Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RUBEOLA AB, IGM

Facility

$119.25

Service Code	HCPCS 86765
Hospital Charge Code	3004371
Hospital Revenue Code	302
Min. Negotiated Rate	$17.89
Max. Negotiated Rate	$17.89
Rate for Payer: Qualcare PPO/HMO/WC	$17.89

RUBEOLA AB, IGM

Facility

$119.25

Service Code	HCPCS 86765
Hospital Charge Code	3004371
Hospital Revenue Code	302
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$35.03
Rate for Payer: Aetna Medicare Advantage	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.49
Rate for Payer: Cigna Commercial	$59.62
Rate for Payer: Cigna Medicare Advantage	$12.88
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.89
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Medicare Advantage	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$3.16

RUBEOLA ANTIBODIES, IGM

Facility

$311.00

Service Code	HCPCS 86765
Hospital Charge Code	38476140
Hospital Revenue Code	302
Min. Negotiated Rate	$46.65
Max. Negotiated Rate	$46.65
Rate for Payer: Qualcare PPO/HMO/WC	$46.65

RUBEOLA ANTIBODIES, IGM

Facility

$311.00

Service Code	HCPCS 86765
Hospital Charge Code	38476140
Hospital Revenue Code	302
Min. Negotiated Rate	$8.24
Max. Negotiated Rate	$155.50
Rate for Payer: Aetna Commercial	$35.03
Rate for Payer: Aetna Medicare Advantage	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.49
Rate for Payer: Cigna Commercial	$155.50
Rate for Payer: Cigna Medicare Advantage	$12.88
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Medicare Advantage	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$8.24

RUBEOLA IGG

Facility

$465.00

Service Code	HCPCS 86765
Hospital Charge Code	38476037
Hospital Revenue Code	302
Min. Negotiated Rate	$69.75
Max. Negotiated Rate	$69.75
Rate for Payer: Qualcare PPO/HMO/WC	$69.75

RUBEOLA IGG

Facility

$465.00

Service Code	HCPCS 86765
Hospital Charge Code	38476037
Hospital Revenue Code	302
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$232.50
Rate for Payer: Aetna Commercial	$35.03
Rate for Payer: Aetna Medicare Advantage	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.49
Rate for Payer: Cigna Commercial	$232.50
Rate for Payer: Cigna Medicare Advantage	$12.88
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Medicare Advantage	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$12.32

Ruby Coil 36mmx60cm

Facility

$6,450.00

Hospital Charge Code	270687055
Hospital Revenue Code	278
Min. Negotiated Rate	$155.44
Max. Negotiated Rate	$3,225.00
Rate for Payer: Aetna Commercial	$2,451.00
Rate for Payer: Aetna Medicare Advantage	$1,935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.75
Rate for Payer: Cigna Commercial	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,419.00
Rate for Payer: Qualcare PPO/HMO/WC	$967.50
Rate for Payer: UnitedHealthcare Community & State	$155.44
Rate for Payer: Wellpoint Medicaid Managed Care	$170.93

Ruby Coil 36mmx60cm

Facility

$6,450.00

Hospital Charge Code	270687055
Hospital Revenue Code	278
Min. Negotiated Rate	$967.50
Max. Negotiated Rate	$1,560.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,419.00
Rate for Payer: Qualcare PPO/HMO/WC	$967.50

Ruby Coil 40mmx60cm

Facility

$6,450.00

Hospital Charge Code	270687054
Hospital Revenue Code	278
Min. Negotiated Rate	$967.50
Max. Negotiated Rate	$1,560.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,419.00
Rate for Payer: Qualcare PPO/HMO/WC	$967.50

Ruby Coil 40mmx60cm

Facility

$6,450.00

Hospital Charge Code	270687054
Hospital Revenue Code	278
Min. Negotiated Rate	$155.44
Max. Negotiated Rate	$3,225.00
Rate for Payer: Aetna Commercial	$2,451.00
Rate for Payer: Aetna Medicare Advantage	$1,935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.75
Rate for Payer: Cigna Commercial	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,419.00
Rate for Payer: Qualcare PPO/HMO/WC	$967.50
Rate for Payer: UnitedHealthcare Community & State	$155.44
Rate for Payer: Wellpoint Medicaid Managed Care	$170.93

RUBY COIL SOFT 4MMX15CM

Facility

$4,950.00

Service Code	HCPCS C1884
Hospital Charge Code	270677078
Hospital Revenue Code	278
Min. Negotiated Rate	$119.30
Max. Negotiated Rate	$2,475.00
Rate for Payer: Aetna Commercial	$1,881.00
Rate for Payer: Aetna Medicare Advantage	$1,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,262.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,262.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,262.25
Rate for Payer: Cigna Commercial	$2,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,197.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$742.50
Rate for Payer: UnitedHealthcare Community & State	$119.30
Rate for Payer: Wellpoint Medicaid Managed Care	$131.18

RUBY COIL SOFT 4MMX15CM

Facility

$4,950.00

Service Code	HCPCS C1884
Hospital Charge Code	270677078
Hospital Revenue Code	278
Min. Negotiated Rate	$742.50
Max. Negotiated Rate	$1,197.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,197.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$742.50

RUFINAMIDE (BANZEL)

Facility

$181.65

Service Code	HCPCS 82542
Hospital Charge Code	3035990
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

RUFINAMIDE (BANZEL)

Facility

$181.65

Service Code	HCPCS 82542
Hospital Charge Code	3035990
Hospital Revenue Code	301
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$65.52
Rate for Payer: Aetna Medicare Advantage	$78.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.96
Rate for Payer: Cigna Commercial	$90.83
Rate for Payer: Cigna Medicare Advantage	$24.09
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$19.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Medicare Advantage	$24.09
Rate for Payer: Wellpoint Medicaid Managed Care	$4.81

RUN DATA & VOICE DRP

Facility

$1,819.00

Hospital Charge Code	270659147
Hospital Revenue Code	278
Min. Negotiated Rate	$43.84
Max. Negotiated Rate	$909.50
Rate for Payer: Aetna Commercial	$691.22
Rate for Payer: Aetna Medicare Advantage	$545.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$463.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$463.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$363.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$463.85
Rate for Payer: Cigna Commercial	$909.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$440.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$400.18
Rate for Payer: Qualcare PPO/HMO/WC	$272.85
Rate for Payer: UnitedHealthcare Community & State	$43.84
Rate for Payer: Wellpoint Medicaid Managed Care	$48.20

RUN DATA & VOICE DRP

Facility

$1,819.00

Hospital Charge Code	270659147
Hospital Revenue Code	278
Min. Negotiated Rate	$272.85
Max. Negotiated Rate	$440.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$363.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$440.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$400.18
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

RUSH MEDULLARY PINS

Facility

$147.00

Hospital Charge Code	270335009
Hospital Revenue Code	278
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$35.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.34
Rate for Payer: Qualcare PPO/HMO/WC	$22.05

RUSH MEDULLARY PINS

Facility

$147.00

Hospital Charge Code	270335009
Hospital Revenue Code	278
Min. Negotiated Rate	$3.54
Max. Negotiated Rate	$73.50
Rate for Payer: Aetna Commercial	$55.86
Rate for Payer: Aetna Medicare Advantage	$44.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.48
Rate for Payer: Cigna Commercial	$73.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$32.34
Rate for Payer: Qualcare PPO/HMO/WC	$22.05
Rate for Payer: UnitedHealthcare Community & State	$3.54
Rate for Payer: Wellpoint Medicaid Managed Care	$3.90

RUSSELL GASTROSTOMY KIT CK****

Facility

$823.00

Hospital Charge Code	2300580
Hospital Revenue Code	279
Min. Negotiated Rate	$19.83
Max. Negotiated Rate	$411.50
Rate for Payer: Aetna Commercial	$312.74
Rate for Payer: Aetna Medicare Advantage	$246.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.87
Rate for Payer: Cigna Commercial	$411.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.90
Rate for Payer: Oxford Commercial	$164.60
Rate for Payer: Qualcare PPO/HMO/WC	$123.45
Rate for Payer: UnitedHealthcare Commercial	$164.60
Rate for Payer: UnitedHealthcare Community & State	$19.83
Rate for Payer: Wellpoint Medicaid Managed Care	$21.81

RUSSELL GASTROSTOMY KIT CK****

Facility

$823.00

Hospital Charge Code	2300580
Hospital Revenue Code	279
Min. Negotiated Rate	$123.45
Max. Negotiated Rate	$123.45
Rate for Payer: Qualcare PPO/HMO/WC	$123.45

RUSSELL VIPER VENOM

Facility

$226.45

Service Code	HCPCS 85613
Hospital Charge Code	3007607
Hospital Revenue Code	305
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$26.06
Rate for Payer: Aetna Medicare Advantage	$31.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.58
Rate for Payer: Cigna Commercial	$113.22
Rate for Payer: Cigna Medicare Advantage	$9.58
Rate for Payer: Clover Medicare Advantage	$9.10
Rate for Payer: EmblemHealth Commercial	$28.74
Rate for Payer: Humana Medicare Advantage	$9.87
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.94
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.97
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.58
Rate for Payer: Wellcare Medicare Advantage	$9.58
Rate for Payer: Wellpoint Medicaid Managed Care	$6.00

RUSSELL VIPER VENOM

Facility

$226.45

Service Code	HCPCS 85613
Hospital Charge Code	3007607
Hospital Revenue Code	305
Min. Negotiated Rate	$33.97
Max. Negotiated Rate	$33.97
Rate for Payer: Qualcare PPO/HMO/WC	$33.97

RV-RIGHT VENTRICLE

Facility

$2,000.00

Hospital Charge Code	270702378
Hospital Revenue Code	278
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

RV-RIGHT VENTRICLE

Facility

$2,000.00

Hospital Charge Code	270702378
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

RVSC EVSC FPVT ST ATHRC SF 1

Facility

$80,096.45

Service Code	HCPCS 37275
Hospital Charge Code	403437275
Hospital Revenue Code	481
Min. Negotiated Rate	$12,014.47
Max. Negotiated Rate	$12,014.47
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47

Know your out-of-pocket cost for care.

All Charges