Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RW APLISOL 5TU VIAL PPD

Facility

$4.00

Hospital Charge Code	87502310
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

RW APLISOL 5TU VIAL PPD

Facility

$4.00

Hospital Charge Code	87502310
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

RW ARTHROCENTESIS INTER/JOINT

Facility

$329.00

Service Code	HCPCS 20610
Hospital Charge Code	87502170
Hospital Revenue Code	761
Min. Negotiated Rate	$49.35
Max. Negotiated Rate	$49.35
Rate for Payer: Qualcare PPO/HMO/WC	$49.35

RW ARTHROCENTESIS INTER/JOINT

Facility

$329.00

Service Code	HCPCS 20610
Hospital Charge Code	87502170
Hospital Revenue Code	761
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$1,316.35
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.70
Rate for Payer: Oxford Commercial	$65.80
Rate for Payer: Qualcare PPO/HMO/WC	$49.35
Rate for Payer: UnitedHealthcare Commercial	$65.80
Rate for Payer: UnitedHealthcare Community & State	$7.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$8.72

RW ARTHROCENTESIS MAJOR JOINT

Facility

$1,091.00

Service Code	HCPCS 20610
Hospital Charge Code	87502175
Hospital Revenue Code	761
Min. Negotiated Rate	$26.29
Max. Negotiated Rate	$1,316.35
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$327.30
Rate for Payer: Oxford Commercial	$218.20
Rate for Payer: Qualcare PPO/HMO/WC	$163.65
Rate for Payer: UnitedHealthcare Commercial	$218.20
Rate for Payer: UnitedHealthcare Community & State	$26.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$28.91

RW ARTHROCENTESIS MAJOR JOINT

Facility

$1,091.00

Service Code	HCPCS 20610
Hospital Charge Code	87502175
Hospital Revenue Code	761
Min. Negotiated Rate	$163.65
Max. Negotiated Rate	$163.65
Rate for Payer: Qualcare PPO/HMO/WC	$163.65

RW ARTHROCENTESIS;SMALL JOINT

Facility

$301.00

Service Code	HCPCS 20600
Hospital Charge Code	84206080
Hospital Revenue Code	761
Min. Negotiated Rate	$45.15
Max. Negotiated Rate	$45.15
Rate for Payer: Qualcare PPO/HMO/WC	$45.15

RW ARTHROCENTESIS;SMALL JOINT

Facility

$301.00

Service Code	HCPCS 20600
Hospital Charge Code	84206080
Hospital Revenue Code	761
Min. Negotiated Rate	$7.25
Max. Negotiated Rate	$1,316.35
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.30
Rate for Payer: Oxford Commercial	$60.20
Rate for Payer: Qualcare PPO/HMO/WC	$45.15
Rate for Payer: UnitedHealthcare Commercial	$60.20
Rate for Payer: UnitedHealthcare Community & State	$7.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$7.98

RW ARTHROCENTESIS SM JNT/BURSA

Facility

$301.00

Service Code	HCPCS 20600
Hospital Charge Code	87502165
Hospital Revenue Code	761
Min. Negotiated Rate	$45.15
Max. Negotiated Rate	$45.15
Rate for Payer: Qualcare PPO/HMO/WC	$45.15

RW ARTHROCENTESIS SM JNT/BURSA

Facility

$301.00

Service Code	HCPCS 20600
Hospital Charge Code	87502165
Hospital Revenue Code	761
Min. Negotiated Rate	$7.25
Max. Negotiated Rate	$1,316.35
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.30
Rate for Payer: Oxford Commercial	$60.20
Rate for Payer: Qualcare PPO/HMO/WC	$45.15
Rate for Payer: UnitedHealthcare Commercial	$60.20
Rate for Payer: UnitedHealthcare Community & State	$7.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$7.98

RW ARTHROCENTSIS INTRMDT JOINT

Facility

$329.00

Service Code	HCPCS 20605
Hospital Charge Code	84206085
Hospital Revenue Code	761
Min. Negotiated Rate	$49.35
Max. Negotiated Rate	$49.35
Rate for Payer: Qualcare PPO/HMO/WC	$49.35

RW ARTHROCENTSIS INTRMDT JOINT

Facility

$329.00

Service Code	HCPCS 20605
Hospital Charge Code	84206085
Hospital Revenue Code	761
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$1,316.35
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.70
Rate for Payer: Oxford Commercial	$65.80
Rate for Payer: Qualcare PPO/HMO/WC	$49.35
Rate for Payer: UnitedHealthcare Commercial	$65.80
Rate for Payer: UnitedHealthcare Community & State	$7.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$8.72

RW ARTHROCENTSIS MAJOR JOINT

Facility

$1,091.00

Service Code	HCPCS 20610
Hospital Charge Code	84206090
Hospital Revenue Code	761
Min. Negotiated Rate	$26.29
Max. Negotiated Rate	$1,316.35
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$327.30
Rate for Payer: Oxford Commercial	$218.20
Rate for Payer: Qualcare PPO/HMO/WC	$163.65
Rate for Payer: UnitedHealthcare Commercial	$218.20
Rate for Payer: UnitedHealthcare Community & State	$26.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$28.91

RW ARTHROCENTSIS MAJOR JOINT

Facility

$1,091.00

Service Code	HCPCS 20610
Hospital Charge Code	84206090
Hospital Revenue Code	761
Min. Negotiated Rate	$163.65
Max. Negotiated Rate	$163.65
Rate for Payer: Qualcare PPO/HMO/WC	$163.65

RW AUDIOMETRY

Facility

$194.00

Service Code	HCPCS 92522
Hospital Charge Code	87502275
Hospital Revenue Code	471
Min. Negotiated Rate	$29.10
Max. Negotiated Rate	$29.10
Rate for Payer: Qualcare PPO/HMO/WC	$29.10

RW AUDIOMETRY

Facility

$194.00

Service Code	HCPCS 92552
Hospital Charge Code	84206275
Hospital Revenue Code	471
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$1,823.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.20
Rate for Payer: Oxford Commercial	$1,040.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.10
Rate for Payer: UnitedHealthcare Commercial	$1,823.00
Rate for Payer: UnitedHealthcare Community & State	$4.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$5.14

RW AUDIOMETRY

Facility

$194.00

Service Code	HCPCS 92552
Hospital Charge Code	84206275
Hospital Revenue Code	471
Min. Negotiated Rate	$29.10
Max. Negotiated Rate	$29.10
Rate for Payer: Qualcare PPO/HMO/WC	$29.10

RW AUDIOMETRY

Facility

$194.00

Service Code	HCPCS 92522
Hospital Charge Code	87502275
Hospital Revenue Code	471
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$1,823.00
Rate for Payer: Aetna Commercial	$73.72
Rate for Payer: Aetna Medicare Advantage	$58.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.47
Rate for Payer: Cigna Commercial	$97.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.20
Rate for Payer: Oxford Commercial	$1,040.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.10
Rate for Payer: UnitedHealthcare Commercial	$1,823.00
Rate for Payer: UnitedHealthcare Community & State	$4.68
Rate for Payer: Wellpoint Medicaid Managed Care	$5.14

RW BRONCHODIALIDATOR ADMIN

Facility

$171.00

Service Code	HCPCS 171
Hospital Charge Code	87502290
Hospital Revenue Code	419
Min. Negotiated Rate	$4.12
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$64.98
Rate for Payer: Aetna Medicare Advantage	$51.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.60
Rate for Payer: Cigna Commercial	$85.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.30
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.65
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$4.12
Rate for Payer: Wellpoint Medicaid Managed Care	$4.53

RW BRONCHODIALIDATOR ADMIN

Facility

$171.00

Service Code	HCPCS 171
Hospital Charge Code	87502290
Hospital Revenue Code	419
Min. Negotiated Rate	$25.65
Max. Negotiated Rate	$25.65
Rate for Payer: Qualcare PPO/HMO/WC	$25.65

RW BRONCHODILATOR ADMIN

Facility

$278.20

Service Code	HCPCS 94644
Hospital Charge Code	87502880
Hospital Revenue Code	410
Min. Negotiated Rate	$41.73
Max. Negotiated Rate	$41.73
Rate for Payer: Qualcare PPO/HMO/WC	$41.73

RW BRONCHODILATOR ADMIN

Facility

$278.20

Service Code	HCPCS 94644
Hospital Charge Code	87502880
Hospital Revenue Code	410
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.46
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.73
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$6.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$7.37

RW BX SKIN & ADD LESION

Facility

$185.00

Service Code	HCPCS 11101
Hospital Charge Code	87502070
Hospital Revenue Code	761
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

RW BX SKIN & ADD LESION

Facility

$185.00

Service Code	HCPCS 11101
Hospital Charge Code	87502070
Hospital Revenue Code	761
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$92.50
Rate for Payer: Aetna Commercial	$70.30
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.50
Rate for Payer: Oxford Commercial	$37.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Commercial	$37.00
Rate for Payer: UnitedHealthcare Community & State	$4.46
Rate for Payer: Wellpoint Medicaid Managed Care	$4.90

RW BX SKIN & ADDN'L LESION

Facility

$185.00

Service Code	HCPCS 11101
Hospital Charge Code	84206040
Hospital Revenue Code	761
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

Know your out-of-pocket cost for care.

All Charges