Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RENTAL XPS LASER

Facility

$3,750.00

Hospital Charge Code	270657508
Hospital Revenue Code	270
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.00
Rate for Payer: Oxford Commercial	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Commercial	$750.00
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

*RENT ANKL DISTRAC SYS 7205434

Facility

$3,475.00

Hospital Charge Code	270639738
Hospital Revenue Code	272
Min. Negotiated Rate	$83.75
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,320.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,042.50
Rate for Payer: Oxford Commercial	$695.00
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Commercial	$695.00
Rate for Payer: UnitedHealthcare Community & State	$83.75
Rate for Payer: Wellpoint Medicaid Managed Care	$92.09

*RENT ANKL DISTRAC SYS 7205434

Facility

$3,475.00

Hospital Charge Code	270639738
Hospital Revenue Code	272
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$521.25
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

RENT DRIL VIS HIG SPD3333616RT

Facility

$5,000.00

Hospital Charge Code	270639695
Hospital Revenue Code	272
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

RENT DRIL VIS HIG SPD3333616RT

Facility

$5,000.00

Hospital Charge Code	270639695
Hospital Revenue Code	272
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.00
Rate for Payer: Oxford Commercial	$1,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Commercial	$1,000.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

RENT XPS POWER CONSOL SPC LOAN

Facility

$5,000.00

Hospital Charge Code	270639492
Hospital Revenue Code	270
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

RENT XPS POWER CONSOL SPC LOAN

Facility

$5,000.00

Hospital Charge Code	270639492
Hospital Revenue Code	270
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.00
Rate for Payer: Oxford Commercial	$1,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Commercial	$1,000.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

RENVELA 0.8GM PWDR

Facility

$112.63

Service Code	NDC 58468013201
Hospital Charge Code	60635733
Hospital Revenue Code	250
Min. Negotiated Rate	$2.71
Max. Negotiated Rate	$56.31
Rate for Payer: Aetna Commercial	$42.80
Rate for Payer: Aetna Medicare Advantage	$33.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.72
Rate for Payer: Cigna Commercial	$56.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.79
Rate for Payer: Oxford Commercial	$22.53
Rate for Payer: Qualcare PPO/HMO/WC	$16.89
Rate for Payer: UnitedHealthcare Commercial	$22.53
Rate for Payer: UnitedHealthcare Community & State	$2.71
Rate for Payer: Wellpoint Medicaid Managed Care	$2.98

RENVELA 0.8GM PWDR

Facility

$112.63

Service Code	NDC 58468013201
Hospital Charge Code	60635733
Hospital Revenue Code	250
Min. Negotiated Rate	$16.89
Max. Negotiated Rate	$16.89
Rate for Payer: Qualcare PPO/HMO/WC	$16.89

RENVELA 2.4GM PWDR

Facility

$48.24

Service Code	NDC 58468013101
Hospital Charge Code	60635734
Hospital Revenue Code	250
Min. Negotiated Rate	$7.24
Max. Negotiated Rate	$7.24
Rate for Payer: Qualcare PPO/HMO/WC	$7.24

RENVELA 2.4GM PWDR

Facility

$48.24

Service Code	NDC 58468013101
Hospital Charge Code	60635734
Hospital Revenue Code	250
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$24.12
Rate for Payer: Aetna Commercial	$18.33
Rate for Payer: Aetna Medicare Advantage	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.30
Rate for Payer: Cigna Commercial	$24.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.47
Rate for Payer: Oxford Commercial	$9.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.24
Rate for Payer: UnitedHealthcare Commercial	$9.65
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.28

RENVELA 800MG

Facility

$34.17

Service Code	NDC 58468013301
Hospital Charge Code	60635712
Hospital Revenue Code	250
Min. Negotiated Rate	$5.13
Max. Negotiated Rate	$5.13
Rate for Payer: Qualcare PPO/HMO/WC	$5.13

RENVELA 800MG

Facility

$34.17

Service Code	NDC 58468013301
Hospital Charge Code	60635712
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$17.09
Rate for Payer: Aetna Commercial	$12.98
Rate for Payer: Aetna Medicare Advantage	$10.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.71
Rate for Payer: Cigna Commercial	$17.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.25
Rate for Payer: Oxford Commercial	$6.83
Rate for Payer: Qualcare PPO/HMO/WC	$5.13
Rate for Payer: UnitedHealthcare Commercial	$6.83
Rate for Payer: UnitedHealthcare Community & State	$0.82
Rate for Payer: Wellpoint Medicaid Managed Care	$0.91

REOPEN FALLOPIAN TUBE

Facility

$32,113.96

Service Code	HCPCS 58350
Hospital Charge Code	160000181
Hospital Revenue Code	360
Min. Negotiated Rate	$4,817.09
Max. Negotiated Rate	$4,817.09
Rate for Payer: Qualcare PPO/HMO/WC	$4,817.09

REOPEN FALLOPIAN TUBE

Facility

$32,113.96

Service Code	HCPCS 58350
Hospital Charge Code	160000181
Hospital Revenue Code	360
Min. Negotiated Rate	$773.95
Max. Negotiated Rate	$21,452.59
Rate for Payer: Aetna Commercial	$16,165.07
Rate for Payer: Aetna Medicare Advantage	$19,255.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,452.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,452.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5,943.04
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	$21,452.59
Rate for Payer: Cigna Commercial	$11,912.81
Rate for Payer: Cigna Medicare Advantage	$5,943.04
Rate for Payer: Clover Medicare Advantage	$5,645.89
Rate for Payer: EmblemHealth Commercial	$17,829.12
Rate for Payer: Humana Medicare Advantage	$6,121.33
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5,943.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,634.19
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,817.09
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$773.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$5,943.04
Rate for Payer: Wellcare Medicare Advantage	$5,943.04
Rate for Payer: Wellpoint Medicaid Managed Care	$851.02

REPAGLINIDE 0.5 MG TAB

Facility

$41.61

Service Code	NDC 169008181
Hospital Charge Code	60629853
Hospital Revenue Code	250
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$20.80
Rate for Payer: Aetna Commercial	$15.81
Rate for Payer: Aetna Medicare Advantage	$12.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.61
Rate for Payer: Cigna Commercial	$20.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.48
Rate for Payer: Oxford Commercial	$8.32
Rate for Payer: Qualcare PPO/HMO/WC	$6.24
Rate for Payer: UnitedHealthcare Commercial	$8.32
Rate for Payer: UnitedHealthcare Community & State	$1.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1.10

REPAGLINIDE 0.5 MG TAB

Facility

$41.61

Service Code	NDC 169008181
Hospital Charge Code	60629853
Hospital Revenue Code	250
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$6.24
Rate for Payer: Qualcare PPO/HMO/WC	$6.24

REPAGLINIDE 2 MG TAB

Facility

$60.43

Service Code	NDC 60846088401
Hospital Charge Code	60628885
Hospital Revenue Code	250
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$30.21
Rate for Payer: Aetna Commercial	$22.96
Rate for Payer: Aetna Medicare Advantage	$18.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.41
Rate for Payer: Cigna Commercial	$30.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.13
Rate for Payer: Oxford Commercial	$12.09
Rate for Payer: Qualcare PPO/HMO/WC	$9.06
Rate for Payer: UnitedHealthcare Commercial	$12.09
Rate for Payer: UnitedHealthcare Community & State	$1.46
Rate for Payer: Wellpoint Medicaid Managed Care	$1.60

REPAGLINIDE 2 MG TAB

Facility

$60.43

Service Code	NDC 60846088401
Hospital Charge Code	60628885
Hospital Revenue Code	250
Min. Negotiated Rate	$9.06
Max. Negotiated Rate	$9.06
Rate for Payer: Qualcare PPO/HMO/WC	$9.06

REPAIR ACHILLES TENDON

Facility

$12,289.60

Service Code	HCPCS 27650
Hospital Charge Code	16000217
Hospital Revenue Code	360
Min. Negotiated Rate	$296.18
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	$1,355.00
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	$3,686.88
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,843.44
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$296.18
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	$325.67

REPAIR ACHILLES TENDON

Facility

$12,289.60

Service Code	HCPCS 27650
Hospital Charge Code	16000217
Hospital Revenue Code	360
Min. Negotiated Rate	$1,843.44
Max. Negotiated Rate	$1,843.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,843.44

REPAIR ANTERIOR ABD HERNIA,ANY

Facility

$16,538.00

Service Code	HCPCS 49616
Hospital Charge Code	16000161
Hospital Revenue Code	360
Min. Negotiated Rate	$2,480.70
Max. Negotiated Rate	$2,480.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,480.70

REPAIR ANTERIOR ABD HERNIA,ANY

Facility

$16,538.00

Service Code	HCPCS 49616
Hospital Charge Code	16000161
Hospital Revenue Code	360
Min. Negotiated Rate	$398.57
Max. Negotiated Rate	$14,834.00
Rate for Payer: Aetna Commercial	$6,284.44
Rate for Payer: Aetna Medicare Advantage	$4,961.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,217.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,217.19
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	$4,217.19
Rate for Payer: Cigna Commercial	$8,269.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,961.40
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,480.70
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$398.57
Rate for Payer: Wellpoint Medicaid Managed Care	$438.26

REPAIR BALDDER & VAGINA

Facility

$42,695.42

Service Code	HCPCS 57240
Hospital Charge Code	1600000399
Hospital Revenue Code	360
Min. Negotiated Rate	$1,028.96
Max. Negotiated Rate	$21,452.59
Rate for Payer: Aetna Commercial	$16,165.07
Rate for Payer: Aetna Medicare Advantage	$19,255.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,452.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,452.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5,943.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,742.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21,452.59
Rate for Payer: Cigna Commercial	$11,912.81
Rate for Payer: Cigna Medicare Advantage	$5,943.04
Rate for Payer: Clover Medicare Advantage	$5,645.89
Rate for Payer: EmblemHealth Commercial	$17,829.12
Rate for Payer: Humana Medicare Advantage	$6,121.33
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5,943.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,808.63
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,404.31
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$1,028.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$5,943.04
Rate for Payer: Wellcare Medicare Advantage	$5,943.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1,131.43

REPAIR BALDDER & VAGINA

Facility

$42,695.42

Service Code	HCPCS 57240
Hospital Charge Code	1600000399
Hospital Revenue Code	360
Min. Negotiated Rate	$6,404.31
Max. Negotiated Rate	$6,404.31
Rate for Payer: Qualcare PPO/HMO/WC	$6,404.31

Know your out-of-pocket cost for care.

All Charges