Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PROSHIELD PLUS SPRAY

Facility

$49.85

Service Code	NDC 64015008
Hospital Charge Code	6063943165
Hospital Revenue Code	250
Min. Negotiated Rate	$7.48
Max. Negotiated Rate	$7.48
Rate for Payer: Qualcare PPO/HMO/WC	$7.48

PROS McGEE PISTONS MALL1156348

Facility

$405.00

Hospital Charge Code	270640806
Hospital Revenue Code	272
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$60.75
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

PROS McGEE PISTONS MALL1156348

Facility

$405.00

Hospital Charge Code	270640806
Hospital Revenue Code	272
Min. Negotiated Rate	$9.76
Max. Negotiated Rate	$202.50
Rate for Payer: Aetna Commercial	$153.90
Rate for Payer: Aetna Medicare Advantage	$121.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.28
Rate for Payer: Cigna Commercial	$202.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.50
Rate for Payer: Oxford Commercial	$81.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.75
Rate for Payer: UnitedHealthcare Commercial	$81.00
Rate for Payer: UnitedHealthcare Community & State	$9.76
Rate for Payer: Wellpoint Medicaid Managed Care	$10.73

PROSPERA IPG

Facility

$100,000.00

Service Code	HCPCS C1820
Hospital Charge Code	270705872
Hospital Revenue Code	278
Min. Negotiated Rate	$15,000.00
Max. Negotiated Rate	$24,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24,200.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$22,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$15,000.00

PROSPERA IPG

Facility

$100,000.00

Service Code	HCPCS C1820
Hospital Charge Code	270705872
Hospital Revenue Code	278
Min. Negotiated Rate	$2,410.00
Max. Negotiated Rate	$50,000.00
Rate for Payer: Aetna Commercial	$38,000.00
Rate for Payer: Aetna Medicare Advantage	$30,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,500.00
Rate for Payer: Cigna Commercial	$50,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24,200.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$22,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$15,000.00
Rate for Payer: UnitedHealthcare Community & State	$2,410.00
Rate for Payer: Wellpoint Medicaid Managed Care	$2,650.00

PROSTAGLANDIN E2 JELLY 2MG/3ML

Facility

$736.00

Hospital Charge Code	6007405
Hospital Revenue Code	252
Min. Negotiated Rate	$17.74
Max. Negotiated Rate	$368.00
Rate for Payer: Aetna Commercial	$279.68
Rate for Payer: Aetna Medicare Advantage	$220.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$187.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$187.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$187.68
Rate for Payer: Cigna Commercial	$368.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.80
Rate for Payer: Oxford Commercial	$147.20
Rate for Payer: Qualcare PPO/HMO/WC	$110.40
Rate for Payer: UnitedHealthcare Commercial	$147.20
Rate for Payer: UnitedHealthcare Community & State	$17.74
Rate for Payer: Wellpoint Medicaid Managed Care	$19.50

PROSTAGLANDIN E2 JELLY 2MG/3ML

Facility

$736.00

Hospital Charge Code	6007405
Hospital Revenue Code	252
Min. Negotiated Rate	$110.40
Max. Negotiated Rate	$110.40
Rate for Payer: Qualcare PPO/HMO/WC	$110.40

PROSTAGLANDIN E2 SUPP 20MG

Facility

$765.45

Hospital Charge Code	6007413
Hospital Revenue Code	252
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$382.73
Rate for Payer: Aetna Commercial	$290.87
Rate for Payer: Aetna Medicare Advantage	$229.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.19
Rate for Payer: Cigna Commercial	$382.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.63
Rate for Payer: Oxford Commercial	$153.09
Rate for Payer: Qualcare PPO/HMO/WC	$114.82
Rate for Payer: UnitedHealthcare Commercial	$153.09
Rate for Payer: UnitedHealthcare Community & State	$18.45
Rate for Payer: Wellpoint Medicaid Managed Care	$20.28

PROSTAGLANDIN E2 SUPP 20MG

Facility

$765.45

Hospital Charge Code	6007413
Hospital Revenue Code	252
Min. Negotiated Rate	$114.82
Max. Negotiated Rate	$114.82
Rate for Payer: Qualcare PPO/HMO/WC	$114.82

PROSTAGLANDIN,EACH

Facility

$176.74

Service Code	HCPCS 84150
Hospital Charge Code	38477177
Hospital Revenue Code	301
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$150.78
Rate for Payer: Aetna Commercial	$113.61
Rate for Payer: Aetna Medicare Advantage	$135.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.78
Rate for Payer: Cigna Commercial	$88.37
Rate for Payer: Cigna Medicare Advantage	$41.77
Rate for Payer: Clover Medicare Advantage	$39.68
Rate for Payer: EmblemHealth Commercial	$125.31
Rate for Payer: Humana Medicare Advantage	$43.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$41.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.02
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.51
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$33.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$41.77
Rate for Payer: Wellcare Medicare Advantage	$41.77
Rate for Payer: Wellpoint Medicaid Managed Care	$4.68

PROSTAGLANDIN,EACH

Facility

$176.74

Service Code	HCPCS 84150
Hospital Charge Code	38477177
Hospital Revenue Code	301
Min. Negotiated Rate	$26.51
Max. Negotiated Rate	$26.51
Rate for Payer: Qualcare PPO/HMO/WC	$26.51

PROSTATECTOMY CONE 18CM

Facility

$304.00

Hospital Charge Code	6017685
Hospital Revenue Code	250
Min. Negotiated Rate	$7.33
Max. Negotiated Rate	$152.00
Rate for Payer: Aetna Commercial	$115.52
Rate for Payer: Aetna Medicare Advantage	$91.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.52
Rate for Payer: Cigna Commercial	$152.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.20
Rate for Payer: Oxford Commercial	$60.80
Rate for Payer: Qualcare PPO/HMO/WC	$45.60
Rate for Payer: UnitedHealthcare Commercial	$60.80
Rate for Payer: UnitedHealthcare Community & State	$7.33
Rate for Payer: Wellpoint Medicaid Managed Care	$8.06

PROSTATECTOMY CONE 18CM

Facility

$304.00

Hospital Charge Code	6017685
Hospital Revenue Code	250
Min. Negotiated Rate	$45.60
Max. Negotiated Rate	$45.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.60

PROSTATECTOMY WITH CC

Facility

$58,674.31

Service Code	MSDRG 666
Min. Negotiated Rate	$17,865.58
Max. Negotiated Rate	$58,674.31
Rate for Payer: Aetna Commercial	$40,573.29
Rate for Payer: Aetna Medicare Advantage	$58,674.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40,008.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40,008.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,805.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40,008.92
Rate for Payer: Cigna Commercial	$32,736.40
Rate for Payer: Cigna Medicare Advantage	$18,805.87
Rate for Payer: Clover Medicare Advantage	$17,865.58
Rate for Payer: EmblemHealth Commercial	$56,417.61
Rate for Payer: Humana Medicare Advantage	$19,370.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,805.87
Rate for Payer: Oxford Commercial	$23,528.08
Rate for Payer: UnitedHealthcare Commercial	$41,257.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,805.87
Rate for Payer: Wellcare Medicare Advantage	$18,805.87

PROSTATECTOMY WITH MCC

Facility

$103,016.44

Service Code	MSDRG 665
Min. Negotiated Rate	$31,367.19
Max. Negotiated Rate	$103,016.44
Rate for Payer: Aetna Commercial	$71,041.35
Rate for Payer: Aetna Medicare Advantage	$103,016.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71,876.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71,876.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$33,018.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71,876.49
Rate for Payer: Cigna Commercial	$58,410.14
Rate for Payer: Cigna Medicare Advantage	$33,018.09
Rate for Payer: Clover Medicare Advantage	$31,367.19
Rate for Payer: EmblemHealth Commercial	$99,054.27
Rate for Payer: Humana Medicare Advantage	$34,008.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$33,018.09
Rate for Payer: Oxford Commercial	$41,980.14
Rate for Payer: UnitedHealthcare Commercial	$73,613.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$33,018.09
Rate for Payer: Wellcare Medicare Advantage	$33,018.09

PROSTATECTOMY WITHOUT CC/MCC

Facility

$37,888.31

Service Code	MSDRG 667
Min. Negotiated Rate	$11,536.51
Max. Negotiated Rate	$37,888.31
Rate for Payer: Aetna Commercial	$26,290.91
Rate for Payer: Aetna Medicare Advantage	$37,888.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,424.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,424.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,143.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,424.05
Rate for Payer: Cigna Commercial	$20,701.43
Rate for Payer: Cigna Medicare Advantage	$12,143.69
Rate for Payer: Clover Medicare Advantage	$11,536.51
Rate for Payer: EmblemHealth Commercial	$36,431.07
Rate for Payer: Humana Medicare Advantage	$12,508.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,143.69
Rate for Payer: Oxford Commercial	$14,878.39
Rate for Payer: UnitedHealthcare Commercial	$26,089.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,143.69
Rate for Payer: Wellcare Medicare Advantage	$12,143.69

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55712
Hospital Charge Code	1600000845
Hospital Revenue Code	360
Min. Negotiated Rate	$137.33
Max. Negotiated Rate	$15,116.59
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,116.59
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,709.46
Rate for Payer: Qualcare PPO/HMO/WC	$854.73
Rate for Payer: UnitedHealthcare Community & State	$137.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$151.00

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55708
Hospital Charge Code	1600000831
Hospital Revenue Code	360
Min. Negotiated Rate	$137.33
Max. Negotiated Rate	$15,116.59
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,116.59
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,709.46
Rate for Payer: Qualcare PPO/HMO/WC	$854.73
Rate for Payer: UnitedHealthcare Community & State	$137.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$151.00

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55711
Hospital Charge Code	1600000844
Hospital Revenue Code	360
Min. Negotiated Rate	$137.33
Max. Negotiated Rate	$15,116.59
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,116.59
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,709.46
Rate for Payer: Qualcare PPO/HMO/WC	$854.73
Rate for Payer: UnitedHealthcare Community & State	$137.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$151.00

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55714
Hospital Charge Code	1600000846
Hospital Revenue Code	360
Min. Negotiated Rate	$854.73
Max. Negotiated Rate	$854.73
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55712
Hospital Charge Code	1600000845
Hospital Revenue Code	360
Min. Negotiated Rate	$854.73
Max. Negotiated Rate	$854.73
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 57714
Hospital Charge Code	404155714
Hospital Revenue Code	361
Min. Negotiated Rate	$137.33
Max. Negotiated Rate	$2,849.10
Rate for Payer: Aetna Commercial	$2,165.32
Rate for Payer: Aetna Medicare Advantage	$1,709.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.04
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	$1,453.04
Rate for Payer: Cigna Commercial	$2,849.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,709.46
Rate for Payer: Qualcare PPO/HMO/WC	$854.73
Rate for Payer: UnitedHealthcare Community & State	$137.33
Rate for Payer: Wellpoint Medicaid Managed Care	$151.00

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55712
Hospital Charge Code	404155712
Hospital Revenue Code	361
Min. Negotiated Rate	$137.33
Max. Negotiated Rate	$15,116.59
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,116.59
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,709.46
Rate for Payer: Qualcare PPO/HMO/WC	$854.73
Rate for Payer: UnitedHealthcare Community & State	$137.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$151.00

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 57714
Hospital Charge Code	404155714
Hospital Revenue Code	361
Min. Negotiated Rate	$854.73
Max. Negotiated Rate	$854.73
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55711
Hospital Charge Code	404155711
Hospital Revenue Code	361
Min. Negotiated Rate	$854.73
Max. Negotiated Rate	$854.73
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

Know your out-of-pocket cost for care.

All Charges