Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LD ISOENZYMES

Facility

$349.00

Service Code	HCPCS 83625
Hospital Charge Code	38472010
Hospital Revenue Code	301
Min. Negotiated Rate	$9.25
Max. Negotiated Rate	$174.50
Rate for Payer: Aetna Commercial	$34.79
Rate for Payer: Aetna Medicare Advantage	$41.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.79
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	$46.17
Rate for Payer: Cigna Commercial	$174.50
Rate for Payer: Cigna Medicare Advantage	$12.79
Rate for Payer: Clover Medicare Advantage	$12.15
Rate for Payer: EmblemHealth Commercial	$38.37
Rate for Payer: Humana Medicare Advantage	$13.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.79
Rate for Payer: Wellcare Medicare Advantage	$12.79
Rate for Payer: Wellpoint Medicaid Managed Care	$9.25

LD ISOENZYMES

Facility

$349.00

Service Code	HCPCS 83625
Hospital Charge Code	38472010
Hospital Revenue Code	301
Min. Negotiated Rate	$52.35
Max. Negotiated Rate	$52.35
Rate for Payer: Qualcare PPO/HMO/WC	$52.35

LDL CHOLESTEROL

Facility

$125.75

Service Code	HCPCS 83721
Hospital Charge Code	3006459C
Hospital Revenue Code	301
Min. Negotiated Rate	$18.86
Max. Negotiated Rate	$18.86
Rate for Payer: Qualcare PPO/HMO/WC	$18.86

LDL CHOLESTEROL

Facility

$125.75

Service Code	HCPCS 83721
Hospital Charge Code	3006459C
Hospital Revenue Code	301
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$28.56
Rate for Payer: Aetna Medicare Advantage	$34.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.90
Rate for Payer: Cigna Commercial	$62.88
Rate for Payer: Cigna Medicare Advantage	$10.50
Rate for Payer: Clover Medicare Advantage	$9.97
Rate for Payer: EmblemHealth Commercial	$31.50
Rate for Payer: Humana Medicare Advantage	$10.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.86
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.50
Rate for Payer: Wellcare Medicare Advantage	$10.50
Rate for Payer: Wellpoint Medicaid Managed Care	$3.33

LDL CHOLESTEROL***

Facility

$61.20

Service Code	HCPCS 83721
Hospital Charge Code	3030940
Hospital Revenue Code	301
Min. Negotiated Rate	$9.18
Max. Negotiated Rate	$9.18
Rate for Payer: Qualcare PPO/HMO/WC	$9.18

LDL CHOLESTEROL***

Facility

$61.20

Service Code	HCPCS 83721
Hospital Charge Code	3030940
Hospital Revenue Code	301
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$28.56
Rate for Payer: Aetna Medicare Advantage	$34.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.90
Rate for Payer: Cigna Commercial	$30.60
Rate for Payer: Cigna Medicare Advantage	$10.50
Rate for Payer: Clover Medicare Advantage	$9.97
Rate for Payer: EmblemHealth Commercial	$31.50
Rate for Payer: Humana Medicare Advantage	$10.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.18
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.50
Rate for Payer: Wellcare Medicare Advantage	$10.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1.62

L&D NITROUS OXIDE ANALGESIA

Facility

$15.29

Hospital Charge Code	3190999015
Hospital Revenue Code	270
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$2.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.29

L&D NITROUS OXIDE ANALGESIA

Facility

$15.29

Hospital Charge Code	3190999015
Hospital Revenue Code	270
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$7.64
Rate for Payer: Aetna Commercial	$5.81
Rate for Payer: Aetna Medicare Advantage	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.90
Rate for Payer: Cigna Commercial	$7.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.59
Rate for Payer: Oxford Commercial	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$2.29
Rate for Payer: UnitedHealthcare Commercial	$3.06
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

L&D RECOVERY ADDL 1/2 HOUR

Facility

$331.00

Hospital Charge Code	73190137
Hospital Revenue Code	710
Min. Negotiated Rate	$7.98
Max. Negotiated Rate	$165.50
Rate for Payer: Aetna Commercial	$125.78
Rate for Payer: Aetna Medicare Advantage	$99.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.41
Rate for Payer: Cigna Commercial	$165.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.30
Rate for Payer: Oxford Commercial	$66.20
Rate for Payer: Qualcare PPO/HMO/WC	$49.65
Rate for Payer: UnitedHealthcare Commercial	$66.20
Rate for Payer: UnitedHealthcare Community & State	$7.98
Rate for Payer: Wellpoint Medicaid Managed Care	$8.77

L&D RECOVERY ADDL 1/2 HOUR

Facility

$331.00

Hospital Charge Code	73190137
Hospital Revenue Code	710
Min. Negotiated Rate	$49.65
Max. Negotiated Rate	$49.65
Rate for Payer: Qualcare PPO/HMO/WC	$49.65

L&D RECOVERY UPTO ONE HOUR

Facility

$662.00

Hospital Charge Code	73190135
Hospital Revenue Code	710
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$99.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

L&D RECOVERY UPTO ONE HOUR

Facility

$662.00

Hospital Charge Code	73190135
Hospital Revenue Code	710
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$331.00
Rate for Payer: Aetna Commercial	$251.56
Rate for Payer: Aetna Medicare Advantage	$198.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.81
Rate for Payer: Cigna Commercial	$331.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.60
Rate for Payer: Oxford Commercial	$132.40
Rate for Payer: Qualcare PPO/HMO/WC	$99.30
Rate for Payer: UnitedHealthcare Commercial	$132.40
Rate for Payer: UnitedHealthcare Community & State	$15.95
Rate for Payer: Wellpoint Medicaid Managed Care	$17.54

L D SEROUS FL

Facility

$282.00

Service Code	HCPCS 83615
Hospital Charge Code	38479476
Hospital Revenue Code	301
Min. Negotiated Rate	$42.30
Max. Negotiated Rate	$42.30
Rate for Payer: Qualcare PPO/HMO/WC	$42.30

L D SEROUS FL

Facility

$282.00

Service Code	HCPCS 83615
Hospital Charge Code	38479476
Hospital Revenue Code	301
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$141.00
Rate for Payer: Aetna Commercial	$16.43
Rate for Payer: Aetna Medicare Advantage	$19.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.80
Rate for Payer: Cigna Commercial	$141.00
Rate for Payer: Cigna Medicare Advantage	$6.04
Rate for Payer: Clover Medicare Advantage	$5.74
Rate for Payer: EmblemHealth Commercial	$18.12
Rate for Payer: Humana Medicare Advantage	$6.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.04
Rate for Payer: Wellcare Medicare Advantage	$6.04
Rate for Payer: Wellpoint Medicaid Managed Care	$7.47

LDS SURGICAL STAPLER *******

Facility

$270.00

Hospital Charge Code	1603083
Hospital Revenue Code	272
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

LDS SURGICAL STAPLER *******

Facility

$270.00

Hospital Charge Code	1603083
Hospital Revenue Code	272
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.00
Rate for Payer: Oxford Commercial	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Commercial	$54.00
Rate for Payer: UnitedHealthcare Community & State	$6.51
Rate for Payer: Wellpoint Medicaid Managed Care	$7.16

LEAD

Facility

$82.45

Hospital Charge Code	39990166C
Hospital Revenue Code	301
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$31.33
Rate for Payer: Aetna Medicare Advantage	$24.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.02
Rate for Payer: Cigna Commercial	$41.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.37
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.99
Rate for Payer: Wellpoint Medicaid Managed Care	$2.18

LEAD

Facility

$390.00

Service Code	HCPCS 83655
Hospital Charge Code	401083018D
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LEAD

Facility

$390.00

Service Code	HCPCS 83655
Hospital Charge Code	401083018D
Hospital Revenue Code	301
Min. Negotiated Rate	$9.69
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.94
Rate for Payer: Aetna Medicare Advantage	$39.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.11
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	$43.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.11
Rate for Payer: Clover Medicare Advantage	$11.50
Rate for Payer: EmblemHealth Commercial	$36.33
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.11
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	$9.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.11
Rate for Payer: Wellcare Medicare Advantage	$12.11
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

LEAD

Facility

$82.45

Hospital Charge Code	39990166C
Hospital Revenue Code	301
Min. Negotiated Rate	$12.37
Max. Negotiated Rate	$12.37
Rate for Payer: Qualcare PPO/HMO/WC	$12.37

LEAD 12 CONTACT

Facility

$15,625.00

Service Code	HCPCS C1788
Hospital Charge Code	270683889
Hospital Revenue Code	278
Min. Negotiated Rate	$376.56
Max. Negotiated Rate	$7,812.50
Rate for Payer: Aetna Commercial	$5,937.50
Rate for Payer: Aetna Medicare Advantage	$4,687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,984.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,984.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,984.38
Rate for Payer: Cigna Commercial	$7,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,781.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,437.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.75
Rate for Payer: UnitedHealthcare Community & State	$376.56
Rate for Payer: Wellpoint Medicaid Managed Care	$414.06

LEAD 12 CONTACT

Facility

$15,625.00

Service Code	HCPCS C1788
Hospital Charge Code	270683889
Hospital Revenue Code	278
Min. Negotiated Rate	$2,343.75
Max. Negotiated Rate	$3,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,781.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,437.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.75

LEAD 407458 PACE TRANSV

Facility

$2,795.00

Service Code	HCPCS C1898
Hospital Charge Code	270686930
Hospital Revenue Code	278
Min. Negotiated Rate	$419.25
Max. Negotiated Rate	$676.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$614.90
Rate for Payer: Qualcare PPO/HMO/WC	$419.25

LEAD 407458 PACE TRANSV

Facility

$2,795.00

Service Code	HCPCS C1898
Hospital Charge Code	270686930
Hospital Revenue Code	278
Min. Negotiated Rate	$67.36
Max. Negotiated Rate	$1,397.50
Rate for Payer: Aetna Commercial	$1,062.10
Rate for Payer: Aetna Medicare Advantage	$838.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$712.73
Rate for Payer: Cigna Commercial	$1,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$614.90
Rate for Payer: Qualcare PPO/HMO/WC	$419.25
Rate for Payer: UnitedHealthcare Community & State	$67.36
Rate for Payer: Wellpoint Medicaid Managed Care	$74.07

LEAD 457453 PACE TRANSV

Facility

$2,795.00

Service Code	HCPCS C1898
Hospital Charge Code	270686929
Hospital Revenue Code	278
Min. Negotiated Rate	$67.36
Max. Negotiated Rate	$1,397.50
Rate for Payer: Aetna Commercial	$1,062.10
Rate for Payer: Aetna Medicare Advantage	$838.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$712.73
Rate for Payer: Cigna Commercial	$1,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$614.90
Rate for Payer: Qualcare PPO/HMO/WC	$419.25
Rate for Payer: UnitedHealthcare Community & State	$67.36
Rate for Payer: Wellpoint Medicaid Managed Care	$74.07

Know your out-of-pocket cost for care.

All Charges