Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$2,250.00

Service Code	HCPCS M0243
Hospital Charge Code	3043M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$2,250.00

Service Code	HCPCS M0243
Hospital Charge Code	3246M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$675.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$2,250.00

Service Code	HCPCS M0243
Hospital Charge Code	3230M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$2,250.00

Service Code	HCPCS M0243
Hospital Charge Code	3042M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$1,548.00

Service Code	HCPCS M0243
Hospital Charge Code	3121M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$37.31
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$588.24
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.40
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$37.31
Rate for Payer: Wellpoint Medicaid Managed Care	$41.02

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$2,250.00

Service Code	HCPCS M0243
Hospital Charge Code	3042M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$675.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$1,548.00

Service Code	HCPCS M0243
Hospital Charge Code	3033M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$37.31
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$588.24
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.40
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$37.31
Rate for Payer: Wellpoint Medicaid Managed Care	$41.02

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$1,548.00

Service Code	HCPCS M0243
Hospital Charge Code	3033M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$2,250.00

Service Code	HCPCS M0243
Hospital Charge Code	3050M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$675.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$1,548.00

Service Code	HCPCS M0243
Hospital Charge Code	3046M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$37.31
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$588.24
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.40
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$37.31
Rate for Payer: Wellpoint Medicaid Managed Care	$41.02

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$1,548.00

Service Code	HCPCS M0243
Hospital Charge Code	3046M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$2,250.00

Service Code	HCPCS M0243
Hospital Charge Code	3247M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$675.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$2,250.00

Service Code	HCPCS M0243
Hospital Charge Code	3247M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$2,250.00

Service Code	HCPCS M0243
Hospital Charge Code	3050M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$2,250.00

Service Code	HCPCS M0243
Hospital Charge Code	3024M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$675.00
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

REGEN(CAS+IMDVIMB)INFUS&MONITR

Facility

$2,250.00

Service Code	HCPCS M0243
Hospital Charge Code	3246M0243
Hospital Revenue Code	771
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

REGENERATION MESHED TEMPLATE

Facility

$18,500.00

Hospital Charge Code	270703940
Hospital Revenue Code	272
Min. Negotiated Rate	$2,775.00
Max. Negotiated Rate	$2,775.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,775.00

REGENERATION MESHED TEMPLATE

Facility

$18,500.00

Hospital Charge Code	270703940
Hospital Revenue Code	272
Min. Negotiated Rate	$445.85
Max. Negotiated Rate	$9,250.00
Rate for Payer: Aetna Commercial	$7,030.00
Rate for Payer: Aetna Medicare Advantage	$5,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,717.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,717.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,717.50
Rate for Payer: Cigna Commercial	$9,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,550.00
Rate for Payer: Oxford Commercial	$3,700.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,775.00
Rate for Payer: UnitedHealthcare Commercial	$3,700.00
Rate for Payer: UnitedHealthcare Community & State	$445.85
Rate for Payer: Wellpoint Medicaid Managed Care	$490.25

REGENERON EUA 2400MG VIAL

Facility

$0.01

Service Code	HCPCS Q0243
Hospital Charge Code	606390393
Hospital Revenue Code	636
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

REGENERON EUA 2400MG VIAL

Facility

$0.01

Service Code	HCPCS Q0243
Hospital Charge Code	606390393
Hospital Revenue Code	636
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

REGENKIT THT AUTOLOG FOR PRP

Facility

$1,738.15

Service Code	HCPCS A4649
Hospital Charge Code	270700253
Hospital Revenue Code	272
Min. Negotiated Rate	$260.72
Max. Negotiated Rate	$260.72
Rate for Payer: Qualcare PPO/HMO/WC	$260.72

REGENKIT THT AUTOLOG FOR PRP

Facility

$1,738.15

Service Code	HCPCS A4649
Hospital Charge Code	270700253
Hospital Revenue Code	272
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$869.08
Rate for Payer: Aetna Commercial	$660.50
Rate for Payer: Aetna Medicare Advantage	$521.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$443.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$443.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$443.23
Rate for Payer: Cigna Commercial	$869.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$521.45
Rate for Payer: Oxford Commercial	$347.63
Rate for Payer: Qualcare PPO/HMO/WC	$260.72
Rate for Payer: UnitedHealthcare Commercial	$347.63
Rate for Payer: UnitedHealthcare Community & State	$41.89
Rate for Payer: Wellpoint Medicaid Managed Care	$46.06

REGITINE/5MG

Facility

$61.00

Hospital Charge Code	60633805
Hospital Revenue Code	250
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$23.18
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.30
Rate for Payer: Oxford Commercial	$12.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$12.20
Rate for Payer: UnitedHealthcare Community & State	$1.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.62

REGITINE/5MG

Facility

$61.00

Hospital Charge Code	60633805
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

REGLAN/10MG/BULK

Facility

$3.00

Hospital Charge Code	60634683
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

Know your out-of-pocket cost for care.

All Charges