Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	2011453
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	2301096
Hospital Revenue Code	260
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.81
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.56
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.78
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$8.79

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	3401031
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	73190097
Hospital Revenue Code	260
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.81
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.56
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.78
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$8.79

INF THERAPEUTIC EA ADDL HR

Facility

$598.74

Service Code	HCPCS 96366
Hospital Charge Code	5700376
Hospital Revenue Code	450
Min. Negotiated Rate	$89.81
Max. Negotiated Rate	$89.81
Rate for Payer: Qualcare PPO/HMO/WC	$89.81

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	3401027
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	2300909
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$221.80

Service Code	HCPCS 96366
Hospital Charge Code	5700261
Hospital Revenue Code	260
Min. Negotiated Rate	$33.27
Max. Negotiated Rate	$33.27
Rate for Payer: Qualcare PPO/HMO/WC	$33.27

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	1500109
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	395096366
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	73050920
Hospital Revenue Code	260
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.81
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.56
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.78
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$8.79

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	5100783
Hospital Revenue Code	260
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.81
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.56
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.78
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$8.79

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	2301096
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	100120
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	73237022
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	73237022
Hospital Revenue Code	260
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.81
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.56
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.78
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$8.79

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	93500041
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	395096366
Hospital Revenue Code	260
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.81
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.56
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.78
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$8.79

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	100118
Hospital Revenue Code	260
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.81
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.56
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.78
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$8.79

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	4501036
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	4501036
Hospital Revenue Code	260
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.81
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.56
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.78
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$8.79

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	411096366
Hospital Revenue Code	260
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.81
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.56
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.78
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$8.79

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	270329881
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INFUMORPH 25MG/ML 20ML

Facility

$41.00

Hospital Charge Code	60635370
Hospital Revenue Code	250
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$6.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.15

INFUMORPH 25MG/ML 20ML

Facility

$41.00

Hospital Charge Code	60635370
Hospital Revenue Code	250
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$20.50
Rate for Payer: Aetna Commercial	$15.58
Rate for Payer: Aetna Medicare Advantage	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.46
Rate for Payer: Cigna Commercial	$20.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.30
Rate for Payer: Oxford Commercial	$8.20
Rate for Payer: Qualcare PPO/HMO/WC	$6.15
Rate for Payer: UnitedHealthcare Commercial	$8.20
Rate for Payer: UnitedHealthcare Community & State	$0.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1.09

Know your out-of-pocket cost for care.

All Charges