Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

APO A1 + B II

Facility

$205.65

Service Code	HCPCS 82172
Hospital Charge Code	3038527B
Hospital Revenue Code	300
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

APO E GENOTYPE

Facility

$429.00

Service Code	HCPCS 83890
Hospital Charge Code	38472935
Hospital Revenue Code	301
Min. Negotiated Rate	$64.35
Max. Negotiated Rate	$64.35
Rate for Payer: Qualcare PPO/HMO/WC	$64.35

APO E GENOTYPE

Facility

$429.00

Service Code	HCPCS 83890
Hospital Charge Code	38472935
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$214.50
Rate for Payer: Aetna Commercial	$163.02
Rate for Payer: Aetna Medicare Advantage	$128.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.39
Rate for Payer: Cigna Commercial	$214.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$64.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.34
Rate for Payer: Wellpoint Medicaid Managed Care	$11.37

APOLIPOPROTEIN A-1

Facility

$109.75

Service Code	HCPCS 82172
Hospital Charge Code	38479459
Hospital Revenue Code	301
Min. Negotiated Rate	$16.46
Max. Negotiated Rate	$16.46
Rate for Payer: Qualcare PPO/HMO/WC	$16.46

APOLIPOPROTEIN A-1

Facility

$109.75

Service Code	HCPCS 82172
Hospital Charge Code	38472019
Hospital Revenue Code	301
Min. Negotiated Rate	$2.91
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$57.36
Rate for Payer: Aetna Medicare Advantage	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.13
Rate for Payer: Cigna Commercial	$54.88
Rate for Payer: Cigna Medicare Advantage	$21.09
Rate for Payer: Clover Medicare Advantage	$20.04
Rate for Payer: EmblemHealth Commercial	$63.27
Rate for Payer: Humana Medicare Advantage	$21.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.46
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.09
Rate for Payer: Wellcare Medicare Advantage	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$2.91

APOLIPOPROTEIN A-1

Facility

$109.75

Service Code	HCPCS 82172
Hospital Charge Code	38472019
Hospital Revenue Code	301
Min. Negotiated Rate	$16.46
Max. Negotiated Rate	$16.46
Rate for Payer: Qualcare PPO/HMO/WC	$16.46

APOLIPOPROTEIN A-1

Facility

$106.50

Service Code	HCPCS 82172
Hospital Charge Code	39900044
Hospital Revenue Code	301
Min. Negotiated Rate	$2.82
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$57.36
Rate for Payer: Aetna Medicare Advantage	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.13
Rate for Payer: Cigna Commercial	$53.25
Rate for Payer: Cigna Medicare Advantage	$21.09
Rate for Payer: Clover Medicare Advantage	$20.04
Rate for Payer: EmblemHealth Commercial	$63.27
Rate for Payer: Humana Medicare Advantage	$21.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.95
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.97
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.09
Rate for Payer: Wellcare Medicare Advantage	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$2.82

APOLIPOPROTEIN A-1

Facility

$109.75

Service Code	HCPCS 82172
Hospital Charge Code	38479459
Hospital Revenue Code	301
Min. Negotiated Rate	$2.91
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$57.36
Rate for Payer: Aetna Medicare Advantage	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.13
Rate for Payer: Cigna Commercial	$54.88
Rate for Payer: Cigna Medicare Advantage	$21.09
Rate for Payer: Clover Medicare Advantage	$20.04
Rate for Payer: EmblemHealth Commercial	$63.27
Rate for Payer: Humana Medicare Advantage	$21.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.46
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.09
Rate for Payer: Wellcare Medicare Advantage	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$2.91

APOLIPOPROTEIN A-1

Facility

$106.50

Service Code	HCPCS 82172
Hospital Charge Code	39900044
Hospital Revenue Code	301
Min. Negotiated Rate	$15.97
Max. Negotiated Rate	$15.97
Rate for Payer: Qualcare PPO/HMO/WC	$15.97

APOLIPOPROTEIN B

Facility

$109.75

Service Code	HCPCS 82172
Hospital Charge Code	38472021
Hospital Revenue Code	301
Min. Negotiated Rate	$16.46
Max. Negotiated Rate	$16.46
Rate for Payer: Qualcare PPO/HMO/WC	$16.46

APOLIPOPROTEIN B

Facility

$109.75

Service Code	HCPCS 82172
Hospital Charge Code	38479460
Hospital Revenue Code	301
Min. Negotiated Rate	$16.46
Max. Negotiated Rate	$16.46
Rate for Payer: Qualcare PPO/HMO/WC	$16.46

APOLIPOPROTEIN B

Facility

$205.65

Service Code	HCPCS 82172
Hospital Charge Code	3003135
Hospital Revenue Code	301
Min. Negotiated Rate	$5.45
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$57.36
Rate for Payer: Aetna Medicare Advantage	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.13
Rate for Payer: Cigna Commercial	$102.83
Rate for Payer: Cigna Medicare Advantage	$21.09
Rate for Payer: Clover Medicare Advantage	$20.04
Rate for Payer: EmblemHealth Commercial	$63.27
Rate for Payer: Humana Medicare Advantage	$21.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.09
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	$16.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.09
Rate for Payer: Wellcare Medicare Advantage	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$5.45

APOLIPOPROTEIN B

Facility

$205.65

Service Code	HCPCS 82172
Hospital Charge Code	3003135
Hospital Revenue Code	301
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

APOLIPOPROTEIN B

Facility

$109.75

Service Code	HCPCS 82172
Hospital Charge Code	38472021
Hospital Revenue Code	301
Min. Negotiated Rate	$2.91
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$57.36
Rate for Payer: Aetna Medicare Advantage	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.13
Rate for Payer: Cigna Commercial	$54.88
Rate for Payer: Cigna Medicare Advantage	$21.09
Rate for Payer: Clover Medicare Advantage	$20.04
Rate for Payer: EmblemHealth Commercial	$63.27
Rate for Payer: Humana Medicare Advantage	$21.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.46
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.09
Rate for Payer: Wellcare Medicare Advantage	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$2.91

APOLIPOPROTEIN B

Facility

$109.75

Service Code	HCPCS 82172
Hospital Charge Code	38479460
Hospital Revenue Code	301
Min. Negotiated Rate	$2.91
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$57.36
Rate for Payer: Aetna Medicare Advantage	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.13
Rate for Payer: Cigna Commercial	$54.88
Rate for Payer: Cigna Medicare Advantage	$21.09
Rate for Payer: Clover Medicare Advantage	$20.04
Rate for Payer: EmblemHealth Commercial	$63.27
Rate for Payer: Humana Medicare Advantage	$21.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.46
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.09
Rate for Payer: Wellcare Medicare Advantage	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$2.91

APOLIPOPROTEIN E ISOFORM PLASM

Facility

$550.00

Service Code	HCPCS 82542
Hospital Charge Code	401112563
Hospital Revenue Code	301
Min. Negotiated Rate	$14.57
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$65.52
Rate for Payer: Aetna Medicare Advantage	$78.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.96
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: Cigna Medicare Advantage	$24.09
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$19.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Medicare Advantage	$24.09
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

APOLIPOPROTEIN E ISOFORM PLASM

Facility

$550.00

Service Code	HCPCS 82542
Hospital Charge Code	401112563
Hospital Revenue Code	301
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

APOLIPOPROTEIN EVALUATION

Facility

$390.00

Service Code	HCPCS 82172
Hospital Charge Code	401082172
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

APOLIPOPROTEIN EVALUATION

Facility

$390.00

Service Code	HCPCS 82172
Hospital Charge Code	401082172
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$57.36
Rate for Payer: Aetna Medicare Advantage	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.13
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$21.09
Rate for Payer: Clover Medicare Advantage	$20.04
Rate for Payer: EmblemHealth Commercial	$63.27
Rate for Payer: Humana Medicare Advantage	$21.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.09
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	$16.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.09
Rate for Payer: Wellcare Medicare Advantage	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

APOLIPROTEIN A-1

Facility

$109.75

Service Code	HCPCS 82172
Hospital Charge Code	38479409
Hospital Revenue Code	301
Min. Negotiated Rate	$16.46
Max. Negotiated Rate	$16.46
Rate for Payer: Qualcare PPO/HMO/WC	$16.46

APOLIPROTEIN A-1

Facility

$109.75

Service Code	HCPCS 82172
Hospital Charge Code	38479409
Hospital Revenue Code	301
Min. Negotiated Rate	$2.91
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$57.36
Rate for Payer: Aetna Medicare Advantage	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.13
Rate for Payer: Cigna Commercial	$54.88
Rate for Payer: Cigna Medicare Advantage	$21.09
Rate for Payer: Clover Medicare Advantage	$20.04
Rate for Payer: EmblemHealth Commercial	$63.27
Rate for Payer: Humana Medicare Advantage	$21.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.46
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.09
Rate for Payer: Wellcare Medicare Advantage	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$2.91

APOLIPROTEIN B

Facility

$109.75

Service Code	HCPCS 82172
Hospital Charge Code	38479410
Hospital Revenue Code	301
Min. Negotiated Rate	$16.46
Max. Negotiated Rate	$16.46
Rate for Payer: Qualcare PPO/HMO/WC	$16.46

APOLIPROTEIN B

Facility

$109.75

Service Code	HCPCS 82172
Hospital Charge Code	38479410
Hospital Revenue Code	301
Min. Negotiated Rate	$2.91
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$57.36
Rate for Payer: Aetna Medicare Advantage	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.13
Rate for Payer: Cigna Commercial	$54.88
Rate for Payer: Cigna Medicare Advantage	$21.09
Rate for Payer: Clover Medicare Advantage	$20.04
Rate for Payer: EmblemHealth Commercial	$63.27
Rate for Payer: Humana Medicare Advantage	$21.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.46
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.09
Rate for Payer: Wellcare Medicare Advantage	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$2.91

APOLLO RF

Facility

$775.00

Hospital Charge Code	270682020
Hospital Revenue Code	272
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$116.25
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

APOLLO RF

Facility

$775.00

Hospital Charge Code	270682020
Hospital Revenue Code	272
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.50
Rate for Payer: Oxford Commercial	$155.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Commercial	$155.00
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

Know your out-of-pocket cost for care.

All Charges