Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HYPERBARIC CHAMBER SGL****

Facility

$300.00

Service Code	HCPCS 99183
Hospital Charge Code	9000365
Hospital Revenue Code	413
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$3,554.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$2,027.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$3,554.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

HYPERBARIC CHAMBER SUPERVISION

Facility

$300.00

Service Code	HCPCS 99183
Hospital Charge Code	9808275
Hospital Revenue Code	413
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$3,554.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$2,027.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$3,554.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

HYPERBARIC CHAMBER SUPERVISION

Facility

$300.00

Service Code	HCPCS 99183
Hospital Charge Code	9808275
Hospital Revenue Code	413
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

HYPERHEP

Facility

$711.14

Service Code	NDC 13533063603
Hospital Charge Code	6063943285
Hospital Revenue Code	250
Min. Negotiated Rate	$106.67
Max. Negotiated Rate	$106.67
Rate for Payer: Qualcare PPO/HMO/WC	$106.67

HYPERHEP

Facility

$711.14

Service Code	NDC 13533063603
Hospital Charge Code	6063943285
Hospital Revenue Code	250
Min. Negotiated Rate	$17.14
Max. Negotiated Rate	$355.57
Rate for Payer: Aetna Commercial	$270.23
Rate for Payer: Aetna Medicare Advantage	$213.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.34
Rate for Payer: Cigna Commercial	$355.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.34
Rate for Payer: Oxford Commercial	$142.23
Rate for Payer: Qualcare PPO/HMO/WC	$106.67
Rate for Payer: UnitedHealthcare Commercial	$142.23
Rate for Payer: UnitedHealthcare Community & State	$17.14
Rate for Payer: Wellpoint Medicaid Managed Care	$18.85

HYPERHEP/1ML

Facility

$322.00

Hospital Charge Code	60633140
Hospital Revenue Code	250
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$161.00
Rate for Payer: Aetna Commercial	$122.36
Rate for Payer: Aetna Medicare Advantage	$96.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.11
Rate for Payer: Cigna Commercial	$161.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.60
Rate for Payer: Oxford Commercial	$64.40
Rate for Payer: Qualcare PPO/HMO/WC	$48.30
Rate for Payer: UnitedHealthcare Commercial	$64.40
Rate for Payer: UnitedHealthcare Community & State	$7.76
Rate for Payer: Wellpoint Medicaid Managed Care	$8.53

HYPERHEP/1ML

Facility

$322.00

Hospital Charge Code	60633140
Hospital Revenue Code	250
Min. Negotiated Rate	$48.30
Max. Negotiated Rate	$48.30
Rate for Payer: Qualcare PPO/HMO/WC	$48.30

HYPERHEP/5ML

Facility

$1,095.00

Hospital Charge Code	60633139
Hospital Revenue Code	250
Min. Negotiated Rate	$26.39
Max. Negotiated Rate	$547.50
Rate for Payer: Aetna Commercial	$416.10
Rate for Payer: Aetna Medicare Advantage	$328.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$279.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$279.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$279.23
Rate for Payer: Cigna Commercial	$547.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$328.50
Rate for Payer: Oxford Commercial	$219.00
Rate for Payer: Qualcare PPO/HMO/WC	$164.25
Rate for Payer: UnitedHealthcare Commercial	$219.00
Rate for Payer: UnitedHealthcare Community & State	$26.39
Rate for Payer: Wellpoint Medicaid Managed Care	$29.02

HYPERHEP/5ML

Facility

$1,095.00

Hospital Charge Code	60633139
Hospital Revenue Code	250
Min. Negotiated Rate	$164.25
Max. Negotiated Rate	$164.25
Rate for Payer: Qualcare PPO/HMO/WC	$164.25

HYPERSTAT IV INJ/300MG

Facility

$404.00

Hospital Charge Code	60634260
Hospital Revenue Code	250
Min. Negotiated Rate	$60.60
Max. Negotiated Rate	$60.60
Rate for Payer: Qualcare PPO/HMO/WC	$60.60

HYPERSTAT IV INJ/300MG

Facility

$404.00

Hospital Charge Code	60634260
Hospital Revenue Code	250
Min. Negotiated Rate	$9.74
Max. Negotiated Rate	$202.00
Rate for Payer: Aetna Commercial	$153.52
Rate for Payer: Aetna Medicare Advantage	$121.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.02
Rate for Payer: Cigna Commercial	$202.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.20
Rate for Payer: Oxford Commercial	$80.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.60
Rate for Payer: UnitedHealthcare Commercial	$80.80
Rate for Payer: UnitedHealthcare Community & State	$9.74
Rate for Payer: Wellpoint Medicaid Managed Care	$10.71

HYPERTENSION

Facility

$18,559.53

Service Code	APR-DRG 1994
Min. Negotiated Rate	$18,195.62
Max. Negotiated Rate	$18,559.53
Rate for Payer: UnitedHealthcare Community & State	$18,195.62
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,559.53
Rate for Payer: Wellpoint Medicaid Managed Care	$18,195.62

HYPERTENSION

Facility

$6,277.60

Service Code	APR-DRG 1991
Min. Negotiated Rate	$6,154.51
Max. Negotiated Rate	$6,277.60
Rate for Payer: UnitedHealthcare Community & State	$6,154.51
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,277.60
Rate for Payer: Wellpoint Medicaid Managed Care	$6,154.51

HYPERTENSION

Facility

$7,660.25

Service Code	APR-DRG 1992
Min. Negotiated Rate	$7,510.05
Max. Negotiated Rate	$7,660.25
Rate for Payer: UnitedHealthcare Community & State	$7,510.05
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,660.25
Rate for Payer: Wellpoint Medicaid Managed Care	$7,510.05

HYPERTENSION

Facility

$10,603.06

Service Code	APR-DRG 1993
Min. Negotiated Rate	$10,395.16
Max. Negotiated Rate	$10,603.06
Rate for Payer: UnitedHealthcare Community & State	$10,395.16
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,603.06
Rate for Payer: Wellpoint Medicaid Managed Care	$10,395.16

HYPERTENSION WITH MCC

Facility

$40,596.88

Service Code	MSDRG 304
Min. Negotiated Rate	$12,361.23
Max. Negotiated Rate	$40,596.88
Rate for Payer: Aetna Commercial	$28,152.00
Rate for Payer: Aetna Medicare Advantage	$40,596.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,750.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,750.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,011.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26,750.15
Rate for Payer: Cigna Commercial	$22,269.66
Rate for Payer: Cigna Medicare Advantage	$13,011.82
Rate for Payer: Clover Medicare Advantage	$12,361.23
Rate for Payer: EmblemHealth Commercial	$39,035.46
Rate for Payer: Humana Medicare Advantage	$13,402.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,011.82
Rate for Payer: Oxford Commercial	$16,005.50
Rate for Payer: UnitedHealthcare Commercial	$28,066.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,011.82
Rate for Payer: Wellcare Medicare Advantage	$13,011.82

HYPERTENSION WITHOUT MCC

Facility

$26,540.19

Service Code	MSDRG 305
Min. Negotiated Rate	$8,081.15
Max. Negotiated Rate	$26,540.19
Rate for Payer: Aetna Commercial	$18,493.47
Rate for Payer: Aetna Medicare Advantage	$26,540.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,445.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,445.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,506.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,445.75
Rate for Payer: Cigna Commercial	$14,130.94
Rate for Payer: Cigna Medicare Advantage	$8,506.47
Rate for Payer: Clover Medicare Advantage	$8,081.15
Rate for Payer: EmblemHealth Commercial	$25,519.41
Rate for Payer: Humana Medicare Advantage	$8,761.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,506.47
Rate for Payer: Oxford Commercial	$10,156.09
Rate for Payer: UnitedHealthcare Commercial	$17,809.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,506.47
Rate for Payer: Wellcare Medicare Advantage	$8,506.47

HYPERTENSIVE ENCEPHALOPATHY WITH CC

Facility

$23,726.22

Service Code	MSDRG 078
Min. Negotiated Rate	$23,726.22
Max. Negotiated Rate	$23,726.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,726.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,726.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,726.22

HYPERTENSIVE ENCEPHALOPATHY WITH MCC

Facility

$35,124.11

Service Code	MSDRG 077
Min. Negotiated Rate	$35,124.11
Max. Negotiated Rate	$35,124.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,124.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,124.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,124.11

HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC

Facility

$17,213.14

Service Code	MSDRG 079
Min. Negotiated Rate	$17,213.14
Max. Negotiated Rate	$17,213.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,213.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,213.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,213.14

HYPNOTHERAPY

Facility

$6,800.00

Service Code	HCPCS 90880
Hospital Charge Code	94810155
Hospital Revenue Code	900
Min. Negotiated Rate	$98.02
Max. Negotiated Rate	$3,081.00
Rate for Payer: Aetna Commercial	$328.28
Rate for Payer: Aetna Medicare Advantage	$391.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$435.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$435.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$120.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$435.65
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: Cigna Medicare Advantage	$120.69
Rate for Payer: Clover Medicare Advantage	$114.66
Rate for Payer: EmblemHealth Commercial	$362.07
Rate for Payer: Humana Medicare Advantage	$124.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$120.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,040.00
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00
Rate for Payer: UnitedHealthcare Commercial	$3,081.00
Rate for Payer: UnitedHealthcare Community & State	$163.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$120.69
Rate for Payer: Wellcare Medicare Advantage	$120.69
Rate for Payer: Wellpoint Medicaid Managed Care	$180.20

HYPNOTHERAPY

Facility

$6,800.00

Service Code	HCPCS 90880
Hospital Charge Code	94810155
Hospital Revenue Code	900
Min. Negotiated Rate	$1,020.00
Max. Negotiated Rate	$1,020.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00

HYPNOTHERAPY

Facility

$750.00

Service Code	HCPCS 90880
Hospital Charge Code	4546775
Hospital Revenue Code	914
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

HYPNOTHERAPY

Facility

$750.00

Service Code	HCPCS 90880
Hospital Charge Code	4546775
Hospital Revenue Code	914
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$435.65
Rate for Payer: Aetna Commercial	$328.28
Rate for Payer: Aetna Medicare Advantage	$391.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$435.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$435.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$120.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$435.65
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: Cigna Medicare Advantage	$120.69
Rate for Payer: Clover Medicare Advantage	$114.66
Rate for Payer: EmblemHealth Commercial	$362.07
Rate for Payer: Humana Medicare Advantage	$124.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$120.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$120.69
Rate for Payer: Wellcare Medicare Advantage	$120.69
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

HYPNOTHERAPY ADULT

Facility

$750.00

Service Code	HCPCS 90880
Hospital Charge Code	4504522
Hospital Revenue Code	914
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

Know your out-of-pocket cost for care.

All Charges