Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PYRLINKS-D***

Facility

$74.00

Service Code	HCPCS 82523
Hospital Charge Code	3032739
Hospital Revenue Code	301
Min. Negotiated Rate	$1.96
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$50.81
Rate for Payer: Aetna Medicare Advantage	$60.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.43
Rate for Payer: Cigna Commercial	$37.00
Rate for Payer: Cigna Medicare Advantage	$18.68
Rate for Payer: Clover Medicare Advantage	$17.75
Rate for Payer: EmblemHealth Commercial	$56.04
Rate for Payer: Humana Medicare Advantage	$19.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.68
Rate for Payer: Wellcare Medicare Advantage	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$1.96

PYRLINKS-D***

Facility

$74.00

Service Code	HCPCS 82523
Hospital Charge Code	3032739
Hospital Revenue Code	301
Min. Negotiated Rate	$11.10
Max. Negotiated Rate	$11.10
Rate for Payer: Qualcare PPO/HMO/WC	$11.10

PYROVATE

Facility

$303.00

Service Code	HCPCS 84210
Hospital Charge Code	38472930
Hospital Revenue Code	301
Min. Negotiated Rate	$8.03
Max. Negotiated Rate	$151.50
Rate for Payer: Aetna Commercial	$39.39
Rate for Payer: Aetna Medicare Advantage	$46.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.27
Rate for Payer: Cigna Commercial	$151.50
Rate for Payer: Cigna Medicare Advantage	$14.48
Rate for Payer: Clover Medicare Advantage	$13.76
Rate for Payer: EmblemHealth Commercial	$43.44
Rate for Payer: Humana Medicare Advantage	$14.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.48
Rate for Payer: Wellcare Medicare Advantage	$14.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.03

PYROVATE

Facility

$303.00

Service Code	HCPCS 84210
Hospital Charge Code	38472930
Hospital Revenue Code	301
Min. Negotiated Rate	$45.45
Max. Negotiated Rate	$45.45
Rate for Payer: Qualcare PPO/HMO/WC	$45.45

PYRUVATE,BLOOD

Facility

$74.60

Service Code	HCPCS 84210
Hospital Charge Code	39900127
Hospital Revenue Code	301
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.39
Rate for Payer: Aetna Medicare Advantage	$46.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.27
Rate for Payer: Cigna Commercial	$37.30
Rate for Payer: Cigna Medicare Advantage	$14.48
Rate for Payer: Clover Medicare Advantage	$13.76
Rate for Payer: EmblemHealth Commercial	$43.44
Rate for Payer: Humana Medicare Advantage	$14.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.19
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.48
Rate for Payer: Wellcare Medicare Advantage	$14.48
Rate for Payer: Wellpoint Medicaid Managed Care	$1.98

PYRUVATE,BLOOD

Facility

$74.60

Service Code	HCPCS 84210
Hospital Charge Code	39900127
Hospital Revenue Code	301
Min. Negotiated Rate	$11.19
Max. Negotiated Rate	$11.19
Rate for Payer: Qualcare PPO/HMO/WC	$11.19

PYRUVATE, CSF

Facility

$360.00

Service Code	HCPCS 84210
Hospital Charge Code	38472929
Hospital Revenue Code	301
Min. Negotiated Rate	$9.54
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$39.39
Rate for Payer: Aetna Medicare Advantage	$46.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.27
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: Cigna Medicare Advantage	$14.48
Rate for Payer: Clover Medicare Advantage	$13.76
Rate for Payer: EmblemHealth Commercial	$43.44
Rate for Payer: Humana Medicare Advantage	$14.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.48
Rate for Payer: Wellcare Medicare Advantage	$14.48
Rate for Payer: Wellpoint Medicaid Managed Care	$9.54

PYRUVATE, CSF

Facility

$360.00

Service Code	HCPCS 84210
Hospital Charge Code	38472929
Hospital Revenue Code	301
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

PYSCH DIAG EVAL NONMD 30 MIN

Facility

$6,800.00

Service Code	HCPCS 90791
Hospital Charge Code	4546762
Hospital Revenue Code	918
Min. Negotiated Rate	$1,020.00
Max. Negotiated Rate	$1,020.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00

PYSCH DIAG EVAL NONMD 30 MIN

Facility

$6,800.00

Service Code	HCPCS 90791
Hospital Charge Code	4546762
Hospital Revenue Code	918
Min. Negotiated Rate	$163.88
Max. Negotiated Rate	$3,081.00
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$267.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$761.18
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,040.00
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00
Rate for Payer: UnitedHealthcare Commercial	$3,081.00
Rate for Payer: UnitedHealthcare Community & State	$163.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$171.99
Rate for Payer: Wellpoint Medicaid Managed Care	$180.20

QC DRILL BIT 2.5MM DIA X 110MM

Facility

$269.60

Hospital Charge Code	270663182
Hospital Revenue Code	272
Min. Negotiated Rate	$40.44
Max. Negotiated Rate	$40.44
Rate for Payer: Qualcare PPO/HMO/WC	$40.44

QC DRILL BIT 2.5MM DIA X 110MM

Facility

$269.60

Hospital Charge Code	270663182
Hospital Revenue Code	272
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$134.80
Rate for Payer: Aetna Commercial	$102.45
Rate for Payer: Aetna Medicare Advantage	$80.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.75
Rate for Payer: Cigna Commercial	$134.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.88
Rate for Payer: Oxford Commercial	$53.92
Rate for Payer: Qualcare PPO/HMO/WC	$40.44
Rate for Payer: UnitedHealthcare Commercial	$53.92
Rate for Payer: UnitedHealthcare Community & State	$6.50
Rate for Payer: Wellpoint Medicaid Managed Care	$7.14

QCKFIX SCREW4.0X46

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270686388
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

QCKFIX SCREW4.0X46

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270686388
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

QCKFIX SCREW 4.0X54

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270686389
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

QCKFIX SCREW 4.0X54

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270686389
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

QCKFIX SCREW TI CANN ST 4.0x22

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270688390
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

QCKFIX SCREW TI CANN ST 4.0x22

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270688390
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

Q FEVER ANTIBODY

Facility

$85.90

Service Code	HCPCS 86638
Hospital Charge Code	38476245
Hospital Revenue Code	302
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.97
Rate for Payer: Aetna Medicare Advantage	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.75
Rate for Payer: Cigna Commercial	$42.95
Rate for Payer: Cigna Medicare Advantage	$12.12
Rate for Payer: Clover Medicare Advantage	$11.51
Rate for Payer: EmblemHealth Commercial	$36.36
Rate for Payer: Humana Medicare Advantage	$12.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.88
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.12
Rate for Payer: Wellcare Medicare Advantage	$12.12
Rate for Payer: Wellpoint Medicaid Managed Care	$2.28

Q FEVER ANTIBODY

Facility

$558.45

Service Code	HCPCS 86638
Hospital Charge Code	3032273
Hospital Revenue Code	302
Min. Negotiated Rate	$83.77
Max. Negotiated Rate	$83.77
Rate for Payer: Qualcare PPO/HMO/WC	$83.77

Q FEVER ANTIBODY

Facility

$85.90

Service Code	HCPCS 86638
Hospital Charge Code	38476245
Hospital Revenue Code	302
Min. Negotiated Rate	$12.88
Max. Negotiated Rate	$12.88
Rate for Payer: Qualcare PPO/HMO/WC	$12.88

Q FEVER ANTIBODY

Facility

$558.45

Service Code	HCPCS 86638
Hospital Charge Code	3032273
Hospital Revenue Code	302
Min. Negotiated Rate	$9.70
Max. Negotiated Rate	$279.23
Rate for Payer: Aetna Commercial	$32.97
Rate for Payer: Aetna Medicare Advantage	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.75
Rate for Payer: Cigna Commercial	$279.23
Rate for Payer: Cigna Medicare Advantage	$12.12
Rate for Payer: Clover Medicare Advantage	$11.51
Rate for Payer: EmblemHealth Commercial	$36.36
Rate for Payer: Humana Medicare Advantage	$12.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$83.77
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.12
Rate for Payer: Wellcare Medicare Advantage	$12.12
Rate for Payer: Wellpoint Medicaid Managed Care	$14.80

QFIX 1.8 MINI SUTURE ANCHOR KI

Facility

$3,415.00

Hospital Charge Code	2707229012
Hospital Revenue Code	272
Min. Negotiated Rate	$512.25
Max. Negotiated Rate	$512.25
Rate for Payer: Qualcare PPO/HMO/WC	$512.25

QFIX 1.8 MINI SUTURE ANCHOR KI

Facility

$3,415.00

Hospital Charge Code	2707229012
Hospital Revenue Code	272
Min. Negotiated Rate	$82.30
Max. Negotiated Rate	$1,707.50
Rate for Payer: Aetna Commercial	$1,297.70
Rate for Payer: Aetna Medicare Advantage	$1,024.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$870.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$870.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$870.83
Rate for Payer: Cigna Commercial	$1,707.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,024.50
Rate for Payer: Oxford Commercial	$683.00
Rate for Payer: Qualcare PPO/HMO/WC	$512.25
Rate for Payer: UnitedHealthcare Commercial	$683.00
Rate for Payer: UnitedHealthcare Community & State	$82.30
Rate for Payer: Wellpoint Medicaid Managed Care	$90.50

QHERIT EXPANDED CARRIER SCREEN

Facility

$12,242.80

Service Code	HCPCS 81443
Hospital Charge Code	401181443
Hospital Revenue Code	300
Min. Negotiated Rate	$1,836.42
Max. Negotiated Rate	$1,836.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,836.42

Know your out-of-pocket cost for care.

All Charges