Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LINER ZIM HIP 53 28 50015328

Facility

$1,666.55

Hospital Charge Code	270627235
Hospital Revenue Code	278
Min. Negotiated Rate	$40.16
Max. Negotiated Rate	$833.27
Rate for Payer: Aetna Commercial	$633.29
Rate for Payer: Aetna Medicare Advantage	$499.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$424.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$424.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$424.97
Rate for Payer: Cigna Commercial	$833.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$366.64
Rate for Payer: Qualcare PPO/HMO/WC	$249.98
Rate for Payer: UnitedHealthcare Community & State	$40.16
Rate for Payer: Wellpoint Medicaid Managed Care	$44.16

LINER ZIM HIP 53 28 50015328

Facility

$1,666.55

Hospital Charge Code	270627235
Hospital Revenue Code	278
Min. Negotiated Rate	$249.98
Max. Negotiated Rate	$403.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$366.64
Rate for Payer: Qualcare PPO/HMO/WC	$249.98

LINES BIOSPY ********

Facility

$168.00

Hospital Charge Code	8002297
Hospital Revenue Code	279
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$84.00
Rate for Payer: Aetna Commercial	$63.84
Rate for Payer: Aetna Medicare Advantage	$50.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.84
Rate for Payer: Cigna Commercial	$84.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.40
Rate for Payer: Oxford Commercial	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$25.20
Rate for Payer: UnitedHealthcare Commercial	$33.60
Rate for Payer: UnitedHealthcare Community & State	$4.05
Rate for Payer: Wellpoint Medicaid Managed Care	$4.45

LINES BIOSPY ********

Facility

$168.00

Hospital Charge Code	8002297
Hospital Revenue Code	279
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$25.20
Rate for Payer: Qualcare PPO/HMO/WC	$25.20

LINES BLOOD C3 RENAL

Facility

$44.85

Hospital Charge Code	270606421
Hospital Revenue Code	272
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$6.73
Rate for Payer: Qualcare PPO/HMO/WC	$6.73

LINES BLOOD C3 RENAL

Facility

$44.85

Hospital Charge Code	270606421
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.43
Rate for Payer: Aetna Commercial	$17.04
Rate for Payer: Aetna Medicare Advantage	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.44
Rate for Payer: Cigna Commercial	$22.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.46
Rate for Payer: Oxford Commercial	$8.97
Rate for Payer: Qualcare PPO/HMO/WC	$6.73
Rate for Payer: UnitedHealthcare Commercial	$8.97
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

LINEZOLID 2MG/ML (600/300) NS

Facility

$1,255.85

Service Code	NDC 409488301
Hospital Charge Code	606390163
Hospital Revenue Code	250
Min. Negotiated Rate	$30.27
Max. Negotiated Rate	$627.92
Rate for Payer: Aetna Commercial	$477.22
Rate for Payer: Aetna Medicare Advantage	$376.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.24
Rate for Payer: Cigna Commercial	$627.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$376.75
Rate for Payer: Oxford Commercial	$251.17
Rate for Payer: Qualcare PPO/HMO/WC	$188.38
Rate for Payer: UnitedHealthcare Commercial	$251.17
Rate for Payer: UnitedHealthcare Community & State	$30.27
Rate for Payer: Wellpoint Medicaid Managed Care	$33.28

LINEZOLID 2MG/ML (600/300) NS

Facility

$1,255.85

Service Code	NDC 409488301
Hospital Charge Code	606390163
Hospital Revenue Code	250
Min. Negotiated Rate	$188.38
Max. Negotiated Rate	$188.38
Rate for Payer: Qualcare PPO/HMO/WC	$188.38

LINEZOLID 600 MG/ 300ML

Facility

$1,255.85

Service Code	HCPCS J2020
Hospital Charge Code	60629093
Hospital Revenue Code	636
Min. Negotiated Rate	$30.27
Max. Negotiated Rate	$627.92
Rate for Payer: Aetna Commercial	$477.22
Rate for Payer: Aetna Medicare Advantage	$376.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.24
Rate for Payer: Cigna Commercial	$627.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.92
Rate for Payer: Qualcare PPO/HMO/WC	$188.38
Rate for Payer: UnitedHealthcare Community & State	$30.27
Rate for Payer: Wellpoint Medicaid Managed Care	$33.28

LINEZOLID 600 MG/ 300ML

Facility

$1,255.85

Service Code	HCPCS J2020
Hospital Charge Code	60629093
Hospital Revenue Code	636
Min. Negotiated Rate	$188.38
Max. Negotiated Rate	$303.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.92
Rate for Payer: Qualcare PPO/HMO/WC	$188.38

LINEZOLID 600 MG TAB

Facility

$1,220.81

Service Code	NDC 9513502
Hospital Charge Code	60629115
Hospital Revenue Code	250
Min. Negotiated Rate	$29.42
Max. Negotiated Rate	$610.40
Rate for Payer: Aetna Commercial	$463.91
Rate for Payer: Aetna Medicare Advantage	$366.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.31
Rate for Payer: Cigna Commercial	$610.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.24
Rate for Payer: Oxford Commercial	$244.16
Rate for Payer: Qualcare PPO/HMO/WC	$183.12
Rate for Payer: UnitedHealthcare Commercial	$244.16
Rate for Payer: UnitedHealthcare Community & State	$29.42
Rate for Payer: Wellpoint Medicaid Managed Care	$32.35

LINEZOLID 600 MG TAB

Facility

$1,220.81

Service Code	NDC 9513502
Hospital Charge Code	60629115
Hospital Revenue Code	250
Min. Negotiated Rate	$183.12
Max. Negotiated Rate	$183.12
Rate for Payer: Qualcare PPO/HMO/WC	$183.12

LIN HI 24x32 RIN LOC 11105924

Facility

$4,285.00

Hospital Charge Code	270639701
Hospital Revenue Code	278
Min. Negotiated Rate	$103.27
Max. Negotiated Rate	$2,142.50
Rate for Payer: Aetna Commercial	$1,628.30
Rate for Payer: Aetna Medicare Advantage	$1,285.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,092.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,092.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$857.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,092.67
Rate for Payer: Cigna Commercial	$2,142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,036.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$942.70
Rate for Payer: Qualcare PPO/HMO/WC	$642.75
Rate for Payer: UnitedHealthcare Community & State	$103.27
Rate for Payer: Wellpoint Medicaid Managed Care	$113.55

LIN HI 24x32 RIN LOC 11105924

Facility

$4,285.00

Hospital Charge Code	270639701
Hospital Revenue Code	278
Min. Negotiated Rate	$642.75
Max. Negotiated Rate	$1,036.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$857.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,036.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$942.70
Rate for Payer: Qualcare PPO/HMO/WC	$642.75

LINQ RECORDER REMOVAL

Facility

$2,026.92

Service Code	HCPCS 33284
Hospital Charge Code	5100537
Hospital Revenue Code	361
Min. Negotiated Rate	$48.85
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$770.23
Rate for Payer: Aetna Medicare Advantage	$608.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$516.86
Rate for Payer: Cigna Commercial	$1,013.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$608.08
Rate for Payer: Qualcare PPO/HMO/WC	$304.04
Rate for Payer: UnitedHealthcare Community & State	$48.85
Rate for Payer: Wellpoint Medicaid Managed Care	$53.71

LINQ RECORDER REMOVAL

Facility

$2,026.92

Service Code	HCPCS 33284
Hospital Charge Code	5100537
Hospital Revenue Code	361
Min. Negotiated Rate	$304.04
Max. Negotiated Rate	$304.04
Rate for Payer: Qualcare PPO/HMO/WC	$304.04

LINQ SYSTEM INCL DEVICE/MONITR

Facility

$26,475.00

Hospital Charge Code	270677215
Hospital Revenue Code	278
Min. Negotiated Rate	$638.05
Max. Negotiated Rate	$13,237.50
Rate for Payer: Aetna Commercial	$10,060.50
Rate for Payer: Aetna Medicare Advantage	$7,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,751.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,751.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,751.12
Rate for Payer: Cigna Commercial	$13,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,406.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,824.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,971.25
Rate for Payer: UnitedHealthcare Community & State	$638.05
Rate for Payer: Wellpoint Medicaid Managed Care	$701.59

LINQ SYSTEM INCL DEVICE/MONITR

Facility

$26,475.00

Hospital Charge Code	270677215
Hospital Revenue Code	278
Min. Negotiated Rate	$3,971.25
Max. Negotiated Rate	$6,406.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,406.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,824.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,971.25

LINR ARCOM 20mm RNGLC XL105903

Facility

$5,728.85

Hospital Charge Code	270636128
Hospital Revenue Code	278
Min. Negotiated Rate	$859.33
Max. Negotiated Rate	$1,386.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,145.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,386.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,260.35
Rate for Payer: Qualcare PPO/HMO/WC	$859.33

LINR ARCOM 20mm RNGLC XL105903

Facility

$5,728.85

Hospital Charge Code	270636128
Hospital Revenue Code	278
Min. Negotiated Rate	$138.07
Max. Negotiated Rate	$2,864.43
Rate for Payer: Aetna Commercial	$2,176.96
Rate for Payer: Aetna Medicare Advantage	$1,718.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,460.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,460.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,145.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,460.86
Rate for Payer: Cigna Commercial	$2,864.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,386.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,260.35
Rate for Payer: Qualcare PPO/HMO/WC	$859.33
Rate for Payer: UnitedHealthcare Community & State	$138.07
Rate for Payer: Wellpoint Medicaid Managed Care	$151.81

LINR SCTION 3000c 65651530

Facility

$8.25

Hospital Charge Code	270301243
Hospital Revenue Code	272
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$1.24
Rate for Payer: Qualcare PPO/HMO/WC	$1.24

LINR SCTION 3000c 65651530

Facility

$8.25

Hospital Charge Code	270301243
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$4.12
Rate for Payer: Aetna Commercial	$3.13
Rate for Payer: Aetna Medicare Advantage	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.10
Rate for Payer: Cigna Commercial	$4.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.48
Rate for Payer: Oxford Commercial	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.24
Rate for Payer: UnitedHealthcare Commercial	$1.65
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

LINR VIVACR DM BEAR 28X40MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693906
Hospital Revenue Code	278
Min. Negotiated Rate	$325.35
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$5,130.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,970.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: UnitedHealthcare Community & State	$325.35
Rate for Payer: Wellpoint Medicaid Managed Care	$357.75

LINR VIVACR DM BEAR 28X40MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693906
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,970.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

LIORESAL/10MG/TAB

Facility

$4.00

Hospital Charge Code	60633308
Hospital Revenue Code	250
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	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

Know your out-of-pocket cost for care.

All Charges