Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility

$13,688.89

Service Code	APR-DRG 0432
Min. Negotiated Rate	$13,420.48
Max. Negotiated Rate	$13,688.89
Rate for Payer: UnitedHealthcare Community & State	$13,420.48
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,688.89
Rate for Payer: Wellpoint Medicaid Managed Care	$13,420.48

MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility

$20,263.95

Service Code	APR-DRG 0433
Min. Negotiated Rate	$19,866.62
Max. Negotiated Rate	$20,263.95
Rate for Payer: UnitedHealthcare Community & State	$19,866.62
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,263.95
Rate for Payer: Wellpoint Medicaid Managed Care	$19,866.62

MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility

$10,221.35

Service Code	APR-DRG 0431
Min. Negotiated Rate	$10,020.93
Max. Negotiated Rate	$10,221.35
Rate for Payer: UnitedHealthcare Community & State	$10,020.93
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,221.35
Rate for Payer: Wellpoint Medicaid Managed Care	$10,020.93

MULTIPLE SCLEROSIS PROF 1

Facility

$257.65

Service Code	HCPCS 83873
Hospital Charge Code	3035107B
Hospital Revenue Code	301
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$128.82
Rate for Payer: Aetna Commercial	$46.78
Rate for Payer: Aetna Medicare Advantage	$55.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.09
Rate for Payer: Cigna Commercial	$128.82
Rate for Payer: Cigna Medicare Advantage	$17.20
Rate for Payer: Clover Medicare Advantage	$16.34
Rate for Payer: EmblemHealth Commercial	$51.60
Rate for Payer: Humana Medicare Advantage	$17.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.20
Rate for Payer: Wellcare Medicare Advantage	$17.20
Rate for Payer: Wellpoint Medicaid Managed Care	$6.83

MULTIPLE SCLEROSIS PROF 1

Facility

$181.65

Service Code	HCPCS 83916
Hospital Charge Code	3035107A
Hospital Revenue Code	301
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$74.50
Rate for Payer: Aetna Medicare Advantage	$88.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.87
Rate for Payer: Cigna Commercial	$90.83
Rate for Payer: Cigna Medicare Advantage	$27.39
Rate for Payer: Clover Medicare Advantage	$26.02
Rate for Payer: EmblemHealth Commercial	$82.17
Rate for Payer: Humana Medicare Advantage	$28.21
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.39
Rate for Payer: Wellcare Medicare Advantage	$27.39
Rate for Payer: Wellpoint Medicaid Managed Care	$4.81

MULTIPLE SCLEROSIS PROF 1

Facility

$257.65

Service Code	HCPCS 83873
Hospital Charge Code	3035107B
Hospital Revenue Code	301
Min. Negotiated Rate	$38.65
Max. Negotiated Rate	$38.65
Rate for Payer: Qualcare PPO/HMO/WC	$38.65

MULTIPLE SCLEROSIS PROF 1

Facility

$181.65

Service Code	HCPCS 83916
Hospital Charge Code	3035107A
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

MULTIPLE SCLEROSIS PROF 2

Facility

$181.65

Service Code	HCPCS 83916
Hospital Charge Code	3035117G
Hospital Revenue Code	301
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$74.50
Rate for Payer: Aetna Medicare Advantage	$88.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.87
Rate for Payer: Cigna Commercial	$90.83
Rate for Payer: Cigna Medicare Advantage	$27.39
Rate for Payer: Clover Medicare Advantage	$26.02
Rate for Payer: EmblemHealth Commercial	$82.17
Rate for Payer: Humana Medicare Advantage	$28.21
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.39
Rate for Payer: Wellcare Medicare Advantage	$27.39
Rate for Payer: Wellpoint Medicaid Managed Care	$4.81

MULTIPLE SCLEROSIS PROF 2

Facility

$81.25

Service Code	HCPCS 82784
Hospital Charge Code	3035117D
Hospital Revenue Code	301
Min. Negotiated Rate	$12.19
Max. Negotiated Rate	$12.19
Rate for Payer: Qualcare PPO/HMO/WC	$12.19

MULTIPLE SCLEROSIS PROF 2

Facility

$257.65

Service Code	HCPCS 83873
Hospital Charge Code	3035117E
Hospital Revenue Code	301
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$128.82
Rate for Payer: Aetna Commercial	$46.78
Rate for Payer: Aetna Medicare Advantage	$55.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.09
Rate for Payer: Cigna Commercial	$128.82
Rate for Payer: Cigna Medicare Advantage	$17.20
Rate for Payer: Clover Medicare Advantage	$16.34
Rate for Payer: EmblemHealth Commercial	$51.60
Rate for Payer: Humana Medicare Advantage	$17.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.20
Rate for Payer: Wellcare Medicare Advantage	$17.20
Rate for Payer: Wellpoint Medicaid Managed Care	$6.83

MULTIPLE SCLEROSIS PROF 2

Facility

$81.25

Service Code	HCPCS 82784
Hospital Charge Code	3035117D
Hospital Revenue Code	301
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$25.30
Rate for Payer: Aetna Medicare Advantage	$30.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.57
Rate for Payer: Cigna Commercial	$40.62
Rate for Payer: Cigna Medicare Advantage	$9.30
Rate for Payer: Clover Medicare Advantage	$8.84
Rate for Payer: EmblemHealth Commercial	$27.90
Rate for Payer: Humana Medicare Advantage	$9.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.19
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.30
Rate for Payer: Wellcare Medicare Advantage	$9.30
Rate for Payer: Wellpoint Medicaid Managed Care	$2.15

MULTIPLE SCLEROSIS PROF 2

Facility

$81.25

Service Code	HCPCS 82784
Hospital Charge Code	3035117C
Hospital Revenue Code	301
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$25.30
Rate for Payer: Aetna Medicare Advantage	$30.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.57
Rate for Payer: Cigna Commercial	$40.62
Rate for Payer: Cigna Medicare Advantage	$9.30
Rate for Payer: Clover Medicare Advantage	$8.84
Rate for Payer: EmblemHealth Commercial	$27.90
Rate for Payer: Humana Medicare Advantage	$9.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.19
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.30
Rate for Payer: Wellcare Medicare Advantage	$9.30
Rate for Payer: Wellpoint Medicaid Managed Care	$2.15

MULTIPLE SCLEROSIS PROF 2

Facility

$47.50

Service Code	HCPCS 82042
Hospital Charge Code	3035117B
Hospital Revenue Code	307
Min. Negotiated Rate	$1.26
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$21.16
Rate for Payer: Aetna Medicare Advantage	$25.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.08
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: Cigna Medicare Advantage	$7.78
Rate for Payer: Clover Medicare Advantage	$7.39
Rate for Payer: EmblemHealth Commercial	$23.34
Rate for Payer: Humana Medicare Advantage	$8.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.12
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.78
Rate for Payer: Wellcare Medicare Advantage	$7.78
Rate for Payer: Wellpoint Medicaid Managed Care	$1.26

MULTIPLE SCLEROSIS PROF 2

Facility

$137.50

Service Code	HCPCS 82040
Hospital Charge Code	3035117A
Hospital Revenue Code	307
Min. Negotiated Rate	$20.62
Max. Negotiated Rate	$20.62
Rate for Payer: Qualcare PPO/HMO/WC	$20.62

MULTIPLE SCLEROSIS PROF 2

Facility

$257.65

Service Code	HCPCS 83873
Hospital Charge Code	3035117E
Hospital Revenue Code	301
Min. Negotiated Rate	$38.65
Max. Negotiated Rate	$38.65
Rate for Payer: Qualcare PPO/HMO/WC	$38.65

MULTIPLE SCLEROSIS PROF 2

Facility

$137.50

Service Code	HCPCS 82040
Hospital Charge Code	3035117A
Hospital Revenue Code	307
Min. Negotiated Rate	$3.48
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$13.46
Rate for Payer: Aetna Medicare Advantage	$16.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.87
Rate for Payer: Cigna Commercial	$68.75
Rate for Payer: Cigna Medicare Advantage	$4.95
Rate for Payer: Clover Medicare Advantage	$4.70
Rate for Payer: EmblemHealth Commercial	$14.85
Rate for Payer: Humana Medicare Advantage	$5.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.62
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.95
Rate for Payer: Wellcare Medicare Advantage	$4.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.64

MULTIPLE SCLEROSIS PROF 2

Facility

$47.50

Service Code	HCPCS 82042
Hospital Charge Code	3035117B
Hospital Revenue Code	307
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

MULTIPLE SCLEROSIS PROF 2

Facility

$181.65

Service Code	HCPCS 83916
Hospital Charge Code	3035117F
Hospital Revenue Code	301
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$74.50
Rate for Payer: Aetna Medicare Advantage	$88.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.87
Rate for Payer: Cigna Commercial	$90.83
Rate for Payer: Cigna Medicare Advantage	$27.39
Rate for Payer: Clover Medicare Advantage	$26.02
Rate for Payer: EmblemHealth Commercial	$82.17
Rate for Payer: Humana Medicare Advantage	$28.21
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.39
Rate for Payer: Wellcare Medicare Advantage	$27.39
Rate for Payer: Wellpoint Medicaid Managed Care	$4.81

MULTIPLE SCLEROSIS PROF 2

Facility

$181.65

Service Code	HCPCS 83916
Hospital Charge Code	3035117G
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

MULTIPLE SCLEROSIS PROF 2

Facility

$181.65

Service Code	HCPCS 83916
Hospital Charge Code	3035117F
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

MULTIPLE SCLEROSIS PROF 2

Facility

$81.25

Service Code	HCPCS 82784
Hospital Charge Code	3035117C
Hospital Revenue Code	301
Min. Negotiated Rate	$12.19
Max. Negotiated Rate	$12.19
Rate for Payer: Qualcare PPO/HMO/WC	$12.19

MULTIPLE SCLEROSIS PROFILE, MS

Facility

$257.65

Service Code	HCPCS 83873
Hospital Charge Code	3006905
Hospital Revenue Code	301
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$128.82
Rate for Payer: Aetna Commercial	$46.78
Rate for Payer: Aetna Medicare Advantage	$55.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.09
Rate for Payer: Cigna Commercial	$128.82
Rate for Payer: Cigna Medicare Advantage	$17.20
Rate for Payer: Clover Medicare Advantage	$16.34
Rate for Payer: EmblemHealth Commercial	$51.60
Rate for Payer: Humana Medicare Advantage	$17.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.20
Rate for Payer: Wellcare Medicare Advantage	$17.20
Rate for Payer: Wellpoint Medicaid Managed Care	$6.83

MULTIPLE SCLEROSIS PROFILE, MS

Facility

$257.65

Service Code	HCPCS 83873
Hospital Charge Code	3006905
Hospital Revenue Code	301
Min. Negotiated Rate	$38.65
Max. Negotiated Rate	$38.65
Rate for Payer: Qualcare PPO/HMO/WC	$38.65

MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE

Facility

$11,333.34

Service Code	APR-DRG 9302
Min. Negotiated Rate	$11,111.12
Max. Negotiated Rate	$11,333.34
Rate for Payer: UnitedHealthcare Community & State	$11,111.12
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,333.34
Rate for Payer: Wellpoint Medicaid Managed Care	$11,111.12

MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE

Facility

$35,639.33

Service Code	APR-DRG 9304
Min. Negotiated Rate	$34,940.52
Max. Negotiated Rate	$35,639.33
Rate for Payer: UnitedHealthcare Community & State	$34,940.52
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$35,639.33
Rate for Payer: Wellpoint Medicaid Managed Care	$34,940.52

Know your out-of-pocket cost for care.

All Charges