Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RAST ALLERGEN #8

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3031200H
Hospital Revenue Code	305
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

RAST ALLERGEN #8

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3031200H
Hospital Revenue Code	305
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

RAST ALLERGEN #9

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3031200I
Hospital Revenue Code	305
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

RAST ALLERGEN #9

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3031200I
Hospital Revenue Code	305
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

RAST TEST

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3006871
Hospital Revenue Code	305
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

RAST TEST

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3006871
Hospital Revenue Code	305
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

RATIONAL LIVING GROUP PSYCHOTR

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246305
Hospital Revenue Code	915
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

RATIONAL LIVING GROUP PSYCHOTR

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	83246305
Hospital Revenue Code	915
Min. Negotiated Rate	$19.30
Max. Negotiated Rate	$435.65
Rate for Payer: Aetna Commercial	$328.28
Rate for Payer: Aetna Medicare Advantage	$391.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$435.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$435.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$120.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$435.65
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: Cigna Medicare Advantage	$120.69
Rate for Payer: Clover Medicare Advantage	$114.66
Rate for Payer: EmblemHealth Commercial	$362.07
Rate for Payer: Humana Medicare Advantage	$124.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$120.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.24
Rate for Payer: Qualcare PPO/HMO/WC	$120.12
Rate for Payer: UnitedHealthcare Community & State	$19.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$120.69
Rate for Payer: Wellcare Medicare Advantage	$120.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48
Rate for Payer: Wellpoint Medicaid Managed Care	$21.22

RA TRACER ID OF SENTINL NODE

Facility

$1,397.76

Service Code	HCPCS 38792
Hospital Charge Code	16000959
Hospital Revenue Code	360
Min. Negotiated Rate	$33.69
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,291.84
Rate for Payer: Aetna Medicare Advantage	$1,538.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$474.94
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	$1,714.39
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: Cigna Medicare Advantage	$474.94
Rate for Payer: Clover Medicare Advantage	$451.19
Rate for Payer: EmblemHealth Commercial	$1,424.82
Rate for Payer: Humana Medicare Advantage	$489.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$474.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$419.33
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$209.66
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$33.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$474.94
Rate for Payer: Wellcare Medicare Advantage	$474.94
Rate for Payer: Wellpoint Medicaid Managed Care	$37.04

RA TRACER ID OF SENTINL NODE

Facility

$1,397.76

Service Code	HCPCS 38792
Hospital Charge Code	16000959
Hospital Revenue Code	360
Min. Negotiated Rate	$209.66
Max. Negotiated Rate	$209.66
Rate for Payer: Qualcare PPO/HMO/WC	$209.66

RAW

Facility

$336.00

Hospital Charge Code	95090375
Hospital Revenue Code	460
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$127.68
Rate for Payer: Aetna Medicare Advantage	$100.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.68
Rate for Payer: Cigna Commercial	$168.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.80
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.40
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$8.10
Rate for Payer: Wellpoint Medicaid Managed Care	$8.90

RAW

Facility

$336.00

Hospital Charge Code	95090375
Hospital Revenue Code	460
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$50.40
Rate for Payer: Qualcare PPO/HMO/WC	$50.40

R & B 4NORTH-SEMI PRIVATE

Facility

$18,000.00

Hospital Charge Code	100811
Hospital Revenue Code	121
Min. Negotiated Rate	$2,312.00
Max. Negotiated Rate	$6,764.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,312.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,764.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.00

R&B 5P MED/SURG-SEMI PRIVATE

Facility

$18,000.00

Hospital Charge Code	100812
Hospital Revenue Code	121
Min. Negotiated Rate	$2,312.00
Max. Negotiated Rate	$6,764.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,312.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,764.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.00

R&B 6SO-SELFCARE (MED/SURG)

Facility

$18,000.00

Hospital Charge Code	100809
Hospital Revenue Code	167
Min. Negotiated Rate	$2,700.00
Max. Negotiated Rate	$6,764.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,764.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.00

RBC

Facility

$4.24

Service Code	HCPCS 85045
Hospital Charge Code	8200339RS
Hospital Revenue Code	301
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$0.64
Rate for Payer: Qualcare PPO/HMO/WC	$0.64

RBC

Facility

$4.24

Service Code	HCPCS 85045
Hospital Charge Code	8200339RS
Hospital Revenue Code	301
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$10.85
Rate for Payer: Aetna Medicare Advantage	$12.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.40
Rate for Payer: Cigna Commercial	$2.12
Rate for Payer: Cigna Medicare Advantage	$3.99
Rate for Payer: Clover Medicare Advantage	$3.79
Rate for Payer: EmblemHealth Commercial	$11.97
Rate for Payer: Humana Medicare Advantage	$4.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.27
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.64
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.99
Rate for Payer: Wellcare Medicare Advantage	$3.99
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

RBC ABSORPTION EACH

Facility

$149.00

Service Code	HCPCS 86978
Hospital Charge Code	38471150
Hospital Revenue Code	302
Min. Negotiated Rate	$22.35
Max. Negotiated Rate	$22.35
Rate for Payer: Qualcare PPO/HMO/WC	$22.35

RBC ABSORPTION EACH

Facility

$149.00

Service Code	HCPCS 86978
Hospital Charge Code	38471150
Hospital Revenue Code	302
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$252.97
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.97
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$35.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.95

RBC BUFFY COAT REMOVED, 1 UNIT

Facility

$1,180.73

Hospital Charge Code	38471040
Hospital Revenue Code	390
Min. Negotiated Rate	$28.46
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$448.68
Rate for Payer: Aetna Medicare Advantage	$354.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$301.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$301.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.09
Rate for Payer: Cigna Commercial	$590.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.22
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$177.11
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$28.46
Rate for Payer: Wellpoint Medicaid Managed Care	$31.29

RBC BUFFY COAT REMOVED, 1 UNIT

Facility

$1,180.73

Hospital Charge Code	38471040
Hospital Revenue Code	390
Min. Negotiated Rate	$177.11
Max. Negotiated Rate	$177.11
Rate for Payer: Qualcare PPO/HMO/WC	$177.11

RBC COUNT

Facility

$142.00

Service Code	HCPCS 85041
Hospital Charge Code	38473013
Hospital Revenue Code	301
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$21.30
Rate for Payer: Qualcare PPO/HMO/WC	$21.30

RBC COUNT

Facility

$142.00

Service Code	HCPCS 85041
Hospital Charge Code	38473013
Hospital Revenue Code	301
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$8.21
Rate for Payer: Aetna Medicare Advantage	$9.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.90
Rate for Payer: Cigna Commercial	$71.00
Rate for Payer: Cigna Medicare Advantage	$3.02
Rate for Payer: Clover Medicare Advantage	$2.87
Rate for Payer: EmblemHealth Commercial	$9.06
Rate for Payer: Humana Medicare Advantage	$3.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.02
Rate for Payer: Wellcare Medicare Advantage	$3.02
Rate for Payer: Wellpoint Medicaid Managed Care	$3.76

RBC DEGLYCEROLIZED

Facility

$2,959.25

Service Code	HCPCS P9039
Hospital Charge Code	3101517
Hospital Revenue Code	390
Min. Negotiated Rate	$71.32
Max. Negotiated Rate	$1,313.82
Rate for Payer: Aetna Commercial	$990.00
Rate for Payer: Aetna Medicare Advantage	$1,179.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,313.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,313.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$363.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,313.82
Rate for Payer: Cigna Commercial	$729.59
Rate for Payer: Cigna Medicare Advantage	$363.97
Rate for Payer: Clover Medicare Advantage	$345.77
Rate for Payer: EmblemHealth Commercial	$1,091.91
Rate for Payer: Humana Medicare Advantage	$374.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$363.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$887.77
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$443.89
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$71.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$363.97
Rate for Payer: Wellcare Medicare Advantage	$363.97
Rate for Payer: Wellpoint Medicaid Managed Care	$78.42

RBC DEGLYCEROLIZED

Facility

$2,959.25

Service Code	HCPCS P9039
Hospital Charge Code	3101517
Hospital Revenue Code	390
Min. Negotiated Rate	$443.89
Max. Negotiated Rate	$443.89
Rate for Payer: Qualcare PPO/HMO/WC	$443.89

Know your out-of-pocket cost for care.

All Charges