Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC

Facility

$178,949.69

Service Code	MSDRG 405
Min. Negotiated Rate	$54,487.89
Max. Negotiated Rate	$178,949.69
Rate for Payer: Aetna Commercial	$123,216.18
Rate for Payer: Aetna Medicare Advantage	$178,949.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128,168.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128,168.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$57,355.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128,168.11
Rate for Payer: Cigna Commercial	$102,374.94
Rate for Payer: Cigna Medicare Advantage	$57,355.67
Rate for Payer: Clover Medicare Advantage	$54,487.89
Rate for Payer: EmblemHealth Commercial	$172,067.01
Rate for Payer: Humana Medicare Advantage	$59,076.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$57,355.67
Rate for Payer: Oxford Commercial	$73,578.23
Rate for Payer: UnitedHealthcare Commercial	$129,021.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$57,355.67
Rate for Payer: Wellcare Medicare Advantage	$57,355.67

PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC

Facility

$73,875.20

Service Code	MSDRG 407
Min. Negotiated Rate	$22,494.05
Max. Negotiated Rate	$73,875.20
Rate for Payer: Aetna Commercial	$51,018.00
Rate for Payer: Aetna Medicare Advantage	$73,875.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50,011.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50,011.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,677.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50,011.15
Rate for Payer: Cigna Commercial	$41,537.59
Rate for Payer: Cigna Medicare Advantage	$23,677.95
Rate for Payer: Clover Medicare Advantage	$22,494.05
Rate for Payer: EmblemHealth Commercial	$71,033.85
Rate for Payer: Humana Medicare Advantage	$24,388.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23,677.95
Rate for Payer: Oxford Commercial	$29,853.62
Rate for Payer: UnitedHealthcare Commercial	$52,349.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,677.95
Rate for Payer: Wellcare Medicare Advantage	$23,677.95

PANCREAS TRANSPLANT

Facility

$234,064.52

Service Code	MSDRG 010
Min. Negotiated Rate	$57,450.11
Max. Negotiated Rate	$234,064.52
Rate for Payer: Aetna Medicare Advantage	$234,064.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111,885.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111,885.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$75,020.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111,885.41
Rate for Payer: Cigna Commercial	$57,450.11
Rate for Payer: Cigna Medicare Advantage	$75,020.68
Rate for Payer: Clover Medicare Advantage	$71,269.65
Rate for Payer: EmblemHealth Commercial	$225,062.04
Rate for Payer: Humana Medicare Advantage	$77,271.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$75,020.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$75,020.68
Rate for Payer: Wellcare Medicare Advantage	$75,020.68

PANCREAS TRANSPLANT

Facility

$96,054.51

Service Code	APR-DRG 0062
Min. Negotiated Rate	$94,171.09
Max. Negotiated Rate	$96,054.51
Rate for Payer: UnitedHealthcare Community & State	$94,171.09
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$96,054.51
Rate for Payer: Wellpoint Medicaid Managed Care	$94,171.09

PANCREAS TRANSPLANT

Facility

$147,705.06

Service Code	APR-DRG 0064
Min. Negotiated Rate	$144,808.88
Max. Negotiated Rate	$147,705.06
Rate for Payer: UnitedHealthcare Community & State	$144,808.88
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$147,705.06
Rate for Payer: Wellpoint Medicaid Managed Care	$144,808.88

PANCREAS TRANSPLANT

Facility

$79,793.08

Service Code	APR-DRG 0061
Min. Negotiated Rate	$78,228.51
Max. Negotiated Rate	$79,793.08
Rate for Payer: UnitedHealthcare Community & State	$78,228.51
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$79,793.08
Rate for Payer: Wellpoint Medicaid Managed Care	$78,228.51

PANCREAS TRANSPLANT

Facility

$116,936.37

Service Code	APR-DRG 0063
Min. Negotiated Rate	$114,643.50
Max. Negotiated Rate	$116,936.37
Rate for Payer: UnitedHealthcare Community & State	$114,643.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$116,936.37
Rate for Payer: Wellpoint Medicaid Managed Care	$114,643.50

PANCREAT EXOCRINE CELL AB

Facility

$60.25

Service Code	HCPCS 86255
Hospital Charge Code	38476000
Hospital Revenue Code	302
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$30.12
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.04
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1.60

PANCREAT EXOCRINE CELL AB

Facility

$60.25

Service Code	HCPCS 86255
Hospital Charge Code	38476000
Hospital Revenue Code	302
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$9.04
Rate for Payer: Qualcare PPO/HMO/WC	$9.04

PANCREATIC ELASTASE, FECAL

Facility

$75.65

Service Code	HCPCS 82656
Hospital Charge Code	3038144
Hospital Revenue Code	301
Min. Negotiated Rate	$11.35
Max. Negotiated Rate	$11.35
Rate for Payer: Qualcare PPO/HMO/WC	$11.35

PANCREATIC ELASTASE, FECAL

Facility

$75.65

Service Code	HCPCS 82656
Hospital Charge Code	3038144
Hospital Revenue Code	301
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$31.36
Rate for Payer: Aetna Medicare Advantage	$37.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.62
Rate for Payer: Cigna Commercial	$37.83
Rate for Payer: Cigna Medicare Advantage	$11.53
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Medicare Advantage	$11.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.00

PANCREATIC POLYPEPTIDE

Facility

$390.00

Service Code	HCPCS 83519
Hospital Charge Code	39900446
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$50.05
Rate for Payer: Aetna Medicare Advantage	$59.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.42
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$18.40
Rate for Payer: Clover Medicare Advantage	$17.48
Rate for Payer: EmblemHealth Commercial	$55.20
Rate for Payer: Humana Medicare Advantage	$18.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.40
Rate for Payer: Wellcare Medicare Advantage	$18.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

PANCREATIC POLYPEPTIDE

Facility

$390.00

Service Code	HCPCS 83519
Hospital Charge Code	39900446
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PANCREATOGRAM-ENDO RETRO

Facility

$840.00

Hospital Charge Code	2009375
Hospital Revenue Code	320
Min. Negotiated Rate	$20.24
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$319.20
Rate for Payer: Aetna Medicare Advantage	$252.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.20
Rate for Payer: Cigna Commercial	$420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$20.24
Rate for Payer: Wellpoint Medicaid Managed Care	$22.26

PANCREATOGRAM-ENDO RETRO

Facility

$840.00

Hospital Charge Code	2009375
Hospital Revenue Code	320
Min. Negotiated Rate	$126.00
Max. Negotiated Rate	$126.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.00

PANCREAZE 21000U

Facility

$48.24

Service Code	NDC 62541040510
Hospital Charge Code	606390159
Hospital Revenue Code	250
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$24.12
Rate for Payer: Aetna Commercial	$18.33
Rate for Payer: Aetna Medicare Advantage	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.30
Rate for Payer: Cigna Commercial	$24.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.47
Rate for Payer: Oxford Commercial	$9.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.24
Rate for Payer: UnitedHealthcare Commercial	$9.65
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.28

PANCREAZE 21000U

Facility

$48.24

Service Code	NDC 62541040510
Hospital Charge Code	606390159
Hospital Revenue Code	250
Min. Negotiated Rate	$7.24
Max. Negotiated Rate	$7.24
Rate for Payer: Qualcare PPO/HMO/WC	$7.24

PANCRELIPASE 4200 U

Facility

$8.11

Hospital Charge Code	606390040
Hospital Revenue Code	250
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$1.22
Rate for Payer: Qualcare PPO/HMO/WC	$1.22

PANCRELIPASE 4200 U

Facility

$8.11

Hospital Charge Code	606390040
Hospital Revenue Code	250
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$4.05
Rate for Payer: Aetna Commercial	$3.08
Rate for Payer: Aetna Medicare Advantage	$2.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.07
Rate for Payer: Cigna Commercial	$4.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.43
Rate for Payer: Oxford Commercial	$1.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.22
Rate for Payer: UnitedHealthcare Commercial	$1.62
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

PANCRELIPASE CAP EC

Facility

$3.20

Hospital Charge Code	6027205
Hospital Revenue Code	251
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

PANCRELIPASE CAP EC

Facility

$3.20

Hospital Charge Code	6027205
Hospital Revenue Code	251
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$1.60
Rate for Payer: Aetna Commercial	$1.22
Rate for Payer: Aetna Medicare Advantage	$0.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.82
Rate for Payer: Cigna Commercial	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.96
Rate for Payer: Oxford Commercial	$0.64
Rate for Payer: Qualcare PPO/HMO/WC	$0.48
Rate for Payer: UnitedHealthcare Commercial	$0.64
Rate for Payer: UnitedHealthcare Community & State	$0.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

PANCRELIPASE POWD 120GM

Facility

$519.70

Hospital Charge Code	6010375
Hospital Revenue Code	251
Min. Negotiated Rate	$77.95
Max. Negotiated Rate	$77.95
Rate for Payer: Qualcare PPO/HMO/WC	$77.95

PANCRELIPASE POWD 120GM

Facility

$519.70

Hospital Charge Code	6010375
Hospital Revenue Code	251
Min. Negotiated Rate	$12.52
Max. Negotiated Rate	$259.85
Rate for Payer: Aetna Commercial	$197.49
Rate for Payer: Aetna Medicare Advantage	$155.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.52
Rate for Payer: Cigna Commercial	$259.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.91
Rate for Payer: Oxford Commercial	$103.94
Rate for Payer: Qualcare PPO/HMO/WC	$77.95
Rate for Payer: UnitedHealthcare Commercial	$103.94
Rate for Payer: UnitedHealthcare Community & State	$12.52
Rate for Payer: Wellpoint Medicaid Managed Care	$13.77

PANCRNIUM BROM INJ 1MG/ML 10ML

Facility

$21.15

Hospital Charge Code	6004063
Hospital Revenue Code	250
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

PANCRNIUM BROM INJ 1MG/ML 10ML

Facility

$21.15

Hospital Charge Code	6004063
Hospital Revenue Code	250
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$10.57
Rate for Payer: Aetna Commercial	$8.04
Rate for Payer: Aetna Medicare Advantage	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.39
Rate for Payer: Cigna Commercial	$10.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.34
Rate for Payer: Oxford Commercial	$4.23
Rate for Payer: Qualcare PPO/HMO/WC	$3.17
Rate for Payer: UnitedHealthcare Commercial	$4.23
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

Know your out-of-pocket cost for care.

All Charges