Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

POD REMOVAL OF CAST

Facility

$468.75

Service Code	HCPCS 29700
Hospital Charge Code	84208195
Hospital Revenue Code	361
Min. Negotiated Rate	$11.30
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$903.80
Rate for Payer: Aetna Medicare Advantage	$1,076.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,199.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,199.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$332.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,199.43
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: Cigna Medicare Advantage	$332.28
Rate for Payer: Clover Medicare Advantage	$315.67
Rate for Payer: EmblemHealth Commercial	$996.84
Rate for Payer: Humana Medicare Advantage	$342.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$332.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.62
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.31
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$11.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.28
Rate for Payer: Wellcare Medicare Advantage	$332.28
Rate for Payer: Wellpoint Medicaid Managed Care	$12.42

POD SOFT CAST - UNNA

Facility

$468.75

Service Code	HCPCS 29580
Hospital Charge Code	84208190
Hospital Revenue Code	510
Min. Negotiated Rate	$70.31
Max. Negotiated Rate	$70.31
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

POD SOFT CAST - UNNA

Facility

$468.75

Service Code	HCPCS 29580
Hospital Charge Code	84208190
Hospital Revenue Code	510
Min. Negotiated Rate	$11.30
Max. Negotiated Rate	$696.85
Rate for Payer: Aetna Commercial	$525.10
Rate for Payer: Aetna Medicare Advantage	$625.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$193.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.85
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: Cigna Medicare Advantage	$193.05
Rate for Payer: Clover Medicare Advantage	$183.40
Rate for Payer: EmblemHealth Commercial	$579.15
Rate for Payer: Humana Medicare Advantage	$198.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$193.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.62
Rate for Payer: Qualcare PPO/HMO/WC	$70.31
Rate for Payer: UnitedHealthcare Community & State	$11.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$193.05
Rate for Payer: Wellcare Medicare Advantage	$193.05
Rate for Payer: Wellpoint Medicaid Managed Care	$12.42

POD STRAPPING FOOT-ANKLE

Facility

$468.75

Service Code	HCPCS 29540
Hospital Charge Code	84208180
Hospital Revenue Code	510
Min. Negotiated Rate	$70.31
Max. Negotiated Rate	$70.31
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

POD STRAPPING FOOT-ANKLE

Facility

$468.75

Service Code	HCPCS 29540
Hospital Charge Code	84208180
Hospital Revenue Code	510
Min. Negotiated Rate	$11.30
Max. Negotiated Rate	$696.85
Rate for Payer: Aetna Commercial	$525.10
Rate for Payer: Aetna Medicare Advantage	$625.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$193.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.85
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: Cigna Medicare Advantage	$193.05
Rate for Payer: Clover Medicare Advantage	$183.40
Rate for Payer: EmblemHealth Commercial	$579.15
Rate for Payer: Humana Medicare Advantage	$198.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$193.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.62
Rate for Payer: Qualcare PPO/HMO/WC	$70.31
Rate for Payer: UnitedHealthcare Community & State	$11.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$193.05
Rate for Payer: Wellcare Medicare Advantage	$193.05
Rate for Payer: Wellpoint Medicaid Managed Care	$12.42

POD STRAPPING TOE

Facility

$468.75

Service Code	HCPCS 29550
Hospital Charge Code	84208185
Hospital Revenue Code	510
Min. Negotiated Rate	$70.31
Max. Negotiated Rate	$70.31
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

POD STRAPPING TOE

Facility

$468.75

Service Code	HCPCS 29550
Hospital Charge Code	84208185
Hospital Revenue Code	510
Min. Negotiated Rate	$11.30
Max. Negotiated Rate	$252.97
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.97
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.62
Rate for Payer: Qualcare PPO/HMO/WC	$70.31
Rate for Payer: UnitedHealthcare Community & State	$11.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$12.42

POINTER TRACER AXIEM

Facility

$3,190.00

Hospital Charge Code	270703109
Hospital Revenue Code	278
Min. Negotiated Rate	$478.50
Max. Negotiated Rate	$771.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$638.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$771.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$478.50

POINTER TRACER AXIEM

Facility

$3,190.00

Hospital Charge Code	270703109
Hospital Revenue Code	278
Min. Negotiated Rate	$76.88
Max. Negotiated Rate	$1,595.00
Rate for Payer: Aetna Commercial	$1,212.20
Rate for Payer: Aetna Medicare Advantage	$957.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$813.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$813.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$638.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$813.45
Rate for Payer: Cigna Commercial	$1,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$771.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$478.50
Rate for Payer: UnitedHealthcare Community & State	$76.88
Rate for Payer: Wellpoint Medicaid Managed Care	$84.53

POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC

Facility

$52,827.37

Service Code	MSDRG 917
Min. Negotiated Rate	$16,085.26
Max. Negotiated Rate	$52,827.37
Rate for Payer: Aetna Commercial	$36,555.72
Rate for Payer: Aetna Medicare Advantage	$52,827.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37,217.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37,217.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,931.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37,217.60
Rate for Payer: Cigna Commercial	$29,351.04
Rate for Payer: Cigna Medicare Advantage	$16,931.85
Rate for Payer: Clover Medicare Advantage	$16,085.26
Rate for Payer: EmblemHealth Commercial	$50,795.55
Rate for Payer: Humana Medicare Advantage	$17,439.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,931.85
Rate for Payer: Oxford Commercial	$21,094.98
Rate for Payer: UnitedHealthcare Commercial	$36,990.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,931.85
Rate for Payer: Wellcare Medicare Advantage	$16,931.85

POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC

Facility

$29,836.93

Service Code	MSDRG 918
Min. Negotiated Rate	$9,084.96
Max. Negotiated Rate	$29,836.93
Rate for Payer: Aetna Commercial	$20,758.70
Rate for Payer: Aetna Medicare Advantage	$29,836.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,004.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,004.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,563.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20,004.46
Rate for Payer: Cigna Commercial	$16,039.77
Rate for Payer: Cigna Medicare Advantage	$9,563.12
Rate for Payer: Clover Medicare Advantage	$9,084.96
Rate for Payer: EmblemHealth Commercial	$28,689.36
Rate for Payer: Humana Medicare Advantage	$9,850.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,563.12
Rate for Payer: Oxford Commercial	$11,528.00
Rate for Payer: UnitedHealthcare Commercial	$20,214.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,563.12
Rate for Payer: Wellcare Medicare Advantage	$9,563.12

POISONING OF MEDICINAL AGENTS

Facility

$9,451.50

Service Code	APR-DRG 8123
Min. Negotiated Rate	$9,266.18
Max. Negotiated Rate	$9,451.50
Rate for Payer: UnitedHealthcare Community & State	$9,266.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,451.50
Rate for Payer: Wellpoint Medicaid Managed Care	$9,266.18

POISONING OF MEDICINAL AGENTS

Facility

$4,290.99

Service Code	APR-DRG 8121
Min. Negotiated Rate	$4,206.85
Max. Negotiated Rate	$4,290.99
Rate for Payer: UnitedHealthcare Community & State	$4,206.85
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,290.99
Rate for Payer: Wellpoint Medicaid Managed Care	$4,206.85

POISONING OF MEDICINAL AGENTS

Facility

$6,227.76

Service Code	APR-DRG 8122
Min. Negotiated Rate	$6,105.65
Max. Negotiated Rate	$6,227.76
Rate for Payer: UnitedHealthcare Community & State	$6,105.65
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,227.76
Rate for Payer: Wellpoint Medicaid Managed Care	$6,105.65

POISONING OF MEDICINAL AGENTS

Facility

$18,002.85

Service Code	APR-DRG 8124
Min. Negotiated Rate	$17,649.85
Max. Negotiated Rate	$18,002.85
Rate for Payer: UnitedHealthcare Community & State	$17,649.85
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,002.85
Rate for Payer: Wellpoint Medicaid Managed Care	$17,649.85

POISON IVY EXTRACT/1ML

Facility

$43.00

Hospital Charge Code	60633670
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

POISON IVY EXTRACT/1ML

Facility

$43.00

Hospital Charge Code	60633670
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

POLARAMINE/6MG/TAB

Facility

$3.00

Hospital Charge Code	60634391
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

POLARAMINE/6MG/TAB

Facility

$3.00

Hospital Charge Code	60634391
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

POLARCATH .014 2.5X20 150CM

Facility

$4,232.25

Hospital Charge Code	270642198
Hospital Revenue Code	278
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$2,116.12
Rate for Payer: Aetna Commercial	$1,608.26
Rate for Payer: Aetna Medicare Advantage	$1,269.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,079.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,079.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,079.22
Rate for Payer: Cigna Commercial	$2,116.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,024.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$931.10
Rate for Payer: Qualcare PPO/HMO/WC	$634.84
Rate for Payer: UnitedHealthcare Community & State	$102.00
Rate for Payer: Wellpoint Medicaid Managed Care	$112.15

POLARCATH .014 2.5X20 150CM

Facility

$4,232.25

Hospital Charge Code	270642198
Hospital Revenue Code	278
Min. Negotiated Rate	$634.84
Max. Negotiated Rate	$1,024.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,024.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$931.10
Rate for Payer: Qualcare PPO/HMO/WC	$634.84

POLAR CATH .014 2x100 150cm

Facility

$4,745.25

Hospital Charge Code	270639685
Hospital Revenue Code	278
Min. Negotiated Rate	$711.79
Max. Negotiated Rate	$1,148.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$949.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,148.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$711.79

POLAR CATH .014 2x100 150cm

Facility

$4,745.25

Hospital Charge Code	270639685
Hospital Revenue Code	278
Min. Negotiated Rate	$114.36
Max. Negotiated Rate	$2,372.62
Rate for Payer: Aetna Commercial	$1,803.19
Rate for Payer: Aetna Medicare Advantage	$1,423.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,210.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,210.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$949.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,210.04
Rate for Payer: Cigna Commercial	$2,372.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,148.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$711.79
Rate for Payer: UnitedHealthcare Community & State	$114.36
Rate for Payer: Wellpoint Medicaid Managed Care	$125.75

POLARCATH .014 2X20 150CM

Facility

$4,232.25

Hospital Charge Code	270642194
Hospital Revenue Code	278
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$2,116.12
Rate for Payer: Aetna Commercial	$1,608.26
Rate for Payer: Aetna Medicare Advantage	$1,269.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,079.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,079.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,079.22
Rate for Payer: Cigna Commercial	$2,116.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,024.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$931.10
Rate for Payer: Qualcare PPO/HMO/WC	$634.84
Rate for Payer: UnitedHealthcare Community & State	$102.00
Rate for Payer: Wellpoint Medicaid Managed Care	$112.15

POLARCATH .014 2X20 150CM

Facility

$4,232.25

Hospital Charge Code	270642194
Hospital Revenue Code	278
Min. Negotiated Rate	$634.84
Max. Negotiated Rate	$1,024.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,024.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$931.10
Rate for Payer: Qualcare PPO/HMO/WC	$634.84

Know your out-of-pocket cost for care.

All Charges