Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PHOSPHOROUS URINE

Facility

$390.00

Service Code	HCPCS 84105
Hospital Charge Code	39990241H
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PHOSPHORUS

Facility

$141.80

Service Code	HCPCS 84100
Hospital Charge Code	8200322RS
Hospital Revenue Code	301
Min. Negotiated Rate	$3.76
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$12.89
Rate for Payer: Aetna Medicare Advantage	$15.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.74
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	$17.11
Rate for Payer: Cigna Commercial	$70.90
Rate for Payer: Cigna Medicare Advantage	$4.74
Rate for Payer: Clover Medicare Advantage	$4.50
Rate for Payer: EmblemHealth Commercial	$14.22
Rate for Payer: Humana Medicare Advantage	$4.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.27
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.74
Rate for Payer: Wellcare Medicare Advantage	$4.74
Rate for Payer: Wellpoint Medicaid Managed Care	$3.76

PHOSPHORUS

Facility

$141.80

Service Code	HCPCS 84100
Hospital Charge Code	8200322RS
Hospital Revenue Code	301
Min. Negotiated Rate	$21.27
Max. Negotiated Rate	$21.27
Rate for Payer: Qualcare PPO/HMO/WC	$21.27

PHOSPHORUS***

Facility

$18.00

Hospital Charge Code	3012093
Hospital Revenue Code	309
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$124.00
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	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

PHOSPHORUS***

Facility

$18.00

Hospital Charge Code	3012093
Hospital Revenue Code	309
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

PHOSPHORUS RANDOM UR

Facility

$163.00

Service Code	HCPCS 84105
Hospital Charge Code	38479041
Hospital Revenue Code	301
Min. Negotiated Rate	$24.45
Max. Negotiated Rate	$24.45
Rate for Payer: Qualcare PPO/HMO/WC	$24.45

PHOSPHORUS RANDOM UR

Facility

$163.00

Service Code	HCPCS 84105
Hospital Charge Code	38479041
Hospital Revenue Code	301
Min. Negotiated Rate	$4.32
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	$81.50
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	$48.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.45
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	$4.32

PHOSPHORUS, SERUM

Facility

$656.14

Service Code	HCPCS 84100
Hospital Charge Code	3002094
Hospital Revenue Code	301
Min. Negotiated Rate	$98.42
Max. Negotiated Rate	$98.42
Rate for Payer: Qualcare PPO/HMO/WC	$98.42

PHOSPHORUS, SERUM

Facility

$656.14

Service Code	HCPCS 84100
Hospital Charge Code	3002094
Hospital Revenue Code	301
Min. Negotiated Rate	$3.79
Max. Negotiated Rate	$328.07
Rate for Payer: Aetna Commercial	$12.89
Rate for Payer: Aetna Medicare Advantage	$15.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.74
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	$17.11
Rate for Payer: Cigna Commercial	$328.07
Rate for Payer: Cigna Medicare Advantage	$4.74
Rate for Payer: Clover Medicare Advantage	$4.50
Rate for Payer: EmblemHealth Commercial	$14.22
Rate for Payer: Humana Medicare Advantage	$4.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.42
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.74
Rate for Payer: Wellcare Medicare Advantage	$4.74
Rate for Payer: Wellpoint Medicaid Managed Care	$17.39

PHOSPHORUS SERUM PANEL***

Facility

$6.00

Service Code	HCPCS 84100
Hospital Charge Code	3002094P
Hospital Revenue Code	301
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$12.89
Rate for Payer: Aetna Medicare Advantage	$15.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.74
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	$17.11
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: Cigna Medicare Advantage	$4.74
Rate for Payer: Clover Medicare Advantage	$4.50
Rate for Payer: EmblemHealth Commercial	$14.22
Rate for Payer: Humana Medicare Advantage	$4.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.74
Rate for Payer: Wellcare Medicare Advantage	$4.74
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

PHOSPHORUS SERUM PANEL***

Facility

$6.00

Service Code	HCPCS 84100
Hospital Charge Code	3002094P
Hospital Revenue Code	301
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

PHOSPHORUS SUPPLEMENT TABLET

Facility

$5.70

Service Code	NDC 486112501
Hospital Charge Code	60632341
Hospital Revenue Code	250
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$0.86
Rate for Payer: Qualcare PPO/HMO/WC	$0.86

PHOSPHORUS SUPPLEMENT TABLET

Facility

$5.70

Service Code	NDC 486112501
Hospital Charge Code	60632341
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.85
Rate for Payer: Aetna Commercial	$2.17
Rate for Payer: Aetna Medicare Advantage	$1.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.45
Rate for Payer: Cigna Commercial	$2.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.71
Rate for Payer: Oxford Commercial	$1.14
Rate for Payer: Qualcare PPO/HMO/WC	$0.86
Rate for Payer: UnitedHealthcare Commercial	$1.14
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

PHOSPHORUS URINE

Facility

$390.00

Service Code	HCPCS 84105
Hospital Charge Code	3030855
Hospital Revenue Code	301
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$195.00
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	$195.00
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	$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	$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	$10.34

PHOSPHORUS URINE

Facility

$390.00

Service Code	HCPCS 84105
Hospital Charge Code	3030855
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PHOSPHORUS, URINE

Facility

$163.00

Service Code	HCPCS 84105
Hospital Charge Code	38472542
Hospital Revenue Code	301
Min. Negotiated Rate	$24.45
Max. Negotiated Rate	$24.45
Rate for Payer: Qualcare PPO/HMO/WC	$24.45

PHOSPHORUS, URINE

Facility

$163.00

Service Code	HCPCS 84105
Hospital Charge Code	38472542
Hospital Revenue Code	301
Min. Negotiated Rate	$4.32
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	$81.50
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	$48.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.45
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	$4.32

PHOSPHORUS, URINE 24 HOUR

Facility

$322.47

Service Code	HCPCS 82150
Hospital Charge Code	3030848
Hospital Revenue Code	301
Min. Negotiated Rate	$48.37
Max. Negotiated Rate	$48.37
Rate for Payer: Qualcare PPO/HMO/WC	$48.37

PHOSPHORUS, URINE 24 HOUR

Facility

$322.47

Service Code	HCPCS 82150
Hospital Charge Code	3030848
Hospital Revenue Code	301
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$161.24
Rate for Payer: Aetna Commercial	$17.63
Rate for Payer: Aetna Medicare Advantage	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.39
Rate for Payer: Cigna Commercial	$161.24
Rate for Payer: Cigna Medicare Advantage	$6.48
Rate for Payer: Clover Medicare Advantage	$6.16
Rate for Payer: EmblemHealth Commercial	$19.44
Rate for Payer: Humana Medicare Advantage	$6.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.37
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.48
Rate for Payer: Wellcare Medicare Advantage	$6.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.55

PHOSPHO-SODA FLAVORED/90M

Facility

$5.00

Hospital Charge Code	60633660
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

PHOSPHO-SODA FLAVORED/90M

Facility

$5.00

Hospital Charge Code	60633660
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

PHOTHERAPY/ACTINOTHERAPY

Facility

$209.59

Service Code	HCPCS 96900
Hospital Charge Code	83092030
Hospital Revenue Code	940
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$2,407.00
Rate for Payer: Aetna Commercial	$120.69
Rate for Payer: Aetna Medicare Advantage	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.16
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$44.37
Rate for Payer: Clover Medicare Advantage	$42.15
Rate for Payer: EmblemHealth Commercial	$133.11
Rate for Payer: Humana Medicare Advantage	$45.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.88
Rate for Payer: Oxford Commercial	$1,373.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.44
Rate for Payer: UnitedHealthcare Commercial	$2,407.00
Rate for Payer: UnitedHealthcare Community & State	$5.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.37
Rate for Payer: Wellcare Medicare Advantage	$44.37
Rate for Payer: Wellpoint Medicaid Managed Care	$5.55

PHOTHERAPY/ACTINOTHERAPY

Facility

$209.59

Service Code	HCPCS 96900
Hospital Charge Code	83080045
Hospital Revenue Code	940
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$2,407.00
Rate for Payer: Aetna Commercial	$120.69
Rate for Payer: Aetna Medicare Advantage	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.16
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$44.37
Rate for Payer: Clover Medicare Advantage	$42.15
Rate for Payer: EmblemHealth Commercial	$133.11
Rate for Payer: Humana Medicare Advantage	$45.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.88
Rate for Payer: Oxford Commercial	$1,373.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.44
Rate for Payer: UnitedHealthcare Commercial	$2,407.00
Rate for Payer: UnitedHealthcare Community & State	$5.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.37
Rate for Payer: Wellcare Medicare Advantage	$44.37
Rate for Payer: Wellpoint Medicaid Managed Care	$5.55

PHOTHERAPY/ACTINOTHERAPY

Facility

$209.59

Service Code	HCPCS 96900
Hospital Charge Code	83090020
Hospital Revenue Code	940
Min. Negotiated Rate	$31.44
Max. Negotiated Rate	$31.44
Rate for Payer: Qualcare PPO/HMO/WC	$31.44

PHOTHERAPY/ACTINOTHERAPY

Facility

$209.59

Service Code	HCPCS 96900
Hospital Charge Code	83080045
Hospital Revenue Code	940
Min. Negotiated Rate	$31.44
Max. Negotiated Rate	$31.44
Rate for Payer: Qualcare PPO/HMO/WC	$31.44

Know your out-of-pocket cost for care.

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