Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INF CONCURRENT THERAPEUTIC

Facility

$335.00

Service Code	HCPCS 96368
Hospital Charge Code	270329882
Hospital Revenue Code	260
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$127.30
Rate for Payer: Aetna Medicare Advantage	$100.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.42
Rate for Payer: Cigna Commercial	$167.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.50
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.25
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$8.07
Rate for Payer: Wellpoint Medicaid Managed Care	$8.88

INF CONCURRENT THERAPEUTIC

Facility

$145.60

Service Code	HCPCS 96368
Hospital Charge Code	5700405
Hospital Revenue Code	450
Min. Negotiated Rate	$21.84
Max. Negotiated Rate	$21.84
Rate for Payer: Qualcare PPO/HMO/WC	$21.84

INF CONCURRENT THERAPEUTIC

Facility

$2,800.00

Service Code	HCPCS 96368
Hospital Charge Code	73190101
Hospital Revenue Code	260
Min. Negotiated Rate	$21.68
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$1,064.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$67.48
Rate for Payer: Wellpoint Medicaid Managed Care	$74.20

INF CONCURRENT THERAPEUTIC

Facility

$2,800.00

Service Code	HCPCS 96368
Hospital Charge Code	3401042
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF CONCURRENT THERAPEUTIC

Facility

$2,800.00

Service Code	HCPCS 96368
Hospital Charge Code	100129
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INF CONCURRENT THERAPEUTIC

Facility

$335.00

Service Code	HCPCS 96368
Hospital Charge Code	270329882
Hospital Revenue Code	260
Min. Negotiated Rate	$50.25
Max. Negotiated Rate	$50.25
Rate for Payer: Qualcare PPO/HMO/WC	$50.25

INF CONCURRENT THERAPEUTIC

Facility

$145.60

Service Code	HCPCS 96368
Hospital Charge Code	8200518
Hospital Revenue Code	260
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$55.33
Rate for Payer: Aetna Medicare Advantage	$43.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.13
Rate for Payer: Cigna Commercial	$72.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.68
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.84
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$3.51
Rate for Payer: Wellpoint Medicaid Managed Care	$3.86

INF CONCURRENT THERAPEUTIC

Facility

$2,800.00

Service Code	HCPCS 96368
Hospital Charge Code	100129
Hospital Revenue Code	260
Min. Negotiated Rate	$21.68
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$1,064.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$67.48
Rate for Payer: Wellpoint Medicaid Managed Care	$74.20

INF CONCURRENT THERAPEUTIC

Facility

$111.00

Service Code	HCPCS 96368
Hospital Charge Code	73050930
Hospital Revenue Code	260
Min. Negotiated Rate	$16.65
Max. Negotiated Rate	$16.65
Rate for Payer: Qualcare PPO/HMO/WC	$16.65

INF CONCURRENT THERAPEUTIC

Facility

$2,800.00

Service Code	HCPCS 96368
Hospital Charge Code	3401042
Hospital Revenue Code	260
Min. Negotiated Rate	$21.68
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$1,064.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$67.48
Rate for Payer: Wellpoint Medicaid Managed Care	$74.20

INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC

Facility

$33,777.03

Service Code	MSDRG 758
Min. Negotiated Rate	$10,284.67
Max. Negotiated Rate	$33,777.03
Rate for Payer: Aetna Commercial	$23,465.99
Rate for Payer: Aetna Medicare Advantage	$33,777.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,028.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,028.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10,825.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,028.39
Rate for Payer: Cigna Commercial	$18,321.01
Rate for Payer: Cigna Medicare Advantage	$10,825.97
Rate for Payer: Clover Medicare Advantage	$10,284.67
Rate for Payer: EmblemHealth Commercial	$32,477.91
Rate for Payer: Humana Medicare Advantage	$11,150.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10,825.97
Rate for Payer: Oxford Commercial	$13,167.55
Rate for Payer: UnitedHealthcare Commercial	$23,089.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$10,825.97
Rate for Payer: Wellcare Medicare Advantage	$10,825.97

INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$48,415.44

Service Code	MSDRG 757
Min. Negotiated Rate	$14,741.88
Max. Negotiated Rate	$48,415.44
Rate for Payer: Aetna Commercial	$33,524.27
Rate for Payer: Aetna Medicare Advantage	$48,415.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34,658.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34,658.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,517.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34,658.89
Rate for Payer: Cigna Commercial	$26,796.58
Rate for Payer: Cigna Medicare Advantage	$15,517.77
Rate for Payer: Clover Medicare Advantage	$14,741.88
Rate for Payer: EmblemHealth Commercial	$46,553.31
Rate for Payer: Humana Medicare Advantage	$15,983.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,517.77
Rate for Payer: Oxford Commercial	$19,259.06
Rate for Payer: UnitedHealthcare Commercial	$33,771.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,517.77
Rate for Payer: Wellcare Medicare Advantage	$15,517.77

INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC

Facility

$23,582.74

Service Code	MSDRG 759
Min. Negotiated Rate	$7,180.64
Max. Negotiated Rate	$23,582.74
Rate for Payer: Aetna Commercial	$16,461.35
Rate for Payer: Aetna Medicare Advantage	$23,582.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,119.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,119.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,558.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,119.65
Rate for Payer: Cigna Commercial	$12,418.61
Rate for Payer: Cigna Medicare Advantage	$7,558.57
Rate for Payer: Clover Medicare Advantage	$7,180.64
Rate for Payer: EmblemHealth Commercial	$22,675.71
Rate for Payer: Humana Medicare Advantage	$7,785.33
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,558.57
Rate for Payer: Oxford Commercial	$8,925.42
Rate for Payer: UnitedHealthcare Commercial	$15,651.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,558.57
Rate for Payer: Wellcare Medicare Advantage	$7,558.57

INFECTIONS OF UPPER RESPIRATORY TRACT

Facility

$5,931.62

Service Code	APR-DRG 1132
Min. Negotiated Rate	$5,815.31
Max. Negotiated Rate	$5,931.62
Rate for Payer: UnitedHealthcare Community & State	$5,815.31
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,931.62
Rate for Payer: Wellpoint Medicaid Managed Care	$5,815.31

INFECTIONS OF UPPER RESPIRATORY TRACT

Facility

$17,642.84

Service Code	APR-DRG 1134
Min. Negotiated Rate	$17,296.90
Max. Negotiated Rate	$17,642.84
Rate for Payer: UnitedHealthcare Community & State	$17,296.90
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,642.84
Rate for Payer: Wellpoint Medicaid Managed Care	$17,296.90

INFECTIONS OF UPPER RESPIRATORY TRACT

Facility

$4,073.99

Service Code	APR-DRG 1131
Min. Negotiated Rate	$3,994.11
Max. Negotiated Rate	$4,073.99
Rate for Payer: UnitedHealthcare Community & State	$3,994.11
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,073.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3,994.11

INFECTIONS OF UPPER RESPIRATORY TRACT

Facility

$8,907.58

Service Code	APR-DRG 1133
Min. Negotiated Rate	$8,732.92
Max. Negotiated Rate	$8,907.58
Rate for Payer: UnitedHealthcare Community & State	$8,732.92
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,907.58
Rate for Payer: Wellpoint Medicaid Managed Care	$8,732.92

INFECTIOUS AGENT DETECTION DNA

Facility

$284.50

Service Code	HCPCS 87800
Hospital Charge Code	38475119
Hospital Revenue Code	306
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$157.64
Rate for Payer: Aetna Commercial	$118.78
Rate for Payer: Aetna Medicare Advantage	$141.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$43.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.64
Rate for Payer: Cigna Commercial	$142.25
Rate for Payer: Cigna Medicare Advantage	$43.67
Rate for Payer: Clover Medicare Advantage	$41.49
Rate for Payer: EmblemHealth Commercial	$131.01
Rate for Payer: Humana Medicare Advantage	$44.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$43.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.67
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$34.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$43.67
Rate for Payer: Wellcare Medicare Advantage	$43.67
Rate for Payer: Wellpoint Medicaid Managed Care	$7.54

INFECTIOUS AGENT DETECTION DNA

Facility

$284.50

Service Code	HCPCS 87800
Hospital Charge Code	38475119
Hospital Revenue Code	306
Min. Negotiated Rate	$42.67
Max. Negotiated Rate	$42.67
Rate for Payer: Qualcare PPO/HMO/WC	$42.67

INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE

Facility

$53,458.40

Service Code	APR-DRG 7104
Min. Negotiated Rate	$52,410.20
Max. Negotiated Rate	$53,458.40
Rate for Payer: UnitedHealthcare Community & State	$52,410.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$53,458.40
Rate for Payer: Wellpoint Medicaid Managed Care	$52,410.20

INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE

Facility

$12,432.57

Service Code	APR-DRG 7101
Min. Negotiated Rate	$12,188.79
Max. Negotiated Rate	$12,432.57
Rate for Payer: UnitedHealthcare Community & State	$12,188.79
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,432.57
Rate for Payer: Wellpoint Medicaid Managed Care	$12,188.79

INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE

Facility

$18,144.60

Service Code	APR-DRG 7102
Min. Negotiated Rate	$17,788.82
Max. Negotiated Rate	$18,144.60
Rate for Payer: UnitedHealthcare Community & State	$17,788.82
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$17,788.82

INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE

Facility

$29,797.12

Service Code	APR-DRG 7103
Min. Negotiated Rate	$29,212.86
Max. Negotiated Rate	$29,797.12
Rate for Payer: UnitedHealthcare Community & State	$29,212.86
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,797.12
Rate for Payer: Wellpoint Medicaid Managed Care	$29,212.86

INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC

Facility

$66,716.02

Service Code	MSDRG 854
Min. Negotiated Rate	$20,314.17
Max. Negotiated Rate	$66,716.02
Rate for Payer: Aetna Commercial	$46,098.84
Rate for Payer: Aetna Medicare Advantage	$66,716.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47,452.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47,452.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,383.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47,452.44
Rate for Payer: Cigna Commercial	$37,392.44
Rate for Payer: Cigna Medicare Advantage	$21,383.34
Rate for Payer: Clover Medicare Advantage	$20,314.17
Rate for Payer: EmblemHealth Commercial	$64,150.02
Rate for Payer: Humana Medicare Advantage	$22,024.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,383.34
Rate for Payer: Oxford Commercial	$26,874.44
Rate for Payer: UnitedHealthcare Commercial	$47,125.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,383.34
Rate for Payer: Wellcare Medicare Advantage	$21,383.34

INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC

Facility

$161,757.80

Service Code	MSDRG 853
Min. Negotiated Rate	$49,253.18
Max. Negotiated Rate	$161,757.80
Rate for Payer: Aetna Commercial	$111,403.38
Rate for Payer: Aetna Medicare Advantage	$161,757.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$51,845.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116,305.00
Rate for Payer: Cigna Commercial	$92,420.96
Rate for Payer: Cigna Medicare Advantage	$51,845.45
Rate for Payer: Clover Medicare Advantage	$49,253.18
Rate for Payer: EmblemHealth Commercial	$155,536.35
Rate for Payer: Humana Medicare Advantage	$53,400.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$51,845.45
Rate for Payer: Oxford Commercial	$66,424.17
Rate for Payer: UnitedHealthcare Commercial	$116,476.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$51,845.45
Rate for Payer: Wellcare Medicare Advantage	$51,845.45

Know your out-of-pocket cost for care.

All Charges