Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LIPID PROFILE PANEL

Facility

$1,475.31

Service Code	HCPCS 80061
Hospital Charge Code	3006459
Hospital Revenue Code	301
Min. Negotiated Rate	$221.30
Max. Negotiated Rate	$221.30
Rate for Payer: Qualcare PPO/HMO/WC	$221.30

LIPID PROFILE PANEL

Facility

$1,475.31

Service Code	HCPCS 80061
Hospital Charge Code	3006459
Hospital Revenue Code	301
Min. Negotiated Rate	$10.71
Max. Negotiated Rate	$737.65
Rate for Payer: Aetna Commercial	$36.42
Rate for Payer: Aetna Medicare Advantage	$43.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.33
Rate for Payer: Cigna Commercial	$737.65
Rate for Payer: Cigna Medicare Advantage	$13.39
Rate for Payer: Clover Medicare Advantage	$12.72
Rate for Payer: EmblemHealth Commercial	$40.17
Rate for Payer: Humana Medicare Advantage	$13.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.59
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.39
Rate for Payer: Wellcare Medicare Advantage	$13.39
Rate for Payer: Wellpoint Medicaid Managed Care	$39.10

LIPID RESCUE KIT

Facility

$257.88

Service Code	NDC 338051904
Hospital Charge Code	606351002
Hospital Revenue Code	250
Min. Negotiated Rate	$6.21
Max. Negotiated Rate	$128.94
Rate for Payer: Aetna Commercial	$97.99
Rate for Payer: Aetna Medicare Advantage	$77.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.76
Rate for Payer: Cigna Commercial	$128.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.36
Rate for Payer: Oxford Commercial	$51.58
Rate for Payer: Qualcare PPO/HMO/WC	$38.68
Rate for Payer: UnitedHealthcare Commercial	$51.58
Rate for Payer: UnitedHealthcare Community & State	$6.21
Rate for Payer: Wellpoint Medicaid Managed Care	$6.83

LIPID RESCUE KIT

Facility

$257.88

Service Code	NDC 338051904
Hospital Charge Code	606351002
Hospital Revenue Code	250
Min. Negotiated Rate	$38.68
Max. Negotiated Rate	$38.68
Rate for Payer: Qualcare PPO/HMO/WC	$38.68

LIPIDS STOOL, QUAL

Facility

$264.00

Service Code	HCPCS 82705
Hospital Charge Code	38472030
Hospital Revenue Code	301
Min. Negotiated Rate	$39.60
Max. Negotiated Rate	$39.60
Rate for Payer: Qualcare PPO/HMO/WC	$39.60

LIPIDS STOOL, QUAL

Facility

$264.00

Service Code	HCPCS 82705
Hospital Charge Code	38472030
Hospital Revenue Code	301
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$132.00
Rate for Payer: Aetna Commercial	$13.87
Rate for Payer: Aetna Medicare Advantage	$16.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.41
Rate for Payer: Cigna Commercial	$132.00
Rate for Payer: Cigna Medicare Advantage	$5.10
Rate for Payer: Clover Medicare Advantage	$4.84
Rate for Payer: EmblemHealth Commercial	$15.30
Rate for Payer: Humana Medicare Advantage	$5.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.10
Rate for Payer: Wellcare Medicare Advantage	$5.10
Rate for Payer: Wellpoint Medicaid Managed Care	$7.00

LIPIDS TOTAL****

Facility

$18.00

Hospital Charge Code	3011830
Hospital Revenue Code	309
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

LIPIDS TOTAL****

Facility

$18.00

Hospital Charge Code	3011830
Hospital Revenue Code	309
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

LIPIDS, TOTAL***

Facility

$47.00

Service Code	HCPCS 84999
Hospital Charge Code	3001831
Hospital Revenue Code	301
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$17.86
Rate for Payer: Aetna Medicare Advantage	$14.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.98
Rate for Payer: Cigna Commercial	$23.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.13
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

LIPIDS, TOTAL***

Facility

$47.00

Service Code	HCPCS 84999
Hospital Charge Code	3001831
Hospital Revenue Code	301
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$7.05
Rate for Payer: Qualcare PPO/HMO/WC	$7.05

LIPID SURVEY, URINE***

Facility

$198.00

Service Code	HCPCS 80061
Hospital Charge Code	3008976
Hospital Revenue Code	301
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$36.42
Rate for Payer: Aetna Medicare Advantage	$43.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.33
Rate for Payer: Cigna Commercial	$99.00
Rate for Payer: Cigna Medicare Advantage	$13.39
Rate for Payer: Clover Medicare Advantage	$12.72
Rate for Payer: EmblemHealth Commercial	$40.17
Rate for Payer: Humana Medicare Advantage	$13.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.39
Rate for Payer: Wellcare Medicare Advantage	$13.39
Rate for Payer: Wellpoint Medicaid Managed Care	$5.25

LIPID SURVEY, URINE***

Facility

$198.00

Service Code	HCPCS 80061
Hospital Charge Code	3008976
Hospital Revenue Code	301
Min. Negotiated Rate	$29.70
Max. Negotiated Rate	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$29.70

LIPITOR 10MG TAB

Facility

$13.00

Hospital Charge Code	60635187
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

LIPITOR 10MG TAB

Facility

$13.00

Hospital Charge Code	60635187
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

LIPITOR 20MG TAB

Facility

$18.00

Hospital Charge Code	60635188
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

LIPITOR 20MG TAB

Facility

$18.00

Hospital Charge Code	60635188
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

LIPITOR 40MG TAB

Facility

$18.00

Hospital Charge Code	60635189
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

LIPITOR 40MG TAB

Facility

$18.00

Hospital Charge Code	60635189
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

LIPOPROTEIN (a)

Facility

$205.65

Service Code	HCPCS 83695
Hospital Charge Code	3001848
Hospital Revenue Code	301
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

LIPOPROTEIN (a)

Facility

$205.65

Service Code	HCPCS 83695
Hospital Charge Code	3001848
Hospital Revenue Code	301
Min. Negotiated Rate	$5.45
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$38.95
Rate for Payer: Aetna Medicare Advantage	$46.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.69
Rate for Payer: Cigna Commercial	$102.83
Rate for Payer: Cigna Medicare Advantage	$14.32
Rate for Payer: Clover Medicare Advantage	$13.60
Rate for Payer: EmblemHealth Commercial	$42.96
Rate for Payer: Humana Medicare Advantage	$14.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.32
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	$11.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.32
Rate for Payer: Wellcare Medicare Advantage	$14.32
Rate for Payer: Wellpoint Medicaid Managed Care	$5.45

LIPOPROTEIN (A)

Facility

$91.70

Service Code	HCPCS 83695
Hospital Charge Code	38477110
Hospital Revenue Code	301
Min. Negotiated Rate	$13.76
Max. Negotiated Rate	$13.76
Rate for Payer: Qualcare PPO/HMO/WC	$13.76

LIPOPROTEIN (A)

Facility

$91.70

Service Code	HCPCS 83695
Hospital Charge Code	38477110
Hospital Revenue Code	301
Min. Negotiated Rate	$2.43
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$38.95
Rate for Payer: Aetna Medicare Advantage	$46.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.69
Rate for Payer: Cigna Commercial	$45.85
Rate for Payer: Cigna Medicare Advantage	$14.32
Rate for Payer: Clover Medicare Advantage	$13.60
Rate for Payer: EmblemHealth Commercial	$42.96
Rate for Payer: Humana Medicare Advantage	$14.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.51
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.76
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.32
Rate for Payer: Wellcare Medicare Advantage	$14.32
Rate for Payer: Wellpoint Medicaid Managed Care	$2.43

LIPOPROTEIN (A)

Facility

$390.00

Service Code	HCPCS 83695
Hospital Charge Code	39900104
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$38.95
Rate for Payer: Aetna Medicare Advantage	$46.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.69
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.32
Rate for Payer: Clover Medicare Advantage	$13.60
Rate for Payer: EmblemHealth Commercial	$42.96
Rate for Payer: Humana Medicare Advantage	$14.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.32
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	$11.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.32
Rate for Payer: Wellcare Medicare Advantage	$14.32
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

LIPOPROTEIN (A)

Facility

$390.00

Service Code	HCPCS 83695
Hospital Charge Code	39900104
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LIPOPROTEIN BLOOD

Facility

$316.75

Service Code	HCPCS 83704
Hospital Charge Code	3036000A
Hospital Revenue Code	301
Min. Negotiated Rate	$8.39
Max. Negotiated Rate	$158.38
Rate for Payer: Aetna Commercial	$93.00
Rate for Payer: Aetna Medicare Advantage	$110.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.42
Rate for Payer: Cigna Commercial	$158.38
Rate for Payer: Cigna Medicare Advantage	$34.19
Rate for Payer: Clover Medicare Advantage	$32.48
Rate for Payer: EmblemHealth Commercial	$102.57
Rate for Payer: Humana Medicare Advantage	$35.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.51
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$27.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.19
Rate for Payer: Wellcare Medicare Advantage	$34.19
Rate for Payer: Wellpoint Medicaid Managed Care	$8.39

Know your out-of-pocket cost for care.

All Charges