Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MAGNETIC IMG BONE MAROW-TC

Facility

$2,006.10

Service Code	HCPCS 77084TC
Hospital Charge Code	85000360
Hospital Revenue Code	610
Min. Negotiated Rate	$48.35
Max. Negotiated Rate	$6,162.00
Rate for Payer: Aetna Commercial	$762.32
Rate for Payer: Aetna Medicare Advantage	$601.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$511.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$511.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$511.56
Rate for Payer: Cigna Commercial	$1,003.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$601.83
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.92
Rate for Payer: UnitedHealthcare Commercial	$6,162.00
Rate for Payer: UnitedHealthcare Community & State	$48.35
Rate for Payer: Wellpoint Medicaid Managed Care	$53.16

MAGNETOS 1.5CC

Facility

$2,500.00

Hospital Charge Code	270703491
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

MAGNETOS 1.5CC

Facility

$2,500.00

Hospital Charge Code	270703491
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

MAGNET OS 2.5CC

Facility

$4,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270704883
Hospital Revenue Code	278
Min. Negotiated Rate	$607.50
Max. Negotiated Rate	$980.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$980.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$891.00
Rate for Payer: Qualcare PPO/HMO/WC	$607.50

MAGNET OS 2.5CC

Facility

$4,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270704883
Hospital Revenue Code	278
Min. Negotiated Rate	$97.61
Max. Negotiated Rate	$2,025.00
Rate for Payer: Aetna Commercial	$1,539.00
Rate for Payer: Aetna Medicare Advantage	$1,215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,032.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,032.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,032.75
Rate for Payer: Cigna Commercial	$2,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$980.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$891.00
Rate for Payer: Qualcare PPO/HMO/WC	$607.50
Rate for Payer: UnitedHealthcare Community & State	$97.61
Rate for Payer: Wellpoint Medicaid Managed Care	$107.33

MAGNUM 2 KNOTLESS IMPLANT

Facility

$5,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270668401
Hospital Revenue Code	278
Min. Negotiated Rate	$768.75
Max. Negotiated Rate	$1,240.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,240.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,127.50
Rate for Payer: Qualcare PPO/HMO/WC	$768.75

MAGNUM 2 KNOTLESS IMPLANT

Facility

$5,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270668401
Hospital Revenue Code	278
Min. Negotiated Rate	$123.51
Max. Negotiated Rate	$2,562.50
Rate for Payer: Aetna Commercial	$1,947.50
Rate for Payer: Aetna Medicare Advantage	$1,537.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,306.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,306.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,306.88
Rate for Payer: Cigna Commercial	$2,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,240.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,127.50
Rate for Payer: Qualcare PPO/HMO/WC	$768.75
Rate for Payer: UnitedHealthcare Community & State	$123.51
Rate for Payer: Wellpoint Medicaid Managed Care	$135.81

MAGNUS V-CELLULAR ALLOGRFT 5CC

Facility

$13,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694686
Hospital Revenue Code	278
Min. Negotiated Rate	$336.80
Max. Negotiated Rate	$6,987.50
Rate for Payer: Aetna Commercial	$5,310.50
Rate for Payer: Aetna Medicare Advantage	$4,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,563.62
Rate for Payer: Cigna Commercial	$6,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,381.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,074.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25
Rate for Payer: UnitedHealthcare Community & State	$336.80
Rate for Payer: Wellpoint Medicaid Managed Care	$370.34

MAGNUS V-CELLULAR ALLOGRFT 5CC

Facility

$13,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694686
Hospital Revenue Code	278
Min. Negotiated Rate	$2,096.25
Max. Negotiated Rate	$3,381.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,381.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,074.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25

MAG/NYST/LIDO VIS MAGIC MIX #9

Facility

$175.00

Hospital Charge Code	60629918
Hospital Revenue Code	250
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

MAG/NYST/LIDO VIS MAGIC MIX #9

Facility

$175.00

Hospital Charge Code	60629918
Hospital Revenue Code	250
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.50
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$35.00
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

MAGONATE/1GM/5ML

Facility

$53.00

Hospital Charge Code	60633351
Hospital Revenue Code	250
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$7.95
Rate for Payer: Qualcare PPO/HMO/WC	$7.95

MAGONATE/1GM/5ML

Facility

$53.00

Hospital Charge Code	60633351
Hospital Revenue Code	250
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$26.50
Rate for Payer: Aetna Commercial	$20.14
Rate for Payer: Aetna Medicare Advantage	$15.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.52
Rate for Payer: Cigna Commercial	$26.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.90
Rate for Payer: Oxford Commercial	$10.60
Rate for Payer: Qualcare PPO/HMO/WC	$7.95
Rate for Payer: UnitedHealthcare Commercial	$10.60
Rate for Payer: UnitedHealthcare Community & State	$1.28
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

MAGSEED IMG MARKER 18G 7CM

Facility

$2,981.55

Service Code	HCPCS A4648
Hospital Charge Code	270697617
Hospital Revenue Code	278
Min. Negotiated Rate	$71.86
Max. Negotiated Rate	$1,490.78
Rate for Payer: Aetna Commercial	$1,132.99
Rate for Payer: Aetna Medicare Advantage	$894.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$760.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$760.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$596.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$760.30
Rate for Payer: Cigna Commercial	$1,490.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$721.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$655.94
Rate for Payer: Qualcare PPO/HMO/WC	$447.23
Rate for Payer: UnitedHealthcare Community & State	$71.86
Rate for Payer: Wellpoint Medicaid Managed Care	$79.01

MAGSEED IMG MARKER 18G 7CM

Facility

$2,981.55

Service Code	HCPCS A4648
Hospital Charge Code	270697617
Hospital Revenue Code	278
Min. Negotiated Rate	$447.23
Max. Negotiated Rate	$721.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$596.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$721.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$655.94
Rate for Payer: Qualcare PPO/HMO/WC	$447.23

MAG-SGPG AB (IGM)

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	39900527
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.34
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
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	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

MAG-SGPG AB (IGM)

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	39900527
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MAG SULFATE 1GM/2ML INJ 10 ML

Facility

$13.94

Service Code	HCPCS J3475
Hospital Charge Code	60627751
Hospital Revenue Code	636
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$6.97
Rate for Payer: Aetna Commercial	$5.30
Rate for Payer: Aetna Medicare Advantage	$4.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.55
Rate for Payer: Cigna Commercial	$6.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.09
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

MAG SULFATE 1GM/2ML INJ 10 ML

Facility

$13.94

Service Code	HCPCS J3475
Hospital Charge Code	60627751
Hospital Revenue Code	636
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$3.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.09

MAG SULFATE 8.12 MEQ/2 ML INJ

Facility

$9.65

Service Code	HCPCS J3475
Hospital Charge Code	6022669
Hospital Revenue Code	636
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$3.67
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

MAG SULFATE 8.12 MEQ/2 ML INJ

Facility

$9.65

Service Code	HCPCS J3475
Hospital Charge Code	6022669
Hospital Revenue Code	636
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$2.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

MAG,WESTERN BLOT W/RFX

Facility

$390.00

Service Code	HCPCS 84181
Hospital Charge Code	39900526
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$46.32
Rate for Payer: Aetna Medicare Advantage	$55.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.47
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.03
Rate for Payer: Clover Medicare Advantage	$16.18
Rate for Payer: EmblemHealth Commercial	$51.09
Rate for Payer: Humana Medicare Advantage	$17.54
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.03
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	$13.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.03
Rate for Payer: Wellcare Medicare Advantage	$17.03
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

MAG,WESTERN BLOT W/RFX

Facility

$390.00

Service Code	HCPCS 84181
Hospital Charge Code	39900526
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MAILMAN 300CM 3CN 1212001

Facility

$471.25

Hospital Charge Code	270636692
Hospital Revenue Code	278
Min. Negotiated Rate	$70.69
Max. Negotiated Rate	$114.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$103.67
Rate for Payer: Qualcare PPO/HMO/WC	$70.69

MAILMAN 300CM 3CN 1212001

Facility

$471.25

Hospital Charge Code	270636692
Hospital Revenue Code	278
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$235.62
Rate for Payer: Aetna Commercial	$179.07
Rate for Payer: Aetna Medicare Advantage	$141.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.17
Rate for Payer: Cigna Commercial	$235.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$103.67
Rate for Payer: Qualcare PPO/HMO/WC	$70.69
Rate for Payer: UnitedHealthcare Community & State	$11.36
Rate for Payer: Wellpoint Medicaid Managed Care	$12.49

Know your out-of-pocket cost for care.

All Charges