Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INTERGRO DBM PLUS 5cc DBMW005

Facility

$4,092.00

Hospital Charge Code	270636732
Hospital Revenue Code	272
Min. Negotiated Rate	$98.62
Max. Negotiated Rate	$2,046.00
Rate for Payer: Aetna Commercial	$1,554.96
Rate for Payer: Aetna Medicare Advantage	$1,227.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,043.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,043.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,043.46
Rate for Payer: Cigna Commercial	$2,046.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,227.60
Rate for Payer: Oxford Commercial	$818.40
Rate for Payer: Qualcare PPO/HMO/WC	$613.80
Rate for Payer: UnitedHealthcare Commercial	$818.40
Rate for Payer: UnitedHealthcare Community & State	$98.62
Rate for Payer: Wellpoint Medicaid Managed Care	$108.44

INTERGRO DBM PLUS 5cc DBMW005

Facility

$4,092.00

Hospital Charge Code	270636732
Hospital Revenue Code	272
Min. Negotiated Rate	$613.80
Max. Negotiated Rate	$613.80
Rate for Payer: Qualcare PPO/HMO/WC	$613.80

INTERLAM FUSION DEVICE-14

Facility

$35,000.00

Service Code	HCPCS C1765
Hospital Charge Code	270705823
Hospital Revenue Code	278
Min. Negotiated Rate	$843.50
Max. Negotiated Rate	$17,500.00
Rate for Payer: Aetna Commercial	$13,300.00
Rate for Payer: Aetna Medicare Advantage	$10,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,925.00
Rate for Payer: Cigna Commercial	$17,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,700.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00
Rate for Payer: UnitedHealthcare Community & State	$843.50
Rate for Payer: Wellpoint Medicaid Managed Care	$927.50

INTERLAM FUSION DEVICE-14

Facility

$35,000.00

Service Code	HCPCS C1765
Hospital Charge Code	270705823
Hospital Revenue Code	278
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$8,470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,700.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00

INTERLAMINATE FUSION DEVICE 10

Facility

$35,000.00

Hospital Charge Code	270702354
Hospital Revenue Code	278
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$8,470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,700.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00

INTERLAMINATE FUSION DEVICE 10

Facility

$35,000.00

Hospital Charge Code	270702354
Hospital Revenue Code	278
Min. Negotiated Rate	$843.50
Max. Negotiated Rate	$17,500.00
Rate for Payer: Aetna Commercial	$13,300.00
Rate for Payer: Aetna Medicare Advantage	$10,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,925.00
Rate for Payer: Cigna Commercial	$17,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,700.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00
Rate for Payer: UnitedHealthcare Community & State	$843.50
Rate for Payer: Wellpoint Medicaid Managed Care	$927.50

INTERLEUKIN-10 (IL-10) Serum

Facility

$86.35

Service Code	HCPCS 83520
Hospital Charge Code	401383520
Hospital Revenue Code	306
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$124.00
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	$43.17
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	$25.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.95
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	$2.29

INTERLEUKIN-10 (IL-10) Serum

Facility

$86.35

Service Code	HCPCS 83520
Hospital Charge Code	401383520
Hospital Revenue Code	306
Min. Negotiated Rate	$12.95
Max. Negotiated Rate	$12.95
Rate for Payer: Qualcare PPO/HMO/WC	$12.95

INTERLEUKIN-1 BETA

Facility

$582.68

Service Code	HCPCS 83520
Hospital Charge Code	401183520H
Hospital Revenue Code	301
Min. Negotiated Rate	$13.82
Max. Negotiated Rate	$291.34
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	$291.34
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	$174.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.40
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	$15.44

INTERLEUKIN-1 BETA

Facility

$582.68

Service Code	HCPCS 83520
Hospital Charge Code	401183520H
Hospital Revenue Code	301
Min. Negotiated Rate	$87.40
Max. Negotiated Rate	$87.40
Rate for Payer: Qualcare PPO/HMO/WC	$87.40

INTERLEUKIN 2 (IL-2)

Facility

$253.45

Service Code	HCPCS 83520
Hospital Charge Code	3006810
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

INTERLEUKIN 2 (IL-2)

Facility

$253.45

Service Code	HCPCS 83520
Hospital Charge Code	3006810
Hospital Revenue Code	301
Min. Negotiated Rate	$38.02
Max. Negotiated Rate	$38.02
Rate for Payer: Qualcare PPO/HMO/WC	$38.02

INTERLEUKIN 2 RECEPTOR

Facility

$205.65

Service Code	HCPCS 84238
Hospital Charge Code	3009164
Hospital Revenue Code	301
Min. Negotiated Rate	$5.45
Max. Negotiated Rate	$132.01
Rate for Payer: Aetna Commercial	$99.47
Rate for Payer: Aetna Medicare Advantage	$118.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$36.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.01
Rate for Payer: Cigna Commercial	$102.83
Rate for Payer: Cigna Medicare Advantage	$36.57
Rate for Payer: Clover Medicare Advantage	$34.74
Rate for Payer: EmblemHealth Commercial	$109.71
Rate for Payer: Humana Medicare Advantage	$37.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$36.57
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	$29.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$36.57
Rate for Payer: Wellcare Medicare Advantage	$36.57
Rate for Payer: Wellpoint Medicaid Managed Care	$5.45

INTERLEUKIN 2 RECEPTOR

Facility

$205.65

Service Code	HCPCS 84238
Hospital Charge Code	3009164
Hospital Revenue Code	301
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

INTERLEUKIN-2 VL 22ML UNITS

Facility

$3,025.95

Hospital Charge Code	6007470
Hospital Revenue Code	251
Min. Negotiated Rate	$72.93
Max. Negotiated Rate	$1,512.97
Rate for Payer: Aetna Commercial	$1,149.86
Rate for Payer: Aetna Medicare Advantage	$907.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$771.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$771.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$771.62
Rate for Payer: Cigna Commercial	$1,512.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.78
Rate for Payer: Oxford Commercial	$605.19
Rate for Payer: Qualcare PPO/HMO/WC	$453.89
Rate for Payer: UnitedHealthcare Commercial	$605.19
Rate for Payer: UnitedHealthcare Community & State	$72.93
Rate for Payer: Wellpoint Medicaid Managed Care	$80.19

INTERLEUKIN-2 VL 22ML UNITS

Facility

$3,025.95

Hospital Charge Code	6007470
Hospital Revenue Code	251
Min. Negotiated Rate	$453.89
Max. Negotiated Rate	$453.89
Rate for Payer: Qualcare PPO/HMO/WC	$453.89

INTERLEUKIN 6 HIGH SENSITIVEIT

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	39900440
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

INTERLEUKIN 6 HIGH SENSITIVEIT

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	39900440
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
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	$195.00
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	$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	$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	$10.34

INTERLINK INJECTION SITE

Facility

$610.00

Hospital Charge Code	270655515
Hospital Revenue Code	271
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

INTERLINK INJECTION SITE

Facility

$610.00

Hospital Charge Code	270655515
Hospital Revenue Code	271
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$231.80
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.00
Rate for Payer: Oxford Commercial	$122.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$122.00
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: Wellpoint Medicaid Managed Care	$16.16

INTERLOCK 10MM X 30CM

Facility

$2,695.00

Hospital Charge Code	270662973
Hospital Revenue Code	278
Min. Negotiated Rate	$404.25
Max. Negotiated Rate	$652.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$539.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$652.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$404.25

INTERLOCK 10MM X 30CM

Facility

$2,695.00

Hospital Charge Code	270662973
Hospital Revenue Code	278
Min. Negotiated Rate	$64.95
Max. Negotiated Rate	$1,347.50
Rate for Payer: Aetna Commercial	$1,024.10
Rate for Payer: Aetna Medicare Advantage	$808.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$687.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$687.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$539.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$687.23
Rate for Payer: Cigna Commercial	$1,347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$652.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$404.25
Rate for Payer: UnitedHealthcare Community & State	$64.95
Rate for Payer: Wellpoint Medicaid Managed Care	$71.42

INTERLOCK 12MM X 30CM

Facility

$2,499.00

Hospital Charge Code	270662972
Hospital Revenue Code	278
Min. Negotiated Rate	$60.23
Max. Negotiated Rate	$1,249.50
Rate for Payer: Aetna Commercial	$949.62
Rate for Payer: Aetna Medicare Advantage	$749.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.25
Rate for Payer: Cigna Commercial	$1,249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$604.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$549.78
Rate for Payer: Qualcare PPO/HMO/WC	$374.85
Rate for Payer: UnitedHealthcare Community & State	$60.23
Rate for Payer: Wellpoint Medicaid Managed Care	$66.22

INTERLOCK 12MM X 30CM

Facility

$2,499.00

Hospital Charge Code	270662972
Hospital Revenue Code	278
Min. Negotiated Rate	$374.85
Max. Negotiated Rate	$604.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$499.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$604.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$549.78
Rate for Payer: Qualcare PPO/HMO/WC	$374.85

INTERLOCK 18MM X50CM

Facility

$4,777.50

Hospital Charge Code	270680002
Hospital Revenue Code	278
Min. Negotiated Rate	$716.62
Max. Negotiated Rate	$1,156.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$955.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,156.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,051.05
Rate for Payer: Qualcare PPO/HMO/WC	$716.62

Know your out-of-pocket cost for care.

All Charges