Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RPR TITER

Facility

$390.00

Service Code	HCPCS 86593
Hospital Charge Code	39900225
Hospital Revenue Code	302
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$11.97
Rate for Payer: Aetna Medicare Advantage	$14.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.88
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.40
Rate for Payer: Clover Medicare Advantage	$4.18
Rate for Payer: EmblemHealth Commercial	$13.20
Rate for Payer: Humana Medicare Advantage	$4.53
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.40
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	$3.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.40
Rate for Payer: Wellcare Medicare Advantage	$4.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

RPR, Treponema pallidum IA

Facility

$42.06

Service Code	HCPCS 36126
Hospital Charge Code	3000078
Hospital Revenue Code	306
Min. Negotiated Rate	$6.31
Max. Negotiated Rate	$6.31
Rate for Payer: Qualcare PPO/HMO/WC	$6.31

RPR, Treponema pallidum IA

Facility

$42.06

Service Code	HCPCS 36126
Hospital Charge Code	3000078
Hospital Revenue Code	306
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.98
Rate for Payer: Aetna Medicare Advantage	$12.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.73
Rate for Payer: Cigna Commercial	$21.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.31
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.01
Rate for Payer: Wellpoint Medicaid Managed Care	$1.11

RPR UMBIL HERN REDUC 5+YR

Facility

$30,877.00

Service Code	HCPCS 49585
Hospital Charge Code	16000991
Hospital Revenue Code	360
Min. Negotiated Rate	$744.14
Max. Negotiated Rate	$15,438.50
Rate for Payer: Aetna Commercial	$11,733.26
Rate for Payer: Aetna Medicare Advantage	$9,263.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,873.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,873.64
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	$7,873.64
Rate for Payer: Cigna Commercial	$15,438.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,263.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55
Rate for Payer: UnitedHealthcare Community & State	$744.14
Rate for Payer: Wellpoint Medicaid Managed Care	$818.24

RPR UMBIL HERN REDUC 5+YR

Facility

$30,877.00

Service Code	HCPCS 49585
Hospital Charge Code	16000991
Hospital Revenue Code	360
Min. Negotiated Rate	$4,631.55
Max. Negotiated Rate	$4,631.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55

RR ICU 1 1/2 TO 2 HOURS

Facility

$1,430.45

Hospital Charge Code	1500123
Hospital Revenue Code	710
Min. Negotiated Rate	$34.47
Max. Negotiated Rate	$715.23
Rate for Payer: Aetna Commercial	$543.57
Rate for Payer: Aetna Medicare Advantage	$429.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.76
Rate for Payer: Cigna Commercial	$715.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.13
Rate for Payer: Oxford Commercial	$286.09
Rate for Payer: Qualcare PPO/HMO/WC	$214.57
Rate for Payer: UnitedHealthcare Commercial	$286.09
Rate for Payer: UnitedHealthcare Community & State	$34.47
Rate for Payer: Wellpoint Medicaid Managed Care	$37.91

RR ICU 1 1/2 TO 2 HOURS

Facility

$1,430.45

Hospital Charge Code	1500123
Hospital Revenue Code	710
Min. Negotiated Rate	$214.57
Max. Negotiated Rate	$214.57
Rate for Payer: Qualcare PPO/HMO/WC	$214.57

RR ICU 1 TO 1 1/2 HOURS

Facility

$1,252.85

Hospital Charge Code	1500115
Hospital Revenue Code	710
Min. Negotiated Rate	$187.93
Max. Negotiated Rate	$187.93
Rate for Payer: Qualcare PPO/HMO/WC	$187.93

RR ICU 1 TO 1 1/2 HOURS

Facility

$1,252.85

Hospital Charge Code	1500115
Hospital Revenue Code	710
Min. Negotiated Rate	$30.19
Max. Negotiated Rate	$626.42
Rate for Payer: Aetna Commercial	$476.08
Rate for Payer: Aetna Medicare Advantage	$375.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$319.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$319.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$319.48
Rate for Payer: Cigna Commercial	$626.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.86
Rate for Payer: Oxford Commercial	$250.57
Rate for Payer: Qualcare PPO/HMO/WC	$187.93
Rate for Payer: UnitedHealthcare Commercial	$250.57
Rate for Payer: UnitedHealthcare Community & State	$30.19
Rate for Payer: Wellpoint Medicaid Managed Care	$33.20

RR ICU 2 1/2 TO 3 HOURS

Facility

$1,788.00

Hospital Charge Code	1500149
Hospital Revenue Code	710
Min. Negotiated Rate	$268.20
Max. Negotiated Rate	$268.20
Rate for Payer: Qualcare PPO/HMO/WC	$268.20

RR ICU 2 1/2 TO 3 HOURS

Facility

$1,788.00

Hospital Charge Code	1500149
Hospital Revenue Code	710
Min. Negotiated Rate	$43.09
Max. Negotiated Rate	$894.00
Rate for Payer: Aetna Commercial	$679.44
Rate for Payer: Aetna Medicare Advantage	$536.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$455.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$455.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$455.94
Rate for Payer: Cigna Commercial	$894.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$536.40
Rate for Payer: Oxford Commercial	$357.60
Rate for Payer: Qualcare PPO/HMO/WC	$268.20
Rate for Payer: UnitedHealthcare Commercial	$357.60
Rate for Payer: UnitedHealthcare Community & State	$43.09
Rate for Payer: Wellpoint Medicaid Managed Care	$47.38

RR ICU 2 TO 2 1/2 HOURS

Facility

$1,609.65

Hospital Charge Code	1500131
Hospital Revenue Code	710
Min. Negotiated Rate	$241.45
Max. Negotiated Rate	$241.45
Rate for Payer: Qualcare PPO/HMO/WC	$241.45

RR ICU 2 TO 2 1/2 HOURS

Facility

$1,609.65

Hospital Charge Code	1500131
Hospital Revenue Code	710
Min. Negotiated Rate	$38.79
Max. Negotiated Rate	$804.83
Rate for Payer: Aetna Commercial	$611.67
Rate for Payer: Aetna Medicare Advantage	$482.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.46
Rate for Payer: Cigna Commercial	$804.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.89
Rate for Payer: Oxford Commercial	$321.93
Rate for Payer: Qualcare PPO/HMO/WC	$241.45
Rate for Payer: UnitedHealthcare Commercial	$321.93
Rate for Payer: UnitedHealthcare Community & State	$38.79
Rate for Payer: Wellpoint Medicaid Managed Care	$42.66

RR ICU 3 1/2 TO 4 HOURS

Facility

$2,146.45

Hospital Charge Code	1500164
Hospital Revenue Code	710
Min. Negotiated Rate	$321.97
Max. Negotiated Rate	$321.97
Rate for Payer: Qualcare PPO/HMO/WC	$321.97

RR ICU 3 1/2 TO 4 HOURS

Facility

$2,146.45

Hospital Charge Code	1500164
Hospital Revenue Code	710
Min. Negotiated Rate	$51.73
Max. Negotiated Rate	$1,073.22
Rate for Payer: Aetna Commercial	$815.65
Rate for Payer: Aetna Medicare Advantage	$643.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$547.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$547.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$547.34
Rate for Payer: Cigna Commercial	$1,073.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$643.93
Rate for Payer: Oxford Commercial	$429.29
Rate for Payer: Qualcare PPO/HMO/WC	$321.97
Rate for Payer: UnitedHealthcare Commercial	$429.29
Rate for Payer: UnitedHealthcare Community & State	$51.73
Rate for Payer: Wellpoint Medicaid Managed Care	$56.88

RR ICU 3 TO 3 1/2 HOURS

Facility

$1,967.25

Hospital Charge Code	1500156
Hospital Revenue Code	710
Min. Negotiated Rate	$295.09
Max. Negotiated Rate	$295.09
Rate for Payer: Qualcare PPO/HMO/WC	$295.09

RR ICU 3 TO 3 1/2 HOURS

Facility

$1,967.25

Hospital Charge Code	1500156
Hospital Revenue Code	710
Min. Negotiated Rate	$47.41
Max. Negotiated Rate	$983.62
Rate for Payer: Aetna Commercial	$747.55
Rate for Payer: Aetna Medicare Advantage	$590.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$501.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$501.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$501.65
Rate for Payer: Cigna Commercial	$983.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$590.17
Rate for Payer: Oxford Commercial	$393.45
Rate for Payer: Qualcare PPO/HMO/WC	$295.09
Rate for Payer: UnitedHealthcare Commercial	$393.45
Rate for Payer: UnitedHealthcare Community & State	$47.41
Rate for Payer: Wellpoint Medicaid Managed Care	$52.13

RR ICU EACH ADD'L 1/2 HOUR

Facility

$179.25

Hospital Charge Code	1500172
Hospital Revenue Code	710
Min. Negotiated Rate	$26.89
Max. Negotiated Rate	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$26.89

RR ICU EACH ADD'L 1/2 HOUR

Facility

$179.25

Hospital Charge Code	1500172
Hospital Revenue Code	710
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$89.62
Rate for Payer: Aetna Commercial	$68.11
Rate for Payer: Aetna Medicare Advantage	$53.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.71
Rate for Payer: Cigna Commercial	$89.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.77
Rate for Payer: Oxford Commercial	$35.85
Rate for Payer: Qualcare PPO/HMO/WC	$26.89
Rate for Payer: UnitedHealthcare Commercial	$35.85
Rate for Payer: UnitedHealthcare Community & State	$4.32
Rate for Payer: Wellpoint Medicaid Managed Care	$4.75

RR ICU ONE HOUR

Facility

$1,073.65

Hospital Charge Code	1500107
Hospital Revenue Code	710
Min. Negotiated Rate	$25.87
Max. Negotiated Rate	$536.83
Rate for Payer: Aetna Commercial	$407.99
Rate for Payer: Aetna Medicare Advantage	$322.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.78
Rate for Payer: Cigna Commercial	$536.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.10
Rate for Payer: Oxford Commercial	$214.73
Rate for Payer: Qualcare PPO/HMO/WC	$161.05
Rate for Payer: UnitedHealthcare Commercial	$214.73
Rate for Payer: UnitedHealthcare Community & State	$25.87
Rate for Payer: Wellpoint Medicaid Managed Care	$28.45

RR ICU ONE HOUR

Facility

$1,073.65

Hospital Charge Code	1500107
Hospital Revenue Code	710
Min. Negotiated Rate	$161.05
Max. Negotiated Rate	$161.05
Rate for Payer: Qualcare PPO/HMO/WC	$161.05

RSI KIT(RAPID SEQ INTUBA)

Facility

$83.00

Hospital Charge Code	60635402
Hospital Revenue Code	250
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$41.50
Rate for Payer: Aetna Commercial	$31.54
Rate for Payer: Aetna Medicare Advantage	$24.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.16
Rate for Payer: Cigna Commercial	$41.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.90
Rate for Payer: Oxford Commercial	$16.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.45
Rate for Payer: UnitedHealthcare Commercial	$16.60
Rate for Payer: UnitedHealthcare Community & State	$2.00
Rate for Payer: Wellpoint Medicaid Managed Care	$2.20

RSI KIT(RAPID SEQ INTUBA)

Facility

$83.00

Hospital Charge Code	60635402
Hospital Revenue Code	250
Min. Negotiated Rate	$12.45
Max. Negotiated Rate	$12.45
Rate for Payer: Qualcare PPO/HMO/WC	$12.45

RSS BODY SCREW

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270688882
Hospital Revenue Code	278
Min. Negotiated Rate	$23.73
Max. Negotiated Rate	$492.38
Rate for Payer: Aetna Commercial	$374.20
Rate for Payer: Aetna Medicare Advantage	$295.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.11
Rate for Payer: Cigna Commercial	$492.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$216.65
Rate for Payer: Qualcare PPO/HMO/WC	$147.71
Rate for Payer: UnitedHealthcare Community & State	$23.73
Rate for Payer: Wellpoint Medicaid Managed Care	$26.10

RSS BODY SCREW

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270688882
Hospital Revenue Code	278
Min. Negotiated Rate	$147.71
Max. Negotiated Rate	$238.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$216.65
Rate for Payer: Qualcare PPO/HMO/WC	$147.71

Know your out-of-pocket cost for care.

All Charges