Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATELET AB PROFILE

Facility

$493.65

Service Code	HCPCS 8602291
Hospital Charge Code	3007119A
Hospital Revenue Code	302
Min. Negotiated Rate	$74.05
Max. Negotiated Rate	$74.05
Rate for Payer: Qualcare PPO/HMO/WC	$74.05

PLATELET AB PROFILE

Facility

$493.65

Service Code	HCPCS 8602291
Hospital Charge Code	3007119B
Hospital Revenue Code	302
Min. Negotiated Rate	$74.05
Max. Negotiated Rate	$74.05
Rate for Payer: Qualcare PPO/HMO/WC	$74.05

PLATELET AB PROFILE

Facility

$493.65

Service Code	HCPCS 8602291
Hospital Charge Code	3007119A
Hospital Revenue Code	302
Min. Negotiated Rate	$11.90
Max. Negotiated Rate	$246.82
Rate for Payer: Aetna Commercial	$187.59
Rate for Payer: Aetna Medicare Advantage	$148.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.88
Rate for Payer: Cigna Commercial	$246.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.90
Rate for Payer: Wellpoint Medicaid Managed Care	$13.08

PLATELET AB PROFILE

Facility

$493.65

Service Code	HCPCS 8602291
Hospital Charge Code	3007119B
Hospital Revenue Code	302
Min. Negotiated Rate	$11.90
Max. Negotiated Rate	$246.82
Rate for Payer: Aetna Commercial	$187.59
Rate for Payer: Aetna Medicare Advantage	$148.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.88
Rate for Payer: Cigna Commercial	$246.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.90
Rate for Payer: Wellpoint Medicaid Managed Care	$13.08

PLATELET AB PROFILE

Facility

$224.00

Hospital Charge Code	3035073
Hospital Revenue Code	300
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$85.12
Rate for Payer: Aetna Medicare Advantage	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.12
Rate for Payer: Cigna Commercial	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.40
Rate for Payer: Wellpoint Medicaid Managed Care	$5.94

PLATELET AB PROFILE

Facility

$224.00

Hospital Charge Code	3035073
Hospital Revenue Code	300
Min. Negotiated Rate	$33.60
Max. Negotiated Rate	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$33.60

PLATELET AGGREGATION(IN VITRO)

Facility

$390.00

Service Code	HCPCS 85576
Hospital Charge Code	5100825
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PLATELET AGGREGATION(IN VITRO)

Facility

$390.00

Service Code	HCPCS 85576
Hospital Charge Code	5100825
Hospital Revenue Code	300
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$67.76
Rate for Payer: Aetna Medicare Advantage	$80.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.92
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$24.91
Rate for Payer: Clover Medicare Advantage	$23.66
Rate for Payer: EmblemHealth Commercial	$74.73
Rate for Payer: Humana Medicare Advantage	$25.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.91
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	$19.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.91
Rate for Payer: Wellcare Medicare Advantage	$24.91
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

PLATELET ANTIBODIES

Facility

$194.00

Service Code	HCPCS 86022
Hospital Charge Code	38477010
Hospital Revenue Code	300
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$49.97
Rate for Payer: Aetna Medicare Advantage	$59.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.31
Rate for Payer: Cigna Commercial	$97.00
Rate for Payer: Cigna Medicare Advantage	$18.37
Rate for Payer: Clover Medicare Advantage	$17.45
Rate for Payer: EmblemHealth Commercial	$55.11
Rate for Payer: Humana Medicare Advantage	$18.92
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.37
Rate for Payer: Wellcare Medicare Advantage	$18.37
Rate for Payer: Wellpoint Medicaid Managed Care	$5.14

PLATELET ANTIBODIES

Facility

$194.00

Service Code	HCPCS 86022
Hospital Charge Code	38477010
Hospital Revenue Code	300
Min. Negotiated Rate	$29.10
Max. Negotiated Rate	$29.10
Rate for Payer: Qualcare PPO/HMO/WC	$29.10

PLATELET ANTIBODY III

Facility

$493.65

Service Code	HCPCS 8602291
Hospital Charge Code	3007119C
Hospital Revenue Code	302
Min. Negotiated Rate	$11.90
Max. Negotiated Rate	$246.82
Rate for Payer: Aetna Commercial	$187.59
Rate for Payer: Aetna Medicare Advantage	$148.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.88
Rate for Payer: Cigna Commercial	$246.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.90
Rate for Payer: Wellpoint Medicaid Managed Care	$13.08

PLATELET ANTIBODY III

Facility

$493.65

Service Code	HCPCS 8602291
Hospital Charge Code	3007119C
Hospital Revenue Code	302
Min. Negotiated Rate	$74.05
Max. Negotiated Rate	$74.05
Rate for Payer: Qualcare PPO/HMO/WC	$74.05

PLATELET ANTIBODY IV

Facility

$493.65

Service Code	HCPCS 8602291
Hospital Charge Code	3007119D
Hospital Revenue Code	302
Min. Negotiated Rate	$74.05
Max. Negotiated Rate	$74.05
Rate for Payer: Qualcare PPO/HMO/WC	$74.05

PLATELET ANTIBODY IV

Facility

$493.65

Service Code	HCPCS 8602291
Hospital Charge Code	3007119D
Hospital Revenue Code	302
Min. Negotiated Rate	$11.90
Max. Negotiated Rate	$246.82
Rate for Payer: Aetna Commercial	$187.59
Rate for Payer: Aetna Medicare Advantage	$148.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.88
Rate for Payer: Cigna Commercial	$246.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.90
Rate for Payer: Wellpoint Medicaid Managed Care	$13.08

PLATELET ANTIBODY PROFILE

Facility

$1,974.60

Hospital Charge Code	3007119
Hospital Revenue Code	302
Min. Negotiated Rate	$47.59
Max. Negotiated Rate	$987.30
Rate for Payer: Aetna Commercial	$750.35
Rate for Payer: Aetna Medicare Advantage	$592.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.52
Rate for Payer: Cigna Commercial	$987.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$296.19
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$47.59
Rate for Payer: Wellpoint Medicaid Managed Care	$52.33

PLATELET ANTIBODY PROFILE

Facility

$1,974.60

Hospital Charge Code	3007119
Hospital Revenue Code	302
Min. Negotiated Rate	$296.19
Max. Negotiated Rate	$296.19
Rate for Payer: Qualcare PPO/HMO/WC	$296.19

PLATELET BOUND ANTIBODY IGG

Facility

$471.00

Service Code	HCPCS 86022
Hospital Charge Code	38476026
Hospital Revenue Code	302
Min. Negotiated Rate	$12.48
Max. Negotiated Rate	$235.50
Rate for Payer: Aetna Commercial	$49.97
Rate for Payer: Aetna Medicare Advantage	$59.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.31
Rate for Payer: Cigna Commercial	$235.50
Rate for Payer: Cigna Medicare Advantage	$18.37
Rate for Payer: Clover Medicare Advantage	$17.45
Rate for Payer: EmblemHealth Commercial	$55.11
Rate for Payer: Humana Medicare Advantage	$18.92
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.37
Rate for Payer: Wellcare Medicare Advantage	$18.37
Rate for Payer: Wellpoint Medicaid Managed Care	$12.48

PLATELET BOUND ANTIBODY IGG

Facility

$471.00

Service Code	HCPCS 86022
Hospital Charge Code	38476026
Hospital Revenue Code	302
Min. Negotiated Rate	$70.65
Max. Negotiated Rate	$70.65
Rate for Payer: Qualcare PPO/HMO/WC	$70.65

PLATELET CONCENTRATE SYS 30ML

Facility

$3,625.00

Hospital Charge Code	270670801
Hospital Revenue Code	272
Min. Negotiated Rate	$87.36
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,377.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,087.50
Rate for Payer: Oxford Commercial	$725.00
Rate for Payer: Qualcare PPO/HMO/WC	$543.75
Rate for Payer: UnitedHealthcare Commercial	$725.00
Rate for Payer: UnitedHealthcare Community & State	$87.36
Rate for Payer: Wellpoint Medicaid Managed Care	$96.06

PLATELET CONCENTRATE SYS 30ML

Facility

$3,625.00

Hospital Charge Code	270670801
Hospital Revenue Code	272
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$543.75
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

PLATELET CONCENTRATION SYSTEM

Facility

$10,750.00

Hospital Charge Code	270670760
Hospital Revenue Code	272
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$1,612.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

PLATELET CONCENTRATION SYSTEM

Facility

$10,750.00

Hospital Charge Code	270670760
Hospital Revenue Code	272
Min. Negotiated Rate	$259.07
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$4,085.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,225.00
Rate for Payer: Oxford Commercial	$2,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Commercial	$2,150.00
Rate for Payer: UnitedHealthcare Community & State	$259.07
Rate for Payer: Wellpoint Medicaid Managed Care	$284.88

PLATELET COUNT

Facility

$390.00

Service Code	HCPCS 85049
Hospital Charge Code	3002128
Hospital Revenue Code	301
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$12.19
Rate for Payer: Aetna Medicare Advantage	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.17
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.48
Rate for Payer: Clover Medicare Advantage	$4.26
Rate for Payer: EmblemHealth Commercial	$13.44
Rate for Payer: Humana Medicare Advantage	$4.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.48
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	$3.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.48
Rate for Payer: Wellcare Medicare Advantage	$4.48
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

PLATELET COUNT

Facility

$104.00

Service Code	HCPCS 85032
Hospital Charge Code	38473016
Hospital Revenue Code	309
Min. Negotiated Rate	$2.76
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$11.72
Rate for Payer: Aetna Medicare Advantage	$13.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.31
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	$15.56
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: Cigna Medicare Advantage	$4.31
Rate for Payer: Clover Medicare Advantage	$4.09
Rate for Payer: EmblemHealth Commercial	$12.93
Rate for Payer: Humana Medicare Advantage	$4.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.31
Rate for Payer: Wellcare Medicare Advantage	$4.31
Rate for Payer: Wellpoint Medicaid Managed Care	$2.76

PLATELET COUNT

Facility

$43.25

Service Code	HCPCS 85049
Hospital Charge Code	8200341RS
Hospital Revenue Code	301
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

Know your out-of-pocket cost for care.

All Charges