Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MT SHORTEN,1ST MT W ALLOGR LT

Facility

$19,998.60

Service Code	HCPCS 28307
Hospital Charge Code	16000907
Hospital Revenue Code	360
Min. Negotiated Rate	$2,999.79
Max. Negotiated Rate	$2,999.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79

MT TO SHORTEN 1ST MT

Facility

$21,064.69

Service Code	HCPCS 28306
Hospital Charge Code	16000515
Hospital Revenue Code	360
Min. Negotiated Rate	$507.66
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,319.41
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.70
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$507.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$558.21

MT TO SHORTEN 1ST MT

Facility

$21,064.69

Service Code	HCPCS 28306
Hospital Charge Code	16000515
Hospital Revenue Code	360
Min. Negotiated Rate	$3,159.70
Max. Negotiated Rate	$3,159.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.70

MT TO SHORTEN,1ST MT - RT

Facility

$57,534.50

Hospital Charge Code	16000153
Hospital Revenue Code	360
Min. Negotiated Rate	$8,630.17
Max. Negotiated Rate	$8,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$8,630.17

MT TO SHORTEN,1ST MT - RT

Facility

$57,534.50

Hospital Charge Code	16000153
Hospital Revenue Code	360
Min. Negotiated Rate	$1,386.58
Max. Negotiated Rate	$28,767.25
Rate for Payer: Aetna Commercial	$21,863.11
Rate for Payer: Aetna Medicare Advantage	$17,260.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,671.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,671.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,671.30
Rate for Payer: Cigna Commercial	$28,767.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17,260.35
Rate for Payer: Qualcare PPO/HMO/WC	$8,630.17
Rate for Payer: UnitedHealthcare Community & State	$1,386.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1,524.66

M TUBERCULOSIS,PCR/CULTURE I

Facility

$61.35

Service Code	HCPCS 87015
Hospital Charge Code	3038087A
Hospital Revenue Code	309
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$9.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.20

M TUBERCULOSIS,PCR/CULTURE I

Facility

$61.35

Service Code	HCPCS 87015
Hospital Charge Code	3038087A
Hospital Revenue Code	309
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$18.17
Rate for Payer: Aetna Medicare Advantage	$21.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.11
Rate for Payer: Cigna Commercial	$30.68
Rate for Payer: Cigna Medicare Advantage	$6.68
Rate for Payer: Clover Medicare Advantage	$6.35
Rate for Payer: EmblemHealth Commercial	$20.04
Rate for Payer: Humana Medicare Advantage	$6.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.68
Rate for Payer: Wellcare Medicare Advantage	$6.68
Rate for Payer: Wellpoint Medicaid Managed Care	$1.63

M TUBERCULOSIS,PCR/CULTURE II

Facility

$295.25

Service Code	HCPCS 87116
Hospital Charge Code	3038087B
Hospital Revenue Code	309
Min. Negotiated Rate	$44.29
Max. Negotiated Rate	$44.29
Rate for Payer: Qualcare PPO/HMO/WC	$44.29

M TUBERCULOSIS,PCR/CULTURE II

Facility

$295.25

Service Code	HCPCS 87116
Hospital Charge Code	3038087B
Hospital Revenue Code	309
Min. Negotiated Rate	$7.82
Max. Negotiated Rate	$147.62
Rate for Payer: Aetna Commercial	$29.38
Rate for Payer: Aetna Medicare Advantage	$34.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.98
Rate for Payer: Cigna Commercial	$147.62
Rate for Payer: Cigna Medicare Advantage	$10.80
Rate for Payer: Clover Medicare Advantage	$10.26
Rate for Payer: EmblemHealth Commercial	$32.40
Rate for Payer: Humana Medicare Advantage	$11.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.58
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.29
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.80
Rate for Payer: Wellcare Medicare Advantage	$10.80
Rate for Payer: Wellpoint Medicaid Managed Care	$7.82

M TUBERCULOSIS,PCR/CULTURE III

Facility

$71.25

Service Code	HCPCS 87206
Hospital Charge Code	3038087C
Hospital Revenue Code	309
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$10.69
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

M TUBERCULOSIS,PCR/CULTURE III

Facility

$71.25

Service Code	HCPCS 87206
Hospital Charge Code	3038087C
Hospital Revenue Code	309
Min. Negotiated Rate	$1.89
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.66
Rate for Payer: Aetna Medicare Advantage	$17.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.46
Rate for Payer: Cigna Commercial	$35.62
Rate for Payer: Cigna Medicare Advantage	$5.39
Rate for Payer: Clover Medicare Advantage	$5.12
Rate for Payer: EmblemHealth Commercial	$16.17
Rate for Payer: Humana Medicare Advantage	$5.55
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.39
Rate for Payer: Wellcare Medicare Advantage	$5.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.89

M TUBERCULOSIS,PCR/CULTURE IV

Facility

$241.20

Service Code	HCPCS 87556
Hospital Charge Code	3038087D
Hospital Revenue Code	306
Min. Negotiated Rate	$36.18
Max. Negotiated Rate	$36.18
Rate for Payer: Qualcare PPO/HMO/WC	$36.18

M TUBERCULOSIS,PCR/CULTURE IV

Facility

$241.20

Service Code	HCPCS 87556
Hospital Charge Code	3038087D
Hospital Revenue Code	306
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$150.45
Rate for Payer: Aetna Commercial	$113.37
Rate for Payer: Aetna Medicare Advantage	$135.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.45
Rate for Payer: Cigna Commercial	$120.60
Rate for Payer: Cigna Medicare Advantage	$41.68
Rate for Payer: Clover Medicare Advantage	$39.60
Rate for Payer: EmblemHealth Commercial	$125.04
Rate for Payer: Humana Medicare Advantage	$42.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$41.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.18
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$33.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$41.68
Rate for Payer: Wellcare Medicare Advantage	$41.68
Rate for Payer: Wellpoint Medicaid Managed Care	$6.39

MUCIN-MUCICARMINE STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005297
Hospital Revenue Code	310
Min. Negotiated Rate	$17.81
Max. Negotiated Rate	$570.55
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.80
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$68.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$17.81

MUCIN-MUCICARMINE STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005297
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

MUCIN TEST

Facility

$44.00

Service Code	HCPCS 83872
Hospital Charge Code	38475098
Hospital Revenue Code	301
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

MUCIN TEST

Facility

$44.00

Service Code	HCPCS 83872
Hospital Charge Code	38475098
Hospital Revenue Code	301
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.94
Rate for Payer: Aetna Medicare Advantage	$18.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.15
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: Cigna Medicare Advantage	$5.86
Rate for Payer: Clover Medicare Advantage	$5.57
Rate for Payer: EmblemHealth Commercial	$17.58
Rate for Payer: Humana Medicare Advantage	$6.04
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.86
Rate for Payer: Wellcare Medicare Advantage	$5.86
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

MUCOMYST-10 10% INHAL/30M

Facility

$279.00

Hospital Charge Code	60633464
Hospital Revenue Code	250
Min. Negotiated Rate	$41.85
Max. Negotiated Rate	$41.85
Rate for Payer: Qualcare PPO/HMO/WC	$41.85

MUCOMYST-10 10% INHAL/30M

Facility

$279.00

Hospital Charge Code	60633464
Hospital Revenue Code	250
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$139.50
Rate for Payer: Aetna Commercial	$106.02
Rate for Payer: Aetna Medicare Advantage	$83.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.14
Rate for Payer: Cigna Commercial	$139.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.70
Rate for Payer: Oxford Commercial	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$41.85
Rate for Payer: UnitedHealthcare Commercial	$55.80
Rate for Payer: UnitedHealthcare Community & State	$6.72
Rate for Payer: Wellpoint Medicaid Managed Care	$7.39

MUCOMYST-10 10% INHAL/4ML

Facility

$41.00

Hospital Charge Code	60633465
Hospital Revenue Code	250
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$20.50
Rate for Payer: Aetna Commercial	$15.58
Rate for Payer: Aetna Medicare Advantage	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.46
Rate for Payer: Cigna Commercial	$20.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.30
Rate for Payer: Oxford Commercial	$8.20
Rate for Payer: Qualcare PPO/HMO/WC	$6.15
Rate for Payer: UnitedHealthcare Commercial	$8.20
Rate for Payer: UnitedHealthcare Community & State	$0.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1.09

MUCOMYST-10 10% INHAL/4ML

Facility

$41.00

Hospital Charge Code	60633465
Hospital Revenue Code	250
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$6.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.15

MUCOMYST 10% 30ML VIAL

Facility

$76.11

Service Code	NDC 409330703
Hospital Charge Code	6063943283
Hospital Revenue Code	250
Min. Negotiated Rate	$11.42
Max. Negotiated Rate	$11.42
Rate for Payer: Qualcare PPO/HMO/WC	$11.42

MUCOMYST 10% 30ML VIAL

Facility

$76.11

Service Code	NDC 409330703
Hospital Charge Code	6063943283
Hospital Revenue Code	250
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$38.05
Rate for Payer: Aetna Commercial	$28.92
Rate for Payer: Aetna Medicare Advantage	$22.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.41
Rate for Payer: Cigna Commercial	$38.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.83
Rate for Payer: Oxford Commercial	$15.22
Rate for Payer: Qualcare PPO/HMO/WC	$11.42
Rate for Payer: UnitedHealthcare Commercial	$15.22
Rate for Payer: UnitedHealthcare Community & State	$1.83
Rate for Payer: Wellpoint Medicaid Managed Care	$2.02

MUCOMYST 20% INHAL/30ML

Facility

$337.00

Hospital Charge Code	60633463
Hospital Revenue Code	250
Min. Negotiated Rate	$50.55
Max. Negotiated Rate	$50.55
Rate for Payer: Qualcare PPO/HMO/WC	$50.55

MUCOMYST 20% INHAL/30ML

Facility

$337.00

Hospital Charge Code	60633463
Hospital Revenue Code	250
Min. Negotiated Rate	$8.12
Max. Negotiated Rate	$168.50
Rate for Payer: Aetna Commercial	$128.06
Rate for Payer: Aetna Medicare Advantage	$101.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.94
Rate for Payer: Cigna Commercial	$168.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.10
Rate for Payer: Oxford Commercial	$67.40
Rate for Payer: Qualcare PPO/HMO/WC	$50.55
Rate for Payer: UnitedHealthcare Commercial	$67.40
Rate for Payer: UnitedHealthcare Community & State	$8.12
Rate for Payer: Wellpoint Medicaid Managed Care	$8.93

Know your out-of-pocket cost for care.

All Charges