Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PRESSURE MONITORING ACCY

Facility

$775.00

Hospital Charge Code	270687443
Hospital Revenue Code	272
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$116.25
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

PRESSURE MONITOR NEEDLE SET***

Facility

$228.00

Hospital Charge Code	8004384
Hospital Revenue Code	272
Min. Negotiated Rate	$5.49
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$86.64
Rate for Payer: Aetna Medicare Advantage	$68.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.14
Rate for Payer: Cigna Commercial	$114.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.40
Rate for Payer: Oxford Commercial	$45.60
Rate for Payer: Qualcare PPO/HMO/WC	$34.20
Rate for Payer: UnitedHealthcare Commercial	$45.60
Rate for Payer: UnitedHealthcare Community & State	$5.49
Rate for Payer: Wellpoint Medicaid Managed Care	$6.04

PRESSURE MONITOR NEEDLE SET***

Facility

$228.00

Hospital Charge Code	8004384
Hospital Revenue Code	272
Min. Negotiated Rate	$34.20
Max. Negotiated Rate	$34.20
Rate for Payer: Qualcare PPO/HMO/WC	$34.20

PRESSURE MONITOR SYRINGE

Facility

$935.00

Hospital Charge Code	270325447
Hospital Revenue Code	272
Min. Negotiated Rate	$140.25
Max. Negotiated Rate	$140.25
Rate for Payer: Qualcare PPO/HMO/WC	$140.25

PRESSURE MONITOR SYRINGE

Facility

$935.00

Hospital Charge Code	270325447
Hospital Revenue Code	272
Min. Negotiated Rate	$22.53
Max. Negotiated Rate	$467.50
Rate for Payer: Aetna Commercial	$355.30
Rate for Payer: Aetna Medicare Advantage	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.43
Rate for Payer: Cigna Commercial	$467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$280.50
Rate for Payer: Oxford Commercial	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$140.25
Rate for Payer: UnitedHealthcare Commercial	$187.00
Rate for Payer: UnitedHealthcare Community & State	$22.53
Rate for Payer: Wellpoint Medicaid Managed Care	$24.78

PRESTIGE (R) LP CERV DISC 5X16

Facility

$23,290.00

Service Code	HCPCS C1713
Hospital Charge Code	270704991
Hospital Revenue Code	278
Min. Negotiated Rate	$3,493.50
Max. Negotiated Rate	$5,636.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,658.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,636.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,123.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,493.50

PRESTIGE (R) LP CERV DISC 5X16

Facility

$23,290.00

Service Code	HCPCS C1713
Hospital Charge Code	270704991
Hospital Revenue Code	278
Min. Negotiated Rate	$561.29
Max. Negotiated Rate	$11,645.00
Rate for Payer: Aetna Commercial	$8,850.20
Rate for Payer: Aetna Medicare Advantage	$6,987.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,938.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,938.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,658.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,938.95
Rate for Payer: Cigna Commercial	$11,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,636.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,123.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,493.50
Rate for Payer: UnitedHealthcare Community & State	$561.29
Rate for Payer: Wellpoint Medicaid Managed Care	$617.18

PRETREATMENT OF RBC FOR AB ID

Facility

$89.00

Service Code	HCPCS 86970
Hospital Charge Code	38471098
Hospital Revenue Code	300
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$13.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.35

PRETREATMENT OF RBC FOR AB ID

Facility

$89.00

Service Code	HCPCS 86970
Hospital Charge Code	38471098
Hospital Revenue Code	300
Min. Negotiated Rate	$2.36
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	$17.21
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	$26.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$2.36

PRETREATMNT OF SERUM FOR AB ID

Facility

$149.00

Service Code	HCPCS 86975
Hospital Charge Code	38471099
Hospital Revenue Code	300
Min. Negotiated Rate	$22.35
Max. Negotiated Rate	$22.35
Rate for Payer: Qualcare PPO/HMO/WC	$22.35

PRETREATMNT OF SERUM FOR AB ID

Facility

$149.00

Service Code	HCPCS 86975
Hospital Charge Code	38471099
Hospital Revenue Code	300
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$1,915.74
Rate for Payer: Aetna Commercial	$1,443.56
Rate for Payer: Aetna Medicare Advantage	$1,719.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,915.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,915.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$530.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,915.74
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: Cigna Medicare Advantage	$530.72
Rate for Payer: Clover Medicare Advantage	$504.18
Rate for Payer: EmblemHealth Commercial	$1,592.16
Rate for Payer: Humana Medicare Advantage	$546.64
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$530.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$25.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$530.72
Rate for Payer: Wellcare Medicare Advantage	$530.72
Rate for Payer: Wellpoint Medicaid Managed Care	$3.95

PRE TYPING DIRECT DONORS

Facility

$626.42

Service Code	HCPCS 86900
Hospital Charge Code	3100351
Hospital Revenue Code	300
Min. Negotiated Rate	$93.96
Max. Negotiated Rate	$93.96
Rate for Payer: Qualcare PPO/HMO/WC	$93.96

PRE TYPING DIRECT DONORS

Facility

$626.42

Service Code	HCPCS 86900
Hospital Charge Code	3100351
Hospital Revenue Code	300
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$8.13
Rate for Payer: Aetna Medicare Advantage	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.79
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$2.99
Rate for Payer: Clover Medicare Advantage	$2.84
Rate for Payer: EmblemHealth Commercial	$8.97
Rate for Payer: Humana Medicare Advantage	$3.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.96
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.99
Rate for Payer: Wellcare Medicare Advantage	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$16.60

PREVACID 15MG CAPS

Facility

$13.00

Hospital Charge Code	60635127
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

PREVACID 15MG CAPS

Facility

$13.00

Hospital Charge Code	60635127
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

PREVACID 30MG/50ML NS IVPB

Facility

$109.10

Hospital Charge Code	60629355
Hospital Revenue Code	250
Min. Negotiated Rate	$2.63
Max. Negotiated Rate	$54.55
Rate for Payer: Aetna Commercial	$41.46
Rate for Payer: Aetna Medicare Advantage	$32.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.82
Rate for Payer: Cigna Commercial	$54.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.73
Rate for Payer: Oxford Commercial	$21.82
Rate for Payer: Qualcare PPO/HMO/WC	$16.36
Rate for Payer: UnitedHealthcare Commercial	$21.82
Rate for Payer: UnitedHealthcare Community & State	$2.63
Rate for Payer: Wellpoint Medicaid Managed Care	$2.89

PREVACID 30MG/50ML NS IVPB

Facility

$109.10

Hospital Charge Code	60629355
Hospital Revenue Code	250
Min. Negotiated Rate	$16.36
Max. Negotiated Rate	$16.36
Rate for Payer: Qualcare PPO/HMO/WC	$16.36

PREVACID 30MG CAPS

Facility

$18.00

Hospital Charge Code	60635126
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

PREVACID 30MG CAPS

Facility

$18.00

Hospital Charge Code	60635126
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
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	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

PREVACID 3MG SOLUTAB

Facility

$17.00

Hospital Charge Code	60635574
Hospital Revenue Code	250
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.50
Rate for Payer: Aetna Commercial	$6.46
Rate for Payer: Aetna Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.33
Rate for Payer: Cigna Commercial	$8.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.10
Rate for Payer: Oxford Commercial	$3.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$3.40
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

PREVACID 3MG SOLUTAB

Facility

$17.00

Hospital Charge Code	60635574
Hospital Revenue Code	250
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

PREVACID IV 30MG

Facility

$9.00

Hospital Charge Code	60635481
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

PREVACID IV 30MG

Facility

$9.00

Hospital Charge Code	60635481
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

PREVALON TAP 2.0 TURN & POSITI

Facility

$623.80

Hospital Charge Code	270675835
Hospital Revenue Code	272
Min. Negotiated Rate	$15.03
Max. Negotiated Rate	$311.90
Rate for Payer: Aetna Commercial	$237.04
Rate for Payer: Aetna Medicare Advantage	$187.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.07
Rate for Payer: Cigna Commercial	$311.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.14
Rate for Payer: Oxford Commercial	$124.76
Rate for Payer: Qualcare PPO/HMO/WC	$93.57
Rate for Payer: UnitedHealthcare Commercial	$124.76
Rate for Payer: UnitedHealthcare Community & State	$15.03
Rate for Payer: Wellpoint Medicaid Managed Care	$16.53

PREVALON TAP 2.0 TURN & POSITI

Facility

$623.80

Hospital Charge Code	270675835
Hospital Revenue Code	272
Min. Negotiated Rate	$93.57
Max. Negotiated Rate	$93.57
Rate for Payer: Qualcare PPO/HMO/WC	$93.57

Know your out-of-pocket cost for care.

All Charges