Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NPWT TWO DRESSING KIT 10X40CM

Facility

$572.83

Hospital Charge Code	270693968
Hospital Revenue Code	270
Min. Negotiated Rate	$85.92
Max. Negotiated Rate	$85.92
Rate for Payer: Qualcare PPO/HMO/WC	$85.92

NPWT TWO DRESSING KIT 10X40CM

Facility

$572.83

Hospital Charge Code	270693968
Hospital Revenue Code	270
Min. Negotiated Rate	$13.81
Max. Negotiated Rate	$286.42
Rate for Payer: Aetna Commercial	$217.68
Rate for Payer: Aetna Medicare Advantage	$171.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.07
Rate for Payer: Cigna Commercial	$286.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.85
Rate for Payer: Oxford Commercial	$114.57
Rate for Payer: Qualcare PPO/HMO/WC	$85.92
Rate for Payer: UnitedHealthcare Commercial	$114.57
Rate for Payer: UnitedHealthcare Community & State	$13.81
Rate for Payer: Wellpoint Medicaid Managed Care	$15.18

NSL/SINS NDSC TOTAL

Facility

$31,659.60

Service Code	HCPCS 31253
Hospital Charge Code	1600000467
Hospital Revenue Code	360
Min. Negotiated Rate	$763.00
Max. Negotiated Rate	$30,265.35
Rate for Payer: Aetna Commercial	$22,805.70
Rate for Payer: Aetna Medicare Advantage	$27,165.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,265.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,265.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,384.45
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	$30,265.35
Rate for Payer: Cigna Commercial	$16,806.60
Rate for Payer: Cigna Medicare Advantage	$8,384.45
Rate for Payer: Clover Medicare Advantage	$7,965.23
Rate for Payer: EmblemHealth Commercial	$25,153.35
Rate for Payer: Humana Medicare Advantage	$8,635.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,384.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,497.88
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,748.94
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$763.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,384.45
Rate for Payer: Wellcare Medicare Advantage	$8,384.45
Rate for Payer: Wellpoint Medicaid Managed Care	$838.98

NSL/SINS NDSC TOTAL

Facility

$31,659.60

Service Code	HCPCS 31253
Hospital Charge Code	1600000467
Hospital Revenue Code	360
Min. Negotiated Rate	$4,748.94
Max. Negotiated Rate	$4,748.94
Rate for Payer: Qualcare PPO/HMO/WC	$4,748.94

NSL/SINS NDSC TOT W/SPHENDT

Facility

$31,659.60

Service Code	HCPCS 31257
Hospital Charge Code	1600000466
Hospital Revenue Code	360
Min. Negotiated Rate	$763.00
Max. Negotiated Rate	$30,265.35
Rate for Payer: Aetna Commercial	$22,805.70
Rate for Payer: Aetna Medicare Advantage	$27,165.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,265.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,265.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,384.45
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	$30,265.35
Rate for Payer: Cigna Commercial	$16,806.60
Rate for Payer: Cigna Medicare Advantage	$8,384.45
Rate for Payer: Clover Medicare Advantage	$7,965.23
Rate for Payer: EmblemHealth Commercial	$25,153.35
Rate for Payer: Humana Medicare Advantage	$8,635.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,384.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,497.88
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,748.94
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$763.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,384.45
Rate for Payer: Wellcare Medicare Advantage	$8,384.45
Rate for Payer: Wellpoint Medicaid Managed Care	$838.98

NSL/SINS NDSC TOT W/SPHENDT

Facility

$31,659.60

Service Code	HCPCS 31257
Hospital Charge Code	1600000466
Hospital Revenue Code	360
Min. Negotiated Rate	$4,748.94
Max. Negotiated Rate	$4,748.94
Rate for Payer: Qualcare PPO/HMO/WC	$4,748.94

N TELOPEPTIDE CROSS LINK URINE

Facility

$92.85

Service Code	HCPCS 82523
Hospital Charge Code	3008902A
Hospital Revenue Code	301
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$50.81
Rate for Payer: Aetna Medicare Advantage	$60.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.43
Rate for Payer: Cigna Commercial	$46.42
Rate for Payer: Cigna Medicare Advantage	$18.68
Rate for Payer: Clover Medicare Advantage	$17.75
Rate for Payer: EmblemHealth Commercial	$56.04
Rate for Payer: Humana Medicare Advantage	$19.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.93
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.68
Rate for Payer: Wellcare Medicare Advantage	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$2.46

N TELOPEPTIDE CROSS LINK URINE

Facility

$92.85

Service Code	HCPCS 82523
Hospital Charge Code	3008902A
Hospital Revenue Code	301
Min. Negotiated Rate	$13.93
Max. Negotiated Rate	$13.93
Rate for Payer: Qualcare PPO/HMO/WC	$13.93

N TELOPEPTIDE SERUM

Facility

$92.85

Service Code	HCPCS 82523
Hospital Charge Code	3008905
Hospital Revenue Code	301
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$50.81
Rate for Payer: Aetna Medicare Advantage	$60.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.43
Rate for Payer: Cigna Commercial	$46.42
Rate for Payer: Cigna Medicare Advantage	$18.68
Rate for Payer: Clover Medicare Advantage	$17.75
Rate for Payer: EmblemHealth Commercial	$56.04
Rate for Payer: Humana Medicare Advantage	$19.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.93
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.68
Rate for Payer: Wellcare Medicare Advantage	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$2.46

N TELOPEPTIDE SERUM

Facility

$92.85

Service Code	HCPCS 82523
Hospital Charge Code	3008905
Hospital Revenue Code	301
Min. Negotiated Rate	$13.93
Max. Negotiated Rate	$13.93
Rate for Payer: Qualcare PPO/HMO/WC	$13.93

NTERNOCLAVICULAR JT-BI

Facility

$250.00

Service Code	HCPCS 7113050
Hospital Charge Code	94061207
Hospital Revenue Code	320
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

NTERNOCLAVICULAR JT-BI

Facility

$250.00

Service Code	HCPCS 7113050
Hospital Charge Code	94061207
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

NTRSTL RADJ SRC APPL CMPLX

Facility

$5,678.18

Service Code	HCPCS 77778
Hospital Charge Code	85000875
Hospital Revenue Code	342
Min. Negotiated Rate	$851.73
Max. Negotiated Rate	$851.73
Rate for Payer: Qualcare PPO/HMO/WC	$851.73

NTRSTL RADJ SRC APPL CMPLX

Facility

$5,678.18

Service Code	HCPCS 77778
Hospital Charge Code	85000875
Hospital Revenue Code	342
Min. Negotiated Rate	$136.84
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$2,250.61
Rate for Payer: Aetna Medicare Advantage	$2,680.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,986.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,986.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$827.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$369.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,986.77
Rate for Payer: Cigna Commercial	$1,658.57
Rate for Payer: Cigna Medicare Advantage	$579.20
Rate for Payer: Clover Medicare Advantage	$786.06
Rate for Payer: EmblemHealth Commercial	$2,482.29
Rate for Payer: Humana Medicare Advantage	$852.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$827.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,703.45
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$851.73
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$136.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$827.43
Rate for Payer: Wellcare Medicare Advantage	$827.43
Rate for Payer: Wellpoint Medicaid Managed Care	$150.47

NUBAIN/10MG/1ML

Facility

$18.00

Hospital Charge Code	60633560
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

NUBAIN/10MG/1ML

Facility

$18.00

Hospital Charge Code	60633559
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

NUBAIN/10MG/1ML

Facility

$18.00

Hospital Charge Code	60633559
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

NUBAIN/10MG/1ML

Facility

$18.00

Hospital Charge Code	60633560
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

NUBASICS BAR

Facility

$5.00

Hospital Charge Code	60635163
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

NUBASICS BAR

Facility

$5.00

Hospital Charge Code	60635163
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

NUBASICS SOUP

Facility

$5.00

Hospital Charge Code	60635164
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

NUBASICS SOUP

Facility

$5.00

Hospital Charge Code	60635164
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

NUBBINS

Facility

$175.00

Hospital Charge Code	270656535
Hospital Revenue Code	271
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.50
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$35.00
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

NUBBINS

Facility

$175.00

Hospital Charge Code	270656535
Hospital Revenue Code	271
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

NUCLEAR ANTIGEN AB

Facility

$667.59

Service Code	HCPCS 86235
Hospital Charge Code	39708042D
Hospital Revenue Code	306
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

Know your out-of-pocket cost for care.

All Charges