Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PROTECTOR HELL/ELBOW UNIV

Facility

$269.03

Hospital Charge Code	270649488
Hospital Revenue Code	272
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$134.51
Rate for Payer: Aetna Commercial	$102.23
Rate for Payer: Aetna Medicare Advantage	$80.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.60
Rate for Payer: Cigna Commercial	$134.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.71
Rate for Payer: Oxford Commercial	$53.81
Rate for Payer: Qualcare PPO/HMO/WC	$40.35
Rate for Payer: UnitedHealthcare Commercial	$53.81
Rate for Payer: UnitedHealthcare Community & State	$6.48
Rate for Payer: Wellpoint Medicaid Managed Care	$7.13

PROTECTOR HELL/ELBOW UNIV

Facility

$269.03

Hospital Charge Code	270649488
Hospital Revenue Code	272
Min. Negotiated Rate	$40.35
Max. Negotiated Rate	$40.35
Rate for Payer: Qualcare PPO/HMO/WC	$40.35

PROTECTOR SAVE-A-TOOTH

Facility

$76.85

Hospital Charge Code	270600767
Hospital Revenue Code	270
Min. Negotiated Rate	$11.53
Max. Negotiated Rate	$11.53
Rate for Payer: Qualcare PPO/HMO/WC	$11.53

PROTECTOR SAVE-A-TOOTH

Facility

$76.85

Hospital Charge Code	270600767
Hospital Revenue Code	270
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$38.42
Rate for Payer: Aetna Commercial	$29.20
Rate for Payer: Aetna Medicare Advantage	$23.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.60
Rate for Payer: Cigna Commercial	$38.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.05
Rate for Payer: Oxford Commercial	$15.37
Rate for Payer: Qualcare PPO/HMO/WC	$11.53
Rate for Payer: UnitedHealthcare Commercial	$15.37
Rate for Payer: UnitedHealthcare Community & State	$1.85
Rate for Payer: Wellpoint Medicaid Managed Care	$2.04

PROTECTOR TEETH PLASTIC

Facility

$292.85

Hospital Charge Code	270600309
Hospital Revenue Code	272
Min. Negotiated Rate	$43.93
Max. Negotiated Rate	$43.93
Rate for Payer: Qualcare PPO/HMO/WC	$43.93

PROTECTOR TEETH PLASTIC

Facility

$292.85

Hospital Charge Code	270600309
Hospital Revenue Code	272
Min. Negotiated Rate	$7.06
Max. Negotiated Rate	$146.43
Rate for Payer: Aetna Commercial	$111.28
Rate for Payer: Aetna Medicare Advantage	$87.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.68
Rate for Payer: Cigna Commercial	$146.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.86
Rate for Payer: Oxford Commercial	$58.57
Rate for Payer: Qualcare PPO/HMO/WC	$43.93
Rate for Payer: UnitedHealthcare Commercial	$58.57
Rate for Payer: UnitedHealthcare Community & State	$7.06
Rate for Payer: Wellpoint Medicaid Managed Care	$7.76

PROTECTOR TOOTH DISPOSABLE

Facility

$12.81

Hospital Charge Code	270682850
Hospital Revenue Code	272
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.92

PROTECTOR TOOTH DISPOSABLE

Facility

$12.81

Hospital Charge Code	270682850
Hospital Revenue Code	272
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.41
Rate for Payer: Aetna Commercial	$4.87
Rate for Payer: Aetna Medicare Advantage	$3.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.27
Rate for Payer: Cigna Commercial	$6.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.84
Rate for Payer: Oxford Commercial	$2.56
Rate for Payer: Qualcare PPO/HMO/WC	$1.92
Rate for Payer: UnitedHealthcare Commercial	$2.56
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

PROTECTOR TRANSDUCER

Facility

$4.00

Hospital Charge Code	270606660
Hospital Revenue Code	272
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

PROTECTOR TRANSDUCER

Facility

$4.00

Hospital Charge Code	270606660
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PROTECTOR ULNA NERVE EA/PR FOA

Facility

$10.95

Hospital Charge Code	270664524
Hospital Revenue Code	278
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$2.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2.41
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

PROTECTOR ULNA NERVE EA/PR FOA

Facility

$10.95

Hospital Charge Code	270664524
Hospital Revenue Code	278
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$5.47
Rate for Payer: Aetna Commercial	$4.16
Rate for Payer: Aetna Medicare Advantage	$3.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.79
Rate for Payer: Cigna Commercial	$5.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2.41
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

PROTEINASE -3

Facility

$390.00

Service Code	HCPCS 86021
Hospital Charge Code	39900509
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$40.94
Rate for Payer: Aetna Medicare Advantage	$48.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.33
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$15.05
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Medicare Advantage	$15.05
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

PROTEINASE -3

Facility

$390.00

Service Code	HCPCS 86021
Hospital Charge Code	39900509
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PROTEIN, BODY FLUID***

Facility

$42.00

Service Code	HCPCS 84155
Hospital Charge Code	3030129
Hospital Revenue Code	301
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

PROTEIN, BODY FLUID***

Facility

$42.00

Service Code	HCPCS 84155
Hospital Charge Code	3030129
Hospital Revenue Code	301
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$9.98
Rate for Payer: Aetna Medicare Advantage	$11.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.25
Rate for Payer: Cigna Commercial	$21.00
Rate for Payer: Cigna Medicare Advantage	$3.67
Rate for Payer: Clover Medicare Advantage	$3.49
Rate for Payer: EmblemHealth Commercial	$11.01
Rate for Payer: Humana Medicare Advantage	$3.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.67
Rate for Payer: Wellcare Medicare Advantage	$3.67
Rate for Payer: Wellpoint Medicaid Managed Care	$1.11

PROTEIN BOUND GLUCOSE

Facility

$51.00

Hospital Charge Code	38472433
Hospital Revenue Code	301
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

PROTEIN BOUND GLUCOSE

Facility

$51.00

Hospital Charge Code	38472433
Hospital Revenue Code	301
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$19.38
Rate for Payer: Aetna Medicare Advantage	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.01
Rate for Payer: Cigna Commercial	$25.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1.35

PROTEIN BOUND GLUCOSE PROFILE

Facility

$141.65

Service Code	HCPCS 82985
Hospital Charge Code	3030061
Hospital Revenue Code	301
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

PROTEIN BOUND GLUCOSE PROFILE

Facility

$141.65

Service Code	HCPCS 82985
Hospital Charge Code	3030061
Hospital Revenue Code	301
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.59
Rate for Payer: Aetna Medicare Advantage	$54.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.50
Rate for Payer: Cigna Commercial	$70.83
Rate for Payer: Cigna Medicare Advantage	$16.76
Rate for Payer: Clover Medicare Advantage	$15.92
Rate for Payer: EmblemHealth Commercial	$50.28
Rate for Payer: Humana Medicare Advantage	$17.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.76
Rate for Payer: Wellcare Medicare Advantage	$16.76
Rate for Payer: Wellpoint Medicaid Managed Care	$3.75

PROTEIN C

Facility

$347.00

Service Code	HCPCS 85302
Hospital Charge Code	38473061
Hospital Revenue Code	305
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$173.50
Rate for Payer: Aetna Commercial	$32.67
Rate for Payer: Aetna Medicare Advantage	$38.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.01
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	$43.35
Rate for Payer: Cigna Commercial	$173.50
Rate for Payer: Cigna Medicare Advantage	$12.01
Rate for Payer: Clover Medicare Advantage	$11.41
Rate for Payer: EmblemHealth Commercial	$36.03
Rate for Payer: Humana Medicare Advantage	$12.37
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.01
Rate for Payer: Wellcare Medicare Advantage	$12.01
Rate for Payer: Wellpoint Medicaid Managed Care	$9.20

PROTEIN C

Facility

$347.00

Service Code	HCPCS 85302
Hospital Charge Code	38473061
Hospital Revenue Code	305
Min. Negotiated Rate	$52.05
Max. Negotiated Rate	$52.05
Rate for Payer: Qualcare PPO/HMO/WC	$52.05

PROTEIN C, ACTIVITY

Facility

$128.00

Service Code	HCPCS 85302
Hospital Charge Code	3035128
Hospital Revenue Code	305
Min. Negotiated Rate	$3.39
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.67
Rate for Payer: Aetna Medicare Advantage	$38.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.01
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	$43.35
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: Cigna Medicare Advantage	$12.01
Rate for Payer: Clover Medicare Advantage	$11.41
Rate for Payer: EmblemHealth Commercial	$36.03
Rate for Payer: Humana Medicare Advantage	$12.37
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.01
Rate for Payer: Wellcare Medicare Advantage	$12.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

PROTEIN C, ACTIVITY

Facility

$128.00

Service Code	HCPCS 85302
Hospital Charge Code	3035128
Hospital Revenue Code	305
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

PROTEIN C,ACTIVITY

Facility

$667.59

Service Code	HCPCS 85303
Hospital Charge Code	39900166
Hospital Revenue Code	305
Min. Negotiated Rate	$11.07
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$37.64
Rate for Payer: Aetna Medicare Advantage	$44.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.96
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$13.84
Rate for Payer: Clover Medicare Advantage	$13.15
Rate for Payer: EmblemHealth Commercial	$41.52
Rate for Payer: Humana Medicare Advantage	$14.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.84
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	$11.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.84
Rate for Payer: Wellcare Medicare Advantage	$13.84
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

Know your out-of-pocket cost for care.

All Charges