Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RAPID FLU A AND B

Facility

$629.98

Service Code	HCPCS 87804
Hospital Charge Code	3036053
Hospital Revenue Code	306
Min. Negotiated Rate	$94.50
Max. Negotiated Rate	$94.50
Rate for Payer: Qualcare PPO/HMO/WC	$94.50

RAPID FLU A AND B

Facility

$629.98

Service Code	HCPCS 87804
Hospital Charge Code	3036053
Hospital Revenue Code	306
Min. Negotiated Rate	$12.08
Max. Negotiated Rate	$314.99
Rate for Payer: Aetna Commercial	$45.02
Rate for Payer: Aetna Medicare Advantage	$53.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.74
Rate for Payer: Cigna Commercial	$314.99
Rate for Payer: Cigna Medicare Advantage	$16.55
Rate for Payer: Clover Medicare Advantage	$15.72
Rate for Payer: EmblemHealth Commercial	$49.65
Rate for Payer: Humana Medicare Advantage	$17.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.99
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.55
Rate for Payer: Wellcare Medicare Advantage	$16.55
Rate for Payer: Wellpoint Medicaid Managed Care	$16.69

RAPID PLASMA REAGIN (RPR),QT

Facility

$141.00

Service Code	HCPCS 86593
Hospital Charge Code	38476024
Hospital Revenue Code	302
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$11.97
Rate for Payer: Aetna Medicare Advantage	$14.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.88
Rate for Payer: Cigna Commercial	$70.50
Rate for Payer: Cigna Medicare Advantage	$4.40
Rate for Payer: Clover Medicare Advantage	$4.18
Rate for Payer: EmblemHealth Commercial	$13.20
Rate for Payer: Humana Medicare Advantage	$4.53
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.40
Rate for Payer: Wellcare Medicare Advantage	$4.40
Rate for Payer: Wellpoint Medicaid Managed Care	$3.74

RAPID PLASMA REAGIN (RPR),QT

Facility

$141.00

Service Code	HCPCS 86593
Hospital Charge Code	38476024
Hospital Revenue Code	302
Min. Negotiated Rate	$21.15
Max. Negotiated Rate	$21.15
Rate for Payer: Qualcare PPO/HMO/WC	$21.15

RAPID RHINO 5.5 NON-INF

Facility

$155.00

Hospital Charge Code	270654032
Hospital Revenue Code	272
Min. Negotiated Rate	$23.25
Max. Negotiated Rate	$23.25
Rate for Payer: Qualcare PPO/HMO/WC	$23.25

RAPID RHINO 5.5 NON-INF

Facility

$155.00

Hospital Charge Code	270654032
Hospital Revenue Code	272
Min. Negotiated Rate	$3.74
Max. Negotiated Rate	$77.50
Rate for Payer: Aetna Commercial	$58.90
Rate for Payer: Aetna Medicare Advantage	$46.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.52
Rate for Payer: Cigna Commercial	$77.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.50
Rate for Payer: Oxford Commercial	$31.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.25
Rate for Payer: UnitedHealthcare Commercial	$31.00
Rate for Payer: UnitedHealthcare Community & State	$3.74
Rate for Payer: Wellpoint Medicaid Managed Care	$4.11

RAPID STREP A

Facility

$618.59

Service Code	HCPCS 87430
Hospital Charge Code	3036054
Hospital Revenue Code	306
Min. Negotiated Rate	$12.08
Max. Negotiated Rate	$309.30
Rate for Payer: Aetna Commercial	$45.72
Rate for Payer: Aetna Medicare Advantage	$54.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.68
Rate for Payer: Cigna Commercial	$309.30
Rate for Payer: Cigna Medicare Advantage	$16.81
Rate for Payer: Clover Medicare Advantage	$15.97
Rate for Payer: EmblemHealth Commercial	$50.43
Rate for Payer: Humana Medicare Advantage	$17.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.58
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.79
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.81
Rate for Payer: Wellcare Medicare Advantage	$16.81
Rate for Payer: Wellpoint Medicaid Managed Care	$16.39

RAPID STREP A

Facility

$618.59

Service Code	HCPCS 87430
Hospital Charge Code	3036054
Hospital Revenue Code	306
Min. Negotiated Rate	$92.79
Max. Negotiated Rate	$92.79
Rate for Payer: Qualcare PPO/HMO/WC	$92.79

RAP-PAC 1.5 7209217

Facility

$800.65

Hospital Charge Code	270635329
Hospital Revenue Code	272
Min. Negotiated Rate	$120.10
Max. Negotiated Rate	$120.10
Rate for Payer: Qualcare PPO/HMO/WC	$120.10

RAP-PAC 1.5 7209217

Facility

$800.65

Hospital Charge Code	270635329
Hospital Revenue Code	272
Min. Negotiated Rate	$19.30
Max. Negotiated Rate	$400.32
Rate for Payer: Aetna Commercial	$304.25
Rate for Payer: Aetna Medicare Advantage	$240.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.17
Rate for Payer: Cigna Commercial	$400.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.19
Rate for Payer: Oxford Commercial	$160.13
Rate for Payer: Qualcare PPO/HMO/WC	$120.10
Rate for Payer: UnitedHealthcare Commercial	$160.13
Rate for Payer: UnitedHealthcare Community & State	$19.30
Rate for Payer: Wellpoint Medicaid Managed Care	$21.22

RAP-RHINO STAMMBERGER FOAM DRE

Facility

$120.00

Hospital Charge Code	270339116
Hospital Revenue Code	272
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

RAP-RHINO STAMMBERGER FOAM DRE

Facility

$120.00

Hospital Charge Code	270339116
Hospital Revenue Code	272
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$45.60
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.00
Rate for Payer: Oxford Commercial	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$24.00
Rate for Payer: UnitedHealthcare Community & State	$2.89
Rate for Payer: Wellpoint Medicaid Managed Care	$3.18

RA-RIGHT ATRIUM

Facility

$2,000.00

Hospital Charge Code	270702433
Hospital Revenue Code	278
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

RA-RIGHT ATRIUM

Facility

$2,000.00

Hospital Charge Code	270702433
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

RASP COLLATERAL LIGAMENT

Facility

$2,484.00

Hospital Charge Code	270692523
Hospital Revenue Code	272
Min. Negotiated Rate	$59.86
Max. Negotiated Rate	$1,242.00
Rate for Payer: Aetna Commercial	$943.92
Rate for Payer: Aetna Medicare Advantage	$745.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$633.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$633.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$633.42
Rate for Payer: Cigna Commercial	$1,242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$745.20
Rate for Payer: Oxford Commercial	$496.80
Rate for Payer: Qualcare PPO/HMO/WC	$372.60
Rate for Payer: UnitedHealthcare Commercial	$496.80
Rate for Payer: UnitedHealthcare Community & State	$59.86
Rate for Payer: Wellpoint Medicaid Managed Care	$65.83

RASP COLLATERAL LIGAMENT

Facility

$2,484.00

Hospital Charge Code	270692523
Hospital Revenue Code	272
Min. Negotiated Rate	$372.60
Max. Negotiated Rate	$372.60
Rate for Payer: Qualcare PPO/HMO/WC	$372.60

RASP LARGE FOR PEN DRIVE

Facility

$616.00

Hospital Charge Code	270674683
Hospital Revenue Code	272
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$308.00
Rate for Payer: Aetna Commercial	$234.08
Rate for Payer: Aetna Medicare Advantage	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.08
Rate for Payer: Cigna Commercial	$308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.80
Rate for Payer: Oxford Commercial	$123.20
Rate for Payer: Qualcare PPO/HMO/WC	$92.40
Rate for Payer: UnitedHealthcare Commercial	$123.20
Rate for Payer: UnitedHealthcare Community & State	$14.85
Rate for Payer: Wellpoint Medicaid Managed Care	$16.32

RASP LARGE FOR PEN DRIVE

Facility

$616.00

Hospital Charge Code	270674683
Hospital Revenue Code	272
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$92.40

RASP LG CROSSCUT F/PEN DRIVE

Facility

$616.00

Hospital Charge Code	270674681
Hospital Revenue Code	272
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$308.00
Rate for Payer: Aetna Commercial	$234.08
Rate for Payer: Aetna Medicare Advantage	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.08
Rate for Payer: Cigna Commercial	$308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.80
Rate for Payer: Oxford Commercial	$123.20
Rate for Payer: Qualcare PPO/HMO/WC	$92.40
Rate for Payer: UnitedHealthcare Commercial	$123.20
Rate for Payer: UnitedHealthcare Community & State	$14.85
Rate for Payer: Wellpoint Medicaid Managed Care	$16.32

RASP LG CROSSCUT F/PEN DRIVE

Facility

$616.00

Hospital Charge Code	270674681
Hospital Revenue Code	272
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$92.40

RASP LG TEAR 7x12.7MM

Facility

$280.25

Hospital Charge Code	270675674
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$140.12
Rate for Payer: Aetna Commercial	$106.50
Rate for Payer: Aetna Medicare Advantage	$84.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.46
Rate for Payer: Cigna Commercial	$140.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.08
Rate for Payer: Oxford Commercial	$56.05
Rate for Payer: Qualcare PPO/HMO/WC	$42.04
Rate for Payer: UnitedHealthcare Commercial	$56.05
Rate for Payer: UnitedHealthcare Community & State	$6.75
Rate for Payer: Wellpoint Medicaid Managed Care	$7.43

RASP LG TEAR 7x12.7MM

Facility

$280.25

Hospital Charge Code	270675674
Hospital Revenue Code	272
Min. Negotiated Rate	$42.04
Max. Negotiated Rate	$42.04
Rate for Payer: Qualcare PPO/HMO/WC	$42.04

RASP MALTZ RASP DOWN CUTTING

Facility

$356.25

Hospital Charge Code	270688971
Hospital Revenue Code	272
Min. Negotiated Rate	$8.59
Max. Negotiated Rate	$178.12
Rate for Payer: Aetna Commercial	$135.38
Rate for Payer: Aetna Medicare Advantage	$106.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.84
Rate for Payer: Cigna Commercial	$178.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.88
Rate for Payer: Oxford Commercial	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$53.44
Rate for Payer: UnitedHealthcare Commercial	$71.25
Rate for Payer: UnitedHealthcare Community & State	$8.59
Rate for Payer: Wellpoint Medicaid Managed Care	$9.44

RASP MALTZ RASP DOWN CUTTING

Facility

$356.25

Hospital Charge Code	270688971
Hospital Revenue Code	272
Min. Negotiated Rate	$53.44
Max. Negotiated Rate	$53.44
Rate for Payer: Qualcare PPO/HMO/WC	$53.44

RASP MICRO RCPRCT SML 5053-080

Facility

$360.00

Hospital Charge Code	270643474
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

Know your out-of-pocket cost for care.

All Charges