Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PARTICLE AGGLUTINATION;TITER,@

Facility

$75.00

Service Code	HCPCS 86406
Hospital Charge Code	38477074
Hospital Revenue Code	302
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

PARTICLE CONTOUR 355500 760045

Facility

$575.00

Hospital Charge Code	270630468V
Hospital Revenue Code	272
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$86.25
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

PARTICLE CONTOUR 355500 760045

Facility

$575.00

Hospital Charge Code	270630468V
Hospital Revenue Code	272
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.50
Rate for Payer: Oxford Commercial	$115.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Commercial	$115.00
Rate for Payer: UnitedHealthcare Community & State	$13.86
Rate for Payer: Wellpoint Medicaid Managed Care	$15.24

PARTICLES MCV CONTR EMB 760062

Facility

$396.85

Hospital Charge Code	270626576
Hospital Revenue Code	272
Min. Negotiated Rate	$59.53
Max. Negotiated Rate	$59.53
Rate for Payer: Qualcare PPO/HMO/WC	$59.53

PARTICLES MCV CONTR EMB 760062

Facility

$396.85

Hospital Charge Code	270626576
Hospital Revenue Code	272
Min. Negotiated Rate	$9.56
Max. Negotiated Rate	$198.43
Rate for Payer: Aetna Commercial	$150.80
Rate for Payer: Aetna Medicare Advantage	$119.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.20
Rate for Payer: Cigna Commercial	$198.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.06
Rate for Payer: Oxford Commercial	$79.37
Rate for Payer: Qualcare PPO/HMO/WC	$59.53
Rate for Payer: UnitedHealthcare Commercial	$79.37
Rate for Payer: UnitedHealthcare Community & State	$9.56
Rate for Payer: Wellpoint Medicaid Managed Care	$10.52

PARTICLES PVA CONTOUR MED

Facility

$1,425.60

Hospital Charge Code	270651697
Hospital Revenue Code	272
Min. Negotiated Rate	$213.84
Max. Negotiated Rate	$213.84
Rate for Payer: Qualcare PPO/HMO/WC	$213.84

PARTICLES PVA CONTOUR MED

Facility

$1,425.60

Hospital Charge Code	270651697
Hospital Revenue Code	272
Min. Negotiated Rate	$34.36
Max. Negotiated Rate	$712.80
Rate for Payer: Aetna Commercial	$541.73
Rate for Payer: Aetna Medicare Advantage	$427.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.53
Rate for Payer: Cigna Commercial	$712.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$427.68
Rate for Payer: Oxford Commercial	$285.12
Rate for Payer: Qualcare PPO/HMO/WC	$213.84
Rate for Payer: UnitedHealthcare Commercial	$285.12
Rate for Payer: UnitedHealthcare Community & State	$34.36
Rate for Payer: Wellpoint Medicaid Managed Care	$37.78

PARTICULES EMB 700-900

Facility

$1,840.00

Hospital Charge Code	270668927
Hospital Revenue Code	272
Min. Negotiated Rate	$276.00
Max. Negotiated Rate	$276.00
Rate for Payer: Qualcare PPO/HMO/WC	$276.00

PARTICULES EMB 700-900

Facility

$1,840.00

Hospital Charge Code	270668927
Hospital Revenue Code	272
Min. Negotiated Rate	$44.34
Max. Negotiated Rate	$920.00
Rate for Payer: Aetna Commercial	$699.20
Rate for Payer: Aetna Medicare Advantage	$552.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$469.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$469.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$469.20
Rate for Payer: Cigna Commercial	$920.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.00
Rate for Payer: Oxford Commercial	$368.00
Rate for Payer: Qualcare PPO/HMO/WC	$276.00
Rate for Payer: UnitedHealthcare Commercial	$368.00
Rate for Payer: UnitedHealthcare Community & State	$44.34
Rate for Payer: Wellpoint Medicaid Managed Care	$48.76

PARTL EXC ANKLE OR HEEL BONELT

Facility

$22,175.00

Service Code	HCPCS 28120
Hospital Charge Code	16000572
Hospital Revenue Code	360
Min. Negotiated Rate	$534.42
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,652.50
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,326.25
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$534.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$587.64

PARTL EXC ANKLE OR HEEL BONELT

Facility

$22,175.00

Service Code	HCPCS 28120
Hospital Charge Code	16000572
Hospital Revenue Code	360
Min. Negotiated Rate	$3,326.25
Max. Negotiated Rate	$3,326.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,326.25

PARTL EXC TRSL/MTARSL BONE-LT

Facility

$26,594.63

Service Code	HCPCS 28122
Hospital Charge Code	16000340
Hospital Revenue Code	360
Min. Negotiated Rate	$3,989.19
Max. Negotiated Rate	$3,989.19
Rate for Payer: Qualcare PPO/HMO/WC	$3,989.19

PARTL EXC TRSL/MTARSL BONE-LT

Facility

$26,594.63

Service Code	HCPCS 28122
Hospital Charge Code	16000340
Hospital Revenue Code	360
Min. Negotiated Rate	$640.93
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,978.39
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,989.19
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$640.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$704.76

PART REMOVAL OF METATARSAL-50

Facility

$29,836.88

Service Code	HCPCS 28110
Hospital Charge Code	16000283
Hospital Revenue Code	360
Min. Negotiated Rate	$719.07
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,951.06
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,475.53
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$719.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$790.68

PART REMOVAL OF METATARSAL-50

Facility

$29,836.88

Service Code	HCPCS 28110
Hospital Charge Code	16000283
Hospital Revenue Code	360
Min. Negotiated Rate	$4,475.53
Max. Negotiated Rate	$4,475.53
Rate for Payer: Qualcare PPO/HMO/WC	$4,475.53

PART THROMBOPLASTIN TIME (PTT)

Facility

$657.96

Service Code	HCPCS 85730
Hospital Charge Code	3002037
Hospital Revenue Code	305
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$328.98
Rate for Payer: Aetna Commercial	$16.35
Rate for Payer: Aetna Medicare Advantage	$19.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.69
Rate for Payer: Cigna Commercial	$328.98
Rate for Payer: Cigna Medicare Advantage	$6.01
Rate for Payer: Clover Medicare Advantage	$5.71
Rate for Payer: EmblemHealth Commercial	$18.03
Rate for Payer: Humana Medicare Advantage	$6.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$197.39
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.81
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.01
Rate for Payer: Wellcare Medicare Advantage	$6.01
Rate for Payer: Wellpoint Medicaid Managed Care	$17.44

PART THROMBOPLASTIN TIME (PTT)

Facility

$657.96

Service Code	HCPCS 85730
Hospital Charge Code	3002037
Hospital Revenue Code	305
Min. Negotiated Rate	$98.69
Max. Negotiated Rate	$98.69
Rate for Payer: Qualcare PPO/HMO/WC	$98.69

PARVOVIRUS ABS B19 IGG IGM

Facility

$408.85

Hospital Charge Code	3006855
Hospital Revenue Code	302
Min. Negotiated Rate	$61.33
Max. Negotiated Rate	$61.33
Rate for Payer: Qualcare PPO/HMO/WC	$61.33

PARVOVIRUS ABS B19 IGG IGM

Facility

$408.85

Hospital Charge Code	3006855
Hospital Revenue Code	302
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$204.43
Rate for Payer: Aetna Commercial	$155.36
Rate for Payer: Aetna Medicare Advantage	$122.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.26
Rate for Payer: Cigna Commercial	$204.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.33
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.83

PARVOVIRUS ANTIBODY (HPV)

Facility

$581.00

Service Code	HCPCS 86747
Hospital Charge Code	38472902
Hospital Revenue Code	302
Min. Negotiated Rate	$87.15
Max. Negotiated Rate	$87.15
Rate for Payer: Qualcare PPO/HMO/WC	$87.15

PARVOVIRUS ANTIBODY (HPV)

Facility

$581.00

Service Code	HCPCS 86747
Hospital Charge Code	38472902
Hospital Revenue Code	302
Min. Negotiated Rate	$12.02
Max. Negotiated Rate	$290.50
Rate for Payer: Aetna Commercial	$40.88
Rate for Payer: Aetna Medicare Advantage	$48.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.25
Rate for Payer: Cigna Commercial	$290.50
Rate for Payer: Cigna Medicare Advantage	$15.03
Rate for Payer: Clover Medicare Advantage	$14.28
Rate for Payer: EmblemHealth Commercial	$45.09
Rate for Payer: Humana Medicare Advantage	$15.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.03
Rate for Payer: Wellcare Medicare Advantage	$15.03
Rate for Payer: Wellpoint Medicaid Managed Care	$15.40

PARVOVIRUS ANTIBODY, IGG

Facility

$205.65

Service Code	HCPCS 86747
Hospital Charge Code	3006855A
Hospital Revenue Code	302
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

PARVOVIRUS ANTIBODY, IGG

Facility

$205.65

Service Code	HCPCS 86747
Hospital Charge Code	3006855A
Hospital Revenue Code	302
Min. Negotiated Rate	$5.45
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$40.88
Rate for Payer: Aetna Medicare Advantage	$48.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.25
Rate for Payer: Cigna Commercial	$102.83
Rate for Payer: Cigna Medicare Advantage	$15.03
Rate for Payer: Clover Medicare Advantage	$14.28
Rate for Payer: EmblemHealth Commercial	$45.09
Rate for Payer: Humana Medicare Advantage	$15.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.03
Rate for Payer: Wellcare Medicare Advantage	$15.03
Rate for Payer: Wellpoint Medicaid Managed Care	$5.45

PARVOVIRUS ANTIBODY, IGM

Facility

$205.65

Service Code	HCPCS 86747
Hospital Charge Code	3006855B
Hospital Revenue Code	302
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

PARVOVIRUS ANTIBODY, IGM

Facility

$205.65

Service Code	HCPCS 86747
Hospital Charge Code	3006855B
Hospital Revenue Code	302
Min. Negotiated Rate	$5.45
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$40.88
Rate for Payer: Aetna Medicare Advantage	$48.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.25
Rate for Payer: Cigna Commercial	$102.83
Rate for Payer: Cigna Medicare Advantage	$15.03
Rate for Payer: Clover Medicare Advantage	$14.28
Rate for Payer: EmblemHealth Commercial	$45.09
Rate for Payer: Humana Medicare Advantage	$15.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.03
Rate for Payer: Wellcare Medicare Advantage	$15.03
Rate for Payer: Wellpoint Medicaid Managed Care	$5.45

Know your out-of-pocket cost for care.

All Charges