Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NUTREN 1-5

Facility

$61.00

Hospital Charge Code	60634853
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

NUTREN 1.5

Facility

$4.00

Hospital Charge Code	60635162
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NUTREN 1.5

Facility

$4.00

Hospital Charge Code	60635162
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

NUT RETAINING

Facility

$276.00

Hospital Charge Code	270693551
Hospital Revenue Code	278
Min. Negotiated Rate	$41.40
Max. Negotiated Rate	$66.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.72
Rate for Payer: Qualcare PPO/HMO/WC	$41.40

NUT RETAINING

Facility

$276.00

Hospital Charge Code	270693551
Hospital Revenue Code	278
Min. Negotiated Rate	$6.65
Max. Negotiated Rate	$138.00
Rate for Payer: Aetna Commercial	$104.88
Rate for Payer: Aetna Medicare Advantage	$82.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.38
Rate for Payer: Cigna Commercial	$138.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.72
Rate for Payer: Qualcare PPO/HMO/WC	$41.40
Rate for Payer: UnitedHealthcare Community & State	$6.65
Rate for Payer: Wellpoint Medicaid Managed Care	$7.31

NUTRIHEP

Facility

$36.00

Hospital Charge Code	60635161
Hospital Revenue Code	250
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

NUTRIHEP

Facility

$36.00

Hospital Charge Code	60635161
Hospital Revenue Code	250
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$18.00
Rate for Payer: Aetna Commercial	$13.68
Rate for Payer: Aetna Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.18
Rate for Payer: Cigna Commercial	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.80
Rate for Payer: Oxford Commercial	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$5.40
Rate for Payer: UnitedHealthcare Commercial	$7.20
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

NUTRIT COUNSEL 30 MIN

Facility

$61.65

Service Code	HCPCS 99402
Hospital Charge Code	9200034
Hospital Revenue Code	519
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$30.82
Rate for Payer: Aetna Commercial	$23.43
Rate for Payer: Aetna Medicare Advantage	$18.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.72
Rate for Payer: Cigna Commercial	$30.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.25
Rate for Payer: UnitedHealthcare Community & State	$1.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1.63

NUTRIT COUNSEL 30 MIN

Facility

$61.65

Service Code	HCPCS 99402
Hospital Charge Code	9200034
Hospital Revenue Code	519
Min. Negotiated Rate	$9.25
Max. Negotiated Rate	$9.25
Rate for Payer: Qualcare PPO/HMO/WC	$9.25

NUTRIT COUNSEL 45 MIN

Facility

$131.25

Service Code	HCPCS 99403
Hospital Charge Code	9200035
Hospital Revenue Code	519
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$19.69
Rate for Payer: Qualcare PPO/HMO/WC	$19.69

NUTRIT COUNSEL 45 MIN

Facility

$131.25

Service Code	HCPCS 99403
Hospital Charge Code	9200035
Hospital Revenue Code	519
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$65.62
Rate for Payer: Aetna Commercial	$49.88
Rate for Payer: Aetna Medicare Advantage	$39.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.47
Rate for Payer: Cigna Commercial	$65.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.38
Rate for Payer: Qualcare PPO/HMO/WC	$19.69
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$3.48

NUTRIT COUNSEL 60 MIN

Facility

$150.00

Service Code	HCPCS 99404
Hospital Charge Code	9200036
Hospital Revenue Code	519
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

NUTRIT COUNSEL 60 MIN

Facility

$150.00

Service Code	HCPCS 99404
Hospital Charge Code	9200036
Hospital Revenue Code	519
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Community & State	$3.62
Rate for Payer: Wellpoint Medicaid Managed Care	$3.98

NUTRIT COUNSEL GROUP 30 MIN

Facility

$44.85

Service Code	HCPCS 99411
Hospital Charge Code	9200037
Hospital Revenue Code	519
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.43
Rate for Payer: Aetna Commercial	$17.04
Rate for Payer: Aetna Medicare Advantage	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.44
Rate for Payer: Cigna Commercial	$22.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.46
Rate for Payer: Qualcare PPO/HMO/WC	$6.73
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

NUTRIT COUNSEL GROUP 30 MIN

Facility

$44.85

Service Code	HCPCS 99411
Hospital Charge Code	9200037
Hospital Revenue Code	519
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$6.73
Rate for Payer: Qualcare PPO/HMO/WC	$6.73

NUTRIT COUNSEL GROUP 60 MIN

Facility

$61.65

Service Code	HCPCS 99412
Hospital Charge Code	9200038
Hospital Revenue Code	519
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$30.82
Rate for Payer: Aetna Commercial	$23.43
Rate for Payer: Aetna Medicare Advantage	$18.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.72
Rate for Payer: Cigna Commercial	$30.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.25
Rate for Payer: UnitedHealthcare Community & State	$1.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1.63

NUTRIT COUNSEL GROUP 60 MIN

Facility

$61.65

Service Code	HCPCS 99412
Hospital Charge Code	9200038
Hospital Revenue Code	519
Min. Negotiated Rate	$9.25
Max. Negotiated Rate	$9.25
Rate for Payer: Qualcare PPO/HMO/WC	$9.25

NUTRIT COUNSEL INSUL INSTRUCT

Facility

$112.00

Service Code	HCPCS 98960
Hospital Charge Code	9200028
Hospital Revenue Code	942
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$16.80

NUTRIT COUNSEL INSUL INSTRUCT

Facility

$112.00

Service Code	HCPCS 98960
Hospital Charge Code	9200028
Hospital Revenue Code	942
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$1,202.00
Rate for Payer: Aetna Commercial	$42.56
Rate for Payer: Aetna Medicare Advantage	$33.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.56
Rate for Payer: Cigna Commercial	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.60
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.80
Rate for Payer: UnitedHealthcare Commercial	$1,202.00
Rate for Payer: UnitedHealthcare Community & State	$2.70
Rate for Payer: Wellpoint Medicaid Managed Care	$2.97

NUTRIT INITIAL ASSESS EACH 15

Facility

$100.00

Service Code	HCPCS 97802
Hospital Charge Code	9900001
Hospital Revenue Code	942
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

NUTRIT INITIAL ASSESS EACH 15

Facility

$100.00

Service Code	HCPCS 97802
Hospital Charge Code	9200041
Hospital Revenue Code	942
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$1,202.00
Rate for Payer: Aetna Commercial	$38.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.00
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$1,202.00
Rate for Payer: UnitedHealthcare Community & State	$2.41
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

NUTRIT INITIAL ASSESS EACH 15

Facility

$100.00

Service Code	HCPCS 97802
Hospital Charge Code	9900001
Hospital Revenue Code	942
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$1,202.00
Rate for Payer: Aetna Commercial	$38.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.00
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$1,202.00
Rate for Payer: UnitedHealthcare Community & State	$2.41
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

NUTRIT INITIAL ASSESS EACH 15

Facility

$100.00

Service Code	HCPCS 97802
Hospital Charge Code	9200041
Hospital Revenue Code	942
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

NUTRITION SUPPLIES

Facility

$53.05

Hospital Charge Code	270640538
Hospital Revenue Code	270
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$26.52
Rate for Payer: Aetna Commercial	$20.16
Rate for Payer: Aetna Medicare Advantage	$15.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.53
Rate for Payer: Cigna Commercial	$26.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.91
Rate for Payer: Oxford Commercial	$10.61
Rate for Payer: Qualcare PPO/HMO/WC	$7.96
Rate for Payer: UnitedHealthcare Commercial	$10.61
Rate for Payer: UnitedHealthcare Community & State	$1.28
Rate for Payer: Wellpoint Medicaid Managed Care	$1.41

NUTRITION SUPPLIES

Facility

$53.05

Hospital Charge Code	270640538
Hospital Revenue Code	270
Min. Negotiated Rate	$7.96
Max. Negotiated Rate	$7.96
Rate for Payer: Qualcare PPO/HMO/WC	$7.96

Know your out-of-pocket cost for care.

All Charges