Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ANTI GLIADIN ANTIBODY IGG IGA

Facility

$253.45

Service Code	HCPCS 83520
Hospital Charge Code	3032364
Hospital Revenue Code	301
Min. Negotiated Rate	$38.02
Max. Negotiated Rate	$38.02
Rate for Payer: Qualcare PPO/HMO/WC	$38.02

ANTIGLOBULIN TECHNIQUE

Facility

$390.00

Service Code	HCPCS 86922
Hospital Charge Code	3100583B
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ANTIGLOBULIN TECHNIQUE

Facility

$390.00

Service Code	HCPCS 86922
Hospital Charge Code	3100583B
Hospital Revenue Code	300
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$730.60
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$730.60
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
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	$12.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ANTIGLOMERULAR BM AB, QN

Facility

$300.00

Service Code	HCPCS 83516
Hospital Charge Code	3007176
Hospital Revenue Code	310
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

ANTIGLOMERULAR BM AB, QN

Facility

$300.00

Service Code	HCPCS 83516
Hospital Charge Code	3007176
Hospital Revenue Code	310
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$31.36
Rate for Payer: Aetna Medicare Advantage	$37.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.62
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: Cigna Medicare Advantage	$11.53
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$9.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Medicare Advantage	$11.53
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

ANTI GM1 ANTIBODY

Facility

$376.00

Service Code	HCPCS 83520
Hospital Charge Code	38476236
Hospital Revenue Code	301
Min. Negotiated Rate	$56.40
Max. Negotiated Rate	$56.40
Rate for Payer: Qualcare PPO/HMO/WC	$56.40

ANTI GM1 ANTIBODY

Facility

$376.00

Service Code	HCPCS 83520
Hospital Charge Code	38476236
Hospital Revenue Code	301
Min. Negotiated Rate	$9.96
Max. Negotiated Rate	$188.00
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	$188.00
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	$112.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.40
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	$9.96

ANTI HEMOPHILIC FACTOR VIII

Facility

$4.00

Hospital Charge Code	3109015
Hospital Revenue Code	636
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

ANTI HEMOPHILIC FACTOR VIII

Facility

$4.00

Hospital Charge Code	3109015
Hospital Revenue Code	636
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ANTI-HISTONE ANTIBODIES

Facility

$417.00

Service Code	HCPCS 83520
Hospital Charge Code	38476154
Hospital Revenue Code	301
Min. Negotiated Rate	$62.55
Max. Negotiated Rate	$62.55
Rate for Payer: Qualcare PPO/HMO/WC	$62.55

ANTI-HISTONE ANTIBODIES

Facility

$417.00

Service Code	HCPCS 83520
Hospital Charge Code	38476154
Hospital Revenue Code	301
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$208.50
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	$208.50
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	$125.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.55
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	$11.05

ANTI HISTONE ANTIBODY SERUM

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3007051
Hospital Revenue Code	302
Min. Negotiated Rate	$3.82
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.72
Rate for Payer: Cigna Commercial	$72.00
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.82

ANTI HISTONE ANTIBODY SERUM

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3007051
Hospital Revenue Code	302
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.60

ANTI HU ANTIBODY

Facility

$329.00

Service Code	HCPCS 86316
Hospital Charge Code	38476232
Hospital Revenue Code	302
Min. Negotiated Rate	$49.35
Max. Negotiated Rate	$49.35
Rate for Payer: Qualcare PPO/HMO/WC	$49.35

ANTI HU ANTIBODY

Facility

$329.00

Service Code	HCPCS 86316
Hospital Charge Code	38476232
Hospital Revenue Code	302
Min. Negotiated Rate	$8.72
Max. Negotiated Rate	$164.50
Rate for Payer: Aetna Commercial	$56.60
Rate for Payer: Aetna Medicare Advantage	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.12
Rate for Payer: Cigna Commercial	$164.50
Rate for Payer: Cigna Medicare Advantage	$20.81
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Medicare Advantage	$20.81
Rate for Payer: Wellpoint Medicaid Managed Care	$8.72

ANTI HYALURONIDASE, SERUM

Facility

$100.00

Service Code	HCPCS 86060
Hospital Charge Code	3007069
Hospital Revenue Code	302
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$19.86
Rate for Payer: Aetna Medicare Advantage	$23.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.35
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: Cigna Medicare Advantage	$7.30
Rate for Payer: Clover Medicare Advantage	$6.93
Rate for Payer: EmblemHealth Commercial	$21.90
Rate for Payer: Humana Medicare Advantage	$7.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.30
Rate for Payer: Wellcare Medicare Advantage	$7.30
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

ANTI HYALURONIDASE, SERUM

Facility

$100.00

Service Code	HCPCS 86060
Hospital Charge Code	3007069
Hospital Revenue Code	302
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

ANTI-ISLET CELL AB SCREEN

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3007077
Hospital Revenue Code	302
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

ANTI-ISLET CELL AB SCREEN

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3007077
Hospital Revenue Code	302
Min. Negotiated Rate	$3.21
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	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$60.50
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	$36.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
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	$3.21

ANTI-JO 1 AB ENA

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3008299
Hospital Revenue Code	302
Min. Negotiated Rate	$3.82
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.72
Rate for Payer: Cigna Commercial	$72.00
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.82

ANTI-JO 1 AB ENA

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3008299
Hospital Revenue Code	302
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.60

ANTI KERATIN

Facility

$1,259.35

Hospital Charge Code	270655021
Hospital Revenue Code	270
Min. Negotiated Rate	$30.35
Max. Negotiated Rate	$629.67
Rate for Payer: Aetna Commercial	$478.55
Rate for Payer: Aetna Medicare Advantage	$377.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$321.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$321.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$321.13
Rate for Payer: Cigna Commercial	$629.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$377.81
Rate for Payer: Oxford Commercial	$251.87
Rate for Payer: Qualcare PPO/HMO/WC	$188.90
Rate for Payer: UnitedHealthcare Commercial	$251.87
Rate for Payer: UnitedHealthcare Community & State	$30.35
Rate for Payer: Wellpoint Medicaid Managed Care	$33.37

ANTI KERATIN

Facility

$1,259.35

Hospital Charge Code	270655021
Hospital Revenue Code	270
Min. Negotiated Rate	$188.90
Max. Negotiated Rate	$188.90
Rate for Payer: Qualcare PPO/HMO/WC	$188.90

ANTI MICROSOMAL ANTIBODIES

Facility

$160.85

Service Code	HCPCS 86376
Hospital Charge Code	3007143
Hospital Revenue Code	302
Min. Negotiated Rate	$24.13
Max. Negotiated Rate	$24.13
Rate for Payer: Qualcare PPO/HMO/WC	$24.13

ANTI MICROSOMAL ANTIBODIES

Facility

$160.85

Service Code	HCPCS 86376
Hospital Charge Code	3007143
Hospital Revenue Code	302
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.58
Rate for Payer: Aetna Medicare Advantage	$47.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.52
Rate for Payer: Cigna Commercial	$80.42
Rate for Payer: Cigna Medicare Advantage	$14.55
Rate for Payer: Clover Medicare Advantage	$13.82
Rate for Payer: EmblemHealth Commercial	$43.65
Rate for Payer: Humana Medicare Advantage	$14.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.26
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.13
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.55
Rate for Payer: Wellcare Medicare Advantage	$14.55
Rate for Payer: Wellpoint Medicaid Managed Care	$4.26

Know your out-of-pocket cost for care.

All Charges