Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ART SURF LCCK EF 3-4 17MM YEL

Facility

$9,271.00

Hospital Charge Code	270660877
Hospital Revenue Code	278
Min. Negotiated Rate	$1,390.65
Max. Negotiated Rate	$2,243.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,854.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,243.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,039.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,390.65

ART SURF LCCK EF 3-4 17MM YEL

Facility

$9,271.00

Hospital Charge Code	270660877
Hospital Revenue Code	278
Min. Negotiated Rate	$223.43
Max. Negotiated Rate	$4,635.50
Rate for Payer: Aetna Commercial	$3,522.98
Rate for Payer: Aetna Medicare Advantage	$2,781.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,364.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,364.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,854.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,364.11
Rate for Payer: Cigna Commercial	$4,635.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,243.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,039.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,390.65
Rate for Payer: UnitedHealthcare Community & State	$223.43
Rate for Payer: Wellpoint Medicaid Managed Care	$245.68

ART SURF LPS-FLEX EF 3-4 14MM

Facility

$5,862.10

Hospital Charge Code	270663523
Hospital Revenue Code	278
Min. Negotiated Rate	$141.28
Max. Negotiated Rate	$2,931.05
Rate for Payer: Aetna Commercial	$2,227.60
Rate for Payer: Aetna Medicare Advantage	$1,758.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,494.84
Rate for Payer: Cigna Commercial	$2,931.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,289.66
Rate for Payer: Qualcare PPO/HMO/WC	$879.32
Rate for Payer: UnitedHealthcare Community & State	$141.28
Rate for Payer: Wellpoint Medicaid Managed Care	$155.35

ART SURF LPS-FLEX EF 3-4 14MM

Facility

$5,862.10

Hospital Charge Code	270663523
Hospital Revenue Code	278
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$1,418.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,289.66
Rate for Payer: Qualcare PPO/HMO/WC	$879.32

ARYLSULFATASE A, ANTIBODY

Facility

$337.00

Service Code	HCPCS 84311
Hospital Charge Code	38472906
Hospital Revenue Code	301
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$168.50
Rate for Payer: Aetna Commercial	$22.03
Rate for Payer: Aetna Medicare Advantage	$26.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.24
Rate for Payer: Cigna Commercial	$168.50
Rate for Payer: Cigna Medicare Advantage	$8.10
Rate for Payer: Clover Medicare Advantage	$7.70
Rate for Payer: EmblemHealth Commercial	$24.30
Rate for Payer: Humana Medicare Advantage	$8.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.55
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.10
Rate for Payer: Wellcare Medicare Advantage	$8.10
Rate for Payer: Wellpoint Medicaid Managed Care	$8.93

ARYLSULFATASE A, ANTIBODY

Facility

$337.00

Service Code	HCPCS 84311
Hospital Charge Code	38472906
Hospital Revenue Code	301
Min. Negotiated Rate	$50.55
Max. Negotiated Rate	$50.55
Rate for Payer: Qualcare PPO/HMO/WC	$50.55

ASACOL/400MG

Facility

$4.00

Hospital Charge Code	60634902
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

ASACOL/400MG

Facility

$4.00

Hospital Charge Code	60634902
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ASCARIS IGE

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3035140
Hospital Revenue Code	305
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

ASCARIS IGE

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3035140
Hospital Revenue Code	305
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

ASCOPE RHINOLARYNGO INTERVENTI

Facility

$1,365.00

Hospital Charge Code	270688727
Hospital Revenue Code	272
Min. Negotiated Rate	$32.90
Max. Negotiated Rate	$682.50
Rate for Payer: Aetna Commercial	$518.70
Rate for Payer: Aetna Medicare Advantage	$409.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$348.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$348.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$348.07
Rate for Payer: Cigna Commercial	$682.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$409.50
Rate for Payer: Oxford Commercial	$273.00
Rate for Payer: Qualcare PPO/HMO/WC	$204.75
Rate for Payer: UnitedHealthcare Commercial	$273.00
Rate for Payer: UnitedHealthcare Community & State	$32.90
Rate for Payer: Wellpoint Medicaid Managed Care	$36.17

ASCOPE RHINOLARYNGO INTERVENTI

Facility

$1,365.00

Hospital Charge Code	270688727
Hospital Revenue Code	272
Min. Negotiated Rate	$204.75
Max. Negotiated Rate	$204.75
Rate for Payer: Qualcare PPO/HMO/WC	$204.75

ASCORBIC ACID 250 MG TAB

Facility

$4.00

Service Code	NDC 904052260
Hospital Charge Code	60628489
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ASCORBIC ACID 250 MG TAB

Facility

$4.00

Service Code	NDC 904052260
Hospital Charge Code	60628489
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

ASCORBIC ACID/250MG/TAB

Facility

$1.00

Hospital Charge Code	60634305
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.38
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.30
Rate for Payer: Oxford Commercial	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.20
Rate for Payer: UnitedHealthcare Community & State	$0.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.03

ASCORBIC ACID/250MG/TAB

Facility

$1.00

Hospital Charge Code	60634305
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

ASCORBIC ACID 500 MG/5ML LIQ

Facility

$4.00

Service Code	NDC 536016097
Hospital Charge Code	6000467
Hospital Revenue Code	251
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ASCORBIC ACID 500 MG/5ML LIQ

Facility

$4.00

Service Code	NDC 536016097
Hospital Charge Code	6000467
Hospital Revenue Code	251
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

ASCORBIC ACID500MG/ML50ML VIAL

Facility

$14.54

Service Code	NDC 67457011850
Hospital Charge Code	606390138
Hospital Revenue Code	250
Min. Negotiated Rate	$2.18
Max. Negotiated Rate	$2.18
Rate for Payer: Qualcare PPO/HMO/WC	$2.18

ASCORBIC ACID500MG/ML50ML VIAL

Facility

$14.54

Service Code	NDC 67457011850
Hospital Charge Code	606390138
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$7.27
Rate for Payer: Aetna Commercial	$5.53
Rate for Payer: Aetna Medicare Advantage	$4.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.71
Rate for Payer: Cigna Commercial	$7.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.36
Rate for Payer: Oxford Commercial	$2.91
Rate for Payer: Qualcare PPO/HMO/WC	$2.18
Rate for Payer: UnitedHealthcare Commercial	$2.91
Rate for Payer: UnitedHealthcare Community & State	$0.35
Rate for Payer: Wellpoint Medicaid Managed Care	$0.39

ASCORBIC ACID 500 MG TAB

Facility

$4.00

Service Code	NDC 904052360
Hospital Charge Code	60628490
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ASCORBIC ACID 500 MG TAB

Facility

$4.00

Service Code	NDC 904052360
Hospital Charge Code	60628490
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

ASCORBIC ACID/500MG/TAB

Facility

$1.00

Hospital Charge Code	60632486
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.38
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.30
Rate for Payer: Oxford Commercial	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.20
Rate for Payer: UnitedHealthcare Community & State	$0.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.03

ASCORBIC ACID/500MG/TAB

Facility

$1.00

Hospital Charge Code	60632486
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

ASCREW ASNIS SCREW 4.6 X 40MM

Facility

$1,295.00

Hospital Charge Code	270665828
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

Know your out-of-pocket cost for care.

All Charges