Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

JAK2 EXON 12 MUTATION ANALYSIS

Facility

$400.00

Service Code	HCPCS 81403
Hospital Charge Code	401381403
Hospital Revenue Code	310
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

JAK2MUTA PANEL

Facility

$417.55

Service Code	HCPCS 81270
Hospital Charge Code	3036025EX
Hospital Revenue Code	310
Min. Negotiated Rate	$11.07
Max. Negotiated Rate	$330.87
Rate for Payer: Aetna Commercial	$249.32
Rate for Payer: Aetna Medicare Advantage	$296.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$91.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.87
Rate for Payer: Cigna Commercial	$208.78
Rate for Payer: Cigna Medicare Advantage	$91.66
Rate for Payer: Clover Medicare Advantage	$87.08
Rate for Payer: EmblemHealth Commercial	$274.98
Rate for Payer: Humana Medicare Advantage	$94.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$91.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.27
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.63
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$73.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$91.66
Rate for Payer: Wellcare Medicare Advantage	$91.66
Rate for Payer: Wellpoint Medicaid Managed Care	$11.07

JAK2MUTA PANEL

Facility

$417.55

Service Code	HCPCS 81270
Hospital Charge Code	3036025EX
Hospital Revenue Code	310
Min. Negotiated Rate	$62.63
Max. Negotiated Rate	$62.63
Rate for Payer: Qualcare PPO/HMO/WC	$62.63

JAK2 MUTATION,QN,PLAS,LEU

Facility

$1,566.65

Service Code	HCPCS 81270
Hospital Charge Code	39900020
Hospital Revenue Code	310
Min. Negotiated Rate	$235.00
Max. Negotiated Rate	$235.00
Rate for Payer: Qualcare PPO/HMO/WC	$235.00

JAK2 MUTATION,QN,PLAS,LEU

Facility

$1,566.65

Service Code	HCPCS 81270
Hospital Charge Code	39900020
Hospital Revenue Code	310
Min. Negotiated Rate	$41.52
Max. Negotiated Rate	$783.33
Rate for Payer: Aetna Commercial	$249.32
Rate for Payer: Aetna Medicare Advantage	$296.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$91.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.87
Rate for Payer: Cigna Commercial	$783.33
Rate for Payer: Cigna Medicare Advantage	$91.66
Rate for Payer: Clover Medicare Advantage	$87.08
Rate for Payer: EmblemHealth Commercial	$274.98
Rate for Payer: Humana Medicare Advantage	$94.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$91.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$470.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$235.00
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$73.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$91.66
Rate for Payer: Wellcare Medicare Advantage	$91.66
Rate for Payer: Wellpoint Medicaid Managed Care	$41.52

JAK2 V617F MUTATION, QL

Facility

$1,566.65

Service Code	HCPCS 81270
Hospital Charge Code	39900021
Hospital Revenue Code	310
Min. Negotiated Rate	$41.52
Max. Negotiated Rate	$783.33
Rate for Payer: Aetna Commercial	$249.32
Rate for Payer: Aetna Medicare Advantage	$296.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$91.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.87
Rate for Payer: Cigna Commercial	$783.33
Rate for Payer: Cigna Medicare Advantage	$91.66
Rate for Payer: Clover Medicare Advantage	$87.08
Rate for Payer: EmblemHealth Commercial	$274.98
Rate for Payer: Humana Medicare Advantage	$94.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$91.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$470.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$235.00
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$73.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$91.66
Rate for Payer: Wellcare Medicare Advantage	$91.66
Rate for Payer: Wellpoint Medicaid Managed Care	$41.52

JAK2 V617F MUTATION, QL

Facility

$1,566.65

Service Code	HCPCS 81270
Hospital Charge Code	39900021
Hospital Revenue Code	310
Min. Negotiated Rate	$235.00
Max. Negotiated Rate	$235.00
Rate for Payer: Qualcare PPO/HMO/WC	$235.00

JAMSHEDI NEEDLE

Facility

$750.00

Hospital Charge Code	270703309
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

JAMSHEDI NEEDLE

Facility

$750.00

Hospital Charge Code	270703309
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

JAMSHEDI /TROCAR

Facility

$750.00

Hospital Charge Code	270704095
Hospital Revenue Code	272
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

JAMSHEDI /TROCAR

Facility

$750.00

Hospital Charge Code	270704095
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

JAMSHIDI

Facility

$1,250.00

Hospital Charge Code	270703278
Hospital Revenue Code	279
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$250.00
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

JAMSHIDI

Facility

$750.00

Hospital Charge Code	270703850
Hospital Revenue Code	272
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

JAMSHIDI

Facility

$1,250.00

Hospital Charge Code	270703278
Hospital Revenue Code	279
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

JAMSHIDI

Facility

$750.00

Hospital Charge Code	270703850
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

JAMSHIDI BONE GRAFT NEEDLE

Facility

$675.00

Hospital Charge Code	270704179
Hospital Revenue Code	279
Min. Negotiated Rate	$16.27
Max. Negotiated Rate	$337.50
Rate for Payer: Aetna Commercial	$256.50
Rate for Payer: Aetna Medicare Advantage	$202.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.12
Rate for Payer: Cigna Commercial	$337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.50
Rate for Payer: Oxford Commercial	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$101.25
Rate for Payer: UnitedHealthcare Commercial	$135.00
Rate for Payer: UnitedHealthcare Community & State	$16.27
Rate for Payer: Wellpoint Medicaid Managed Care	$17.89

JAMSHIDI BONE GRAFT NEEDLE

Facility

$675.00

Hospital Charge Code	270704179
Hospital Revenue Code	279
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$101.25
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

JAMSHIDI EVOLVE

Facility

$875.00

Hospital Charge Code	270702850
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

JAMSHIDI EVOLVE

Facility

$875.00

Hospital Charge Code	270702850
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

JAM SHIDI NEEDLE

Facility

$2,250.00

Hospital Charge Code	270705702
Hospital Revenue Code	279
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$675.00
Rate for Payer: Oxford Commercial	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$450.00
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

JAM SHIDI NEEDLE

Facility

$2,250.00

Hospital Charge Code	270705702
Hospital Revenue Code	279
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

JAMSHIDI NEEDLE 11GX5IN

Facility

$875.00

Hospital Charge Code	270705446
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

JAMSHIDI NEEDLE 11GX5IN

Facility

$875.00

Hospital Charge Code	270705446
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

JAMSHIDI NEEDLE 8G

Facility

$500.00

Hospital Charge Code	270696835
Hospital Revenue Code	270
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

JAMSHIDI NEEDLE 8G

Facility

$500.00

Hospital Charge Code	270696835
Hospital Revenue Code	270
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

Know your out-of-pocket cost for care.

All Charges