Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PREC G GLUCOSE TEST STRIP

Facility

$181.00

Hospital Charge Code	60635199
Hospital Revenue Code	250
Min. Negotiated Rate	$4.36
Max. Negotiated Rate	$90.50
Rate for Payer: Aetna Commercial	$68.78
Rate for Payer: Aetna Medicare Advantage	$54.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.16
Rate for Payer: Cigna Commercial	$90.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.30
Rate for Payer: Oxford Commercial	$36.20
Rate for Payer: Qualcare PPO/HMO/WC	$27.15
Rate for Payer: UnitedHealthcare Commercial	$36.20
Rate for Payer: UnitedHealthcare Community & State	$4.36
Rate for Payer: Wellpoint Medicaid Managed Care	$4.80

PREC G GLUCOSE TEST STRIP

Facility

$181.00

Hospital Charge Code	60635199
Hospital Revenue Code	250
Min. Negotiated Rate	$27.15
Max. Negotiated Rate	$27.15
Rate for Payer: Qualcare PPO/HMO/WC	$27.15

PRECHAMBER PROGAV W/SA10

Facility

$15,112.85

Hospital Charge Code	270686380
Hospital Revenue Code	278
Min. Negotiated Rate	$2,266.93
Max. Negotiated Rate	$3,657.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,022.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,657.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,324.83
Rate for Payer: Qualcare PPO/HMO/WC	$2,266.93

PRECHAMBER PROGAV W/SA10

Facility

$15,112.85

Hospital Charge Code	270686382
Hospital Revenue Code	278
Min. Negotiated Rate	$2,266.93
Max. Negotiated Rate	$3,657.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,022.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,657.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,324.83
Rate for Payer: Qualcare PPO/HMO/WC	$2,266.93

PRECHAMBER PROGAV W/SA10

Facility

$15,112.85

Hospital Charge Code	270686380
Hospital Revenue Code	278
Min. Negotiated Rate	$364.22
Max. Negotiated Rate	$7,556.43
Rate for Payer: Aetna Commercial	$5,742.88
Rate for Payer: Aetna Medicare Advantage	$4,533.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,853.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,853.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,022.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,853.78
Rate for Payer: Cigna Commercial	$7,556.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,657.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,324.83
Rate for Payer: Qualcare PPO/HMO/WC	$2,266.93
Rate for Payer: UnitedHealthcare Community & State	$364.22
Rate for Payer: Wellpoint Medicaid Managed Care	$400.49

PRECHAMBER PROGAV W/SA10

Facility

$15,112.85

Hospital Charge Code	270686382
Hospital Revenue Code	278
Min. Negotiated Rate	$364.22
Max. Negotiated Rate	$7,556.43
Rate for Payer: Aetna Commercial	$5,742.88
Rate for Payer: Aetna Medicare Advantage	$4,533.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,853.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,853.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,022.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,853.78
Rate for Payer: Cigna Commercial	$7,556.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,657.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,324.83
Rate for Payer: Qualcare PPO/HMO/WC	$2,266.93
Rate for Payer: UnitedHealthcare Community & State	$364.22
Rate for Payer: Wellpoint Medicaid Managed Care	$400.49

PRECHAMBER PROGAV W/SA20

Facility

$15,112.85

Hospital Charge Code	270686381
Hospital Revenue Code	278
Min. Negotiated Rate	$2,266.93
Max. Negotiated Rate	$3,657.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,022.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,657.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,324.83
Rate for Payer: Qualcare PPO/HMO/WC	$2,266.93

PRECHAMBER PROGAV W/SA20

Facility

$15,112.85

Hospital Charge Code	270686383
Hospital Revenue Code	278
Min. Negotiated Rate	$2,266.93
Max. Negotiated Rate	$3,657.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,022.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,657.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,324.83
Rate for Payer: Qualcare PPO/HMO/WC	$2,266.93

PRECHAMBER PROGAV W/SA20

Facility

$15,112.85

Hospital Charge Code	270686383
Hospital Revenue Code	278
Min. Negotiated Rate	$364.22
Max. Negotiated Rate	$7,556.43
Rate for Payer: Aetna Commercial	$5,742.88
Rate for Payer: Aetna Medicare Advantage	$4,533.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,853.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,853.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,022.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,853.78
Rate for Payer: Cigna Commercial	$7,556.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,657.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,324.83
Rate for Payer: Qualcare PPO/HMO/WC	$2,266.93
Rate for Payer: UnitedHealthcare Community & State	$364.22
Rate for Payer: Wellpoint Medicaid Managed Care	$400.49

PRECHAMBER PROGAV W/SA20

Facility

$15,112.85

Hospital Charge Code	270686381
Hospital Revenue Code	278
Min. Negotiated Rate	$364.22
Max. Negotiated Rate	$7,556.43
Rate for Payer: Aetna Commercial	$5,742.88
Rate for Payer: Aetna Medicare Advantage	$4,533.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,853.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,853.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,022.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,853.78
Rate for Payer: Cigna Commercial	$7,556.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,657.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,324.83
Rate for Payer: Qualcare PPO/HMO/WC	$2,266.93
Rate for Payer: UnitedHealthcare Community & State	$364.22
Rate for Payer: Wellpoint Medicaid Managed Care	$400.49

PRECISE PRO RX US CAROT STENT

Facility

$6,100.00

Service Code	HCPCS C1876
Hospital Charge Code	270684256
Hospital Revenue Code	278
Min. Negotiated Rate	$915.00
Max. Negotiated Rate	$1,476.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,476.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,342.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00

PRECISE PRO RX US CAROT STENT

Facility

$6,100.00

Service Code	HCPCS C1876
Hospital Charge Code	270684256N
Hospital Revenue Code	278
Min. Negotiated Rate	$915.00
Max. Negotiated Rate	$1,476.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,476.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,342.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00

PRECISE PRO RX US CAROT STENT

Facility

$6,100.00

Service Code	HCPCS C1876
Hospital Charge Code	270684256
Hospital Revenue Code	278
Min. Negotiated Rate	$147.01
Max. Negotiated Rate	$3,050.00
Rate for Payer: Aetna Commercial	$2,318.00
Rate for Payer: Aetna Medicare Advantage	$1,830.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,555.50
Rate for Payer: Cigna Commercial	$3,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,476.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,342.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00
Rate for Payer: UnitedHealthcare Community & State	$147.01
Rate for Payer: Wellpoint Medicaid Managed Care	$161.65

PRECISE PRO RX US CAROT STENT

Facility

$6,100.00

Service Code	HCPCS C1876
Hospital Charge Code	270684256S
Hospital Revenue Code	278
Min. Negotiated Rate	$147.01
Max. Negotiated Rate	$3,050.00
Rate for Payer: Aetna Commercial	$2,318.00
Rate for Payer: Aetna Medicare Advantage	$1,830.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,555.50
Rate for Payer: Cigna Commercial	$3,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,476.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,342.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00
Rate for Payer: UnitedHealthcare Community & State	$147.01
Rate for Payer: Wellpoint Medicaid Managed Care	$161.65

PRECISE PRO RX US CAROT STENT

Facility

$6,100.00

Service Code	HCPCS C1876
Hospital Charge Code	270684256S
Hospital Revenue Code	278
Min. Negotiated Rate	$915.00
Max. Negotiated Rate	$1,476.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,476.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,342.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00

PRECISE PRO RX US CAROT STENT

Facility

$6,100.00

Service Code	HCPCS C1876
Hospital Charge Code	270684256N
Hospital Revenue Code	278
Min. Negotiated Rate	$147.01
Max. Negotiated Rate	$3,050.00
Rate for Payer: Aetna Commercial	$2,318.00
Rate for Payer: Aetna Medicare Advantage	$1,830.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,555.50
Rate for Payer: Cigna Commercial	$3,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,476.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,342.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00
Rate for Payer: UnitedHealthcare Community & State	$147.01
Rate for Payer: Wellpoint Medicaid Managed Care	$161.65

PRECISE STENT 8MMX30MM

Facility

$10,590.00

Service Code	HCPCS C1876
Hospital Charge Code	270682958
Hospital Revenue Code	278
Min. Negotiated Rate	$255.22
Max. Negotiated Rate	$5,295.00
Rate for Payer: Aetna Commercial	$4,024.20
Rate for Payer: Aetna Medicare Advantage	$3,177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,700.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,700.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,118.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,700.45
Rate for Payer: Cigna Commercial	$5,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,562.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,329.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,588.50
Rate for Payer: UnitedHealthcare Community & State	$255.22
Rate for Payer: Wellpoint Medicaid Managed Care	$280.63

PRECISE STENT 8MMX30MM

Facility

$10,590.00

Service Code	HCPCS C1876
Hospital Charge Code	270682958
Hospital Revenue Code	278
Min. Negotiated Rate	$1,588.50
Max. Negotiated Rate	$2,562.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,118.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,562.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,329.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,588.50

PRECISION SPINE DEKOTA CAGE 14

Facility

$32,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270697210
Hospital Revenue Code	278
Min. Negotiated Rate	$4,837.50
Max. Negotiated Rate	$7,804.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,804.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,095.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,837.50

PRECISION SPINE DEKOTA CAGE 14

Facility

$32,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270697210
Hospital Revenue Code	278
Min. Negotiated Rate	$777.23
Max. Negotiated Rate	$16,125.00
Rate for Payer: Aetna Commercial	$12,255.00
Rate for Payer: Aetna Medicare Advantage	$9,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,223.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,223.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,223.75
Rate for Payer: Cigna Commercial	$16,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,804.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,095.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,837.50
Rate for Payer: UnitedHealthcare Community & State	$777.23
Rate for Payer: Wellpoint Medicaid Managed Care	$854.62

PRED FORTE 1% OPHTH/15ML

Facility

$152.00

Hospital Charge Code	60633697
Hospital Revenue Code	250
Min. Negotiated Rate	$3.66
Max. Negotiated Rate	$76.00
Rate for Payer: Aetna Commercial	$57.76
Rate for Payer: Aetna Medicare Advantage	$45.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.76
Rate for Payer: Cigna Commercial	$76.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.60
Rate for Payer: Oxford Commercial	$30.40
Rate for Payer: Qualcare PPO/HMO/WC	$22.80
Rate for Payer: UnitedHealthcare Commercial	$30.40
Rate for Payer: UnitedHealthcare Community & State	$3.66
Rate for Payer: Wellpoint Medicaid Managed Care	$4.03

PRED FORTE 1% OPHTH/15ML

Facility

$152.00

Hospital Charge Code	60633697
Hospital Revenue Code	250
Min. Negotiated Rate	$22.80
Max. Negotiated Rate	$22.80
Rate for Payer: Qualcare PPO/HMO/WC	$22.80

PRED FORTE 1% OPHTH/5ML

Facility

$65.00

Hospital Charge Code	60633696
Hospital Revenue Code	250
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$32.50
Rate for Payer: Aetna Commercial	$24.70
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$13.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$13.00
Rate for Payer: UnitedHealthcare Community & State	$1.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

PRED FORTE 1% OPHTH/5ML

Facility

$65.00

Hospital Charge Code	60633696
Hospital Revenue Code	250
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

PRED MILD 0.12% OPHTH/5ML

Facility

$89.00

Hospital Charge Code	60633698
Hospital Revenue Code	250
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$13.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.35

Know your out-of-pocket cost for care.

All Charges