Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLANTAN PLATE KIT

Facility

$4,750.00

Hospital Charge Code	270657690
Hospital Revenue Code	278
Min. Negotiated Rate	$114.47
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Community & State	$114.47
Rate for Payer: Wellpoint Medicaid Managed Care	$125.88

PLANTAN PLATE KIT

Facility

$4,750.00

Hospital Charge Code	270657690
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

PLANTAR LAPIDUS PLATE LEFT

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270677079
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

PLANTAR LAPIDUS PLATE LEFT

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270677079
Hospital Revenue Code	278
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Community & State	$180.15
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

PLASMA 18 NORM R W/D5W 1000cc

Facility

$8.15

Hospital Charge Code	270650170
Hospital Revenue Code	270
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$4.08
Rate for Payer: Aetna Commercial	$3.10
Rate for Payer: Aetna Medicare Advantage	$2.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.08
Rate for Payer: Cigna Commercial	$4.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.44
Rate for Payer: Oxford Commercial	$1.63
Rate for Payer: Qualcare PPO/HMO/WC	$1.22
Rate for Payer: UnitedHealthcare Commercial	$1.63
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

PLASMA 18 NORM R W/D5W 1000cc

Facility

$8.15

Hospital Charge Code	270650170
Hospital Revenue Code	270
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$1.22
Rate for Payer: Qualcare PPO/HMO/WC	$1.22

PLASMABLADE

Facility

$3,505.00

Hospital Charge Code	270702692
Hospital Revenue Code	270
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$1,752.50
Rate for Payer: Aetna Commercial	$1,331.90
Rate for Payer: Aetna Medicare Advantage	$1,051.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$893.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$893.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$893.77
Rate for Payer: Cigna Commercial	$1,752.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,051.50
Rate for Payer: Oxford Commercial	$701.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.75
Rate for Payer: UnitedHealthcare Commercial	$701.00
Rate for Payer: UnitedHealthcare Community & State	$84.47
Rate for Payer: Wellpoint Medicaid Managed Care	$92.88

PLASMABLADE

Facility

$3,505.00

Hospital Charge Code	270702692
Hospital Revenue Code	270
Min. Negotiated Rate	$525.75
Max. Negotiated Rate	$525.75
Rate for Payer: Qualcare PPO/HMO/WC	$525.75

PLASMA FROZEN WITHIN 24 H (ADD

Facility

$289.45

Hospital Charge Code	3101535
Hospital Revenue Code	390
Min. Negotiated Rate	$6.98
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$109.99
Rate for Payer: Aetna Medicare Advantage	$86.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.81
Rate for Payer: Cigna Commercial	$144.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.83
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.42
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$6.98
Rate for Payer: Wellpoint Medicaid Managed Care	$7.67

PLASMA FROZEN WITHIN 24 H (ADD

Facility

$289.45

Hospital Charge Code	3101535
Hospital Revenue Code	390
Min. Negotiated Rate	$43.42
Max. Negotiated Rate	$43.42
Rate for Payer: Qualcare PPO/HMO/WC	$43.42

PLASMA HEMOGLOBIN

Facility

$51.75

Service Code	HCPCS 83051
Hospital Charge Code	38478084
Hospital Revenue Code	301
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$7.76
Rate for Payer: Qualcare PPO/HMO/WC	$7.76

PLASMA HEMOGLOBIN

Facility

$51.75

Service Code	HCPCS 83051
Hospital Charge Code	38478084
Hospital Revenue Code	301
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$19.88
Rate for Payer: Aetna Medicare Advantage	$23.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.39
Rate for Payer: Cigna Commercial	$25.88
Rate for Payer: Cigna Medicare Advantage	$7.31
Rate for Payer: Clover Medicare Advantage	$6.94
Rate for Payer: EmblemHealth Commercial	$21.93
Rate for Payer: Humana Medicare Advantage	$7.53
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.76
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.31
Rate for Payer: Wellcare Medicare Advantage	$7.31
Rate for Payer: Wellpoint Medicaid Managed Care	$1.37

PLASMA HOOK FOR COBLATOR II

Facility

$714.25

Hospital Charge Code	270630933
Hospital Revenue Code	278
Min. Negotiated Rate	$17.21
Max. Negotiated Rate	$357.12
Rate for Payer: Aetna Commercial	$271.42
Rate for Payer: Aetna Medicare Advantage	$214.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.13
Rate for Payer: Cigna Commercial	$357.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$157.13
Rate for Payer: Qualcare PPO/HMO/WC	$107.14
Rate for Payer: UnitedHealthcare Community & State	$17.21
Rate for Payer: Wellpoint Medicaid Managed Care	$18.93

PLASMA HOOK FOR COBLATOR II

Facility

$714.25

Hospital Charge Code	270630933
Hospital Revenue Code	278
Min. Negotiated Rate	$107.14
Max. Negotiated Rate	$172.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$157.13
Rate for Payer: Qualcare PPO/HMO/WC	$107.14

PLASMA LYTE 148 NORM R 1000cc

Facility

$7.25

Hospital Charge Code	270650171
Hospital Revenue Code	270
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

PLASMA LYTE 148 NORM R 1000cc

Facility

$7.25

Hospital Charge Code	270650171
Hospital Revenue Code	270
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.75
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.17
Rate for Payer: Oxford Commercial	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$1.45
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

PLASMA LYTE 56 (NORM.M)

Facility

$11.00

Hospital Charge Code	270651077
Hospital Revenue Code	270
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

PLASMA LYTE 56 (NORM.M)

Facility

$11.00

Hospital Charge Code	270651077
Hospital Revenue Code	270
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.50
Rate for Payer: Aetna Commercial	$4.18
Rate for Payer: Aetna Medicare Advantage	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.81
Rate for Payer: Cigna Commercial	$5.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.30
Rate for Payer: Oxford Commercial	$2.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.65
Rate for Payer: UnitedHealthcare Commercial	$2.20
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

PLASMANATE *******

Facility

$425.00

Hospital Charge Code	7000482
Hospital Revenue Code	279
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.50
Rate for Payer: Oxford Commercial	$85.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$85.00
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

PLASMANATE *******

Facility

$425.00

Hospital Charge Code	7000482
Hospital Revenue Code	279
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

PLASMAPHERESIS

Facility

$1,057.00

Service Code	HCPCS 36520
Hospital Charge Code	3400033
Hospital Revenue Code	761
Min. Negotiated Rate	$25.47
Max. Negotiated Rate	$528.50
Rate for Payer: Aetna Commercial	$401.66
Rate for Payer: Aetna Medicare Advantage	$317.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.54
Rate for Payer: Cigna Commercial	$528.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$317.10
Rate for Payer: Oxford Commercial	$211.40
Rate for Payer: Qualcare PPO/HMO/WC	$158.55
Rate for Payer: UnitedHealthcare Commercial	$211.40
Rate for Payer: UnitedHealthcare Community & State	$25.47
Rate for Payer: Wellpoint Medicaid Managed Care	$28.01

PLASMAPHERESIS

Facility

$1,057.00

Service Code	HCPCS 36520
Hospital Charge Code	3400033
Hospital Revenue Code	761
Min. Negotiated Rate	$158.55
Max. Negotiated Rate	$158.55
Rate for Payer: Qualcare PPO/HMO/WC	$158.55

PLASMA PLATELET RICH PRP

Facility

$2,500.00

Hospital Charge Code	270646448
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

PLASMA PLATELET RICH PRP

Facility

$2,500.00

Hospital Charge Code	270646448
Hospital Revenue Code	272
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$500.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

PLASMA PROTEIN 5% INJ 250ML

Facility

$90.90

Hospital Charge Code	6004451
Hospital Revenue Code	250
Min. Negotiated Rate	$13.63
Max. Negotiated Rate	$13.63
Rate for Payer: Qualcare PPO/HMO/WC	$13.63

Know your out-of-pocket cost for care.

All Charges