Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PENILE PROTHESIS 16CMX14MM

Facility

$88,525.00

Service Code	HCPCS C1813
Hospital Charge Code	270694753
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.45
Max. Negotiated Rate	$44,262.50
Rate for Payer: Aetna Commercial	$33,639.50
Rate for Payer: Aetna Medicare Advantage	$26,557.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,573.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,573.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17,705.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,573.88
Rate for Payer: Cigna Commercial	$44,262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21,423.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19,475.50
Rate for Payer: Qualcare PPO/HMO/WC	$13,278.75
Rate for Payer: UnitedHealthcare Community & State	$2,133.45
Rate for Payer: Wellpoint Medicaid Managed Care	$2,345.91

PENILE TIP 18CM CX

Facility

$41,915.00

Hospital Charge Code	270674330
Hospital Revenue Code	278
Min. Negotiated Rate	$1,010.15
Max. Negotiated Rate	$20,957.50
Rate for Payer: Aetna Commercial	$15,927.70
Rate for Payer: Aetna Medicare Advantage	$12,574.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,688.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,688.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,383.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,688.33
Rate for Payer: Cigna Commercial	$20,957.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,143.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,221.30
Rate for Payer: Qualcare PPO/HMO/WC	$6,287.25
Rate for Payer: UnitedHealthcare Community & State	$1,010.15
Rate for Payer: Wellpoint Medicaid Managed Care	$1,110.75

PENILE TIP 18CM CX

Facility

$41,915.00

Hospital Charge Code	270674330
Hospital Revenue Code	278
Min. Negotiated Rate	$6,287.25
Max. Negotiated Rate	$10,143.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,383.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,143.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,221.30
Rate for Payer: Qualcare PPO/HMO/WC	$6,287.25

PENIS PROCEDURES WITH CC/MCC

Facility

$77,349.82

Service Code	MSDRG 709
Min. Negotiated Rate	$23,552.03
Max. Negotiated Rate	$77,349.82
Rate for Payer: Aetna Commercial	$53,405.48
Rate for Payer: Aetna Medicare Advantage	$77,349.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50,476.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50,476.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24,791.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50,476.37
Rate for Payer: Cigna Commercial	$43,549.35
Rate for Payer: Cigna Medicare Advantage	$24,791.61
Rate for Payer: Clover Medicare Advantage	$23,552.03
Rate for Payer: EmblemHealth Commercial	$74,374.83
Rate for Payer: Humana Medicare Advantage	$25,535.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24,791.61
Rate for Payer: Oxford Commercial	$31,299.49
Rate for Payer: UnitedHealthcare Commercial	$54,884.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$24,791.61
Rate for Payer: Wellcare Medicare Advantage	$24,791.61

PENIS PROCEDURES WITHOUT CC/MCC

Facility

$47,423.16

Service Code	MSDRG 710
Min. Negotiated Rate	$14,439.74
Max. Negotiated Rate	$47,423.16
Rate for Payer: Aetna Commercial	$32,842.45
Rate for Payer: Aetna Medicare Advantage	$47,423.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,239.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,239.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,199.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30,239.30
Rate for Payer: Cigna Commercial	$26,222.06
Rate for Payer: Cigna Medicare Advantage	$15,199.73
Rate for Payer: Clover Medicare Advantage	$14,439.74
Rate for Payer: EmblemHealth Commercial	$45,599.19
Rate for Payer: Humana Medicare Advantage	$15,655.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,199.73
Rate for Payer: Oxford Commercial	$18,846.14
Rate for Payer: UnitedHealthcare Commercial	$33,047.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,199.73
Rate for Payer: Wellcare Medicare Advantage	$15,199.73

PENIS, TESTES AND SCROTAL PROCEDURES

Facility

$39,443.91

Service Code	APR-DRG 4834
Min. Negotiated Rate	$38,670.50
Max. Negotiated Rate	$39,443.91
Rate for Payer: UnitedHealthcare Community & State	$38,670.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$39,443.91
Rate for Payer: Wellpoint Medicaid Managed Care	$38,670.50

PENIS, TESTES AND SCROTAL PROCEDURES

Facility

$23,201.67

Service Code	APR-DRG 4833
Min. Negotiated Rate	$22,746.74
Max. Negotiated Rate	$23,201.67
Rate for Payer: UnitedHealthcare Community & State	$22,746.74
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,201.67
Rate for Payer: Wellpoint Medicaid Managed Care	$22,746.74

PENIS, TESTES AND SCROTAL PROCEDURES

Facility

$15,315.41

Service Code	APR-DRG 4832
Min. Negotiated Rate	$15,015.11
Max. Negotiated Rate	$15,315.41
Rate for Payer: UnitedHealthcare Community & State	$15,015.11
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,315.41
Rate for Payer: Wellpoint Medicaid Managed Care	$15,015.11

PENIS, TESTES AND SCROTAL PROCEDURES

Facility

$11,269.48

Service Code	APR-DRG 4831
Min. Negotiated Rate	$11,048.51
Max. Negotiated Rate	$11,269.48
Rate for Payer: UnitedHealthcare Community & State	$11,048.51
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,269.48
Rate for Payer: Wellpoint Medicaid Managed Care	$11,048.51

PEN & LABEL SET

Facility

$12.50

Hospital Charge Code	2709000382
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

PEN & LABEL SET

Facility

$12.50

Hospital Charge Code	2709000382
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$6.25
Rate for Payer: Aetna Commercial	$4.75
Rate for Payer: Aetna Medicare Advantage	$3.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.19
Rate for Payer: Cigna Commercial	$6.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.75
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.88
Rate for Payer: UnitedHealthcare Commercial	$2.50
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

PENLIGHT DISPO COBALT BLUE

Facility

$210.00

Hospital Charge Code	270653912
Hospital Revenue Code	272
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$79.80
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.00
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$42.00
Rate for Payer: UnitedHealthcare Community & State	$5.06
Rate for Payer: Wellpoint Medicaid Managed Care	$5.57

PENLIGHT DISPO COBALT BLUE

Facility

$210.00

Hospital Charge Code	270653912
Hospital Revenue Code	272
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

PENPADINID INJ ISET INJ

Facility

$914.45

Hospital Charge Code	6004147
Hospital Revenue Code	250
Min. Negotiated Rate	$137.17
Max. Negotiated Rate	$137.17
Rate for Payer: Qualcare PPO/HMO/WC	$137.17

PENPADINID INJ ISET INJ

Facility

$914.45

Hospital Charge Code	6004147
Hospital Revenue Code	250
Min. Negotiated Rate	$22.04
Max. Negotiated Rate	$457.23
Rate for Payer: Aetna Commercial	$347.49
Rate for Payer: Aetna Medicare Advantage	$274.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$233.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$233.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$233.18
Rate for Payer: Cigna Commercial	$457.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.33
Rate for Payer: Oxford Commercial	$182.89
Rate for Payer: Qualcare PPO/HMO/WC	$137.17
Rate for Payer: UnitedHealthcare Commercial	$182.89
Rate for Payer: UnitedHealthcare Community & State	$22.04
Rate for Payer: Wellpoint Medicaid Managed Care	$24.23

PEN SKIN SCRIBE

Facility

$10.45

Hospital Charge Code	270061160
Hospital Revenue Code	272
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.22
Rate for Payer: Aetna Commercial	$3.97
Rate for Payer: Aetna Medicare Advantage	$3.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.66
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.13
Rate for Payer: Oxford Commercial	$2.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.57
Rate for Payer: UnitedHealthcare Commercial	$2.09
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

PEN SKIN SCRIBE

Facility

$10.45

Hospital Charge Code	270061160
Hospital Revenue Code	272
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$1.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.57

PENSTIC TIB/FIB SPLNT KNEE LG*

Facility

$70.00

Hospital Charge Code	8003584
Hospital Revenue Code	279
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$35.00
Rate for Payer: Aetna Commercial	$26.60
Rate for Payer: Aetna Medicare Advantage	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.85
Rate for Payer: Cigna Commercial	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.00
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.50
Rate for Payer: UnitedHealthcare Commercial	$14.00
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

PENSTIC TIB/FIB SPLNT KNEE LG*

Facility

$70.00

Hospital Charge Code	8003584
Hospital Revenue Code	279
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.50

PENTAM INJ/300MG/VIAL

Facility

$358.05

Service Code	NDC 63323011310
Hospital Charge Code	60634265
Hospital Revenue Code	250
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$179.03
Rate for Payer: Aetna Commercial	$136.06
Rate for Payer: Aetna Medicare Advantage	$107.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.30
Rate for Payer: Cigna Commercial	$179.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.42
Rate for Payer: Oxford Commercial	$71.61
Rate for Payer: Qualcare PPO/HMO/WC	$53.71
Rate for Payer: UnitedHealthcare Commercial	$71.61
Rate for Payer: UnitedHealthcare Community & State	$8.63
Rate for Payer: Wellpoint Medicaid Managed Care	$9.49

PENTAM INJ/300MG/VIAL

Facility

$358.05

Service Code	NDC 63323011310
Hospital Charge Code	60634265
Hospital Revenue Code	250
Min. Negotiated Rate	$53.71
Max. Negotiated Rate	$53.71
Rate for Payer: Qualcare PPO/HMO/WC	$53.71

PENTAZOCINE INJ 30MG

Facility

$19.85

Hospital Charge Code	6009534
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$9.93
Rate for Payer: Aetna Commercial	$7.54
Rate for Payer: Aetna Medicare Advantage	$5.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.06
Rate for Payer: Cigna Commercial	$9.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.96
Rate for Payer: Oxford Commercial	$3.97
Rate for Payer: Qualcare PPO/HMO/WC	$2.98
Rate for Payer: UnitedHealthcare Commercial	$3.97
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

PENTAZOCINE INJ 30MG

Facility

$19.85

Hospital Charge Code	6009534
Hospital Revenue Code	250
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$2.98
Rate for Payer: Qualcare PPO/HMO/WC	$2.98

PENTAZOCINE NALOXN

Facility

$7.70

Hospital Charge Code	6011134
Hospital Revenue Code	252
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

PENTAZOCINE NALOXN

Facility

$7.70

Hospital Charge Code	6011134
Hospital Revenue Code	252
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.85
Rate for Payer: Aetna Commercial	$2.93
Rate for Payer: Aetna Medicare Advantage	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.96
Rate for Payer: Cigna Commercial	$3.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.31
Rate for Payer: Oxford Commercial	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$1.54
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

Know your out-of-pocket cost for care.

All Charges