Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PHILADELPHIA CHROMOSOME

Facility

$2,902.00

Service Code	HCPCS 88262
Hospital Charge Code	38474103
Hospital Revenue Code	311
Min. Negotiated Rate	$435.30
Max. Negotiated Rate	$435.30
Rate for Payer: Qualcare PPO/HMO/WC	$435.30

PHISODERM/150ML

Facility

$18.00

Hospital Charge Code	60633658
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

PHISODERM/150ML

Facility

$18.00

Hospital Charge Code	60633658
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

PHISODERM FOR BABY/150ML

Facility

$18.00

Hospital Charge Code	60633659
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

PHISODERM FOR BABY/150ML

Facility

$18.00

Hospital Charge Code	60633659
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

PHLEB VEINS - EXTREM 20+

Facility

$17,623.95

Service Code	HCPCS 37766
Hospital Charge Code	421037766
Hospital Revenue Code	761
Min. Negotiated Rate	$424.74
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$820.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,287.19
Rate for Payer: Oxford Commercial	$3,524.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,643.59
Rate for Payer: UnitedHealthcare Commercial	$3,524.79
Rate for Payer: UnitedHealthcare Community & State	$424.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$467.03

PHLEB VEINS - EXTREM 20+

Facility

$17,623.95

Service Code	HCPCS 37766
Hospital Charge Code	421037766
Hospital Revenue Code	761
Min. Negotiated Rate	$2,643.59
Max. Negotiated Rate	$2,643.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,643.59

PHOSLO GEL CAPS

Facility

$1.00

Hospital Charge Code	60635476
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

PHOSLO GEL CAPS

Facility

$1.00

Hospital Charge Code	60635476
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.38
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.30
Rate for Payer: Oxford Commercial	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.20
Rate for Payer: UnitedHealthcare Community & State	$0.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.03

PHOS-LO/TAB

Facility

$3.00

Hospital Charge Code	60634446
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PHOS-LO/TAB

Facility

$3.00

Hospital Charge Code	60634446
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

PHOSPH ANTIB (IGG,IGA,IGM) PLA

Facility

$80.35

Service Code	HCPCS 86148
Hospital Charge Code	401186148B
Hospital Revenue Code	306
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$43.71
Rate for Payer: Aetna Medicare Advantage	$52.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.01
Rate for Payer: Cigna Commercial	$40.17
Rate for Payer: Cigna Medicare Advantage	$16.07
Rate for Payer: Clover Medicare Advantage	$15.27
Rate for Payer: EmblemHealth Commercial	$48.21
Rate for Payer: Humana Medicare Advantage	$16.55
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.07
Rate for Payer: Wellcare Medicare Advantage	$16.07
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

PHOSPH ANTIB (IGG,IGA,IGM) PLA

Facility

$80.35

Service Code	HCPCS 86148
Hospital Charge Code	401186148C
Hospital Revenue Code	306
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$43.71
Rate for Payer: Aetna Medicare Advantage	$52.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.01
Rate for Payer: Cigna Commercial	$40.17
Rate for Payer: Cigna Medicare Advantage	$16.07
Rate for Payer: Clover Medicare Advantage	$15.27
Rate for Payer: EmblemHealth Commercial	$48.21
Rate for Payer: Humana Medicare Advantage	$16.55
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.07
Rate for Payer: Wellcare Medicare Advantage	$16.07
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

PHOSPH ANTIB (IGG,IGA,IGM) PLA

Facility

$80.35

Service Code	HCPCS 86148
Hospital Charge Code	401186148D
Hospital Revenue Code	306
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$12.05
Rate for Payer: Qualcare PPO/HMO/WC	$12.05

PHOSPH ANTIB (IGG,IGA,IGM) PLA

Facility

$80.35

Service Code	HCPCS 86148
Hospital Charge Code	401186148C
Hospital Revenue Code	306
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$12.05
Rate for Payer: Qualcare PPO/HMO/WC	$12.05

PHOSPH ANTIB (IGG,IGA,IGM) PLA

Facility

$80.35

Service Code	HCPCS 86148
Hospital Charge Code	401186148D
Hospital Revenue Code	306
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$43.71
Rate for Payer: Aetna Medicare Advantage	$52.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.01
Rate for Payer: Cigna Commercial	$40.17
Rate for Payer: Cigna Medicare Advantage	$16.07
Rate for Payer: Clover Medicare Advantage	$15.27
Rate for Payer: EmblemHealth Commercial	$48.21
Rate for Payer: Humana Medicare Advantage	$16.55
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.07
Rate for Payer: Wellcare Medicare Advantage	$16.07
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

PHOSPH ANTIB (IGG,IGA,IGM) PLA

Facility

$80.35

Service Code	HCPCS 86148
Hospital Charge Code	401186148B
Hospital Revenue Code	306
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$12.05
Rate for Payer: Qualcare PPO/HMO/WC	$12.05

PHOSPH ANTIBOD (IGG,IGA,IGM)

Facility

$148.86

Service Code	HCPCS 83520
Hospital Charge Code	401383520D
Hospital Revenue Code	301
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.34
Rate for Payer: Cigna Commercial	$74.43
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.33
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$3.94

PHOSPH ANTIBOD (IGG,IGA,IGM)

Facility

$148.86

Service Code	HCPCS 83520
Hospital Charge Code	401383520E
Hospital Revenue Code	301
Min. Negotiated Rate	$22.33
Max. Negotiated Rate	$22.33
Rate for Payer: Qualcare PPO/HMO/WC	$22.33

PHOSPH ANTIBOD (IGG,IGA,IGM)

Facility

$148.86

Service Code	HCPCS 83520
Hospital Charge Code	401383520E
Hospital Revenue Code	301
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.34
Rate for Payer: Cigna Commercial	$74.43
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.33
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$3.94

PHOSPH ANTIBOD (IGG,IGA,IGM)

Facility

$148.86

Service Code	HCPCS 83520
Hospital Charge Code	401383520F
Hospital Revenue Code	301
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.34
Rate for Payer: Cigna Commercial	$74.43
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.33
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$3.94

PHOSPH ANTIBOD (IGG,IGA,IGM)

Facility

$148.86

Service Code	HCPCS 83520
Hospital Charge Code	401383520F
Hospital Revenue Code	301
Min. Negotiated Rate	$22.33
Max. Negotiated Rate	$22.33
Rate for Payer: Qualcare PPO/HMO/WC	$22.33

PHOSPH ANTIBOD (IGG,IGA,IGM)

Facility

$148.86

Service Code	HCPCS 83520
Hospital Charge Code	401383520D
Hospital Revenue Code	301
Min. Negotiated Rate	$22.33
Max. Negotiated Rate	$22.33
Rate for Payer: Qualcare PPO/HMO/WC	$22.33

PHOSPHATE24HR URINE WO CREATIN

Facility

$65.24

Service Code	HCPCS 84105
Hospital Charge Code	401184105
Hospital Revenue Code	301
Min. Negotiated Rate	$9.79
Max. Negotiated Rate	$9.79
Rate for Payer: Qualcare PPO/HMO/WC	$9.79

PHOSPHATE24HR URINE WO CREATIN

Facility

$65.24

Service Code	HCPCS 84105
Hospital Charge Code	401184105
Hospital Revenue Code	301
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.72
Rate for Payer: Aetna Medicare Advantage	$18.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
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	$20.86
Rate for Payer: Cigna Commercial	$32.62
Rate for Payer: Cigna Medicare Advantage	$5.78
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.57
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.79
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.78
Rate for Payer: Wellcare Medicare Advantage	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$1.73

Know your out-of-pocket cost for care.

All Charges