Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LIPOPROTEIN BLOOD

Facility

$316.75

Service Code	HCPCS 83704
Hospital Charge Code	3036000A
Hospital Revenue Code	301
Min. Negotiated Rate	$47.51
Max. Negotiated Rate	$47.51
Rate for Payer: Qualcare PPO/HMO/WC	$47.51

LIPOPROTEIN BLOOD QUANT LPN/LP

Facility

$223.44

Service Code	HCPCS 83704
Hospital Charge Code	38477187
Hospital Revenue Code	301
Min. Negotiated Rate	$5.92
Max. Negotiated Rate	$124.00
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	$111.72
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	$67.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.52
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	$5.92

LIPOPROTEIN BLOOD QUANT LPN/LP

Facility

$223.44

Service Code	HCPCS 83704
Hospital Charge Code	38477187
Hospital Revenue Code	301
Min. Negotiated Rate	$33.52
Max. Negotiated Rate	$33.52
Rate for Payer: Qualcare PPO/HMO/WC	$33.52

LIPOPROTEIN ELECTRO, FLUID

Facility

$85.00

Service Code	HCPCS 82664
Hospital Charge Code	3035129
Hospital Revenue Code	301
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

LIPOPROTEIN ELECTRO, FLUID

Facility

$85.00

Service Code	HCPCS 82664
Hospital Charge Code	3035129
Hospital Revenue Code	301
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$222.00
Rate for Payer: Aetna Commercial	$167.28
Rate for Payer: Aetna Medicare Advantage	$199.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$222.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$222.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61.50
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	$222.00
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: Cigna Medicare Advantage	$61.50
Rate for Payer: Clover Medicare Advantage	$58.42
Rate for Payer: EmblemHealth Commercial	$184.50
Rate for Payer: Humana Medicare Advantage	$63.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$61.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$49.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.50
Rate for Payer: Wellcare Medicare Advantage	$61.50
Rate for Payer: Wellpoint Medicaid Managed Care	$2.25

LIPOPROTEIN ELECTROPHORESIS

Facility

$242.00

Service Code	HCPCS 83700
Hospital Charge Code	38472458
Hospital Revenue Code	301
Min. Negotiated Rate	$6.41
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$30.63
Rate for Payer: Aetna Medicare Advantage	$36.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.65
Rate for Payer: Cigna Commercial	$121.00
Rate for Payer: Cigna Medicare Advantage	$11.26
Rate for Payer: Clover Medicare Advantage	$10.70
Rate for Payer: EmblemHealth Commercial	$33.78
Rate for Payer: Humana Medicare Advantage	$11.60
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.26
Rate for Payer: Wellcare Medicare Advantage	$11.26
Rate for Payer: Wellpoint Medicaid Managed Care	$6.41

LIPOPROTEIN ELECTROPHORESIS

Facility

$242.00

Service Code	HCPCS 83700
Hospital Charge Code	38472458
Hospital Revenue Code	301
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

LIPOPROTEIN FRACTIONATION I

Facility

$390.00

Service Code	HCPCS 82465
Hospital Charge Code	39990161A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LIPOPROTEIN FRACTIONATION I

Facility

$390.00

Service Code	HCPCS 82465
Hospital Charge Code	39990161A
Hospital Revenue Code	301
Min. Negotiated Rate	$3.48
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$11.83
Rate for Payer: Aetna Medicare Advantage	$14.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.35
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	$15.70
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.35
Rate for Payer: Clover Medicare Advantage	$4.13
Rate for Payer: EmblemHealth Commercial	$13.05
Rate for Payer: Humana Medicare Advantage	$4.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.35
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	$3.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.35
Rate for Payer: Wellcare Medicare Advantage	$4.35
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

LIPOPROTEIN FRACTIONATION II

Facility

$390.00

Service Code	HCPCS 83701
Hospital Charge Code	39990161B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LIPOPROTEIN FRACTIONATION II

Facility

$390.00

Service Code	HCPCS 83701
Hospital Charge Code	39990161B
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$92.10
Rate for Payer: Aetna Medicare Advantage	$109.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$33.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.22
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$33.86
Rate for Payer: Clover Medicare Advantage	$32.17
Rate for Payer: EmblemHealth Commercial	$101.58
Rate for Payer: Humana Medicare Advantage	$34.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$33.86
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	$27.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$33.86
Rate for Payer: Wellcare Medicare Advantage	$33.86
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

LIPOPROTEIN FRACTIONATION III

Facility

$390.00

Service Code	HCPCS 84478
Hospital Charge Code	39990161C
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LIPOPROTEIN FRACTIONATION III

Facility

$390.00

Service Code	HCPCS 84478
Hospital Charge Code	39990161C
Hospital Revenue Code	301
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$15.61
Rate for Payer: Aetna Medicare Advantage	$18.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.72
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.74
Rate for Payer: Clover Medicare Advantage	$5.45
Rate for Payer: EmblemHealth Commercial	$17.22
Rate for Payer: Humana Medicare Advantage	$5.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.74
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	$4.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.74
Rate for Payer: Wellcare Medicare Advantage	$5.74
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

LIPOPROTEIN FRACTIONATION NMR

Facility

$50.00

Service Code	HCPCS 83704
Hospital Charge Code	401183704
Hospital Revenue Code	301
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$124.00
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	$25.00
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	$15.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
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	$1.32

LIPOPROTEIN FRACTIONATION NMR

Facility

$50.00

Service Code	HCPCS 83704
Hospital Charge Code	401183704
Hospital Revenue Code	301
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

LIPOPROTEINS PHENTYPE ELECTR**

Facility

$48.00

Hospital Charge Code	3011848
Hospital Revenue Code	309
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$18.24
Rate for Payer: Aetna Medicare Advantage	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.24
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

LIPOPROTEINS PHENTYPE ELECTR**

Facility

$48.00

Hospital Charge Code	3011848
Hospital Revenue Code	309
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

LIPOPROTEIN SUBFRACT

Facility

$77.65

Service Code	HCPCS 84478
Hospital Charge Code	3035044A
Hospital Revenue Code	301
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.61
Rate for Payer: Aetna Medicare Advantage	$18.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.72
Rate for Payer: Cigna Commercial	$38.83
Rate for Payer: Cigna Medicare Advantage	$5.74
Rate for Payer: Clover Medicare Advantage	$5.45
Rate for Payer: EmblemHealth Commercial	$17.22
Rate for Payer: Humana Medicare Advantage	$5.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.74
Rate for Payer: Wellcare Medicare Advantage	$5.74
Rate for Payer: Wellpoint Medicaid Managed Care	$2.06

LIPOPROTEIN SUBFRACT

Facility

$77.65

Service Code	HCPCS 84478
Hospital Charge Code	3035044A
Hospital Revenue Code	301
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$11.65
Rate for Payer: Qualcare PPO/HMO/WC	$11.65

LIPOPROTEIN SUBFRACTIONATION

Facility

$858.15

Service Code	HCPCS 83701
Hospital Charge Code	3035044
Hospital Revenue Code	301
Min. Negotiated Rate	$128.72
Max. Negotiated Rate	$128.72
Rate for Payer: Qualcare PPO/HMO/WC	$128.72

LIPOPROTEIN SUBFRACTIONATION

Facility

$858.15

Service Code	HCPCS 83701
Hospital Charge Code	3035044
Hospital Revenue Code	301
Min. Negotiated Rate	$22.74
Max. Negotiated Rate	$429.07
Rate for Payer: Aetna Commercial	$92.10
Rate for Payer: Aetna Medicare Advantage	$109.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$33.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.22
Rate for Payer: Cigna Commercial	$429.07
Rate for Payer: Cigna Medicare Advantage	$33.86
Rate for Payer: Clover Medicare Advantage	$32.17
Rate for Payer: EmblemHealth Commercial	$101.58
Rate for Payer: Humana Medicare Advantage	$34.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$33.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.44
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$128.72
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$27.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$33.86
Rate for Payer: Wellcare Medicare Advantage	$33.86
Rate for Payer: Wellpoint Medicaid Managed Care	$22.74

LIPOSUCTION PANEL (DR. PELOSI)

Facility

$243.25

Hospital Charge Code	3007581
Hospital Revenue Code	300
Min. Negotiated Rate	$5.86
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$92.44
Rate for Payer: Aetna Medicare Advantage	$72.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.03
Rate for Payer: Cigna Commercial	$121.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.86
Rate for Payer: Wellpoint Medicaid Managed Care	$6.45

LIPOSUCTION PANEL (DR. PELOSI)

Facility

$243.25

Hospital Charge Code	3007581
Hospital Revenue Code	300
Min. Negotiated Rate	$36.49
Max. Negotiated Rate	$36.49
Rate for Payer: Qualcare PPO/HMO/WC	$36.49

LIPOSYN II 10%/500ML

Facility

$289.00

Hospital Charge Code	60633309
Hospital Revenue Code	250
Min. Negotiated Rate	$6.96
Max. Negotiated Rate	$144.50
Rate for Payer: Aetna Commercial	$109.82
Rate for Payer: Aetna Medicare Advantage	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.69
Rate for Payer: Cigna Commercial	$144.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.70
Rate for Payer: Oxford Commercial	$57.80
Rate for Payer: Qualcare PPO/HMO/WC	$43.35
Rate for Payer: UnitedHealthcare Commercial	$57.80
Rate for Payer: UnitedHealthcare Community & State	$6.96
Rate for Payer: Wellpoint Medicaid Managed Care	$7.66

LIPOSYN II 10%/500ML

Facility

$289.00

Hospital Charge Code	60633309
Hospital Revenue Code	250
Min. Negotiated Rate	$43.35
Max. Negotiated Rate	$43.35
Rate for Payer: Qualcare PPO/HMO/WC	$43.35

Know your out-of-pocket cost for care.

All Charges