Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RHEUMATOID FACTOR IgG

Facility

$390.00

Service Code	HCPCS 8352091
Hospital Charge Code	38479750B
Hospital Revenue Code	301
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

RHEUMATOID FACTOR IgG

Facility

$390.00

Service Code	HCPCS 8352091
Hospital Charge Code	38479750B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RHEUMATOID FACTOR IgM

Facility

$390.00

Service Code	HCPCS 8352091
Hospital Charge Code	38479750C
Hospital Revenue Code	301
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

RHEUMATOID FACTOR IgM

Facility

$390.00

Service Code	HCPCS 8352091
Hospital Charge Code	38479750C
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RHEUMATOID FACTOR QUANT

Facility

$667.59

Service Code	HCPCS 86431
Hospital Charge Code	39708042F
Hospital Revenue Code	306
Min. Negotiated Rate	$4.54
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$15.42
Rate for Payer: Aetna Medicare Advantage	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.47
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$5.67
Rate for Payer: Clover Medicare Advantage	$5.39
Rate for Payer: EmblemHealth Commercial	$17.01
Rate for Payer: Humana Medicare Advantage	$5.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.67
Rate for Payer: Wellcare Medicare Advantage	$5.67
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

RHEUMATOID FACTOR QUANT

Facility

$667.59

Service Code	HCPCS 86431
Hospital Charge Code	39708042F
Hospital Revenue Code	306
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

RHEUMATOID FACTOR QUANT

Facility

$28.35

Service Code	HCPCS 86431
Hospital Charge Code	401386431C
Hospital Revenue Code	302
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.42
Rate for Payer: Aetna Medicare Advantage	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.47
Rate for Payer: Cigna Commercial	$14.18
Rate for Payer: Cigna Medicare Advantage	$5.67
Rate for Payer: Clover Medicare Advantage	$5.39
Rate for Payer: EmblemHealth Commercial	$17.01
Rate for Payer: Humana Medicare Advantage	$5.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.51
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.67
Rate for Payer: Wellcare Medicare Advantage	$5.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.75

RHEUMATOID FACTOR QUANT

Facility

$28.35

Service Code	HCPCS 86431
Hospital Charge Code	401386431C
Hospital Revenue Code	302
Min. Negotiated Rate	$4.25
Max. Negotiated Rate	$4.25
Rate for Payer: Qualcare PPO/HMO/WC	$4.25

RHINO ROCKET - MEDIUM****

Facility

$5.00

Hospital Charge Code	8003238
Hospital Revenue Code	279
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

RHINO ROCKET - MEDIUM****

Facility

$5.00

Hospital Charge Code	8003238
Hospital Revenue Code	279
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

RHO D 300MG VIAL/INJ

Facility

$593.30

Hospital Charge Code	6009701
Hospital Revenue Code	636
Min. Negotiated Rate	$14.30
Max. Negotiated Rate	$296.65
Rate for Payer: Aetna Commercial	$225.45
Rate for Payer: Aetna Medicare Advantage	$177.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.29
Rate for Payer: Cigna Commercial	$296.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.58
Rate for Payer: Qualcare PPO/HMO/WC	$89.00
Rate for Payer: UnitedHealthcare Community & State	$14.30
Rate for Payer: Wellpoint Medicaid Managed Care	$15.72

RHO D 300MG VIAL/INJ

Facility

$593.30

Hospital Charge Code	6009701
Hospital Revenue Code	636
Min. Negotiated Rate	$89.00
Max. Negotiated Rate	$143.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.58
Rate for Payer: Qualcare PPO/HMO/WC	$89.00

RHO(D) IMM GLOBULIN 300MCG INJ

Facility

$2,700.17

Service Code	HCPCS J2792
Hospital Charge Code	60628296
Hospital Revenue Code	636
Min. Negotiated Rate	$405.03
Max. Negotiated Rate	$653.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.44
Rate for Payer: Qualcare PPO/HMO/WC	$405.03

RHO(D) IMM GLOBULIN 300MCG INJ

Facility

$2,700.17

Service Code	HCPCS J2792
Hospital Charge Code	60628296
Hospital Revenue Code	636
Min. Negotiated Rate	$32.55
Max. Negotiated Rate	$653.44
Rate for Payer: Aetna Commercial	$93.19
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.67
Rate for Payer: Cigna Medicare Advantage	$34.26
Rate for Payer: Clover Medicare Advantage	$32.55
Rate for Payer: EmblemHealth Commercial	$102.78
Rate for Payer: Humana Medicare Advantage	$35.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.44
Rate for Payer: Qualcare PPO/HMO/WC	$405.03
Rate for Payer: UnitedHealthcare Community & State	$65.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.26
Rate for Payer: Wellcare Medicare Advantage	$34.26
Rate for Payer: Wellpoint Medicaid Managed Care	$71.55

RHO(D) IMMUNE GLOB INJ 5000U

Facility

$5,407.50

Hospital Charge Code	60629007
Hospital Revenue Code	636
Min. Negotiated Rate	$130.32
Max. Negotiated Rate	$2,703.75
Rate for Payer: Aetna Commercial	$2,054.85
Rate for Payer: Aetna Medicare Advantage	$1,622.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,378.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,378.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,378.91
Rate for Payer: Cigna Commercial	$2,703.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,308.62
Rate for Payer: Qualcare PPO/HMO/WC	$811.12
Rate for Payer: UnitedHealthcare Community & State	$130.32
Rate for Payer: Wellpoint Medicaid Managed Care	$143.30

RHO(D) IMMUNE GLOB INJ 5000U

Facility

$5,407.50

Hospital Charge Code	60629007
Hospital Revenue Code	636
Min. Negotiated Rate	$811.12
Max. Negotiated Rate	$1,308.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,308.62
Rate for Payer: Qualcare PPO/HMO/WC	$811.12

RHO(D) IMMUNE GLOB INJ 60OU

Facility

$670.00

Hospital Charge Code	60628297
Hospital Revenue Code	636
Min. Negotiated Rate	$100.50
Max. Negotiated Rate	$162.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.50

RHO(D) IMMUNE GLOB INJ 60OU

Facility

$670.00

Hospital Charge Code	60628297
Hospital Revenue Code	636
Min. Negotiated Rate	$16.15
Max. Negotiated Rate	$335.00
Rate for Payer: Aetna Commercial	$254.60
Rate for Payer: Aetna Medicare Advantage	$201.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.85
Rate for Payer: Cigna Commercial	$335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.50
Rate for Payer: UnitedHealthcare Community & State	$16.15
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

RHO D IMMUNE GLOBULIN 100IU

Facility

$126.55

Service Code	HCPCS J2792
Hospital Charge Code	365212792
Hospital Revenue Code	636
Min. Negotiated Rate	$3.05
Max. Negotiated Rate	$123.67
Rate for Payer: Aetna Commercial	$93.19
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.67
Rate for Payer: Cigna Medicare Advantage	$34.26
Rate for Payer: Clover Medicare Advantage	$32.55
Rate for Payer: EmblemHealth Commercial	$102.78
Rate for Payer: Humana Medicare Advantage	$35.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.63
Rate for Payer: Qualcare PPO/HMO/WC	$18.98
Rate for Payer: UnitedHealthcare Community & State	$3.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.26
Rate for Payer: Wellcare Medicare Advantage	$34.26
Rate for Payer: Wellpoint Medicaid Managed Care	$3.35

RHO D IMMUNE GLOBULIN 100IU

Facility

$126.55

Service Code	HCPCS J2792
Hospital Charge Code	365212792
Hospital Revenue Code	636
Min. Negotiated Rate	$18.98
Max. Negotiated Rate	$30.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.63
Rate for Payer: Qualcare PPO/HMO/WC	$18.98

RH-O(D) IMMUNOGLOBULIN

Facility

$883.85

Hospital Charge Code	6004790
Hospital Revenue Code	636
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$441.93
Rate for Payer: Aetna Commercial	$335.86
Rate for Payer: Aetna Medicare Advantage	$265.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.38
Rate for Payer: Cigna Commercial	$441.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.89
Rate for Payer: Qualcare PPO/HMO/WC	$132.58
Rate for Payer: UnitedHealthcare Community & State	$21.30
Rate for Payer: Wellpoint Medicaid Managed Care	$23.42

RH-O(D) IMMUNOGLOBULIN

Facility

$883.85

Hospital Charge Code	6004790
Hospital Revenue Code	636
Min. Negotiated Rate	$132.58
Max. Negotiated Rate	$213.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.89
Rate for Payer: Qualcare PPO/HMO/WC	$132.58

RHOGAM

Facility

$215.00

Service Code	HCPCS 90384
Hospital Charge Code	3100135
Hospital Revenue Code	250
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$107.50
Rate for Payer: Aetna Commercial	$81.70
Rate for Payer: Aetna Medicare Advantage	$64.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.83
Rate for Payer: Cigna Commercial	$107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.50
Rate for Payer: Oxford Commercial	$43.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.25
Rate for Payer: UnitedHealthcare Commercial	$43.00
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$5.70

RHOGAM

Facility

$150.00

Service Code	HCPCS 90385
Hospital Charge Code	270325504
Hospital Revenue Code	636
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$288.78
Rate for Payer: Aetna Commercial	$217.60
Rate for Payer: Aetna Medicare Advantage	$259.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$288.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$288.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$288.78
Rate for Payer: Cigna Medicare Advantage	$80.00
Rate for Payer: Clover Medicare Advantage	$76.00
Rate for Payer: EmblemHealth Commercial	$240.00
Rate for Payer: Humana Medicare Advantage	$82.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Community & State	$3.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$80.00
Rate for Payer: Wellcare Medicare Advantage	$80.00
Rate for Payer: Wellpoint Medicaid Managed Care	$3.98

RHOGAM

Facility

$150.00

Service Code	HCPCS 90385
Hospital Charge Code	270325504
Hospital Revenue Code	636
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$36.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

Know your out-of-pocket cost for care.

All Charges