Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INFLATION DEVICE ENCORE

Facility

$175.00

Hospital Charge Code	2706000658
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

INFLATION DEV MICROTECH BALLN

Facility

$137.00

Hospital Charge Code	270700755
Hospital Revenue Code	272
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$68.50
Rate for Payer: Aetna Commercial	$52.06
Rate for Payer: Aetna Medicare Advantage	$41.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.94
Rate for Payer: Cigna Commercial	$68.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.10
Rate for Payer: Oxford Commercial	$27.40
Rate for Payer: Qualcare PPO/HMO/WC	$20.55
Rate for Payer: UnitedHealthcare Commercial	$27.40
Rate for Payer: UnitedHealthcare Community & State	$3.30
Rate for Payer: Wellpoint Medicaid Managed Care	$3.63

INFLATION DEV MICROTECH BALLN

Facility

$137.00

Hospital Charge Code	270700755
Hospital Revenue Code	272
Min. Negotiated Rate	$20.55
Max. Negotiated Rate	$20.55
Rate for Payer: Qualcare PPO/HMO/WC	$20.55

INFLATION KIT

Facility

$156.80

Hospital Charge Code	270664784S
Hospital Revenue Code	272
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$78.40
Rate for Payer: Aetna Commercial	$59.58
Rate for Payer: Aetna Medicare Advantage	$47.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.98
Rate for Payer: Cigna Commercial	$78.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.04
Rate for Payer: Oxford Commercial	$31.36
Rate for Payer: Qualcare PPO/HMO/WC	$23.52
Rate for Payer: UnitedHealthcare Commercial	$31.36
Rate for Payer: UnitedHealthcare Community & State	$3.78
Rate for Payer: Wellpoint Medicaid Managed Care	$4.16

INFLATION KIT

Facility

$156.80

Hospital Charge Code	270664784
Hospital Revenue Code	272
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$78.40
Rate for Payer: Aetna Commercial	$59.58
Rate for Payer: Aetna Medicare Advantage	$47.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.98
Rate for Payer: Cigna Commercial	$78.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.04
Rate for Payer: Oxford Commercial	$31.36
Rate for Payer: Qualcare PPO/HMO/WC	$23.52
Rate for Payer: UnitedHealthcare Commercial	$31.36
Rate for Payer: UnitedHealthcare Community & State	$3.78
Rate for Payer: Wellpoint Medicaid Managed Care	$4.16

INFLATION KIT

Facility

$156.80

Hospital Charge Code	270664784
Hospital Revenue Code	272
Min. Negotiated Rate	$23.52
Max. Negotiated Rate	$23.52
Rate for Payer: Qualcare PPO/HMO/WC	$23.52

INFLATION KIT

Facility

$154.50

Hospital Charge Code	270664784N
Hospital Revenue Code	272
Min. Negotiated Rate	$3.72
Max. Negotiated Rate	$77.25
Rate for Payer: Aetna Commercial	$58.71
Rate for Payer: Aetna Medicare Advantage	$46.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.40
Rate for Payer: Cigna Commercial	$77.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.35
Rate for Payer: Oxford Commercial	$30.90
Rate for Payer: Qualcare PPO/HMO/WC	$23.18
Rate for Payer: UnitedHealthcare Commercial	$30.90
Rate for Payer: UnitedHealthcare Community & State	$3.72
Rate for Payer: Wellpoint Medicaid Managed Care	$4.09

INFLATION KIT

Facility

$156.80

Hospital Charge Code	270664784S
Hospital Revenue Code	272
Min. Negotiated Rate	$23.52
Max. Negotiated Rate	$23.52
Rate for Payer: Qualcare PPO/HMO/WC	$23.52

INFLATION KIT

Facility

$154.50

Hospital Charge Code	270664784N
Hospital Revenue Code	272
Min. Negotiated Rate	$23.18
Max. Negotiated Rate	$23.18
Rate for Payer: Qualcare PPO/HMO/WC	$23.18

INFLATOR CRYO P-CIU-4

Facility

$5,200.00

Hospital Charge Code	270634520V
Hospital Revenue Code	278
Min. Negotiated Rate	$780.00
Max. Negotiated Rate	$1,258.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,144.00
Rate for Payer: Qualcare PPO/HMO/WC	$780.00

INFLATOR CRYO P-CIU-4

Facility

$5,200.00

Service Code	HCPCS C1725
Hospital Charge Code	270634520
Hospital Revenue Code	278
Min. Negotiated Rate	$125.32
Max. Negotiated Rate	$2,600.00
Rate for Payer: Aetna Commercial	$1,976.00
Rate for Payer: Aetna Medicare Advantage	$1,560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,326.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,326.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,326.00
Rate for Payer: Cigna Commercial	$2,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,144.00
Rate for Payer: Qualcare PPO/HMO/WC	$780.00
Rate for Payer: UnitedHealthcare Community & State	$125.32
Rate for Payer: Wellpoint Medicaid Managed Care	$137.80

INFLATOR CRYO P-CIU-4

Facility

$5,200.00

Hospital Charge Code	270634520V
Hospital Revenue Code	278
Min. Negotiated Rate	$125.32
Max. Negotiated Rate	$2,600.00
Rate for Payer: Aetna Commercial	$1,976.00
Rate for Payer: Aetna Medicare Advantage	$1,560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,326.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,326.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,326.00
Rate for Payer: Cigna Commercial	$2,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,144.00
Rate for Payer: Qualcare PPO/HMO/WC	$780.00
Rate for Payer: UnitedHealthcare Community & State	$125.32
Rate for Payer: Wellpoint Medicaid Managed Care	$137.80

INFLATOR CRYO P-CIU-4

Facility

$5,200.00

Service Code	HCPCS C1725
Hospital Charge Code	270634520
Hospital Revenue Code	278
Min. Negotiated Rate	$780.00
Max. Negotiated Rate	$1,258.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,144.00
Rate for Payer: Qualcare PPO/HMO/WC	$780.00

INFLATOR DEVICE, SYRINGE

Facility

$190.00

Hospital Charge Code	2008095
Hospital Revenue Code	272
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

INFLATOR DEVICE, SYRINGE

Facility

$190.00

Hospital Charge Code	2008095
Hospital Revenue Code	272
Min. Negotiated Rate	$4.58
Max. Negotiated Rate	$95.00
Rate for Payer: Aetna Commercial	$72.20
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.00
Rate for Payer: Oxford Commercial	$38.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$38.00
Rate for Payer: UnitedHealthcare Community & State	$4.58
Rate for Payer: Wellpoint Medicaid Managed Care	$5.04

INFLATOR LEVEEN & PRESS GA****

Facility

$225.00

Hospital Charge Code	1604719
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

INFLATOR LEVEEN & PRESS GA****

Facility

$225.00

Hospital Charge Code	1604719
Hospital Revenue Code	272
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.50
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$45.00
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

INFLATOR LEVEEN W/GA 10CC

Facility

$320.00

Service Code	HCPCS C1769
Hospital Charge Code	270601155
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.40
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

INFLATOR LEVEEN W/GA 10CC

Facility

$320.00

Service Code	HCPCS C1769
Hospital Charge Code	270601155
Hospital Revenue Code	278
Min. Negotiated Rate	$7.71
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$121.60
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.40
Rate for Payer: Qualcare PPO/HMO/WC	$48.00
Rate for Payer: UnitedHealthcare Community & State	$7.71
Rate for Payer: Wellpoint Medicaid Managed Care	$8.48

INF LEVEL 1 VISIT

Facility

$510.60

Service Code	HCPCS 99211
Hospital Charge Code	93500187
Hospital Revenue Code	510
Min. Negotiated Rate	$12.31
Max. Negotiated Rate	$255.30
Rate for Payer: Aetna Commercial	$194.03
Rate for Payer: Aetna Medicare Advantage	$153.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.20
Rate for Payer: Cigna Commercial	$255.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.18
Rate for Payer: Qualcare PPO/HMO/WC	$76.59
Rate for Payer: UnitedHealthcare Community & State	$12.31
Rate for Payer: Wellpoint Medicaid Managed Care	$13.53

INF LEVEL 1 VISIT

Facility

$510.60

Service Code	HCPCS 99211
Hospital Charge Code	93500187
Hospital Revenue Code	510
Min. Negotiated Rate	$76.59
Max. Negotiated Rate	$76.59
Rate for Payer: Qualcare PPO/HMO/WC	$76.59

INFLIXIMAB 100 MG VIAL

Facility

$7,463.06

Service Code	HCPCS J1745
Hospital Charge Code	60628795
Hospital Revenue Code	636
Min. Negotiated Rate	$29.49
Max. Negotiated Rate	$1,806.06
Rate for Payer: Aetna Commercial	$84.43
Rate for Payer: Aetna Medicare Advantage	$100.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$31.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.05
Rate for Payer: Cigna Medicare Advantage	$31.04
Rate for Payer: Clover Medicare Advantage	$29.49
Rate for Payer: EmblemHealth Commercial	$93.12
Rate for Payer: Humana Medicare Advantage	$31.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$31.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,806.06
Rate for Payer: Qualcare PPO/HMO/WC	$1,119.46
Rate for Payer: UnitedHealthcare Community & State	$179.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$31.04
Rate for Payer: Wellcare Medicare Advantage	$31.04
Rate for Payer: Wellpoint Medicaid Managed Care	$197.77

INFLIXIMAB 100 MG VIAL

Facility

$7,463.06

Service Code	HCPCS J1745
Hospital Charge Code	60628795
Hospital Revenue Code	636
Min. Negotiated Rate	$1,119.46
Max. Negotiated Rate	$1,806.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,806.06
Rate for Payer: Qualcare PPO/HMO/WC	$1,119.46

INFLIXIMAB-ABDA 100MG

Facility

$3,705.44

Service Code	HCPCS Q5104
Hospital Charge Code	606390474
Hospital Revenue Code	636
Min. Negotiated Rate	$25.46
Max. Negotiated Rate	$896.72
Rate for Payer: Aetna Commercial	$72.90
Rate for Payer: Aetna Medicare Advantage	$86.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.74
Rate for Payer: Cigna Medicare Advantage	$26.80
Rate for Payer: Clover Medicare Advantage	$25.46
Rate for Payer: EmblemHealth Commercial	$80.40
Rate for Payer: Humana Medicare Advantage	$27.60
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$896.72
Rate for Payer: Qualcare PPO/HMO/WC	$555.82
Rate for Payer: UnitedHealthcare Community & State	$89.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.80
Rate for Payer: Wellcare Medicare Advantage	$26.80
Rate for Payer: Wellpoint Medicaid Managed Care	$98.19

INFLIXIMAB-ABDA 100MG

Facility

$3,705.44

Service Code	HCPCS Q5104
Hospital Charge Code	606390474
Hospital Revenue Code	636
Min. Negotiated Rate	$555.82
Max. Negotiated Rate	$896.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$896.72
Rate for Payer: Qualcare PPO/HMO/WC	$555.82

Know your out-of-pocket cost for care.

All Charges