Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RW GROUP PSYCHOTHERAPY

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	87502010
Hospital Revenue Code	915
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

RW GROUP PSYCHOTHERAPY

Facility

$800.80

Service Code	HCPCS 90853
Hospital Charge Code	87502010
Hospital Revenue Code	915
Min. Negotiated Rate	$19.30
Max. Negotiated Rate	$435.65
Rate for Payer: Aetna Commercial	$328.28
Rate for Payer: Aetna Medicare Advantage	$391.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$435.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$435.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$120.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$435.65
Rate for Payer: Cigna Commercial	$241.93
Rate for Payer: Cigna Medicare Advantage	$120.69
Rate for Payer: Clover Medicare Advantage	$114.66
Rate for Payer: EmblemHealth Commercial	$362.07
Rate for Payer: Humana Medicare Advantage	$124.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$120.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.24
Rate for Payer: Qualcare PPO/HMO/WC	$120.12
Rate for Payer: UnitedHealthcare Community & State	$19.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$120.69
Rate for Payer: Wellcare Medicare Advantage	$120.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27.48
Rate for Payer: Wellpoint Medicaid Managed Care	$21.22

RW HEMOCULT

Facility

$23.00

Service Code	HCPCS 82270
Hospital Charge Code	84206145
Hospital Revenue Code	301
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$11.91
Rate for Payer: Aetna Medicare Advantage	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.81
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: Cigna Medicare Advantage	$4.38
Rate for Payer: Clover Medicare Advantage	$4.16
Rate for Payer: EmblemHealth Commercial	$13.14
Rate for Payer: Humana Medicare Advantage	$4.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.38
Rate for Payer: Wellcare Medicare Advantage	$4.38
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

RW HEMOCULT

Facility

$390.00

Service Code	HCPCS 82270
Hospital Charge Code	87502330
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RW HEMOCULT

Facility

$23.00

Service Code	HCPCS 82270
Hospital Charge Code	84206145
Hospital Revenue Code	301
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

RW HEMOCULT

Facility

$390.00

Service Code	HCPCS 82270
Hospital Charge Code	87502330
Hospital Revenue Code	301
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$11.91
Rate for Payer: Aetna Medicare Advantage	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.81
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.38
Rate for Payer: Clover Medicare Advantage	$4.16
Rate for Payer: EmblemHealth Commercial	$13.14
Rate for Payer: Humana Medicare Advantage	$4.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.38
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	$3.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.38
Rate for Payer: Wellcare Medicare Advantage	$4.38
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

RW HEPATITIS A VACCINE ADULT

Facility

$91.00

Service Code	HCPCS 90632
Hospital Charge Code	87502850
Hospital Revenue Code	636
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$22.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.02
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

RW HEPATITIS A VACCINE ADULT

Facility

$91.00

Service Code	HCPCS 90632
Hospital Charge Code	87502850
Hospital Revenue Code	636
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$153.60
Rate for Payer: Aetna Commercial	$34.58
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.20
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.02
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Community & State	$2.19
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

RW HEPATITIS B VACCINE ADULT

Facility

$114.00

Service Code	HCPCS 90746
Hospital Charge Code	87502845
Hospital Revenue Code	636
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$104.54
Rate for Payer: Aetna Commercial	$43.32
Rate for Payer: Aetna Medicare Advantage	$34.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.07
Rate for Payer: Cigna Commercial	$57.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.59
Rate for Payer: Qualcare PPO/HMO/WC	$17.10
Rate for Payer: UnitedHealthcare Community & State	$2.75
Rate for Payer: Wellpoint Medicaid Managed Care	$3.02

RW HEPATITIS B VACCINE ADULT

Facility

$114.00

Service Code	HCPCS 90746
Hospital Charge Code	87502845
Hospital Revenue Code	636
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$27.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.59
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

RW HEPVAX A & B ADULTS

Facility

$142.00

Service Code	HCPCS 90636
Hospital Charge Code	84206180
Hospital Revenue Code	636
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$215.75
Rate for Payer: Aetna Commercial	$53.96
Rate for Payer: Aetna Medicare Advantage	$42.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.21
Rate for Payer: Cigna Commercial	$71.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.36
Rate for Payer: Qualcare PPO/HMO/WC	$21.30
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: Wellpoint Medicaid Managed Care	$3.76

RW HEPVAX A & B ADULTS

Facility

$142.00

Service Code	HCPCS 90636
Hospital Charge Code	84206180
Hospital Revenue Code	636
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$34.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.36
Rate for Payer: Qualcare PPO/HMO/WC	$21.30

RW I&D ABCESS COMPLICATED

Facility

$610.00

Service Code	HCPCS 10061
Hospital Charge Code	87502120
Hospital Revenue Code	761
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

RW I&D ABCESS COMPLICATED

Facility

$610.00

Service Code	HCPCS 10061
Hospital Charge Code	87502120
Hospital Revenue Code	761
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.00
Rate for Payer: Oxford Commercial	$122.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$122.00
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$16.16

RW I&D ABCESS-SIMPLE

Facility

$610.00

Service Code	HCPCS 10060
Hospital Charge Code	87502115
Hospital Revenue Code	761
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

RW I&D ABCESS-SIMPLE

Facility

$610.00

Service Code	HCPCS 10060
Hospital Charge Code	87502115
Hospital Revenue Code	761
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$962.01
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.41
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.00
Rate for Payer: Oxford Commercial	$122.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$122.00
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$962.01
Rate for Payer: Wellpoint Medicaid Managed Care	$16.16

RW I&D ABSCESS COMPLICATED

Facility

$610.00

Service Code	HCPCS 10061
Hospital Charge Code	84206005
Hospital Revenue Code	761
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.00
Rate for Payer: Oxford Commercial	$122.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$122.00
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$16.16

RW I&D ABSCESS COMPLICATED

Facility

$610.00

Service Code	HCPCS 10061
Hospital Charge Code	84206005
Hospital Revenue Code	761
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

RW I&D ABSCESS,SIMPLE

Facility

$610.00

Service Code	HCPCS 10060
Hospital Charge Code	84206001
Hospital Revenue Code	761
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$962.01
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.41
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.00
Rate for Payer: Oxford Commercial	$122.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$122.00
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$962.01
Rate for Payer: Wellpoint Medicaid Managed Care	$16.16

RW I&D ABSCESS,SIMPLE

Facility

$610.00

Service Code	HCPCS 10060
Hospital Charge Code	84206001
Hospital Revenue Code	761
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

RW I&D HEMATOMA

Facility

$882.00

Service Code	HCPCS 10140
Hospital Charge Code	84206015
Hospital Revenue Code	761
Min. Negotiated Rate	$21.26
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$264.60
Rate for Payer: Oxford Commercial	$176.40
Rate for Payer: Qualcare PPO/HMO/WC	$132.30
Rate for Payer: UnitedHealthcare Commercial	$176.40
Rate for Payer: UnitedHealthcare Community & State	$21.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$23.37

RW I&D HEMATOMA

Facility

$882.00

Service Code	HCPCS 10140
Hospital Charge Code	84206015
Hospital Revenue Code	761
Min. Negotiated Rate	$132.30
Max. Negotiated Rate	$132.30
Rate for Payer: Qualcare PPO/HMO/WC	$132.30

RW IM INJECTION

Facility

$149.00

Service Code	HCPCS 96372
Hospital Charge Code	87502840
Hospital Revenue Code	940
Min. Negotiated Rate	$22.35
Max. Negotiated Rate	$22.35
Rate for Payer: Qualcare PPO/HMO/WC	$22.35

RW IM INJECTION

Facility

$149.00

Service Code	HCPCS 96372
Hospital Charge Code	87502840
Hospital Revenue Code	940
Min. Negotiated Rate	$3.59
Max. Negotiated Rate	$2,407.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.77
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.70
Rate for Payer: Oxford Commercial	$1,373.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.35
Rate for Payer: UnitedHealthcare Commercial	$2,407.00
Rate for Payer: UnitedHealthcare Community & State	$3.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$3.95

RW IND PSY 45-50 MINS W/MD

Facility

$550.00

Service Code	HCPCS 90836
Hospital Charge Code	87502915
Hospital Revenue Code	914
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

Know your out-of-pocket cost for care.

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