Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

APRESOLINE 20MG

Facility

$115.85

Hospital Charge Code	6008098
Hospital Revenue Code	250
Min. Negotiated Rate	$2.79
Max. Negotiated Rate	$57.92
Rate for Payer: Aetna Commercial	$44.02
Rate for Payer: Aetna Medicare Advantage	$34.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.54
Rate for Payer: Cigna Commercial	$57.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.76
Rate for Payer: Oxford Commercial	$23.17
Rate for Payer: Qualcare PPO/HMO/WC	$17.38
Rate for Payer: UnitedHealthcare Commercial	$23.17
Rate for Payer: UnitedHealthcare Community & State	$2.79
Rate for Payer: Wellpoint Medicaid Managed Care	$3.07

APRESOLINE 20MG

Facility

$115.85

Hospital Charge Code	6008098
Hospital Revenue Code	250
Min. Negotiated Rate	$17.38
Max. Negotiated Rate	$17.38
Rate for Payer: Qualcare PPO/HMO/WC	$17.38

APRESOLINE/20MG/1ML

Facility

$28.00

Hospital Charge Code	60632477
Hospital Revenue Code	250
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$10.64
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.40
Rate for Payer: Oxford Commercial	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

APRESOLINE/20MG/1ML

Facility

$28.00

Hospital Charge Code	60632477
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

APRON ACTIVITY BLUE PRO5-1059

Facility

$89.17

Hospital Charge Code	270650456
Hospital Revenue Code	272
Min. Negotiated Rate	$13.38
Max. Negotiated Rate	$13.38
Rate for Payer: Qualcare PPO/HMO/WC	$13.38

APRON ACTIVITY BLUE PRO5-1059

Facility

$89.17

Hospital Charge Code	270650456
Hospital Revenue Code	272
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$44.59
Rate for Payer: Aetna Commercial	$33.88
Rate for Payer: Aetna Medicare Advantage	$26.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.74
Rate for Payer: Cigna Commercial	$44.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.75
Rate for Payer: Oxford Commercial	$17.83
Rate for Payer: Qualcare PPO/HMO/WC	$13.38
Rate for Payer: UnitedHealthcare Commercial	$17.83
Rate for Payer: UnitedHealthcare Community & State	$2.15
Rate for Payer: Wellpoint Medicaid Managed Care	$2.36

APRON LEAD X-RAY

Facility

$2,078.75

Hospital Charge Code	270656098
Hospital Revenue Code	278
Min. Negotiated Rate	$50.10
Max. Negotiated Rate	$1,039.38
Rate for Payer: Aetna Commercial	$789.92
Rate for Payer: Aetna Medicare Advantage	$623.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$530.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$530.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$415.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$530.08
Rate for Payer: Cigna Commercial	$1,039.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$503.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$457.32
Rate for Payer: Qualcare PPO/HMO/WC	$311.81
Rate for Payer: UnitedHealthcare Community & State	$50.10
Rate for Payer: Wellpoint Medicaid Managed Care	$55.09

APRON LEAD X-RAY

Facility

$2,078.75

Hospital Charge Code	270656098
Hospital Revenue Code	278
Min. Negotiated Rate	$311.81
Max. Negotiated Rate	$503.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$415.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$503.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$457.32
Rate for Payer: Qualcare PPO/HMO/WC	$311.81

APRON TUR STER

Facility

$141.65

Hospital Charge Code	270060015
Hospital Revenue Code	272
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$70.83
Rate for Payer: Aetna Commercial	$53.83
Rate for Payer: Aetna Medicare Advantage	$42.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.12
Rate for Payer: Cigna Commercial	$70.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.49
Rate for Payer: Oxford Commercial	$28.33
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$28.33
Rate for Payer: UnitedHealthcare Community & State	$3.41
Rate for Payer: Wellpoint Medicaid Managed Care	$3.75

APRON TUR STER

Facility

$141.65

Hospital Charge Code	270060015
Hospital Revenue Code	272
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

APRON TUR STER *******

Facility

$28.00

Hospital Charge Code	1601236
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$10.64
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.40
Rate for Payer: Oxford Commercial	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

APRON TUR STER *******

Facility

$28.00

Hospital Charge Code	1601236
Hospital Revenue Code	272
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

APTT MIXING STUDIES I

Facility

$390.00

Service Code	HCPCS 85732
Hospital Charge Code	3035067A
Hospital Revenue Code	305
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$17.60
Rate for Payer: Aetna Medicare Advantage	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.35
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$6.47
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.47
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	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Medicare Advantage	$6.47
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

APTT MIXING STUDIES I

Facility

$390.00

Service Code	HCPCS 85732
Hospital Charge Code	3035067A
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

APTT MIXING STUDIES II

Facility

$390.00

Service Code	HCPCS 85730
Hospital Charge Code	3035067B
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

APTT MIXING STUDIES II

Facility

$390.00

Service Code	HCPCS 85730
Hospital Charge Code	3035067B
Hospital Revenue Code	305
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$16.35
Rate for Payer: Aetna Medicare Advantage	$19.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.69
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$6.01
Rate for Payer: Clover Medicare Advantage	$5.71
Rate for Payer: EmblemHealth Commercial	$18.03
Rate for Payer: Humana Medicare Advantage	$6.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.01
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	$4.81
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.01
Rate for Payer: Wellcare Medicare Advantage	$6.01
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

APTT MIXING STUDIES III

Facility

$390.00

Service Code	HCPCS 85732
Hospital Charge Code	3035067C
Hospital Revenue Code	300
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$17.60
Rate for Payer: Aetna Medicare Advantage	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.35
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$6.47
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.47
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	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Medicare Advantage	$6.47
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

APTT MIXING STUDIES III

Facility

$390.00

Service Code	HCPCS 85732
Hospital Charge Code	3035067C
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

APTT MIXING STUDIES IV

Facility

$390.00

Service Code	HCPCS 85732
Hospital Charge Code	3035067D
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

APTT MIXING STUDIES IV

Facility

$390.00

Service Code	HCPCS 85732
Hospital Charge Code	3035067D
Hospital Revenue Code	300
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$17.60
Rate for Payer: Aetna Medicare Advantage	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.35
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$6.47
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.47
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	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Medicare Advantage	$6.47
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

AQP4 ANTIBODY NMO-IGG ELISA

Facility

$815.50

Service Code	HCPCS 83516
Hospital Charge Code	401083516
Hospital Revenue Code	301
Min. Negotiated Rate	$122.33
Max. Negotiated Rate	$122.33
Rate for Payer: Qualcare PPO/HMO/WC	$122.33

AQP4 ANTIBODY NMO-IGG ELISA

Facility

$815.50

Service Code	HCPCS 83516
Hospital Charge Code	401083516
Hospital Revenue Code	301
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$407.75
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) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.62
Rate for Payer: Cigna Commercial	$407.75
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	$244.65
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.33
Rate for Payer: UnitedHealthcare Commercial	$124.00
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	$21.61

AQUAMANTUS MBS W/LIGHT

Facility

$3,420.00

Hospital Charge Code	270667850
Hospital Revenue Code	272
Min. Negotiated Rate	$82.42
Max. Negotiated Rate	$1,710.00
Rate for Payer: Aetna Commercial	$1,299.60
Rate for Payer: Aetna Medicare Advantage	$1,026.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$872.10
Rate for Payer: Cigna Commercial	$1,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,026.00
Rate for Payer: Oxford Commercial	$684.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00
Rate for Payer: UnitedHealthcare Commercial	$684.00
Rate for Payer: UnitedHealthcare Community & State	$82.42
Rate for Payer: Wellpoint Medicaid Managed Care	$90.63

AQUAMANTUS MBS W/LIGHT

Facility

$3,420.00

Hospital Charge Code	270667850
Hospital Revenue Code	272
Min. Negotiated Rate	$513.00
Max. Negotiated Rate	$513.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00

AQUAMATICS BI POLAR SEALER 6.0

Facility

$2,756.25

Hospital Charge Code	270667262
Hospital Revenue Code	272
Min. Negotiated Rate	$413.44
Max. Negotiated Rate	$413.44
Rate for Payer: Qualcare PPO/HMO/WC	$413.44

Know your out-of-pocket cost for care.

All Charges