Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

REMVAL OF ANKLE/HEEL LESION-R

Facility

$20,900.00

Service Code	HCPCS 28100
Hospital Charge Code	1600000589
Hospital Revenue Code	360
Min. Negotiated Rate	$3,135.00
Max. Negotiated Rate	$3,135.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,135.00

REMVAL OF ANKLE/HEEL LESION-R

Facility

$20,900.00

Service Code	HCPCS 28100
Hospital Charge Code	1600000589
Hospital Revenue Code	360
Min. Negotiated Rate	$503.69
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,270.00
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,135.00
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$503.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$553.85

REMVAL OF SPINAL LMNA SGL LMBR

Facility

$47,548.90

Service Code	HCPCS 63047
Hospital Charge Code	16000276
Hospital Revenue Code	360
Min. Negotiated Rate	$7,132.34
Max. Negotiated Rate	$7,132.34
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34

REMVAL OF SPINAL LMNA SGL LMBR

Facility

$47,548.90

Service Code	HCPCS 63047
Hospital Charge Code	16000276
Hospital Revenue Code	360
Min. Negotiated Rate	$1,145.93
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,264.67
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,145.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,260.05

REM VENTIL TUBE UNDER ANESTH

Facility

$14,464.70

Service Code	HCPCS 69424
Hospital Charge Code	16000154
Hospital Revenue Code	360
Min. Negotiated Rate	$348.60
Max. Negotiated Rate	$14,218.07
Rate for Payer: Aetna Commercial	$10,713.67
Rate for Payer: Aetna Medicare Advantage	$12,761.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,218.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,218.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,938.85
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	$14,218.07
Rate for Payer: Cigna Commercial	$7,895.42
Rate for Payer: Cigna Medicare Advantage	$3,938.85
Rate for Payer: Clover Medicare Advantage	$3,741.91
Rate for Payer: EmblemHealth Commercial	$11,816.55
Rate for Payer: Humana Medicare Advantage	$4,057.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,938.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,339.41
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,169.70
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$348.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,938.85
Rate for Payer: Wellcare Medicare Advantage	$3,938.85
Rate for Payer: Wellpoint Medicaid Managed Care	$383.31

REM VENTIL TUBE UNDER ANESTH

Facility

$14,464.70

Service Code	HCPCS 69424
Hospital Charge Code	16000154
Hospital Revenue Code	360
Min. Negotiated Rate	$2,169.70
Max. Negotiated Rate	$2,169.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,169.70

Remv&repl cvd gen mult lead

Facility

$148,575.45

Service Code	HCPCS 33264
Hospital Charge Code	5100830
Hospital Revenue Code	480
Min. Negotiated Rate	$22,286.32
Max. Negotiated Rate	$22,286.32
Rate for Payer: Qualcare PPO/HMO/WC	$22,286.32

Remv&repl cvd gen mult lead

Facility

$148,575.45

Service Code	HCPCS 33264
Hospital Charge Code	5100830
Hospital Revenue Code	480
Min. Negotiated Rate	$422.22
Max. Negotiated Rate	$134,608.60
Rate for Payer: Aetna Commercial	$101,430.98
Rate for Payer: Aetna Medicare Advantage	$120,822.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$134,608.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$134,608.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37,290.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$422.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$134,608.60
Rate for Payer: Cigna Commercial	$74,749.27
Rate for Payer: Cigna Medicare Advantage	$37,290.80
Rate for Payer: Clover Medicare Advantage	$35,426.26
Rate for Payer: EmblemHealth Commercial	$111,872.40
Rate for Payer: Humana Medicare Advantage	$38,409.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$37,290.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44,572.64
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$22,286.32
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$3,580.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$37,290.80
Rate for Payer: Wellcare Medicare Advantage	$37,290.80
Rate for Payer: Wellpoint Medicaid Managed Care	$3,937.25

Remv&repl cvd gen sing lead

Facility

$148,575.45

Service Code	HCPCS 33263
Hospital Charge Code	5100829
Hospital Revenue Code	480
Min. Negotiated Rate	$22,286.32
Max. Negotiated Rate	$22,286.32
Rate for Payer: Qualcare PPO/HMO/WC	$22,286.32

Remv&repl cvd gen sing lead

Facility

$148,575.45

Service Code	HCPCS 33263
Hospital Charge Code	5100829
Hospital Revenue Code	480
Min. Negotiated Rate	$406.97
Max. Negotiated Rate	$95,389.79
Rate for Payer: Aetna Commercial	$71,878.61
Rate for Payer: Aetna Medicare Advantage	$85,620.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95,389.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95,389.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26,425.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$406.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95,389.79
Rate for Payer: Cigna Commercial	$52,970.73
Rate for Payer: Cigna Medicare Advantage	$26,425.96
Rate for Payer: Clover Medicare Advantage	$25,104.66
Rate for Payer: EmblemHealth Commercial	$79,277.88
Rate for Payer: Humana Medicare Advantage	$27,218.74
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26,425.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44,572.64
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$22,286.32
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$3,580.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$26,425.96
Rate for Payer: Wellcare Medicare Advantage	$26,425.96
Rate for Payer: Wellpoint Medicaid Managed Care	$3,937.25

Remv&repl cvd gen sing lead

Facility

$148,575.45

Service Code	HCPCS 33262
Hospital Charge Code	5100828
Hospital Revenue Code	480
Min. Negotiated Rate	$304.15
Max. Negotiated Rate	$95,389.79
Rate for Payer: Aetna Commercial	$71,878.61
Rate for Payer: Aetna Medicare Advantage	$85,620.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95,389.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95,389.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26,425.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$304.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95,389.79
Rate for Payer: Cigna Commercial	$52,970.73
Rate for Payer: Cigna Medicare Advantage	$26,425.96
Rate for Payer: Clover Medicare Advantage	$25,104.66
Rate for Payer: EmblemHealth Commercial	$79,277.88
Rate for Payer: Humana Medicare Advantage	$27,218.74
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26,425.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44,572.64
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$22,286.32
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$3,580.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$26,425.96
Rate for Payer: Wellcare Medicare Advantage	$26,425.96
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,099.11
Rate for Payer: Wellpoint Medicaid Managed Care	$3,937.25

Remv&repl cvd gen sing lead

Facility

$148,575.45

Service Code	HCPCS 33262
Hospital Charge Code	5100828
Hospital Revenue Code	480
Min. Negotiated Rate	$22,286.32
Max. Negotiated Rate	$22,286.32
Rate for Payer: Qualcare PPO/HMO/WC	$22,286.32

REMV/REPL PENIS CONTAIN PROS

Facility

$94,818.40

Service Code	HCPCS 54416
Hospital Charge Code	1600000483
Hospital Revenue Code	360
Min. Negotiated Rate	$1,355.00
Max. Negotiated Rate	$88,882.29
Rate for Payer: Aetna Commercial	$66,975.05
Rate for Payer: Aetna Medicare Advantage	$79,779.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88,882.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88,882.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24,623.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88,882.29
Rate for Payer: Cigna Commercial	$49,357.08
Rate for Payer: Cigna Medicare Advantage	$24,623.18
Rate for Payer: Clover Medicare Advantage	$23,392.02
Rate for Payer: EmblemHealth Commercial	$73,869.54
Rate for Payer: Humana Medicare Advantage	$25,361.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24,623.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28,445.52
Rate for Payer: Oxford Commercial	$10,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$14,222.76
Rate for Payer: UnitedHealthcare Commercial	$17,313.00
Rate for Payer: UnitedHealthcare Community & State	$2,285.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$24,623.18
Rate for Payer: Wellcare Medicare Advantage	$24,623.18
Rate for Payer: Wellpoint Medicaid Managed Care	$2,512.69

REMV/REPL PENIS CONTAIN PROS

Facility

$94,818.40

Service Code	HCPCS 54416
Hospital Charge Code	1600000483
Hospital Revenue Code	360
Min. Negotiated Rate	$14,222.76
Max. Negotiated Rate	$14,222.76
Rate for Payer: Qualcare PPO/HMO/WC	$14,222.76

RENACIDIN POWDER

Facility

$167.00

Hospital Charge Code	60634491
Hospital Revenue Code	250
Min. Negotiated Rate	$4.02
Max. Negotiated Rate	$83.50
Rate for Payer: Aetna Commercial	$63.46
Rate for Payer: Aetna Medicare Advantage	$50.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.59
Rate for Payer: Cigna Commercial	$83.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.10
Rate for Payer: Oxford Commercial	$33.40
Rate for Payer: Qualcare PPO/HMO/WC	$25.05
Rate for Payer: UnitedHealthcare Commercial	$33.40
Rate for Payer: UnitedHealthcare Community & State	$4.02
Rate for Payer: Wellpoint Medicaid Managed Care	$4.43

RENACIDIN POWDER

Facility

$167.00

Hospital Charge Code	60634491
Hospital Revenue Code	250
Min. Negotiated Rate	$25.05
Max. Negotiated Rate	$25.05
Rate for Payer: Qualcare PPO/HMO/WC	$25.05

RENACIDIN SOLN/500ML

Facility

$132.00

Hospital Charge Code	60634499
Hospital Revenue Code	250
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$19.80
Rate for Payer: Qualcare PPO/HMO/WC	$19.80

RENACIDIN SOLN/500ML

Facility

$132.00

Hospital Charge Code	60634499
Hospital Revenue Code	250
Min. Negotiated Rate	$3.18
Max. Negotiated Rate	$66.00
Rate for Payer: Aetna Commercial	$50.16
Rate for Payer: Aetna Medicare Advantage	$39.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.66
Rate for Payer: Cigna Commercial	$66.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.60
Rate for Payer: Oxford Commercial	$26.40
Rate for Payer: Qualcare PPO/HMO/WC	$19.80
Rate for Payer: UnitedHealthcare Commercial	$26.40
Rate for Payer: UnitedHealthcare Community & State	$3.18
Rate for Payer: Wellpoint Medicaid Managed Care	$3.50

RENAGEL 403MG CAP

Facility

$3.00

Hospital Charge Code	60635293
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

RENAGEL 403MG CAP

Facility

$3.00

Hospital Charge Code	60635293
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

RENAGEL 800 MG TAB

Facility

$42.68

Service Code	NDC 58468002101
Hospital Charge Code	60630232
Hospital Revenue Code	250
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$21.34
Rate for Payer: Aetna Commercial	$16.22
Rate for Payer: Aetna Medicare Advantage	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.88
Rate for Payer: Cigna Commercial	$21.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.80
Rate for Payer: Oxford Commercial	$8.54
Rate for Payer: Qualcare PPO/HMO/WC	$6.40
Rate for Payer: UnitedHealthcare Commercial	$8.54
Rate for Payer: UnitedHealthcare Community & State	$1.03
Rate for Payer: Wellpoint Medicaid Managed Care	$1.13

RENAGEL 800 MG TAB

Facility

$42.68

Service Code	NDC 58468002101
Hospital Charge Code	60630232
Hospital Revenue Code	250
Min. Negotiated Rate	$6.40
Max. Negotiated Rate	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$6.40

RENAGEL 800MG TAB

Facility

$3.00

Hospital Charge Code	60635376
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

RENAGEL 800MG TAB

Facility

$3.00

Hospital Charge Code	60635376
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

RENAL ANGIO-BIL

Facility

$5,072.00

Service Code	HCPCS 36252
Hospital Charge Code	7411121
Hospital Revenue Code	361
Min. Negotiated Rate	$760.80
Max. Negotiated Rate	$760.80
Rate for Payer: Qualcare PPO/HMO/WC	$760.80

Know your out-of-pocket cost for care.

All Charges