Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RBC MAGNESIUM

Facility

$390.00

Service Code	HCPCS 83735
Hospital Charge Code	39900443
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RBC OSMOTIC FRAGILITY (INCUB)

Facility

$187.25

Service Code	HCPCS 85557
Hospital Charge Code	3002326
Hospital Revenue Code	305
Min. Negotiated Rate	$28.09
Max. Negotiated Rate	$28.09
Rate for Payer: Qualcare PPO/HMO/WC	$28.09

RBC OSMOTIC FRAGILITY (INCUB)

Facility

$187.25

Service Code	HCPCS 85557
Hospital Charge Code	3002326
Hospital Revenue Code	305
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$36.34
Rate for Payer: Aetna Medicare Advantage	$43.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.23
Rate for Payer: Cigna Commercial	$93.62
Rate for Payer: Cigna Medicare Advantage	$13.36
Rate for Payer: Clover Medicare Advantage	$12.69
Rate for Payer: EmblemHealth Commercial	$40.08
Rate for Payer: Humana Medicare Advantage	$13.76
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.09
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.36
Rate for Payer: Wellcare Medicare Advantage	$13.36
Rate for Payer: Wellpoint Medicaid Managed Care	$4.96

RBC OSMOTIC FRAGILITY INCUBATE

Facility

$187.25

Service Code	HCPCS 85557
Hospital Charge Code	3000726
Hospital Revenue Code	305
Min. Negotiated Rate	$28.09
Max. Negotiated Rate	$28.09
Rate for Payer: Qualcare PPO/HMO/WC	$28.09

RBC OSMOTIC FRAGILITY INCUBATE

Facility

$187.25

Service Code	HCPCS 85557
Hospital Charge Code	3000726
Hospital Revenue Code	305
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$36.34
Rate for Payer: Aetna Medicare Advantage	$43.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.23
Rate for Payer: Cigna Commercial	$93.62
Rate for Payer: Cigna Medicare Advantage	$13.36
Rate for Payer: Clover Medicare Advantage	$12.69
Rate for Payer: EmblemHealth Commercial	$40.08
Rate for Payer: Humana Medicare Advantage	$13.76
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.09
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.36
Rate for Payer: Wellcare Medicare Advantage	$13.36
Rate for Payer: Wellpoint Medicaid Managed Care	$4.96

R&B INTERMEDIATE NRS LEVEL 2

Facility

$18,000.00

Hospital Charge Code	100815
Hospital Revenue Code	172
Min. Negotiated Rate	$2,435.00
Max. Negotiated Rate	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,435.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.00

R&B REHAB MED - PRIVATE

Facility

$18,000.00

Hospital Charge Code	100818
Hospital Revenue Code	118
Min. Negotiated Rate	$2,321.00
Max. Negotiated Rate	$6,764.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,764.00
Rate for Payer: Oxford Commercial	$2,321.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.00
Rate for Payer: UnitedHealthcare Commercial	$4,071.00

RC 50 LEUKOCYTE REMOVAL FILTER

Facility

$70.00

Hospital Charge Code	800334
Hospital Revenue Code	279
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$35.00
Rate for Payer: Aetna Commercial	$26.60
Rate for Payer: Aetna Medicare Advantage	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.85
Rate for Payer: Cigna Commercial	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.00
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.50
Rate for Payer: UnitedHealthcare Commercial	$14.00
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

RC 50 LEUKOCYTE REMOVAL FILTER

Facility

$70.00

Hospital Charge Code	800334
Hospital Revenue Code	279
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.50

RC 50 LEUKOCYTE REMOVAL FILTER

Facility

$179.25

Hospital Charge Code	8003345
Hospital Revenue Code	270
Min. Negotiated Rate	$26.89
Max. Negotiated Rate	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$26.89

RC 50 LEUKOCYTE REMOVAL FILTER

Facility

$179.25

Hospital Charge Code	8003345
Hospital Revenue Code	270
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$89.62
Rate for Payer: Aetna Commercial	$68.11
Rate for Payer: Aetna Medicare Advantage	$53.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.71
Rate for Payer: Cigna Commercial	$89.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.77
Rate for Payer: Oxford Commercial	$35.85
Rate for Payer: Qualcare PPO/HMO/WC	$26.89
Rate for Payer: UnitedHealthcare Commercial	$35.85
Rate for Payer: UnitedHealthcare Community & State	$4.32
Rate for Payer: Wellpoint Medicaid Managed Care	$4.75

RC IMPL NS ELECTRODES,PEPH NV

Facility

$73,873.00

Service Code	HCPCS 64555
Hospital Charge Code	1600000528
Hospital Revenue Code	360
Min. Negotiated Rate	$11,080.95
Max. Negotiated Rate	$11,080.95
Rate for Payer: Qualcare PPO/HMO/WC	$11,080.95

RC IMPL NS ELECTRODES,PEPH NV

Facility

$73,873.00

Service Code	HCPCS 64555
Hospital Charge Code	1600000528
Hospital Revenue Code	360
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$27,330.09
Rate for Payer: Aetna Commercial	$20,593.91
Rate for Payer: Aetna Medicare Advantage	$24,530.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,330.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,330.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,571.29
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	$27,330.09
Rate for Payer: Cigna Commercial	$15,176.62
Rate for Payer: Cigna Medicare Advantage	$7,571.29
Rate for Payer: Clover Medicare Advantage	$7,192.73
Rate for Payer: EmblemHealth Commercial	$22,713.87
Rate for Payer: Humana Medicare Advantage	$7,798.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,571.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,161.90
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$11,080.95
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,780.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,571.29
Rate for Payer: Wellcare Medicare Advantage	$7,571.29
Rate for Payer: Wellpoint Medicaid Managed Care	$1,957.63

REACH BMT FEM 15 200 12-162115

Facility

$18,465.00

Hospital Charge Code	270615807
Hospital Revenue Code	278
Min. Negotiated Rate	$445.01
Max. Negotiated Rate	$9,232.50
Rate for Payer: Aetna Commercial	$7,016.70
Rate for Payer: Aetna Medicare Advantage	$5,539.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,708.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,708.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,693.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,708.57
Rate for Payer: Cigna Commercial	$9,232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,468.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,062.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,769.75
Rate for Payer: UnitedHealthcare Community & State	$445.01
Rate for Payer: Wellpoint Medicaid Managed Care	$489.32

REACH BMT FEM 15 200 12-162115

Facility

$18,465.00

Hospital Charge Code	270615807
Hospital Revenue Code	278
Min. Negotiated Rate	$2,769.75
Max. Negotiated Rate	$4,468.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,693.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,468.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,062.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,769.75

REACHER HANDI HMCFT STD AA8054

Facility

$67.25

Hospital Charge Code	270612560
Hospital Revenue Code	279
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$10.09
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

REACHER HANDI HMCFT STD AA8054

Facility

$67.25

Hospital Charge Code	270612560
Hospital Revenue Code	279
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$33.62
Rate for Payer: Aetna Commercial	$25.55
Rate for Payer: Aetna Medicare Advantage	$20.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$33.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.18
Rate for Payer: Oxford Commercial	$13.45
Rate for Payer: Qualcare PPO/HMO/WC	$10.09
Rate for Payer: UnitedHealthcare Commercial	$13.45
Rate for Payer: UnitedHealthcare Community & State	$1.62
Rate for Payer: Wellpoint Medicaid Managed Care	$1.78

REACH POROUS FEMORAL 13x200mm

Facility

$53,725.00

Service Code	HCPCS C1776
Hospital Charge Code	270615806
Hospital Revenue Code	278
Min. Negotiated Rate	$8,058.75
Max. Negotiated Rate	$13,001.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,745.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,001.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11,819.50
Rate for Payer: Qualcare PPO/HMO/WC	$8,058.75

REACH POROUS FEMORAL 13x200mm

Facility

$53,725.00

Service Code	HCPCS C1776
Hospital Charge Code	270615806
Hospital Revenue Code	278
Min. Negotiated Rate	$1,294.77
Max. Negotiated Rate	$26,862.50
Rate for Payer: Aetna Commercial	$20,415.50
Rate for Payer: Aetna Medicare Advantage	$16,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,699.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,699.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,745.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,699.88
Rate for Payer: Cigna Commercial	$26,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,001.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11,819.50
Rate for Payer: Qualcare PPO/HMO/WC	$8,058.75
Rate for Payer: UnitedHealthcare Community & State	$1,294.77
Rate for Payer: Wellpoint Medicaid Managed Care	$1,423.71

READICAT 2 BARIUM SULFATE

Facility

$728.09

Service Code	NDC 32909071503
Hospital Charge Code	60635890
Hospital Revenue Code	272
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$364.05
Rate for Payer: Aetna Commercial	$276.67
Rate for Payer: Aetna Medicare Advantage	$218.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.66
Rate for Payer: Cigna Commercial	$364.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.43
Rate for Payer: Oxford Commercial	$145.62
Rate for Payer: Qualcare PPO/HMO/WC	$109.21
Rate for Payer: UnitedHealthcare Commercial	$145.62
Rate for Payer: UnitedHealthcare Community & State	$17.55
Rate for Payer: Wellpoint Medicaid Managed Care	$19.29

READICAT 2 BARIUM SULFATE

Facility

$728.09

Service Code	NDC 32909071503
Hospital Charge Code	60635890
Hospital Revenue Code	272
Min. Negotiated Rate	$109.21
Max. Negotiated Rate	$109.21
Rate for Payer: Qualcare PPO/HMO/WC	$109.21

READIGRAFT CANC 5 1-8MM

Facility

$720.00

Hospital Charge Code	270676690
Hospital Revenue Code	278
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Community & State	$17.35
Rate for Payer: Wellpoint Medicaid Managed Care	$19.08

READIGRAFT CANC 5 1-8MM

Facility

$720.00

Hospital Charge Code	270676690
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

REAGENT BOND ORACLE HER2 IHC

Facility

$12,330.30

Hospital Charge Code	270676051
Hospital Revenue Code	272
Min. Negotiated Rate	$297.16
Max. Negotiated Rate	$6,165.15
Rate for Payer: Aetna Commercial	$4,685.51
Rate for Payer: Aetna Medicare Advantage	$3,699.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,144.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,144.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,144.23
Rate for Payer: Cigna Commercial	$6,165.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,699.09
Rate for Payer: Oxford Commercial	$2,466.06
Rate for Payer: Qualcare PPO/HMO/WC	$1,849.55
Rate for Payer: UnitedHealthcare Commercial	$2,466.06
Rate for Payer: UnitedHealthcare Community & State	$297.16
Rate for Payer: Wellpoint Medicaid Managed Care	$326.75

REAGENT BOND ORACLE HER2 IHC

Facility

$12,330.30

Hospital Charge Code	270676051
Hospital Revenue Code	272
Min. Negotiated Rate	$1,849.55
Max. Negotiated Rate	$1,849.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,849.55

Know your out-of-pocket cost for care.

All Charges