Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IBD DIFFERENTIATION PANEL V

Facility

$390.00

Service Code	HCPCS 8667191
Hospital Charge Code	39990078E
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

IBD DIFFERENTIATION PANEL V

Facility

$390.00

Service Code	HCPCS 8667191
Hospital Charge Code	39990078E
Hospital Revenue Code	302
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

IBD PANEL

Facility

$98.00

Service Code	HCPCS 8667191
Hospital Charge Code	3035092D
Hospital Revenue Code	302
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$14.70
Rate for Payer: Qualcare PPO/HMO/WC	$14.70

IBD PANEL

Facility

$98.00

Service Code	HCPCS 86256
Hospital Charge Code	3035092A
Hospital Revenue Code	302
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$49.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$2.60

IBD PANEL

Facility

$98.00

Service Code	HCPCS 8667191
Hospital Charge Code	3035092D
Hospital Revenue Code	302
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$37.24
Rate for Payer: Aetna Medicare Advantage	$29.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.36
Rate for Payer: Wellpoint Medicaid Managed Care	$2.60

IBD PANEL

Facility

$392.00

Hospital Charge Code	3035092
Hospital Revenue Code	302
Min. Negotiated Rate	$58.80
Max. Negotiated Rate	$58.80
Rate for Payer: Qualcare PPO/HMO/WC	$58.80

IBD PANEL

Facility

$392.00

Hospital Charge Code	3035092
Hospital Revenue Code	302
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$196.00
Rate for Payer: Aetna Commercial	$148.96
Rate for Payer: Aetna Medicare Advantage	$117.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.96
Rate for Payer: Cigna Commercial	$196.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.45
Rate for Payer: Wellpoint Medicaid Managed Care	$10.39

IBD PANEL

Facility

$98.00

Service Code	HCPCS 86256
Hospital Charge Code	3035092A
Hospital Revenue Code	302
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$14.70
Rate for Payer: Qualcare PPO/HMO/WC	$14.70

IBD PANEL

Facility

$205.65

Service Code	HCPCS 86021
Hospital Charge Code	3035092B
Hospital Revenue Code	302
Min. Negotiated Rate	$5.45
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$40.94
Rate for Payer: Aetna Medicare Advantage	$48.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.33
Rate for Payer: Cigna Commercial	$102.83
Rate for Payer: Cigna Medicare Advantage	$15.05
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Medicare Advantage	$15.05
Rate for Payer: Wellpoint Medicaid Managed Care	$5.45

IBD PANEL

Facility

$98.00

Service Code	HCPCS 8667191
Hospital Charge Code	3035092C
Hospital Revenue Code	302
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$14.70
Rate for Payer: Qualcare PPO/HMO/WC	$14.70

IBD PANEL

Facility

$205.65

Service Code	HCPCS 86021
Hospital Charge Code	3035092B
Hospital Revenue Code	302
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

IBD PANEL

Facility

$98.00

Service Code	HCPCS 8667191
Hospital Charge Code	3035092C
Hospital Revenue Code	302
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$37.24
Rate for Payer: Aetna Medicare Advantage	$29.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.36
Rate for Payer: Wellpoint Medicaid Managed Care	$2.60

IBD PANEL I

Facility

$103.50

Service Code	HCPCS 8602191
Hospital Charge Code	39990079A
Hospital Revenue Code	302
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.33
Rate for Payer: Aetna Medicare Advantage	$31.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.39
Rate for Payer: Cigna Commercial	$51.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.53
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.49
Rate for Payer: Wellpoint Medicaid Managed Care	$2.74

IBD PANEL I

Facility

$103.50

Service Code	HCPCS 8602191
Hospital Charge Code	39990079A
Hospital Revenue Code	302
Min. Negotiated Rate	$15.53
Max. Negotiated Rate	$15.53
Rate for Payer: Qualcare PPO/HMO/WC	$15.53

IBD PANEL II

Facility

$103.50

Service Code	HCPCS 8602191
Hospital Charge Code	39990079B
Hospital Revenue Code	302
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.33
Rate for Payer: Aetna Medicare Advantage	$31.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.39
Rate for Payer: Cigna Commercial	$51.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.53
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.49
Rate for Payer: Wellpoint Medicaid Managed Care	$2.74

IBD PANEL II

Facility

$103.50

Service Code	HCPCS 8602191
Hospital Charge Code	39990079B
Hospital Revenue Code	302
Min. Negotiated Rate	$15.53
Max. Negotiated Rate	$15.53
Rate for Payer: Qualcare PPO/HMO/WC	$15.53

IBD PANEL III

Facility

$103.50

Service Code	HCPCS 8602191
Hospital Charge Code	39990079C
Hospital Revenue Code	302
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.33
Rate for Payer: Aetna Medicare Advantage	$31.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.39
Rate for Payer: Cigna Commercial	$51.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.53
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.49
Rate for Payer: Wellpoint Medicaid Managed Care	$2.74

IBD PANEL III

Facility

$103.50

Service Code	HCPCS 8602191
Hospital Charge Code	39990079C
Hospital Revenue Code	302
Min. Negotiated Rate	$15.53
Max. Negotiated Rate	$15.53
Rate for Payer: Qualcare PPO/HMO/WC	$15.53

IBD PANEL IV

Facility

$84.25

Service Code	HCPCS 8667191
Hospital Charge Code	39990079D
Hospital Revenue Code	302
Min. Negotiated Rate	$12.64
Max. Negotiated Rate	$12.64
Rate for Payer: Qualcare PPO/HMO/WC	$12.64

IBD PANEL IV

Facility

$84.25

Service Code	HCPCS 8667191
Hospital Charge Code	39990079D
Hospital Revenue Code	302
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.02
Rate for Payer: Aetna Medicare Advantage	$25.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.48
Rate for Payer: Cigna Commercial	$42.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.27
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.64
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.03
Rate for Payer: Wellpoint Medicaid Managed Care	$2.23

IBD PANEL V

Facility

$84.25

Service Code	HCPCS 8667191
Hospital Charge Code	39990079E
Hospital Revenue Code	302
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.02
Rate for Payer: Aetna Medicare Advantage	$25.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.48
Rate for Payer: Cigna Commercial	$42.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.27
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.64
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.03
Rate for Payer: Wellpoint Medicaid Managed Care	$2.23

IBD PANEL V

Facility

$84.25

Service Code	HCPCS 8667191
Hospital Charge Code	39990079E
Hospital Revenue Code	302
Min. Negotiated Rate	$12.64
Max. Negotiated Rate	$12.64
Rate for Payer: Qualcare PPO/HMO/WC	$12.64

IBD SERO 7 QUANTIT IMMUNOASSAY

Facility

$253.45

Service Code	HCPCS 83520
Hospital Charge Code	3035157E
Hospital Revenue Code	301
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$126.72
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.34
Rate for Payer: Cigna Commercial	$126.72
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.02
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.72

IBD SERO 7 QUANTIT IMMUNOASSAY

Facility

$253.45

Service Code	HCPCS 83520
Hospital Charge Code	3035157A
Hospital Revenue Code	301
Min. Negotiated Rate	$38.02
Max. Negotiated Rate	$38.02
Rate for Payer: Qualcare PPO/HMO/WC	$38.02

IBD SERO 7 QUANTIT IMMUNOASSAY

Facility

$253.45

Service Code	HCPCS 83520
Hospital Charge Code	3035157A
Hospital Revenue Code	301
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$126.72
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.34
Rate for Payer: Cigna Commercial	$126.72
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.02
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.72

Know your out-of-pocket cost for care.

All Charges