Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PURCHASE REQUEST

Facility

$117.45

Hospital Charge Code	270656347
Hospital Revenue Code	271
Min. Negotiated Rate	$2.83
Max. Negotiated Rate	$58.73
Rate for Payer: Aetna Commercial	$44.63
Rate for Payer: Aetna Medicare Advantage	$35.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.95
Rate for Payer: Cigna Commercial	$58.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.23
Rate for Payer: Oxford Commercial	$23.49
Rate for Payer: Qualcare PPO/HMO/WC	$17.62
Rate for Payer: UnitedHealthcare Commercial	$23.49
Rate for Payer: UnitedHealthcare Community & State	$2.83
Rate for Payer: Wellpoint Medicaid Managed Care	$3.11

PUREBONE CORTICAL FIBERS 5CC

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270696103
Hospital Revenue Code	278
Min. Negotiated Rate	$78.33
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$1,235.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$715.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Community & State	$78.33
Rate for Payer: Wellpoint Medicaid Managed Care	$86.12

PUREBONE CORTICAL FIBERS 5CC

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270696103
Hospital Revenue Code	278
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$786.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$715.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

PURINETHOL/50MG/TAB

Facility

$9.00

Hospital Charge Code	60633786
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

PURINETHOL/50MG/TAB

Facility

$9.00

Hospital Charge Code	60633786
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

PURKINJE CYTOPLASMIC AB SCRN

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3000717
Hospital Revenue Code	302
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

PURKINJE CYTOPLASMIC AB SCRN

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3000717
Hospital Revenue Code	302
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

PURMARROW-360

Facility

$2,875.00

Hospital Charge Code	270702346
Hospital Revenue Code	278
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$695.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$632.50
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

PURMARROW-360

Facility

$2,875.00

Hospital Charge Code	270702346
Hospital Revenue Code	278
Min. Negotiated Rate	$69.29
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$1,092.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$632.50
Rate for Payer: Qualcare PPO/HMO/WC	$431.25
Rate for Payer: UnitedHealthcare Community & State	$69.29
Rate for Payer: Wellpoint Medicaid Managed Care	$76.19

PUSHER MT COIL MT PULM 401216

Facility

$774.25

Hospital Charge Code	270627378S
Hospital Revenue Code	272
Min. Negotiated Rate	$18.66
Max. Negotiated Rate	$387.12
Rate for Payer: Aetna Commercial	$294.21
Rate for Payer: Aetna Medicare Advantage	$232.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.43
Rate for Payer: Cigna Commercial	$387.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.28
Rate for Payer: Oxford Commercial	$154.85
Rate for Payer: Qualcare PPO/HMO/WC	$116.14
Rate for Payer: UnitedHealthcare Commercial	$154.85
Rate for Payer: UnitedHealthcare Community & State	$18.66
Rate for Payer: Wellpoint Medicaid Managed Care	$20.52

PUSHER MT COIL MT PULM 401216

Facility

$774.25

Hospital Charge Code	270627378
Hospital Revenue Code	272
Min. Negotiated Rate	$116.14
Max. Negotiated Rate	$116.14
Rate for Payer: Qualcare PPO/HMO/WC	$116.14

PUSHER MT COIL MT PULM 401216

Facility

$694.45

Service Code	HCPCS C1884
Hospital Charge Code	270627378N
Hospital Revenue Code	278
Min. Negotiated Rate	$16.74
Max. Negotiated Rate	$347.23
Rate for Payer: Aetna Commercial	$263.89
Rate for Payer: Aetna Medicare Advantage	$208.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.08
Rate for Payer: Cigna Commercial	$347.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$152.78
Rate for Payer: Qualcare PPO/HMO/WC	$104.17
Rate for Payer: UnitedHealthcare Community & State	$16.74
Rate for Payer: Wellpoint Medicaid Managed Care	$18.40

PUSHER MT COIL MT PULM 401216

Facility

$694.45

Service Code	HCPCS C1884
Hospital Charge Code	270627378N
Hospital Revenue Code	278
Min. Negotiated Rate	$104.17
Max. Negotiated Rate	$168.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$152.78
Rate for Payer: Qualcare PPO/HMO/WC	$104.17

PUSHER MT COIL MT PULM 401216

Facility

$774.25

Hospital Charge Code	270627378
Hospital Revenue Code	272
Min. Negotiated Rate	$18.66
Max. Negotiated Rate	$387.12
Rate for Payer: Aetna Commercial	$294.21
Rate for Payer: Aetna Medicare Advantage	$232.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.43
Rate for Payer: Cigna Commercial	$387.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.28
Rate for Payer: Oxford Commercial	$154.85
Rate for Payer: Qualcare PPO/HMO/WC	$116.14
Rate for Payer: UnitedHealthcare Commercial	$154.85
Rate for Payer: UnitedHealthcare Community & State	$18.66
Rate for Payer: Wellpoint Medicaid Managed Care	$20.52

PUSHER MT COIL MT PULM 401216

Facility

$774.25

Hospital Charge Code	270627378S
Hospital Revenue Code	272
Min. Negotiated Rate	$116.14
Max. Negotiated Rate	$116.14
Rate for Payer: Qualcare PPO/HMO/WC	$116.14

PUSHER TOGGLELOC 909864

Facility

$790.00

Hospital Charge Code	270647898
Hospital Revenue Code	272
Min. Negotiated Rate	$19.04
Max. Negotiated Rate	$395.00
Rate for Payer: Aetna Commercial	$300.20
Rate for Payer: Aetna Medicare Advantage	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.45
Rate for Payer: Cigna Commercial	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.00
Rate for Payer: Oxford Commercial	$158.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.50
Rate for Payer: UnitedHealthcare Commercial	$158.00
Rate for Payer: UnitedHealthcare Community & State	$19.04
Rate for Payer: Wellpoint Medicaid Managed Care	$20.93

PUSHER TOGGLELOC 909864

Facility

$790.00

Hospital Charge Code	270647898
Hospital Revenue Code	272
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$118.50
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

PUSH/INFUSION COMBO LEVEL 1

Facility

$467.20

Service Code	HCPCS C8954
Hospital Charge Code	3401020
Hospital Revenue Code	335
Min. Negotiated Rate	$11.26
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$177.54
Rate for Payer: Aetna Medicare Advantage	$140.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.14
Rate for Payer: Cigna Commercial	$233.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.16
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.08
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$11.26
Rate for Payer: Wellpoint Medicaid Managed Care	$12.38

PUSH/INFUSION COMBO LEVEL 1

Facility

$467.20

Service Code	HCPCS C8954
Hospital Charge Code	3401020
Hospital Revenue Code	335
Min. Negotiated Rate	$70.08
Max. Negotiated Rate	$70.08
Rate for Payer: Qualcare PPO/HMO/WC	$70.08

PUSH/INFUSION COMBO LEVEL 2

Facility

$738.60

Service Code	HCPCS 96415
Hospital Charge Code	3401021
Hospital Revenue Code	335
Min. Negotiated Rate	$110.79
Max. Negotiated Rate	$110.79
Rate for Payer: Qualcare PPO/HMO/WC	$110.79

PUSH/INFUSION COMBO LEVEL 2

Facility

$738.60

Service Code	HCPCS 96415
Hospital Charge Code	3401021
Hospital Revenue Code	335
Min. Negotiated Rate	$17.80
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.77
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$59.88
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.58
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$110.79
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$17.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$19.57

PUSH/INFUSION COMBO LEVEL 3

Facility

$937.60

Service Code	HCPCS 96415
Hospital Charge Code	3401022
Hospital Revenue Code	335
Min. Negotiated Rate	$22.60
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.77
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$59.88
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.28
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$140.64
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$22.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

PUSH/INFUSION COMBO LEVEL 3

Facility

$937.60

Service Code	HCPCS 96415
Hospital Charge Code	3401022
Hospital Revenue Code	335
Min. Negotiated Rate	$140.64
Max. Negotiated Rate	$140.64
Rate for Payer: Qualcare PPO/HMO/WC	$140.64

PUSH/INFUSION COMBO LEVEL 4

Facility

$1,141.80

Service Code	HCPCS C8954
Hospital Charge Code	3401023
Hospital Revenue Code	335
Min. Negotiated Rate	$27.52
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$433.88
Rate for Payer: Aetna Medicare Advantage	$342.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$291.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$291.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$291.16
Rate for Payer: Cigna Commercial	$570.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$342.54
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.27
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$27.52
Rate for Payer: Wellpoint Medicaid Managed Care	$30.26

PUSH/INFUSION COMBO LEVEL 4

Facility

$1,141.80

Service Code	HCPCS C8954
Hospital Charge Code	3401023
Hospital Revenue Code	335
Min. Negotiated Rate	$171.27
Max. Negotiated Rate	$171.27
Rate for Payer: Qualcare PPO/HMO/WC	$171.27

Know your out-of-pocket cost for care.

All Charges