Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PARVOVIRUS B19 AB (IGG)

Facility

$205.65

Service Code	HCPCS 86747
Hospital Charge Code	3035153
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 B19 AB (IGG)

Facility

$205.65

Service Code	HCPCS 86747
Hospital Charge Code	3035153
Hospital Revenue Code	302
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

PARVOVIRUS B19 AB (IGG,M) I

Facility

$390.00

Service Code	HCPCS 86747
Hospital Charge Code	39990047A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PARVOVIRUS B19 AB (IGG,M) I

Facility

$390.00

Service Code	HCPCS 86747
Hospital Charge Code	39990047A
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
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	$195.00
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	$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	$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	$10.34

PARVOVIRUS B19 AB (IGG,M) II

Facility

$390.00

Service Code	HCPCS 86747
Hospital Charge Code	39990047B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PARVOVIRUS B19 AB (IGG,M) II

Facility

$390.00

Service Code	HCPCS 86747
Hospital Charge Code	39990047B
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
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	$195.00
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	$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	$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	$10.34

PARVOVIRUS B19 DNA,QL,PCR

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	39900402
Hospital Revenue Code	306
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.66
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
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	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

PARVOVIRUS B19 DNA,QL,PCR

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	39900402
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PARVOVIRUS B19 PCR

Facility

$260.00

Service Code	HCPCS 87798
Hospital Charge Code	3038096
Hospital Revenue Code	306
Min. Negotiated Rate	$6.89
Max. Negotiated Rate	$153.02
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.66
Rate for Payer: Cigna Commercial	$130.00
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$6.89

PARVOVIRUS B19 PCR

Facility

$260.00

Service Code	HCPCS 87798
Hospital Charge Code	3038096
Hospital Revenue Code	306
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00

PAS FUNGUS

Facility

$324.85

Service Code	HCPCS 88312
Hospital Charge Code	3005391
Hospital Revenue Code	310
Min. Negotiated Rate	$48.73
Max. Negotiated Rate	$48.73
Rate for Payer: Qualcare PPO/HMO/WC	$48.73

PAS FUNGUS

Facility

$324.85

Service Code	HCPCS 88312
Hospital Charge Code	3005391
Hospital Revenue Code	310
Min. Negotiated Rate	$8.61
Max. Negotiated Rate	$223.48
Rate for Payer: Aetna Commercial	$168.40
Rate for Payer: Aetna Medicare Advantage	$200.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.48
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$61.91
Rate for Payer: Clover Medicare Advantage	$58.81
Rate for Payer: EmblemHealth Commercial	$185.73
Rate for Payer: Humana Medicare Advantage	$63.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$61.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.73
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$92.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.91
Rate for Payer: Wellcare Medicare Advantage	$61.91
Rate for Payer: Wellpoint Medicaid Managed Care	$8.61

PASSER ATK SUTURE LOOP 906976

Facility

$536.85

Hospital Charge Code	270613301
Hospital Revenue Code	272
Min. Negotiated Rate	$12.94
Max. Negotiated Rate	$268.43
Rate for Payer: Aetna Commercial	$204.00
Rate for Payer: Aetna Medicare Advantage	$161.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.90
Rate for Payer: Cigna Commercial	$268.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.06
Rate for Payer: Oxford Commercial	$107.37
Rate for Payer: Qualcare PPO/HMO/WC	$80.53
Rate for Payer: UnitedHealthcare Commercial	$107.37
Rate for Payer: UnitedHealthcare Community & State	$12.94
Rate for Payer: Wellpoint Medicaid Managed Care	$14.23

PASSER ATK SUTURE LOOP 906976

Facility

$536.85

Hospital Charge Code	270613301
Hospital Revenue Code	272
Min. Negotiated Rate	$80.53
Max. Negotiated Rate	$80.53
Rate for Payer: Qualcare PPO/HMO/WC	$80.53

PASSER CATHETER 60cm S/C DISP

Facility

$888.00

Service Code	HCPCS C1729
Hospital Charge Code	270612675
Hospital Revenue Code	278
Min. Negotiated Rate	$21.40
Max. Negotiated Rate	$444.00
Rate for Payer: Aetna Commercial	$337.44
Rate for Payer: Aetna Medicare Advantage	$266.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.44
Rate for Payer: Cigna Commercial	$444.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.36
Rate for Payer: Qualcare PPO/HMO/WC	$133.20
Rate for Payer: UnitedHealthcare Community & State	$21.40
Rate for Payer: Wellpoint Medicaid Managed Care	$23.53

PASSER CATHETER 60cm S/C DISP

Facility

$888.00

Service Code	HCPCS C1729
Hospital Charge Code	270612675
Hospital Revenue Code	278
Min. Negotiated Rate	$133.20
Max. Negotiated Rate	$214.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.36
Rate for Payer: Qualcare PPO/HMO/WC	$133.20

PASSER JJ CATH 36CM 82-1515

Facility

$284.85

Hospital Charge Code	270600328
Hospital Revenue Code	272
Min. Negotiated Rate	$42.73
Max. Negotiated Rate	$42.73
Rate for Payer: Qualcare PPO/HMO/WC	$42.73

PASSER JJ CATH 36CM 82-1515

Facility

$284.85

Hospital Charge Code	270600328
Hospital Revenue Code	272
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$142.43
Rate for Payer: Aetna Commercial	$108.24
Rate for Payer: Aetna Medicare Advantage	$85.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.64
Rate for Payer: Cigna Commercial	$142.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.45
Rate for Payer: Oxford Commercial	$56.97
Rate for Payer: Qualcare PPO/HMO/WC	$42.73
Rate for Payer: UnitedHealthcare Commercial	$56.97
Rate for Payer: UnitedHealthcare Community & State	$6.86
Rate for Payer: Wellpoint Medicaid Managed Care	$7.55

PASSER JJ CATH 55CM 82-1516

Facility

$309.65

Hospital Charge Code	270600329
Hospital Revenue Code	272
Min. Negotiated Rate	$46.45
Max. Negotiated Rate	$46.45
Rate for Payer: Qualcare PPO/HMO/WC	$46.45

PASSER JJ CATH 55CM 82-1516

Facility

$309.65

Hospital Charge Code	270600329
Hospital Revenue Code	272
Min. Negotiated Rate	$7.46
Max. Negotiated Rate	$154.82
Rate for Payer: Aetna Commercial	$117.67
Rate for Payer: Aetna Medicare Advantage	$92.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.96
Rate for Payer: Cigna Commercial	$154.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.89
Rate for Payer: Oxford Commercial	$61.93
Rate for Payer: Qualcare PPO/HMO/WC	$46.45
Rate for Payer: UnitedHealthcare Commercial	$61.93
Rate for Payer: UnitedHealthcare Community & State	$7.46
Rate for Payer: Wellpoint Medicaid Managed Care	$8.21

PASSER MEDT CATH 38CM 48407

Facility

$536.85

Hospital Charge Code	270612722
Hospital Revenue Code	272
Min. Negotiated Rate	$12.94
Max. Negotiated Rate	$268.43
Rate for Payer: Aetna Commercial	$204.00
Rate for Payer: Aetna Medicare Advantage	$161.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.90
Rate for Payer: Cigna Commercial	$268.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.06
Rate for Payer: Oxford Commercial	$107.37
Rate for Payer: Qualcare PPO/HMO/WC	$80.53
Rate for Payer: UnitedHealthcare Commercial	$107.37
Rate for Payer: UnitedHealthcare Community & State	$12.94
Rate for Payer: Wellpoint Medicaid Managed Care	$14.23

PASSER MEDT CATH 38CM 48407

Facility

$536.85

Hospital Charge Code	270612722
Hospital Revenue Code	272
Min. Negotiated Rate	$80.53
Max. Negotiated Rate	$80.53
Rate for Payer: Qualcare PPO/HMO/WC	$80.53

PASSER SUTURE HEWSON

Facility

$822.50

Hospital Charge Code	270620933
Hospital Revenue Code	272
Min. Negotiated Rate	$19.82
Max. Negotiated Rate	$411.25
Rate for Payer: Aetna Commercial	$312.55
Rate for Payer: Aetna Medicare Advantage	$246.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.74
Rate for Payer: Cigna Commercial	$411.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.75
Rate for Payer: Oxford Commercial	$164.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.38
Rate for Payer: UnitedHealthcare Commercial	$164.50
Rate for Payer: UnitedHealthcare Community & State	$19.82
Rate for Payer: Wellpoint Medicaid Managed Care	$21.80

PASSER SUTURE HEWSON

Facility

$822.50

Hospital Charge Code	270620933
Hospital Revenue Code	272
Min. Negotiated Rate	$123.38
Max. Negotiated Rate	$123.38
Rate for Payer: Qualcare PPO/HMO/WC	$123.38

PASSER SUTURE STRAIGHT

Facility

$1,655.00

Hospital Charge Code	270613181
Hospital Revenue Code	272
Min. Negotiated Rate	$39.89
Max. Negotiated Rate	$827.50
Rate for Payer: Aetna Commercial	$628.90
Rate for Payer: Aetna Medicare Advantage	$496.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$422.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$422.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$422.02
Rate for Payer: Cigna Commercial	$827.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$496.50
Rate for Payer: Oxford Commercial	$331.00
Rate for Payer: Qualcare PPO/HMO/WC	$248.25
Rate for Payer: UnitedHealthcare Commercial	$331.00
Rate for Payer: UnitedHealthcare Community & State	$39.89
Rate for Payer: Wellpoint Medicaid Managed Care	$43.86

Know your out-of-pocket cost for care.

All Charges