Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MYOREGEN PRP KIT

Facility

$1,400.00

Hospital Charge Code	270703613
Hospital Revenue Code	272
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

MYOREGEN PRP KIT

Facility

$1,400.00

Hospital Charge Code	270703613
Hospital Revenue Code	272
Min. Negotiated Rate	$33.74
Max. Negotiated Rate	$700.00
Rate for Payer: Aetna Commercial	$532.00
Rate for Payer: Aetna Medicare Advantage	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.00
Rate for Payer: Cigna Commercial	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.00
Rate for Payer: Oxford Commercial	$280.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00
Rate for Payer: UnitedHealthcare Commercial	$280.00
Rate for Payer: UnitedHealthcare Community & State	$33.74
Rate for Payer: Wellpoint Medicaid Managed Care	$37.10

MYOSITIS ASSESSR

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3009990D
Hospital Revenue Code	302
Min. Negotiated Rate	$3.82
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.72
Rate for Payer: Cigna Commercial	$72.00
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.82

MYOSITIS ASSESSR

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3009990F
Hospital Revenue Code	302
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.60

MYOSITIS ASSESSR

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3009990E
Hospital Revenue Code	302
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.60

MYOSITIS ASSESSR

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3009990D
Hospital Revenue Code	302
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.60

MYOSITIS ASSESSR

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3009990B
Hospital Revenue Code	302
Min. Negotiated Rate	$3.82
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.72
Rate for Payer: Cigna Commercial	$72.00
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.82

MYOSITIS ASSESSR

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3009990A
Hospital Revenue Code	302
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.60

MYOSITIS ASSESSR

Facility

$2,668.85

Hospital Charge Code	3009990
Hospital Revenue Code	301
Min. Negotiated Rate	$400.33
Max. Negotiated Rate	$400.33
Rate for Payer: Qualcare PPO/HMO/WC	$400.33

MYOSITIS ASSESSR

Facility

$2,668.85

Hospital Charge Code	3009990
Hospital Revenue Code	301
Min. Negotiated Rate	$64.32
Max. Negotiated Rate	$1,334.42
Rate for Payer: Aetna Commercial	$1,014.16
Rate for Payer: Aetna Medicare Advantage	$800.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$680.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$680.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$680.56
Rate for Payer: Cigna Commercial	$1,334.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$800.65
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$400.33
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$64.32
Rate for Payer: Wellpoint Medicaid Managed Care	$70.72

MYOSITIS ASSESSR

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3009990A
Hospital Revenue Code	302
Min. Negotiated Rate	$3.82
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.72
Rate for Payer: Cigna Commercial	$72.00
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.82

MYOSITIS ASSESSR

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3009990G
Hospital Revenue Code	302
Min. Negotiated Rate	$3.82
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.72
Rate for Payer: Cigna Commercial	$72.00
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.82

MYOSITIS ASSESSR

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3009990G
Hospital Revenue Code	302
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.60

MYOSITIS ASSESSR

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3009990E
Hospital Revenue Code	302
Min. Negotiated Rate	$3.82
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.72
Rate for Payer: Cigna Commercial	$72.00
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.82

MYOSITIS ASSESSR

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3009990F
Hospital Revenue Code	302
Min. Negotiated Rate	$3.82
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.72
Rate for Payer: Cigna Commercial	$72.00
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.82

MYOSITIS ASSESSR

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3009990C
Hospital Revenue Code	302
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.60

MYOSITIS ASSESSR

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3009990B
Hospital Revenue Code	302
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.60

MYOSITIS ASSESSR

Facility

$143.99

Service Code	HCPCS 86235
Hospital Charge Code	3009990C
Hospital Revenue Code	302
Min. Negotiated Rate	$3.82
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.72
Rate for Payer: Cigna Commercial	$72.00
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.82

MYOSURE FIBROID REMOVAL XL

Facility

$7,271.67

Hospital Charge Code	270662593
Hospital Revenue Code	272
Min. Negotiated Rate	$175.25
Max. Negotiated Rate	$3,635.84
Rate for Payer: Aetna Commercial	$2,763.23
Rate for Payer: Aetna Medicare Advantage	$2,181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,854.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,854.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,854.28
Rate for Payer: Cigna Commercial	$3,635.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,181.50
Rate for Payer: Oxford Commercial	$1,454.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,090.75
Rate for Payer: UnitedHealthcare Commercial	$1,454.33
Rate for Payer: UnitedHealthcare Community & State	$175.25
Rate for Payer: Wellpoint Medicaid Managed Care	$192.70

MYOSURE FIBROID REMOVAL XL

Facility

$7,271.67

Hospital Charge Code	270662593
Hospital Revenue Code	272
Min. Negotiated Rate	$1,090.75
Max. Negotiated Rate	$1,090.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,090.75

MYOSURE TISSUE REMOVAL DEVICE

Facility

$7,790.00

Hospital Charge Code	270660314
Hospital Revenue Code	272
Min. Negotiated Rate	$187.74
Max. Negotiated Rate	$3,895.00
Rate for Payer: Aetna Commercial	$2,960.20
Rate for Payer: Aetna Medicare Advantage	$2,337.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,986.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,986.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,986.45
Rate for Payer: Cigna Commercial	$3,895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,337.00
Rate for Payer: Oxford Commercial	$1,558.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,168.50
Rate for Payer: UnitedHealthcare Commercial	$1,558.00
Rate for Payer: UnitedHealthcare Community & State	$187.74
Rate for Payer: Wellpoint Medicaid Managed Care	$206.44

MYOSURE TISSUE REMOVAL DEVICE

Facility

$7,790.00

Hospital Charge Code	270660314
Hospital Revenue Code	272
Min. Negotiated Rate	$1,168.50
Max. Negotiated Rate	$1,168.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,168.50

MYRIAD ECM MATRIX 10X10 SR3

Facility

$4,593.75

Hospital Charge Code	270692092
Hospital Revenue Code	272
Min. Negotiated Rate	$689.06
Max. Negotiated Rate	$689.06
Rate for Payer: Qualcare PPO/HMO/WC	$689.06

MYRIAD ECM MATRIX 10X10 SR3

Facility

$4,593.75

Hospital Charge Code	270692092
Hospital Revenue Code	272
Min. Negotiated Rate	$110.71
Max. Negotiated Rate	$2,296.88
Rate for Payer: Aetna Commercial	$1,745.62
Rate for Payer: Aetna Medicare Advantage	$1,378.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,171.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,171.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,171.41
Rate for Payer: Cigna Commercial	$2,296.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,378.12
Rate for Payer: Oxford Commercial	$918.75
Rate for Payer: Qualcare PPO/HMO/WC	$689.06
Rate for Payer: UnitedHealthcare Commercial	$918.75
Rate for Payer: UnitedHealthcare Community & State	$110.71
Rate for Payer: Wellpoint Medicaid Managed Care	$121.73

MYRIAD ECM MATRIX 10X10 SR5

Facility

$6,354.65

Hospital Charge Code	270692101
Hospital Revenue Code	272
Min. Negotiated Rate	$953.20
Max. Negotiated Rate	$953.20
Rate for Payer: Qualcare PPO/HMO/WC	$953.20

Know your out-of-pocket cost for care.

All Charges