Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RENAL FUNCTION PANEL

Facility

$61.50

Service Code	HCPCS 80069
Hospital Charge Code	38476798
Hospital Revenue Code	301
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$9.22
Rate for Payer: Qualcare PPO/HMO/WC	$9.22

RENAL FUNCTION PROFILE

Facility

$390.00

Service Code	HCPCS 80069
Hospital Charge Code	3002343
Hospital Revenue Code	301
Min. Negotiated Rate	$6.94
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$23.61
Rate for Payer: Aetna Medicare Advantage	$28.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.33
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$8.68
Rate for Payer: Clover Medicare Advantage	$8.25
Rate for Payer: EmblemHealth Commercial	$26.04
Rate for Payer: Humana Medicare Advantage	$8.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.68
Rate for Payer: Wellcare Medicare Advantage	$8.68
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

RENAL FUNCTION PROFILE

Facility

$390.00

Service Code	HCPCS 80069
Hospital Charge Code	3002343
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RENAL UNIL ARTERI0

Facility

$6,122.00

Hospital Charge Code	2009005
Hospital Revenue Code	323
Min. Negotiated Rate	$147.54
Max. Negotiated Rate	$3,061.00
Rate for Payer: Aetna Commercial	$2,326.36
Rate for Payer: Aetna Medicare Advantage	$1,836.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,561.11
Rate for Payer: Cigna Commercial	$3,061.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.60
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$918.30
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$147.54
Rate for Payer: Wellpoint Medicaid Managed Care	$162.23

RENAL UNIL ARTERI0

Facility

$6,122.00

Hospital Charge Code	2009005
Hospital Revenue Code	323
Min. Negotiated Rate	$918.30
Max. Negotiated Rate	$918.30
Rate for Payer: Qualcare PPO/HMO/WC	$918.30

RENAL VENIPUNCTURE

Facility

$26.25

Service Code	HCPCS 36415
Hospital Charge Code	8200502
Hospital Revenue Code	300
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$25.40
Rate for Payer: Aetna Medicare Advantage	$30.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.71
Rate for Payer: Cigna Commercial	$13.12
Rate for Payer: Cigna Medicare Advantage	$9.34
Rate for Payer: Clover Medicare Advantage	$8.87
Rate for Payer: EmblemHealth Commercial	$28.02
Rate for Payer: Humana Medicare Advantage	$9.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.88
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.94
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.34
Rate for Payer: Wellcare Medicare Advantage	$9.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

RENAL VENIPUNCTURE

Facility

$26.25

Service Code	HCPCS 36415
Hospital Charge Code	8200502
Hospital Revenue Code	300
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$3.94
Rate for Payer: Qualcare PPO/HMO/WC	$3.94

RENASOL 0 K 2.5 CAL SB1014

Facility

$22.45

Hospital Charge Code	270605245
Hospital Revenue Code	272
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$8.53
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.74
Rate for Payer: Oxford Commercial	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$4.49
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

RENASOL 0 K 2.5 CAL SB1014

Facility

$22.45

Hospital Charge Code	270605245
Hospital Revenue Code	272
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

RENASOL 2 K 2.5 CA SB1020

Facility

$22.45

Hospital Charge Code	270604649
Hospital Revenue Code	272
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$8.53
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.74
Rate for Payer: Oxford Commercial	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$4.49
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

RENASOL 2 K 2.5 CA SB1020

Facility

$22.45

Hospital Charge Code	270604649
Hospital Revenue Code	272
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

RENASOL BICARB POWDER 25GAL

Facility

$47.65

Hospital Charge Code	270646987
Hospital Revenue Code	270
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$23.82
Rate for Payer: Aetna Commercial	$18.11
Rate for Payer: Aetna Medicare Advantage	$14.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.15
Rate for Payer: Cigna Commercial	$23.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.29
Rate for Payer: Oxford Commercial	$9.53
Rate for Payer: Qualcare PPO/HMO/WC	$7.15
Rate for Payer: UnitedHealthcare Commercial	$9.53
Rate for Payer: UnitedHealthcare Community & State	$1.15
Rate for Payer: Wellpoint Medicaid Managed Care	$1.26

RENASOL BICARB POWDER 25GAL

Facility

$47.65

Hospital Charge Code	270646987
Hospital Revenue Code	270
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$7.15
Rate for Payer: Qualcare PPO/HMO/WC	$7.15

RENASOL CA-2.5 K-3.0 (1057)

Facility

$15.00

Hospital Charge Code	270642576
Hospital Revenue Code	270
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

RENASOL CA-2.5 K-3.0 (1057)

Facility

$15.00

Hospital Charge Code	270642576
Hospital Revenue Code	270
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$3.00
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

RENASOL CA-2 K-2 (1086)

Facility

$15.45

Hospital Charge Code	270633128
Hospital Revenue Code	270
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$2.32
Rate for Payer: Qualcare PPO/HMO/WC	$2.32

RENASOL CA-2 K-2 (1086)

Facility

$15.45

Hospital Charge Code	270633128
Hospital Revenue Code	270
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$7.72
Rate for Payer: Aetna Commercial	$5.87
Rate for Payer: Aetna Medicare Advantage	$4.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.94
Rate for Payer: Cigna Commercial	$7.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.63
Rate for Payer: Oxford Commercial	$3.09
Rate for Payer: Qualcare PPO/HMO/WC	$2.32
Rate for Payer: UnitedHealthcare Commercial	$3.09
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

RENASOL NA-143 CA-0.0 K-2.0

Facility

$15.00

Hospital Charge Code	270643464
Hospital Revenue Code	270
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$3.00
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

RENASOL NA-143 CA-0.0 K-2.0

Facility

$15.00

Hospital Charge Code	270643464
Hospital Revenue Code	270
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

RENASYS DRESSING FOAM KIT

Facility

$141.95

Hospital Charge Code	270659496
Hospital Revenue Code	272
Min. Negotiated Rate	$21.29
Max. Negotiated Rate	$21.29
Rate for Payer: Qualcare PPO/HMO/WC	$21.29

RENASYS DRESSING FOAM KIT

Facility

$141.95

Hospital Charge Code	270659496
Hospital Revenue Code	272
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$70.97
Rate for Payer: Aetna Commercial	$53.94
Rate for Payer: Aetna Medicare Advantage	$42.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.20
Rate for Payer: Cigna Commercial	$70.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.59
Rate for Payer: Oxford Commercial	$28.39
Rate for Payer: Qualcare PPO/HMO/WC	$21.29
Rate for Payer: UnitedHealthcare Commercial	$28.39
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: Wellpoint Medicaid Managed Care	$3.76

RENASYS DRESSING F/P KIT XL

Facility

$456.15

Hospital Charge Code	270659491
Hospital Revenue Code	272
Min. Negotiated Rate	$68.42
Max. Negotiated Rate	$68.42
Rate for Payer: Qualcare PPO/HMO/WC	$68.42

RENASYS DRESSING F/P KIT XL

Facility

$456.15

Hospital Charge Code	270659491
Hospital Revenue Code	272
Min. Negotiated Rate	$10.99
Max. Negotiated Rate	$228.07
Rate for Payer: Aetna Commercial	$173.34
Rate for Payer: Aetna Medicare Advantage	$136.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.32
Rate for Payer: Cigna Commercial	$228.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.84
Rate for Payer: Oxford Commercial	$91.23
Rate for Payer: Qualcare PPO/HMO/WC	$68.42
Rate for Payer: UnitedHealthcare Commercial	$91.23
Rate for Payer: UnitedHealthcare Community & State	$10.99
Rate for Payer: Wellpoint Medicaid Managed Care	$12.09

RENASYS DRESSING F/P MEDIUM

Facility

$349.85

Hospital Charge Code	270649168
Hospital Revenue Code	272
Min. Negotiated Rate	$8.43
Max. Negotiated Rate	$174.93
Rate for Payer: Aetna Commercial	$132.94
Rate for Payer: Aetna Medicare Advantage	$104.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.21
Rate for Payer: Cigna Commercial	$174.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.95
Rate for Payer: Oxford Commercial	$69.97
Rate for Payer: Qualcare PPO/HMO/WC	$52.48
Rate for Payer: UnitedHealthcare Commercial	$69.97
Rate for Payer: UnitedHealthcare Community & State	$8.43
Rate for Payer: Wellpoint Medicaid Managed Care	$9.27

RENASYS DRESSING F/P MEDIUM

Facility

$349.85

Hospital Charge Code	270649168
Hospital Revenue Code	272
Min. Negotiated Rate	$52.48
Max. Negotiated Rate	$52.48
Rate for Payer: Qualcare PPO/HMO/WC	$52.48

Know your out-of-pocket cost for care.

All Charges