare Advantage	$58.00
Rate for Payer: Wellpoint Medicaid Managed Care	$30.47

HLA B27

Facility

$235.25

Service Code	HCPCS 81374
Hospital Charge Code	3007515
Hospital Revenue Code	310
Min. Negotiated Rate	$35.29
Max. Negotiated Rate	$35.29
Rate for Payer: Qualcare PPO/HMO/WC	$35.29

HLA B27

Facility

$235.25

Service Code	HCPCS 81374
Hospital Charge Code	3007515
Hospital Revenue Code	310
Min. Negotiated Rate	$6.23
Max. Negotiated Rate	$268.31
Rate for Payer: Aetna Commercial	$202.18
Rate for Payer: Aetna Medicare Advantage	$240.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$268.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$268.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$74.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$268.31
Rate for Payer: Cigna Commercial	$117.62
Rate for Payer: Cigna Medicare Advantage	$74.33
Rate for Payer: Clover Medicare Advantage	$70.61
Rate for Payer: EmblemHealth Commercial	$222.99
Rate for Payer: Humana Medicare Advantage	$76.56
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$74.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.58
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.29
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$59.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$74.33
Rate for Payer: Wellcare Medicare Advantage	$74.33
Rate for Payer: Wellpoint Medicaid Managed Care	$6.23

HLA-B27

Facility

$390.00

Service Code	HCPCS 86812
Hospital Charge Code	39900262
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges