Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NM PLASMA VOLUMES MULTI SMPLES

Facility

$1,222.15

Service Code	HCPCS 78111
Hospital Charge Code	4500975
Hospital Revenue Code	341
Min. Negotiated Rate	$183.32
Max. Negotiated Rate	$183.32
Rate for Payer: Qualcare PPO/HMO/WC	$183.32

NM PLASMA VOLUMES MULTI SMPLES

Facility

$1,222.15

Service Code	HCPCS 78111
Hospital Charge Code	4500975
Hospital Revenue Code	341
Min. Negotiated Rate	$29.45
Max. Negotiated Rate	$5,552.01
Rate for Payer: Aetna Commercial	$4,183.58
Rate for Payer: Aetna Medicare Advantage	$4,983.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,552.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,552.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,538.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,552.01
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: Cigna Medicare Advantage	$1,076.66
Rate for Payer: Clover Medicare Advantage	$1,461.18
Rate for Payer: EmblemHealth Commercial	$4,614.24
Rate for Payer: Humana Medicare Advantage	$1,584.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,538.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.64
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$183.32
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$29.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,538.08
Rate for Payer: Wellcare Medicare Advantage	$1,538.08
Rate for Payer: Wellpoint Medicaid Managed Care	$32.39

NM PLATELET KINETICS

Facility

$1,249.20

Service Code	HCPCS 78190
Hospital Charge Code	4500976
Hospital Revenue Code	341
Min. Negotiated Rate	$30.11
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$474.70
Rate for Payer: Aetna Medicare Advantage	$374.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.55
Rate for Payer: Cigna Commercial	$624.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$374.76
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.38
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$30.11
Rate for Payer: Wellpoint Medicaid Managed Care	$33.10

NM PLATELET KINETICS

Facility

$1,249.20

Service Code	HCPCS 78190
Hospital Charge Code	4500976
Hospital Revenue Code	341
Min. Negotiated Rate	$187.38
Max. Negotiated Rate	$187.38
Rate for Payer: Qualcare PPO/HMO/WC	$187.38

NM PLMNRY VNT GAS W/RBRTH MLTI

Facility

$1,175.95

Hospital Charge Code	4500980
Hospital Revenue Code	341
Min. Negotiated Rate	$28.34
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$446.86
Rate for Payer: Aetna Medicare Advantage	$352.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.87
Rate for Payer: Cigna Commercial	$587.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.79
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$176.39
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$28.34
Rate for Payer: Wellpoint Medicaid Managed Care	$31.16

NM PLMNRY VNT GAS W/RBRTH MLTI

Facility

$1,175.95

Hospital Charge Code	4500980
Hospital Revenue Code	341
Min. Negotiated Rate	$176.39
Max. Negotiated Rate	$176.39
Rate for Payer: Qualcare PPO/HMO/WC	$176.39

NM PLMNRY VNT GAS W/RBRTH SNGL

Facility

$1,175.95

Hospital Charge Code	4500981
Hospital Revenue Code	341
Min. Negotiated Rate	$176.39
Max. Negotiated Rate	$176.39
Rate for Payer: Qualcare PPO/HMO/WC	$176.39

NM PLMNRY VNT GAS W/RBRTH SNGL

Facility

$1,175.95

Hospital Charge Code	4500981
Hospital Revenue Code	341
Min. Negotiated Rate	$28.34
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$446.86
Rate for Payer: Aetna Medicare Advantage	$352.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.87
Rate for Payer: Cigna Commercial	$587.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.79
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$176.39
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$28.34
Rate for Payer: Wellpoint Medicaid Managed Care	$31.16

NMP MICRO PARTICULATES-MEDIUM

Facility

$13,500.00

Service Code	HCPCS C1762
Hospital Charge Code	270706059
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,970.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

NMP MICRO PARTICULATES-MEDIUM

Facility

$13,500.00

Service Code	HCPCS C1762
Hospital Charge Code	270706059
Hospital Revenue Code	278
Min. Negotiated Rate	$325.35
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$5,130.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,970.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: UnitedHealthcare Community & State	$325.35
Rate for Payer: Wellpoint Medicaid Managed Care	$357.75

NMPMPLG (FIBERS).

Facility

$26,475.00

Service Code	HCPCS C1765
Hospital Charge Code	270703695
Hospital Revenue Code	278
Min. Negotiated Rate	$3,971.25
Max. Negotiated Rate	$6,406.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,406.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,824.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,971.25

NMPMPLG (FIBERS).

Facility

$26,475.00

Service Code	HCPCS C1765
Hospital Charge Code	270703695
Hospital Revenue Code	278
Min. Negotiated Rate	$638.05
Max. Negotiated Rate	$13,237.50
Rate for Payer: Aetna Commercial	$10,060.50
Rate for Payer: Aetna Medicare Advantage	$7,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,751.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,751.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,751.12
Rate for Payer: Cigna Commercial	$13,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,406.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,824.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,971.25
Rate for Payer: UnitedHealthcare Community & State	$638.05
Rate for Payer: Wellpoint Medicaid Managed Care	$701.59

NM PULMNRY VENTILATION/PERFSON

Facility

$1,917.00

Hospital Charge Code	4500984
Hospital Revenue Code	341
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$728.46
Rate for Payer: Aetna Medicare Advantage	$575.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$488.83
Rate for Payer: Cigna Commercial	$958.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.10
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$287.55
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$46.20
Rate for Payer: Wellpoint Medicaid Managed Care	$50.80

NM PULMNRY VENTILATION/PERFSON

Facility

$1,917.00

Hospital Charge Code	4500984
Hospital Revenue Code	341
Min. Negotiated Rate	$287.55
Max. Negotiated Rate	$287.55
Rate for Payer: Qualcare PPO/HMO/WC	$287.55

NM PULMNRY VENTLTN AEROSOL SNG

Facility

$1,175.95

Hospital Charge Code	4500982
Hospital Revenue Code	341
Min. Negotiated Rate	$28.34
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$446.86
Rate for Payer: Aetna Medicare Advantage	$352.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.87
Rate for Payer: Cigna Commercial	$587.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.79
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$176.39
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$28.34
Rate for Payer: Wellpoint Medicaid Managed Care	$31.16

NM PULMNRY VENTLTN AEROSOL SNG

Facility

$1,175.95

Hospital Charge Code	4500982
Hospital Revenue Code	341
Min. Negotiated Rate	$176.39
Max. Negotiated Rate	$176.39
Rate for Payer: Qualcare PPO/HMO/WC	$176.39

NM PULMNRY VENTLTN GASEOUS SNG

Facility

$1,175.95

Hospital Charge Code	4500983
Hospital Revenue Code	341
Min. Negotiated Rate	$28.34
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$446.86
Rate for Payer: Aetna Medicare Advantage	$352.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.87
Rate for Payer: Cigna Commercial	$587.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.79
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$176.39
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$28.34
Rate for Payer: Wellpoint Medicaid Managed Care	$31.16

NM PULMNRY VENTLTN GASEOUS SNG

Facility

$1,175.95

Hospital Charge Code	4500983
Hospital Revenue Code	341
Min. Negotiated Rate	$176.39
Max. Negotiated Rate	$176.39
Rate for Payer: Qualcare PPO/HMO/WC	$176.39

NM-PULMONARY DIFF LUNG

Facility

$1,759.00

Hospital Charge Code	4509010
Hospital Revenue Code	341
Min. Negotiated Rate	$263.85
Max. Negotiated Rate	$263.85
Rate for Payer: Qualcare PPO/HMO/WC	$263.85

NM-PULMONARY DIFF LUNG

Facility

$1,759.00

Hospital Charge Code	4509010
Hospital Revenue Code	341
Min. Negotiated Rate	$42.39
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$668.42
Rate for Payer: Aetna Medicare Advantage	$527.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.55
Rate for Payer: Cigna Commercial	$879.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$527.70
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$263.85
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$42.39
Rate for Payer: Wellpoint Medicaid Managed Care	$46.61

NM PULMONARY PERFUSION W/VENT

Facility

$1,917.00

Hospital Charge Code	4500978
Hospital Revenue Code	341
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$728.46
Rate for Payer: Aetna Medicare Advantage	$575.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$488.83
Rate for Payer: Cigna Commercial	$958.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.10
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$287.55
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$46.20
Rate for Payer: Wellpoint Medicaid Managed Care	$50.80

NM PULMONARY PERFUSION W/VENT

Facility

$1,917.00

Hospital Charge Code	4500978
Hospital Revenue Code	341
Min. Negotiated Rate	$287.55
Max. Negotiated Rate	$287.55
Rate for Payer: Qualcare PPO/HMO/WC	$287.55

NM PULMON PERFUSN W/VENT RBRTH

Facility

$1,917.00

Hospital Charge Code	4500979
Hospital Revenue Code	341
Min. Negotiated Rate	$287.55
Max. Negotiated Rate	$287.55
Rate for Payer: Qualcare PPO/HMO/WC	$287.55

NM PULMON PERFUSN W/VENT RBRTH

Facility

$1,917.00

Hospital Charge Code	4500979
Hospital Revenue Code	341
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$728.46
Rate for Payer: Aetna Medicare Advantage	$575.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$488.83
Rate for Payer: Cigna Commercial	$958.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.10
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$287.55
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$46.20
Rate for Payer: Wellpoint Medicaid Managed Care	$50.80

NM QUANTATIVE PULMONARY SCAN

Facility

$339.25

Service Code	HCPCS 94010
Hospital Charge Code	4501020
Hospital Revenue Code	460
Min. Negotiated Rate	$8.18
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$925.96
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.78
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.89
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$8.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$8.99

Know your out-of-pocket cost for care.

All Charges