Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PROGRESSIVE RIGHT CORONARY 6F

Facility

$40.00

Service Code	HCPCS C1887
Hospital Charge Code	270658056N
Hospital Revenue Code	278
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$9.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

PROGRESSIVE RIGHT CORONARY 6F

Facility

$40.00

Service Code	HCPCS C1887
Hospital Charge Code	270658056N
Hospital Revenue Code	278
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

PROGRESSIVE RIGHT CORONARY 6F

Facility

$37.90

Service Code	HCPCS C1887
Hospital Charge Code	270658056
Hospital Revenue Code	278
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.95
Rate for Payer: Aetna Commercial	$14.40
Rate for Payer: Aetna Medicare Advantage	$11.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.66
Rate for Payer: Cigna Commercial	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.34
Rate for Payer: Qualcare PPO/HMO/WC	$5.68
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

PROGRESSIVE RIGHT CORONARY 6F

Facility

$37.90

Service Code	HCPCS C1887
Hospital Charge Code	270658056S
Hospital Revenue Code	278
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$9.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.34
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

PROGRESSIVE RT CORONARY 6F

Facility

$40.00

Hospital Charge Code	2709000323
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

PROGRESSIVE RT CORONARY 6F

Facility

$40.00

Hospital Charge Code	2709000323
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.00
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

PRO-INSULIN

Facility

$376.00

Service Code	HCPCS 84206
Hospital Charge Code	38476777
Hospital Revenue Code	301
Min. Negotiated Rate	$9.96
Max. Negotiated Rate	$188.00
Rate for Payer: Aetna Commercial	$72.60
Rate for Payer: Aetna Medicare Advantage	$86.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.34
Rate for Payer: Cigna Commercial	$188.00
Rate for Payer: Cigna Medicare Advantage	$26.69
Rate for Payer: Clover Medicare Advantage	$25.36
Rate for Payer: EmblemHealth Commercial	$80.07
Rate for Payer: Humana Medicare Advantage	$27.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.69
Rate for Payer: Wellcare Medicare Advantage	$26.69
Rate for Payer: Wellpoint Medicaid Managed Care	$9.96

PRO-INSULIN

Facility

$376.00

Service Code	HCPCS 84206
Hospital Charge Code	38476777
Hospital Revenue Code	301
Min. Negotiated Rate	$56.40
Max. Negotiated Rate	$56.40
Rate for Payer: Qualcare PPO/HMO/WC	$56.40

PROINSULIN

Facility

$122.45

Service Code	HCPCS 84206
Hospital Charge Code	39900125
Hospital Revenue Code	301
Min. Negotiated Rate	$3.24
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$72.60
Rate for Payer: Aetna Medicare Advantage	$86.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.34
Rate for Payer: Cigna Commercial	$61.23
Rate for Payer: Cigna Medicare Advantage	$26.69
Rate for Payer: Clover Medicare Advantage	$25.36
Rate for Payer: EmblemHealth Commercial	$80.07
Rate for Payer: Humana Medicare Advantage	$27.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.37
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.69
Rate for Payer: Wellcare Medicare Advantage	$26.69
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

PROINSULIN

Facility

$256.00

Service Code	HCPCS 84206
Hospital Charge Code	3032141
Hospital Revenue Code	301
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

PROINSULIN

Facility

$256.00

Service Code	HCPCS 84206
Hospital Charge Code	3032141
Hospital Revenue Code	301
Min. Negotiated Rate	$6.78
Max. Negotiated Rate	$128.00
Rate for Payer: Aetna Commercial	$72.60
Rate for Payer: Aetna Medicare Advantage	$86.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.34
Rate for Payer: Cigna Commercial	$128.00
Rate for Payer: Cigna Medicare Advantage	$26.69
Rate for Payer: Clover Medicare Advantage	$25.36
Rate for Payer: EmblemHealth Commercial	$80.07
Rate for Payer: Humana Medicare Advantage	$27.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.69
Rate for Payer: Wellcare Medicare Advantage	$26.69
Rate for Payer: Wellpoint Medicaid Managed Care	$6.78

PROINSULIN

Facility

$122.45

Service Code	HCPCS 84206
Hospital Charge Code	39900125
Hospital Revenue Code	301
Min. Negotiated Rate	$18.37
Max. Negotiated Rate	$18.37
Rate for Payer: Qualcare PPO/HMO/WC	$18.37

PROJ SAFE IND MSW 45-50 MIN

Facility

$1,423.80

Service Code	HCPCS 90806
Hospital Charge Code	84310025
Hospital Revenue Code	914
Min. Negotiated Rate	$34.31
Max. Negotiated Rate	$711.90
Rate for Payer: Aetna Commercial	$541.04
Rate for Payer: Aetna Medicare Advantage	$427.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.07
Rate for Payer: Cigna Commercial	$711.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$427.14
Rate for Payer: Qualcare PPO/HMO/WC	$213.57
Rate for Payer: UnitedHealthcare Community & State	$34.31
Rate for Payer: Wellpoint Medicaid Managed Care	$37.73

PROJ SAFE IND MSW 45-50 MIN

Facility

$1,423.80

Service Code	HCPCS 90806
Hospital Charge Code	84310025
Hospital Revenue Code	914
Min. Negotiated Rate	$213.57
Max. Negotiated Rate	$213.57
Rate for Payer: Qualcare PPO/HMO/WC	$213.57

PROJ SAFE INDV MSW 20-30 MIN

Facility

$1,296.00

Service Code	HCPCS 90804
Hospital Charge Code	84310015
Hospital Revenue Code	914
Min. Negotiated Rate	$194.40
Max. Negotiated Rate	$194.40
Rate for Payer: Qualcare PPO/HMO/WC	$194.40

PROJ SAFE INDV MSW 20-30 MIN

Facility

$1,296.00

Service Code	HCPCS 90804
Hospital Charge Code	84310015
Hospital Revenue Code	914
Min. Negotiated Rate	$31.23
Max. Negotiated Rate	$648.00
Rate for Payer: Aetna Commercial	$492.48
Rate for Payer: Aetna Medicare Advantage	$388.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.48
Rate for Payer: Cigna Commercial	$648.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$388.80
Rate for Payer: Qualcare PPO/HMO/WC	$194.40
Rate for Payer: UnitedHealthcare Community & State	$31.23
Rate for Payer: Wellpoint Medicaid Managed Care	$34.34

PROKNOT

Facility

$2,585.00

Hospital Charge Code	270670480
Hospital Revenue Code	272
Min. Negotiated Rate	$62.30
Max. Negotiated Rate	$1,292.50
Rate for Payer: Aetna Commercial	$982.30
Rate for Payer: Aetna Medicare Advantage	$775.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$659.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$659.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$659.17
Rate for Payer: Cigna Commercial	$1,292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$775.50
Rate for Payer: Oxford Commercial	$517.00
Rate for Payer: Qualcare PPO/HMO/WC	$387.75
Rate for Payer: UnitedHealthcare Commercial	$517.00
Rate for Payer: UnitedHealthcare Community & State	$62.30
Rate for Payer: Wellpoint Medicaid Managed Care	$68.50

PROKNOT

Facility

$2,585.00

Hospital Charge Code	270670480
Hospital Revenue Code	272
Min. Negotiated Rate	$387.75
Max. Negotiated Rate	$387.75
Rate for Payer: Qualcare PPO/HMO/WC	$387.75

Prolactin

Facility

$667.59

Service Code	HCPCS 84146
Hospital Charge Code	39888020
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

Prolactin

Facility

$667.59

Service Code	HCPCS 84146
Hospital Charge Code	39888020
Hospital Revenue Code	301
Min. Negotiated Rate	$15.50
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$52.71
Rate for Payer: Aetna Medicare Advantage	$62.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.96
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$19.38
Rate for Payer: Clover Medicare Advantage	$18.41
Rate for Payer: EmblemHealth Commercial	$58.14
Rate for Payer: Humana Medicare Advantage	$19.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.38
Rate for Payer: Wellcare Medicare Advantage	$19.38
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

PROLACTIN

Facility

$179.25

Service Code	HCPCS 84146
Hospital Charge Code	39900417
Hospital Revenue Code	301
Min. Negotiated Rate	$4.75
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$52.71
Rate for Payer: Aetna Medicare Advantage	$62.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.96
Rate for Payer: Cigna Commercial	$89.62
Rate for Payer: Cigna Medicare Advantage	$19.38
Rate for Payer: Clover Medicare Advantage	$18.41
Rate for Payer: EmblemHealth Commercial	$58.14
Rate for Payer: Humana Medicare Advantage	$19.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.89
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.38
Rate for Payer: Wellcare Medicare Advantage	$19.38
Rate for Payer: Wellpoint Medicaid Managed Care	$4.75

PROLACTIN

Facility

$1,212.40

Service Code	HCPCS 84146
Hospital Charge Code	38472566
Hospital Revenue Code	301
Min. Negotiated Rate	$15.50
Max. Negotiated Rate	$606.20
Rate for Payer: Aetna Commercial	$52.71
Rate for Payer: Aetna Medicare Advantage	$62.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.96
Rate for Payer: Cigna Commercial	$606.20
Rate for Payer: Cigna Medicare Advantage	$19.38
Rate for Payer: Clover Medicare Advantage	$18.41
Rate for Payer: EmblemHealth Commercial	$58.14
Rate for Payer: Humana Medicare Advantage	$19.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.72
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$181.86
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.38
Rate for Payer: Wellcare Medicare Advantage	$19.38
Rate for Payer: Wellpoint Medicaid Managed Care	$32.13

PROLACTIN

Facility

$179.25

Service Code	HCPCS 84146
Hospital Charge Code	39900417
Hospital Revenue Code	301
Min. Negotiated Rate	$26.89
Max. Negotiated Rate	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$26.89

PROLACTIN

Facility

$1,212.40

Service Code	HCPCS 84146
Hospital Charge Code	38472566
Hospital Revenue Code	301
Min. Negotiated Rate	$181.86
Max. Negotiated Rate	$181.86
Rate for Payer: Qualcare PPO/HMO/WC	$181.86

PROLACTIN

Facility

$179.25

Service Code	HCPCS 84146
Hospital Charge Code	3006327
Hospital Revenue Code	301
Min. Negotiated Rate	$4.75
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$52.71
Rate for Payer: Aetna Medicare Advantage	$62.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.96
Rate for Payer: Cigna Commercial	$89.62
Rate for Payer: Cigna Medicare Advantage	$19.38
Rate for Payer: Clover Medicare Advantage	$18.41
Rate for Payer: EmblemHealth Commercial	$58.14
Rate for Payer: Humana Medicare Advantage	$19.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.89
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.38
Rate for Payer: Wellcare Medicare Advantage	$19.38
Rate for Payer: Wellpoint Medicaid Managed Care	$4.75

Know your out-of-pocket cost for care.

All Charges