Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ASCREW ASNIS SCREW 4.6 X 40MM

Facility

$1,295.00

Hospital Charge Code	270665828
Hospital Revenue Code	278
Min. Negotiated Rate	$31.21
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$492.10
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
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
Rate for Payer: UnitedHealthcare Community & State	$31.21
Rate for Payer: Wellpoint Medicaid Managed Care	$34.32

ASCRIPTIN/325MG/TAB

Facility

$1.00

Hospital Charge Code	60632487
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

ASCRIPTIN/325MG/TAB

Facility

$1.00

Hospital Charge Code	60632487
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

ASENDIN/50MG/TAB

Facility

$6.00

Hospital Charge Code	60634351
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

ASENDIN/50MG/TAB

Facility

$6.00

Hospital Charge Code	60634351
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

ASF VIVACIT PS 12 MM SZ 6-9

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686545
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

ASF VIVACIT PS 12 MM SZ 6-9

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686545
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

ASMBLD PROTEAN FRAGMNT PLATE Y

Facility

$5,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270668299
Hospital Revenue Code	278
Min. Negotiated Rate	$125.92
Max. Negotiated Rate	$2,612.50
Rate for Payer: Aetna Commercial	$1,985.50
Rate for Payer: Aetna Medicare Advantage	$1,567.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,332.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,332.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,045.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,332.38
Rate for Payer: Cigna Commercial	$2,612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,264.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$783.75
Rate for Payer: UnitedHealthcare Community & State	$125.92
Rate for Payer: Wellpoint Medicaid Managed Care	$138.46

ASMBLD PROTEAN FRAGMNT PLATE Y

Facility

$5,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270668299
Hospital Revenue Code	278
Min. Negotiated Rate	$783.75
Max. Negotiated Rate	$1,264.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,045.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,264.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$783.75

ASNIS 6.5/105MM

Facility

$2,020.00

Hospital Charge Code	270664933
Hospital Revenue Code	270
Min. Negotiated Rate	$48.68
Max. Negotiated Rate	$1,010.00
Rate for Payer: Aetna Commercial	$767.60
Rate for Payer: Aetna Medicare Advantage	$606.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$515.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$515.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$515.10
Rate for Payer: Cigna Commercial	$1,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$606.00
Rate for Payer: Oxford Commercial	$404.00
Rate for Payer: Qualcare PPO/HMO/WC	$303.00
Rate for Payer: UnitedHealthcare Commercial	$404.00
Rate for Payer: UnitedHealthcare Community & State	$48.68
Rate for Payer: Wellpoint Medicaid Managed Care	$53.53

ASNIS 6.5/105MM

Facility

$2,020.00

Hospital Charge Code	270664933
Hospital Revenue Code	270
Min. Negotiated Rate	$303.00
Max. Negotiated Rate	$303.00
Rate for Payer: Qualcare PPO/HMO/WC	$303.00

ASO AB

Facility

$390.00

Service Code	HCPCS 86060
Hospital Charge Code	39990022EX
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ASO AB

Facility

$390.00

Service Code	HCPCS 86060
Hospital Charge Code	39990022EX
Hospital Revenue Code	302
Min. Negotiated Rate	$5.84
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$19.86
Rate for Payer: Aetna Medicare Advantage	$23.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.35
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$7.30
Rate for Payer: Clover Medicare Advantage	$6.93
Rate for Payer: EmblemHealth Commercial	$21.90
Rate for Payer: Humana Medicare Advantage	$7.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.30
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	$5.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.30
Rate for Payer: Wellcare Medicare Advantage	$7.30
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ASO AB I

Facility

$50.15

Service Code	HCPCS 86060
Hospital Charge Code	39990022A
Hospital Revenue Code	306
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$19.86
Rate for Payer: Aetna Medicare Advantage	$23.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.35
Rate for Payer: Cigna Commercial	$25.07
Rate for Payer: Cigna Medicare Advantage	$7.30
Rate for Payer: Clover Medicare Advantage	$6.93
Rate for Payer: EmblemHealth Commercial	$21.90
Rate for Payer: Humana Medicare Advantage	$7.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.04
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.52
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.30
Rate for Payer: Wellcare Medicare Advantage	$7.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.33

ASO AB I

Facility

$50.15

Service Code	HCPCS 86060
Hospital Charge Code	39990022A
Hospital Revenue Code	306
Min. Negotiated Rate	$7.52
Max. Negotiated Rate	$7.52
Rate for Payer: Qualcare PPO/HMO/WC	$7.52

ASO AB II

Facility

$39.65

Service Code	HCPCS 86063
Hospital Charge Code	39990022B
Hospital Revenue Code	306
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.69
Rate for Payer: Aetna Medicare Advantage	$18.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.83
Rate for Payer: Cigna Commercial	$19.82
Rate for Payer: Cigna Medicare Advantage	$5.77
Rate for Payer: Clover Medicare Advantage	$5.48
Rate for Payer: EmblemHealth Commercial	$17.31
Rate for Payer: Humana Medicare Advantage	$5.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.89
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.95
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.77
Rate for Payer: Wellcare Medicare Advantage	$5.77
Rate for Payer: Wellpoint Medicaid Managed Care	$1.05

ASO AB II

Facility

$39.65

Service Code	HCPCS 86063
Hospital Charge Code	39990022B
Hospital Revenue Code	306
Min. Negotiated Rate	$5.95
Max. Negotiated Rate	$5.95
Rate for Payer: Qualcare PPO/HMO/WC	$5.95

ASO TITER

Facility

$453.00

Service Code	HCPCS 86060
Hospital Charge Code	38476047
Hospital Revenue Code	302
Min. Negotiated Rate	$67.95
Max. Negotiated Rate	$67.95
Rate for Payer: Qualcare PPO/HMO/WC	$67.95

ASO TITER

Facility

$453.00

Service Code	HCPCS 86060
Hospital Charge Code	38476047
Hospital Revenue Code	302
Min. Negotiated Rate	$5.84
Max. Negotiated Rate	$226.50
Rate for Payer: Aetna Commercial	$19.86
Rate for Payer: Aetna Medicare Advantage	$23.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.35
Rate for Payer: Cigna Commercial	$226.50
Rate for Payer: Cigna Medicare Advantage	$7.30
Rate for Payer: Clover Medicare Advantage	$6.93
Rate for Payer: EmblemHealth Commercial	$21.90
Rate for Payer: Humana Medicare Advantage	$7.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.95
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.30
Rate for Payer: Wellcare Medicare Advantage	$7.30
Rate for Payer: Wellpoint Medicaid Managed Care	$12.00

ASPARAGINASE 10,000IU

Facility

$470.40

Hospital Charge Code	6000020
Hospital Revenue Code	636
Min. Negotiated Rate	$11.34
Max. Negotiated Rate	$235.20
Rate for Payer: Aetna Commercial	$178.75
Rate for Payer: Aetna Medicare Advantage	$141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.95
Rate for Payer: Cigna Commercial	$235.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.84
Rate for Payer: Qualcare PPO/HMO/WC	$70.56
Rate for Payer: UnitedHealthcare Community & State	$11.34
Rate for Payer: Wellpoint Medicaid Managed Care	$12.47

ASPARAGINASE 10,000IU

Facility

$470.40

Hospital Charge Code	6000020
Hospital Revenue Code	636
Min. Negotiated Rate	$70.56
Max. Negotiated Rate	$113.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.84
Rate for Payer: Qualcare PPO/HMO/WC	$70.56

ASPARAGINASE INJ 10MU

Facility

$329.55

Hospital Charge Code	60627363
Hospital Revenue Code	636
Min. Negotiated Rate	$49.43
Max. Negotiated Rate	$79.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.75
Rate for Payer: Qualcare PPO/HMO/WC	$49.43

ASPARAGINASE INJ 10MU

Facility

$329.55

Hospital Charge Code	60627363
Hospital Revenue Code	636
Min. Negotiated Rate	$7.94
Max. Negotiated Rate	$164.78
Rate for Payer: Aetna Commercial	$125.23
Rate for Payer: Aetna Medicare Advantage	$98.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.04
Rate for Payer: Cigna Commercial	$164.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.75
Rate for Payer: Qualcare PPO/HMO/WC	$49.43
Rate for Payer: UnitedHealthcare Community & State	$7.94
Rate for Payer: Wellpoint Medicaid Managed Care	$8.73

ASPARTATE AMINOTRANSFERASE-AST

Facility

$313.00

Service Code	HCPCS 84450
Hospital Charge Code	38472128
Hospital Revenue Code	301
Min. Negotiated Rate	$46.95
Max. Negotiated Rate	$46.95
Rate for Payer: Qualcare PPO/HMO/WC	$46.95

ASPARTATE AMINOTRANSFERASE-AST

Facility

$313.00

Service Code	HCPCS 84450
Hospital Charge Code	38472128
Hospital Revenue Code	301
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$156.50
Rate for Payer: Aetna Commercial	$14.09
Rate for Payer: Aetna Medicare Advantage	$16.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
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	$18.70
Rate for Payer: Cigna Commercial	$156.50
Rate for Payer: Cigna Medicare Advantage	$5.18
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.95
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Medicare Advantage	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$8.29

Know your out-of-pocket cost for care.

All Charges