Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PCP, URINE

Facility

$104.99

Service Code	HCPCS 83992
Hospital Charge Code	38472504
Hospital Revenue Code	301
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$18.00
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

PCP, URINE

Facility

$104.99

Service Code	HCPCS 83992
Hospital Charge Code	38472504
Hospital Revenue Code	301
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

PC RED C5E 10FT

Facility

$25.00

Hospital Charge Code	270659013
Hospital Revenue Code	270
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

PC RED C5E 10FT

Facility

$25.00

Hospital Charge Code	270659013
Hospital Revenue Code	270
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

PC RED C5E 25 FT

Facility

$50.00

Hospital Charge Code	270659012
Hospital Revenue Code	270
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$10.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

PC RED C5E 25 FT

Facility

$50.00

Hospital Charge Code	270659012
Hospital Revenue Code	270
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

PCR-HIV DNA #H61***

Facility

$431.00

Hospital Charge Code	3010816
Hospital Revenue Code	306
Min. Negotiated Rate	$10.39
Max. Negotiated Rate	$215.50
Rate for Payer: Aetna Commercial	$163.78
Rate for Payer: Aetna Medicare Advantage	$129.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.91
Rate for Payer: Cigna Commercial	$215.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$64.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.39
Rate for Payer: Wellpoint Medicaid Managed Care	$11.42

PCR-HIV DNA #H61***

Facility

$431.00

Hospital Charge Code	3010816
Hospital Revenue Code	306
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

PD 103 SPACERS IN NEEDLE 18gA

Facility

$175.50

Hospital Charge Code	270646148
Hospital Revenue Code	278
Min. Negotiated Rate	$4.23
Max. Negotiated Rate	$87.75
Rate for Payer: Aetna Commercial	$66.69
Rate for Payer: Aetna Medicare Advantage	$52.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.75
Rate for Payer: Cigna Commercial	$87.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.61
Rate for Payer: Qualcare PPO/HMO/WC	$26.32
Rate for Payer: UnitedHealthcare Community & State	$4.23
Rate for Payer: Wellpoint Medicaid Managed Care	$4.65

PD 103 SPACERS IN NEEDLE 18gA

Facility

$175.50

Hospital Charge Code	270646148
Hospital Revenue Code	278
Min. Negotiated Rate	$26.32
Max. Negotiated Rate	$42.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.61
Rate for Payer: Qualcare PPO/HMO/WC	$26.32

PD-IT IRRIGATION TUBING

Facility

$705.55

Hospital Charge Code	270699126
Hospital Revenue Code	272
Min. Negotiated Rate	$17.00
Max. Negotiated Rate	$352.77
Rate for Payer: Aetna Commercial	$268.11
Rate for Payer: Aetna Medicare Advantage	$211.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.92
Rate for Payer: Cigna Commercial	$352.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.66
Rate for Payer: Oxford Commercial	$141.11
Rate for Payer: Qualcare PPO/HMO/WC	$105.83
Rate for Payer: UnitedHealthcare Commercial	$141.11
Rate for Payer: UnitedHealthcare Community & State	$17.00
Rate for Payer: Wellpoint Medicaid Managed Care	$18.70

PD-IT IRRIGATION TUBING

Facility

$705.55

Hospital Charge Code	270699126
Hospital Revenue Code	272
Min. Negotiated Rate	$105.83
Max. Negotiated Rate	$105.83
Rate for Payer: Qualcare PPO/HMO/WC	$105.83

PEAK FLOW************

Facility

$48.40

Hospital Charge Code	9501008
Hospital Revenue Code	419
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$18.39
Rate for Payer: Aetna Medicare Advantage	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.34
Rate for Payer: Cigna Commercial	$24.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.52
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.26
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$1.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1.28

PEAK FLOW************

Facility

$48.40

Hospital Charge Code	9501008
Hospital Revenue Code	419
Min. Negotiated Rate	$7.26
Max. Negotiated Rate	$7.26
Rate for Payer: Qualcare PPO/HMO/WC	$7.26

PEAK FLOW METER ASTHMA CHECK

Facility

$37.30

Hospital Charge Code	270643983
Hospital Revenue Code	270
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$5.59
Rate for Payer: Qualcare PPO/HMO/WC	$5.59

PEAK FLOW METER ASTHMA CHECK

Facility

$37.30

Hospital Charge Code	270643983
Hospital Revenue Code	270
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$18.65
Rate for Payer: Aetna Commercial	$14.17
Rate for Payer: Aetna Medicare Advantage	$11.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.51
Rate for Payer: Cigna Commercial	$18.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.19
Rate for Payer: Oxford Commercial	$7.46
Rate for Payer: Qualcare PPO/HMO/WC	$5.59
Rate for Payer: UnitedHealthcare Commercial	$7.46
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

PEAK FLOW METER LOW RANGE

Facility

$37.85

Hospital Charge Code	270638861
Hospital Revenue Code	270
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$5.68
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

PEAK FLOW METER LOW RANGE

Facility

$37.85

Hospital Charge Code	270638861
Hospital Revenue Code	270
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.93
Rate for Payer: Aetna Commercial	$14.38
Rate for Payer: Aetna Medicare Advantage	$11.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.65
Rate for Payer: Cigna Commercial	$18.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.36
Rate for Payer: Oxford Commercial	$7.57
Rate for Payer: Qualcare PPO/HMO/WC	$5.68
Rate for Payer: UnitedHealthcare Commercial	$7.57
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

PEAK FLOW TREATMENT

Facility

$10,357.02

Service Code	HCPCS 94150
Hospital Charge Code	9500589
Hospital Revenue Code	460
Min. Negotiated Rate	$125.84
Max. Negotiated Rate	$3,107.11
Rate for Payer: Aetna Commercial	$415.81
Rate for Payer: Aetna Medicare Advantage	$495.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$551.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$551.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$152.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$551.81
Rate for Payer: Cigna Commercial	$306.43
Rate for Payer: Cigna Medicare Advantage	$152.87
Rate for Payer: Clover Medicare Advantage	$145.23
Rate for Payer: EmblemHealth Commercial	$458.61
Rate for Payer: Humana Medicare Advantage	$157.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$152.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,107.11
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,553.55
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$249.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$152.87
Rate for Payer: Wellcare Medicare Advantage	$152.87
Rate for Payer: Wellpoint Medicaid Managed Care	$274.46

PEAK FLOW TREATMENT

Facility

$10,357.02

Service Code	HCPCS 94150
Hospital Charge Code	9500589
Hospital Revenue Code	460
Min. Negotiated Rate	$1,553.55
Max. Negotiated Rate	$1,553.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,553.55

PEAK FLOW TREATMENT - SUBSEQ**

Facility

$51.00

Service Code	HCPCS 94150
Hospital Charge Code	9500590
Hospital Revenue Code	419
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

PEAK FLOW TREATMENT - SUBSEQ**

Facility

$51.00

Service Code	HCPCS 94150
Hospital Charge Code	9500590
Hospital Revenue Code	419
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$415.81
Rate for Payer: Aetna Medicare Advantage	$495.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$551.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$551.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$152.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$551.81
Rate for Payer: Cigna Commercial	$306.43
Rate for Payer: Cigna Medicare Advantage	$152.87
Rate for Payer: Clover Medicare Advantage	$145.23
Rate for Payer: EmblemHealth Commercial	$458.61
Rate for Payer: Humana Medicare Advantage	$157.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$152.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.30
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$1.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$152.87
Rate for Payer: Wellcare Medicare Advantage	$152.87
Rate for Payer: Wellpoint Medicaid Managed Care	$1.35

PEAK FLOW TRMT - INIT W/SUPPLY

Facility

$89.10

Service Code	HCPCS 94150
Hospital Charge Code	9500588
Hospital Revenue Code	419
Min. Negotiated Rate	$13.37
Max. Negotiated Rate	$13.37
Rate for Payer: Qualcare PPO/HMO/WC	$13.37

PEAK FLOW TRMT - INIT W/SUPPLY

Facility

$89.10

Service Code	HCPCS 94150
Hospital Charge Code	9500588
Hospital Revenue Code	419
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$415.81
Rate for Payer: Aetna Medicare Advantage	$495.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$551.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$551.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$152.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$551.81
Rate for Payer: Cigna Commercial	$306.43
Rate for Payer: Cigna Medicare Advantage	$152.87
Rate for Payer: Clover Medicare Advantage	$145.23
Rate for Payer: EmblemHealth Commercial	$458.61
Rate for Payer: Humana Medicare Advantage	$157.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$152.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.73
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.37
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$2.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$152.87
Rate for Payer: Wellcare Medicare Advantage	$152.87
Rate for Payer: Wellpoint Medicaid Managed Care	$2.36

PEANUT ENDOSCOPIC DEVICE 5MM

Facility

$99.75

Hospital Charge Code	270660429
Hospital Revenue Code	272
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$49.88
Rate for Payer: Aetna Commercial	$37.91
Rate for Payer: Aetna Medicare Advantage	$29.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.44
Rate for Payer: Cigna Commercial	$49.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.93
Rate for Payer: Oxford Commercial	$19.95
Rate for Payer: Qualcare PPO/HMO/WC	$14.96
Rate for Payer: UnitedHealthcare Commercial	$19.95
Rate for Payer: UnitedHealthcare Community & State	$2.40
Rate for Payer: Wellpoint Medicaid Managed Care	$2.64

Know your out-of-pocket cost for care.

All Charges