Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATELET COUNT

Facility

$43.25

Service Code	HCPCS 85049
Hospital Charge Code	8200341RS
Hospital Revenue Code	301
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$124.00
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	$21.62
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	$12.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
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	$1.15

PLATELET COUNT

Facility

$390.00

Service Code	HCPCS 85049
Hospital Charge Code	3002128
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PLATELET COUNT

Facility

$135.00

Service Code	HCPCS 85032
Hospital Charge Code	38479050
Hospital Revenue Code	309
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$20.25
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

PLATELET COUNT

Facility

$135.00

Service Code	HCPCS 85032
Hospital Charge Code	38479050
Hospital Revenue Code	309
Min. Negotiated Rate	$3.45
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	$67.50
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	$40.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
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	$3.58

PLATELET COUNT

Facility

$104.00

Service Code	HCPCS 85032
Hospital Charge Code	38473016
Hospital Revenue Code	309
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

PLATELET COUNT***

Facility

$18.00

Hospital Charge Code	3012127
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

PLATELET COUNT***

Facility

$18.00

Hospital Charge Code	3012127
Hospital Revenue Code	309
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

PLATELET COUNT, MANUAL

Facility

$44.85

Service Code	HCPCS 85032
Hospital Charge Code	3008570
Hospital Revenue Code	301
Min. Negotiated Rate	$1.19
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	$22.43
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	$13.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.73
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	$1.19

PLATELET COUNT, MANUAL

Facility

$44.85

Service Code	HCPCS 85032
Hospital Charge Code	3008570
Hospital Revenue Code	301
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$6.73
Rate for Payer: Qualcare PPO/HMO/WC	$6.73

PLATELET IGG

Facility

$493.65

Service Code	HCPCS 86022
Hospital Charge Code	3035073A
Hospital Revenue Code	300
Min. Negotiated Rate	$74.05
Max. Negotiated Rate	$74.05
Rate for Payer: Qualcare PPO/HMO/WC	$74.05

PLATELET IGG

Facility

$493.65

Service Code	HCPCS 86022
Hospital Charge Code	3035073A
Hospital Revenue Code	300
Min. Negotiated Rate	$13.08
Max. Negotiated Rate	$246.82
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	$246.82
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	$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	$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	$13.08

PLATELET INDIRECT

Facility

$112.00

Service Code	HCPCS 86023
Hospital Charge Code	3035073B
Hospital Revenue Code	300
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$16.80

PLATELET INDIRECT

Facility

$112.00

Service Code	HCPCS 86023
Hospital Charge Code	3035073B
Hospital Revenue Code	300
Min. Negotiated Rate	$2.97
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$33.89
Rate for Payer: Aetna Medicare Advantage	$40.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.98
Rate for Payer: Cigna Commercial	$56.00
Rate for Payer: Cigna Medicare Advantage	$12.46
Rate for Payer: Clover Medicare Advantage	$11.84
Rate for Payer: EmblemHealth Commercial	$37.38
Rate for Payer: Humana Medicare Advantage	$12.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.46
Rate for Payer: Wellcare Medicare Advantage	$12.46
Rate for Payer: Wellpoint Medicaid Managed Care	$2.97

PLATELET NEUTRALIZATION

Facility

$127.00

Service Code	HCPCS 85597
Hospital Charge Code	38477147
Hospital Revenue Code	305
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.91
Rate for Payer: Aetna Medicare Advantage	$58.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.90
Rate for Payer: Cigna Commercial	$63.50
Rate for Payer: Cigna Medicare Advantage	$17.98
Rate for Payer: Clover Medicare Advantage	$17.08
Rate for Payer: EmblemHealth Commercial	$53.94
Rate for Payer: Humana Medicare Advantage	$18.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.98
Rate for Payer: Wellcare Medicare Advantage	$17.98
Rate for Payer: Wellpoint Medicaid Managed Care	$3.37

PLATELET NEUTRALIZATION

Facility

$127.00

Service Code	HCPCS 85597
Hospital Charge Code	38477147
Hospital Revenue Code	305
Min. Negotiated Rate	$19.05
Max. Negotiated Rate	$19.05
Rate for Payer: Qualcare PPO/HMO/WC	$19.05

PLATELETPHERESIS

Facility

$1,057.00

Service Code	HCPCS 36520
Hospital Charge Code	3400025
Hospital Revenue Code	761
Min. Negotiated Rate	$158.55
Max. Negotiated Rate	$158.55
Rate for Payer: Qualcare PPO/HMO/WC	$158.55

PLATELETPHERESIS

Facility

$1,057.00

Service Code	HCPCS 36520
Hospital Charge Code	3400025
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

PLATELET, PHERESIS, EACH UNIT

Facility

$2,722.00

Hospital Charge Code	38471090
Hospital Revenue Code	390
Min. Negotiated Rate	$408.30
Max. Negotiated Rate	$408.30
Rate for Payer: Qualcare PPO/HMO/WC	$408.30

PLATELET, PHERESIS, EACH UNIT

Facility

$2,722.00

Hospital Charge Code	38471090
Hospital Revenue Code	390
Min. Negotiated Rate	$65.60
Max. Negotiated Rate	$1,361.00
Rate for Payer: Aetna Commercial	$1,034.36
Rate for Payer: Aetna Medicare Advantage	$816.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$694.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$694.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$694.11
Rate for Payer: Cigna Commercial	$1,361.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$816.60
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$408.30
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$65.60
Rate for Payer: Wellpoint Medicaid Managed Care	$72.13

PLATELET PHERESIS HLA, L/R

Facility

$4,767.94

Service Code	HCPCS P9052
Hospital Charge Code	38471095
Hospital Revenue Code	390
Min. Negotiated Rate	$114.91
Max. Negotiated Rate	$2,972.08
Rate for Payer: Aetna Commercial	$2,239.54
Rate for Payer: Aetna Medicare Advantage	$2,667.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,972.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,972.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$823.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,972.08
Rate for Payer: Cigna Commercial	$1,650.43
Rate for Payer: Cigna Medicare Advantage	$823.36
Rate for Payer: Clover Medicare Advantage	$782.19
Rate for Payer: EmblemHealth Commercial	$2,470.08
Rate for Payer: Humana Medicare Advantage	$848.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$823.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,430.38
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$715.19
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$114.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$823.36
Rate for Payer: Wellcare Medicare Advantage	$823.36
Rate for Payer: Wellpoint Medicaid Managed Care	$126.35

PLATELET PHERESIS HLA, L/R

Facility

$4,767.94

Service Code	HCPCS P9052
Hospital Charge Code	38471095
Hospital Revenue Code	390
Min. Negotiated Rate	$715.19
Max. Negotiated Rate	$715.19
Rate for Payer: Qualcare PPO/HMO/WC	$715.19

PLATELET PHERESIS IRRADIATED

Facility

$3,294.22

Hospital Charge Code	38471097
Hospital Revenue Code	390
Min. Negotiated Rate	$79.39
Max. Negotiated Rate	$1,647.11
Rate for Payer: Aetna Commercial	$1,251.80
Rate for Payer: Aetna Medicare Advantage	$988.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$840.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$840.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$840.03
Rate for Payer: Cigna Commercial	$1,647.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$988.27
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$494.13
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$79.39
Rate for Payer: Wellpoint Medicaid Managed Care	$87.30

PLATELET PHERESIS IRRADIATED

Facility

$3,294.22

Hospital Charge Code	38471097
Hospital Revenue Code	390
Min. Negotiated Rate	$494.13
Max. Negotiated Rate	$494.13
Rate for Payer: Qualcare PPO/HMO/WC	$494.13

PLATELET PHERESIS IRRADIATED

Facility

$2,582.41

Hospital Charge Code	3101514
Hospital Revenue Code	390
Min. Negotiated Rate	$387.36
Max. Negotiated Rate	$387.36
Rate for Payer: Qualcare PPO/HMO/WC	$387.36

PLATELET PHERESIS IRRADIATED

Facility

$2,582.41

Hospital Charge Code	3101514
Hospital Revenue Code	390
Min. Negotiated Rate	$62.24
Max. Negotiated Rate	$1,291.20
Rate for Payer: Aetna Commercial	$981.32
Rate for Payer: Aetna Medicare Advantage	$774.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$658.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$658.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$658.51
Rate for Payer: Cigna Commercial	$1,291.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$774.72
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$387.36
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$62.24
Rate for Payer: Wellpoint Medicaid Managed Care	$68.43

Know your out-of-pocket cost for care.

All Charges