Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ANDROGEL 5GM GEL PKT

Facility

$35.00

Hospital Charge Code	60635555
Hospital Revenue Code	250
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$17.50
Rate for Payer: Aetna Commercial	$13.30
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.50
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$7.00
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

ANDROGEL 5GM GEL PKT

Facility

$35.00

Hospital Charge Code	60635555
Hospital Revenue Code	250
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

ANDROSTANEDIOL GLUCURONI

Facility

$333.00

Service Code	HCPCS 82154
Hospital Charge Code	38472438
Hospital Revenue Code	301
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$166.50
Rate for Payer: Aetna Commercial	$78.42
Rate for Payer: Aetna Medicare Advantage	$93.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$28.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.07
Rate for Payer: Cigna Commercial	$166.50
Rate for Payer: Cigna Medicare Advantage	$28.83
Rate for Payer: Clover Medicare Advantage	$27.39
Rate for Payer: EmblemHealth Commercial	$86.49
Rate for Payer: Humana Medicare Advantage	$29.69
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$28.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.95
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$23.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$28.83
Rate for Payer: Wellcare Medicare Advantage	$28.83
Rate for Payer: Wellpoint Medicaid Managed Care	$8.82

ANDROSTANEDIOL GLUCURONI

Facility

$333.00

Service Code	HCPCS 82154
Hospital Charge Code	38472438
Hospital Revenue Code	301
Min. Negotiated Rate	$49.95
Max. Negotiated Rate	$49.95
Rate for Payer: Qualcare PPO/HMO/WC	$49.95

ANDROSTENEDIONE

Facility

$487.00

Service Code	HCPCS 82157
Hospital Charge Code	38472107
Hospital Revenue Code	301
Min. Negotiated Rate	$12.91
Max. Negotiated Rate	$243.50
Rate for Payer: Aetna Commercial	$79.64
Rate for Payer: Aetna Medicare Advantage	$94.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.69
Rate for Payer: Cigna Commercial	$243.50
Rate for Payer: Cigna Medicare Advantage	$29.28
Rate for Payer: Clover Medicare Advantage	$27.82
Rate for Payer: EmblemHealth Commercial	$87.84
Rate for Payer: Humana Medicare Advantage	$30.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$23.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.28
Rate for Payer: Wellcare Medicare Advantage	$29.28
Rate for Payer: Wellpoint Medicaid Managed Care	$12.91

ANDROSTENEDIONE

Facility

$487.00

Service Code	HCPCS 82157
Hospital Charge Code	38472107
Hospital Revenue Code	301
Min. Negotiated Rate	$73.05
Max. Negotiated Rate	$73.05
Rate for Payer: Qualcare PPO/HMO/WC	$73.05

ANDROSTENEDIONE

Facility

$390.00

Service Code	HCPCS 82157
Hospital Charge Code	39900507
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ANDROSTENEDIONE

Facility

$256.00

Service Code	HCPCS 82157
Hospital Charge Code	3008984
Hospital Revenue Code	301
Min. Negotiated Rate	$6.78
Max. Negotiated Rate	$128.00
Rate for Payer: Aetna Commercial	$79.64
Rate for Payer: Aetna Medicare Advantage	$94.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.69
Rate for Payer: Cigna Commercial	$128.00
Rate for Payer: Cigna Medicare Advantage	$29.28
Rate for Payer: Clover Medicare Advantage	$27.82
Rate for Payer: EmblemHealth Commercial	$87.84
Rate for Payer: Humana Medicare Advantage	$30.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$23.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.28
Rate for Payer: Wellcare Medicare Advantage	$29.28
Rate for Payer: Wellpoint Medicaid Managed Care	$6.78

ANDROSTENEDIONE

Facility

$390.00

Service Code	HCPCS 82157
Hospital Charge Code	39900507
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$79.64
Rate for Payer: Aetna Medicare Advantage	$94.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.69
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$29.28
Rate for Payer: Clover Medicare Advantage	$27.82
Rate for Payer: EmblemHealth Commercial	$87.84
Rate for Payer: Humana Medicare Advantage	$30.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$23.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.28
Rate for Payer: Wellcare Medicare Advantage	$29.28
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ANDROSTENEDIONE

Facility

$256.00

Service Code	HCPCS 82157
Hospital Charge Code	3008984
Hospital Revenue Code	301
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

ANDROSTENEDIONE,LC/MS/MS

Facility

$201.20

Service Code	HCPCS 82157
Hospital Charge Code	39900042
Hospital Revenue Code	301
Min. Negotiated Rate	$5.33
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$79.64
Rate for Payer: Aetna Medicare Advantage	$94.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.69
Rate for Payer: Cigna Commercial	$100.60
Rate for Payer: Cigna Medicare Advantage	$29.28
Rate for Payer: Clover Medicare Advantage	$27.82
Rate for Payer: EmblemHealth Commercial	$87.84
Rate for Payer: Humana Medicare Advantage	$30.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.18
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$23.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.28
Rate for Payer: Wellcare Medicare Advantage	$29.28
Rate for Payer: Wellpoint Medicaid Managed Care	$5.33

ANDROSTENEDIONE,LC/MS/MS

Facility

$201.20

Service Code	HCPCS 82157
Hospital Charge Code	39900042
Hospital Revenue Code	301
Min. Negotiated Rate	$30.18
Max. Negotiated Rate	$30.18
Rate for Payer: Qualcare PPO/HMO/WC	$30.18

ANECTINE/500MG

Facility

$49.00

Hospital Charge Code	60632466
Hospital Revenue Code	250
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$24.50
Rate for Payer: Aetna Commercial	$18.62
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.49
Rate for Payer: Cigna Commercial	$24.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.70
Rate for Payer: Oxford Commercial	$9.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.35
Rate for Payer: UnitedHealthcare Commercial	$9.80
Rate for Payer: UnitedHealthcare Community & State	$1.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.30

ANECTINE/500MG

Facility

$49.00

Hospital Charge Code	60632466
Hospital Revenue Code	250
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$7.35
Rate for Payer: Qualcare PPO/HMO/WC	$7.35

ANES BRC PLEXUS BLOCK PROC

Facility

$600.00

Service Code	HCPCS 64415
Hospital Charge Code	1650099
Hospital Revenue Code	361
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

ANES BRC PLEXUS BLOCK PROC

Facility

$600.00

Service Code	HCPCS 64415
Hospital Charge Code	1650099
Hospital Revenue Code	361
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$3,793.00
Rate for Payer: Aetna Commercial	$2,858.12
Rate for Payer: Aetna Medicare Advantage	$3,404.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,050.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,793.00
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: Cigna Medicare Advantage	$1,050.78
Rate for Payer: Clover Medicare Advantage	$998.24
Rate for Payer: EmblemHealth Commercial	$3,152.34
Rate for Payer: Humana Medicare Advantage	$1,082.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,050.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.00
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,050.78
Rate for Payer: Wellcare Medicare Advantage	$1,050.78
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

ANES BRC PLEXUS BLOCK US PROC

Facility

$700.00

Hospital Charge Code	1650100
Hospital Revenue Code	361
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

ANES BRC PLEXUS BLOCK US PROC

Facility

$700.00

Hospital Charge Code	1650100
Hospital Revenue Code	361
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

ANES - C-SECTION

Facility

$2,802.00

Hospital Charge Code	73190158
Hospital Revenue Code	370
Min. Negotiated Rate	$67.53
Max. Negotiated Rate	$1,401.00
Rate for Payer: Aetna Commercial	$1,064.76
Rate for Payer: Aetna Medicare Advantage	$840.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.51
Rate for Payer: Cigna Commercial	$1,401.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.60
Rate for Payer: Oxford Commercial	$560.40
Rate for Payer: Qualcare PPO/HMO/WC	$420.30
Rate for Payer: UnitedHealthcare Commercial	$560.40
Rate for Payer: UnitedHealthcare Community & State	$67.53
Rate for Payer: Wellpoint Medicaid Managed Care	$74.25

ANES - C-SECTION

Facility

$2,802.00

Hospital Charge Code	73190158
Hospital Revenue Code	370
Min. Negotiated Rate	$420.30
Max. Negotiated Rate	$420.30
Rate for Payer: Qualcare PPO/HMO/WC	$420.30

ANES - C-SEC W/ PROC

Facility

$3,308.00

Hospital Charge Code	73190159
Hospital Revenue Code	370
Min. Negotiated Rate	$496.20
Max. Negotiated Rate	$496.20
Rate for Payer: Qualcare PPO/HMO/WC	$496.20

ANES - C-SEC W/ PROC

Facility

$3,308.00

Hospital Charge Code	73190159
Hospital Revenue Code	370
Min. Negotiated Rate	$79.72
Max. Negotiated Rate	$1,654.00
Rate for Payer: Aetna Commercial	$1,257.04
Rate for Payer: Aetna Medicare Advantage	$992.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$843.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$843.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$843.54
Rate for Payer: Cigna Commercial	$1,654.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$992.40
Rate for Payer: Oxford Commercial	$661.60
Rate for Payer: Qualcare PPO/HMO/WC	$496.20
Rate for Payer: UnitedHealthcare Commercial	$661.60
Rate for Payer: UnitedHealthcare Community & State	$79.72
Rate for Payer: Wellpoint Medicaid Managed Care	$87.66

ANES FEM NERVE BLOCK

Facility

$3,185.75

Service Code	HCPCS 64447
Hospital Charge Code	1650096
Hospital Revenue Code	361
Min. Negotiated Rate	$477.86
Max. Negotiated Rate	$477.86
Rate for Payer: Qualcare PPO/HMO/WC	$477.86

ANES FEM NERVE BLOCK

Facility

$3,185.75

Service Code	HCPCS 64447
Hospital Charge Code	1650096
Hospital Revenue Code	361
Min. Negotiated Rate	$76.78
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,281.02
Rate for Payer: Aetna Medicare Advantage	$2,717.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$838.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,027.13
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: Cigna Medicare Advantage	$838.61
Rate for Payer: Clover Medicare Advantage	$796.68
Rate for Payer: EmblemHealth Commercial	$2,515.83
Rate for Payer: Humana Medicare Advantage	$863.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$838.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$955.73
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$477.86
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$76.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$84.42

ANES IV SED FIRST HR

Facility

$667.67

Hospital Charge Code	1650015
Hospital Revenue Code	370
Min. Negotiated Rate	$100.15
Max. Negotiated Rate	$100.15
Rate for Payer: Qualcare PPO/HMO/WC	$100.15

Know your out-of-pocket cost for care.

All Charges