Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

REM COREAL FB W/O SLIT LAM

Facility

$440.10

Service Code	HCPCS 65220
Hospital Charge Code	5780245
Hospital Revenue Code	450
Min. Negotiated Rate	$11.66
Max. Negotiated Rate	$1,915.74
Rate for Payer: Aetna Commercial	$1,443.56
Rate for Payer: Aetna Medicare Advantage	$1,719.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,915.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,915.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$530.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,915.74
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: Cigna Medicare Advantage	$530.72
Rate for Payer: Clover Medicare Advantage	$504.18
Rate for Payer: EmblemHealth Commercial	$1,592.16
Rate for Payer: Humana Medicare Advantage	$546.64
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$530.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.02
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$530.72
Rate for Payer: Wellcare Medicare Advantage	$530.72
Rate for Payer: Wellpoint Medicaid Managed Care	$11.66

REM DEEP FB THIGH OR KNEE

Facility

$20,625.50

Service Code	HCPCS 27372
Hospital Charge Code	1600000331
Hospital Revenue Code	360
Min. Negotiated Rate	$3,093.82
Max. Negotiated Rate	$3,093.82
Rate for Payer: Qualcare PPO/HMO/WC	$3,093.82

REM DEEP FB THIGH OR KNEE

Facility

$20,625.50

Service Code	HCPCS 27372
Hospital Charge Code	1600000331
Hospital Revenue Code	360
Min. Negotiated Rate	$497.07
Max. Negotiated Rate	$12,456.64
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,456.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,456.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,456.64
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,187.65
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,093.82
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$497.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$546.58

REMEDY MOISTURE BARRIER 4oz

Facility

$12.99

Hospital Charge Code	270302495W
Hospital Revenue Code	270
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

REMEDY MOISTURE BARRIER 4oz

Facility

$12.99

Hospital Charge Code	270302495W
Hospital Revenue Code	270
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

REMEDY PROTECT NUTRASHIELD 2oz

Facility

$12.36

Hospital Charge Code	270302485
Hospital Revenue Code	270
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$1.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.85

REMEDY PROTECT NUTRASHIELD 2oz

Facility

$12.36

Hospital Charge Code	270302485
Hospital Revenue Code	270
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$6.18
Rate for Payer: Aetna Commercial	$4.70
Rate for Payer: Aetna Medicare Advantage	$3.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.15
Rate for Payer: Cigna Commercial	$6.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.71
Rate for Payer: Oxford Commercial	$2.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.85
Rate for Payer: UnitedHealthcare Commercial	$2.47
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

REMEDY ZGUARD PHYSOPLEX 4oz

Facility

$20.00

Hospital Charge Code	270602490
Hospital Revenue Code	270
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

REMEDY ZGUARD PHYSOPLEX 4oz

Facility

$20.00

Hospital Charge Code	270602490
Hospital Revenue Code	270
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$7.60
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.00
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$4.00
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

REM EMBEDDED SUB CONJUNCTVL FB

Facility

$440.10

Service Code	HCPCS 65210
Hospital Charge Code	5780240
Hospital Revenue Code	450
Min. Negotiated Rate	$66.02
Max. Negotiated Rate	$66.02
Rate for Payer: Qualcare PPO/HMO/WC	$66.02

REM EMBEDDED SUB CONJUNCTVL FB

Facility

$440.10

Service Code	HCPCS 65210
Hospital Charge Code	5780240
Hospital Revenue Code	450
Min. Negotiated Rate	$11.66
Max. Negotiated Rate	$1,915.74
Rate for Payer: Aetna Commercial	$1,443.56
Rate for Payer: Aetna Medicare Advantage	$1,719.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,915.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,915.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$530.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,915.74
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: Cigna Medicare Advantage	$530.72
Rate for Payer: Clover Medicare Advantage	$504.18
Rate for Payer: EmblemHealth Commercial	$1,592.16
Rate for Payer: Humana Medicare Advantage	$546.64
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$530.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.02
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$530.72
Rate for Payer: Wellcare Medicare Advantage	$530.72
Rate for Payer: Wellpoint Medicaid Managed Care	$11.66

REMERON 30 MG TAB U/D

Facility

$13.00

Hospital Charge Code	60635288
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

REMERON 30 MG TAB U/D

Facility

$13.00

Hospital Charge Code	60635288
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

REM EXT FIX SYS W ANESTH

Facility

$27,488.40

Service Code	HCPCS 20694
Hospital Charge Code	16000408
Hospital Revenue Code	360
Min. Negotiated Rate	$4,123.26
Max. Negotiated Rate	$4,123.26
Rate for Payer: Qualcare PPO/HMO/WC	$4,123.26

REM EXT FIX SYS W ANESTH

Facility

$27,488.40

Service Code	HCPCS 20694
Hospital Charge Code	16000408
Hospital Revenue Code	360
Min. Negotiated Rate	$662.47
Max. Negotiated Rate	$8,246.52
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,246.52
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,123.26
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$662.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$728.44

REM FB CONJUNCTIVA SUPERFICIAL

Facility

$528.85

Service Code	HCPCS 65205
Hospital Charge Code	2500366
Hospital Revenue Code	761
Min. Negotiated Rate	$79.33
Max. Negotiated Rate	$79.33
Rate for Payer: Qualcare PPO/HMO/WC	$79.33

REM FB CONJUNCTIVA SUPERFICIAL

Facility

$528.85

Service Code	HCPCS 65205
Hospital Charge Code	2500366
Hospital Revenue Code	761
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$570.55
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.66
Rate for Payer: Oxford Commercial	$105.77
Rate for Payer: Qualcare PPO/HMO/WC	$79.33
Rate for Payer: UnitedHealthcare Commercial	$105.77
Rate for Payer: UnitedHealthcare Community & State	$12.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$14.01

REM FB EXT AUDIT CNL,W ANESTH

Facility

$29,357.70

Service Code	HCPCS 69205
Hospital Charge Code	16000207
Hospital Revenue Code	360
Min. Negotiated Rate	$4,403.65
Max. Negotiated Rate	$4,403.65
Rate for Payer: Qualcare PPO/HMO/WC	$4,403.65

REM FB EXT AUDIT CNL,W ANESTH

Facility

$29,357.70

Service Code	HCPCS 69205
Hospital Charge Code	16000207
Hospital Revenue Code	360
Min. Negotiated Rate	$707.52
Max. Negotiated Rate	$8,807.31
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,807.31
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,403.65
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$707.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$777.98

REM FB FOOT; SQ

Facility

$7,992.92

Service Code	HCPCS 28190
Hospital Charge Code	160000216
Hospital Revenue Code	360
Min. Negotiated Rate	$1,198.94
Max. Negotiated Rate	$1,198.94
Rate for Payer: Qualcare PPO/HMO/WC	$1,198.94

REM FB FOOT; SQ

Facility

$7,992.92

Service Code	HCPCS 28190
Hospital Charge Code	160000216
Hospital Revenue Code	360
Min. Negotiated Rate	$192.63
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,036.77
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,397.88
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,198.94
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$192.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$211.81

REMICADE 10MG INJ

Facility

$208.00

Hospital Charge Code	60635384
Hospital Revenue Code	636
Min. Negotiated Rate	$5.01
Max. Negotiated Rate	$104.00
Rate for Payer: Aetna Commercial	$79.04
Rate for Payer: Aetna Medicare Advantage	$62.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.04
Rate for Payer: Cigna Commercial	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.34
Rate for Payer: Qualcare PPO/HMO/WC	$31.20
Rate for Payer: UnitedHealthcare Community & State	$5.01
Rate for Payer: Wellpoint Medicaid Managed Care	$5.51

REMICADE 10MG INJ

Facility

$208.00

Hospital Charge Code	60635384
Hospital Revenue Code	636
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$50.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.34
Rate for Payer: Qualcare PPO/HMO/WC	$31.20

REMIFENTANIL I MG VIAL

Facility

$321.13

Service Code	NDC 72078003401
Hospital Charge Code	60632221
Hospital Revenue Code	250
Min. Negotiated Rate	$7.74
Max. Negotiated Rate	$160.56
Rate for Payer: Aetna Commercial	$122.03
Rate for Payer: Aetna Medicare Advantage	$96.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.89
Rate for Payer: Cigna Commercial	$160.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.34
Rate for Payer: Oxford Commercial	$64.23
Rate for Payer: Qualcare PPO/HMO/WC	$48.17
Rate for Payer: UnitedHealthcare Commercial	$64.23
Rate for Payer: UnitedHealthcare Community & State	$7.74
Rate for Payer: Wellpoint Medicaid Managed Care	$8.51

REMIFENTANIL I MG VIAL

Facility

$321.13

Service Code	NDC 72078003401
Hospital Charge Code	60632221
Hospital Revenue Code	250
Min. Negotiated Rate	$48.17
Max. Negotiated Rate	$48.17
Rate for Payer: Qualcare PPO/HMO/WC	$48.17

Know your out-of-pocket cost for care.

All Charges