Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCAPULA COMPL-RT

Facility

$294.00

Service Code	HCPCS 73010RT
Hospital Charge Code	94061283
Hospital Revenue Code	320
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$111.72
Rate for Payer: Aetna Medicare Advantage	$88.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.97
Rate for Payer: Cigna Commercial	$147.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.20
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.10
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$7.09
Rate for Payer: Wellpoint Medicaid Managed Care	$7.79

SCARLET RED OINT 5% 28GM

Facility

$52.50

Hospital Charge Code	6004832
Hospital Revenue Code	252
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$26.25
Rate for Payer: Aetna Commercial	$19.95
Rate for Payer: Aetna Medicare Advantage	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.39
Rate for Payer: Cigna Commercial	$26.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.75
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.88
Rate for Payer: UnitedHealthcare Commercial	$10.50
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.39

SCARLET RED OINT 5% 28GM

Facility

$52.50

Hospital Charge Code	6004832
Hospital Revenue Code	252
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$7.88
Rate for Payer: Qualcare PPO/HMO/WC	$7.88

SCARLET RED OINT DRESSG 5 X 9

Facility

$25.60

Hospital Charge Code	6008577
Hospital Revenue Code	252
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$3.84
Rate for Payer: Qualcare PPO/HMO/WC	$3.84

SCARLET RED OINT DRESSG 5 X 9

Facility

$25.60

Hospital Charge Code	6008577
Hospital Revenue Code	252
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$12.80
Rate for Payer: Aetna Commercial	$9.73
Rate for Payer: Aetna Medicare Advantage	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.53
Rate for Payer: Cigna Commercial	$12.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.68
Rate for Payer: Oxford Commercial	$5.12
Rate for Payer: Qualcare PPO/HMO/WC	$3.84
Rate for Payer: UnitedHealthcare Commercial	$5.12
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.68

SCAT TEST

Facility

$71.25

Service Code	HCPCS 83872
Hospital Charge Code	3006723
Hospital Revenue Code	301
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$10.69
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

SCAT TEST

Facility

$71.25

Service Code	HCPCS 83872
Hospital Charge Code	3006723
Hospital Revenue Code	301
Min. Negotiated Rate	$1.89
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.94
Rate for Payer: Aetna Medicare Advantage	$18.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.15
Rate for Payer: Cigna Commercial	$35.62
Rate for Payer: Cigna Medicare Advantage	$5.86
Rate for Payer: Clover Medicare Advantage	$5.57
Rate for Payer: EmblemHealth Commercial	$17.58
Rate for Payer: Humana Medicare Advantage	$6.04
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.86
Rate for Payer: Wellcare Medicare Advantage	$5.86
Rate for Payer: Wellpoint Medicaid Managed Care	$1.89

SC CAN 7.0Dx45mL32mTHD11464532

Facility

$751.95

Hospital Charge Code	270638693
Hospital Revenue Code	278
Min. Negotiated Rate	$18.12
Max. Negotiated Rate	$375.98
Rate for Payer: Aetna Commercial	$285.74
Rate for Payer: Aetna Medicare Advantage	$225.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.75
Rate for Payer: Cigna Commercial	$375.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.43
Rate for Payer: Qualcare PPO/HMO/WC	$112.79
Rate for Payer: UnitedHealthcare Community & State	$18.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.93

SC CAN 7.0Dx45mL32mTHD11464532

Facility

$751.95

Hospital Charge Code	270638693
Hospital Revenue Code	278
Min. Negotiated Rate	$112.79
Max. Negotiated Rate	$181.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.43
Rate for Payer: Qualcare PPO/HMO/WC	$112.79

SC CAN 7.0Dx45mL32mTHD11465032

Facility

$751.95

Hospital Charge Code	270638694
Hospital Revenue Code	278
Min. Negotiated Rate	$18.12
Max. Negotiated Rate	$375.98
Rate for Payer: Aetna Commercial	$285.74
Rate for Payer: Aetna Medicare Advantage	$225.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.75
Rate for Payer: Cigna Commercial	$375.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.43
Rate for Payer: Qualcare PPO/HMO/WC	$112.79
Rate for Payer: UnitedHealthcare Community & State	$18.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.93

SC CAN 7.0Dx45mL32mTHD11465032

Facility

$751.95

Hospital Charge Code	270638694
Hospital Revenue Code	278
Min. Negotiated Rate	$112.79
Max. Negotiated Rate	$181.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.43
Rate for Payer: Qualcare PPO/HMO/WC	$112.79

SC COR 2.4x12mSELFTAP40151296

Facility

$297.65

Hospital Charge Code	270636269
Hospital Revenue Code	278
Min. Negotiated Rate	$44.65
Max. Negotiated Rate	$72.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.48
Rate for Payer: Qualcare PPO/HMO/WC	$44.65

SC COR 2.4x12mSELFTAP40151296

Facility

$297.65

Hospital Charge Code	270636269
Hospital Revenue Code	278
Min. Negotiated Rate	$7.17
Max. Negotiated Rate	$148.82
Rate for Payer: Aetna Commercial	$113.11
Rate for Payer: Aetna Medicare Advantage	$89.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.90
Rate for Payer: Cigna Commercial	$148.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.48
Rate for Payer: Qualcare PPO/HMO/WC	$44.65
Rate for Payer: UnitedHealthcare Community & State	$7.17
Rate for Payer: Wellpoint Medicaid Managed Care	$7.89

SC COR 2.4x14m SELFTAP40151496

Facility

$297.65

Hospital Charge Code	270636270
Hospital Revenue Code	278
Min. Negotiated Rate	$7.17
Max. Negotiated Rate	$148.82
Rate for Payer: Aetna Commercial	$113.11
Rate for Payer: Aetna Medicare Advantage	$89.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.90
Rate for Payer: Cigna Commercial	$148.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.48
Rate for Payer: Qualcare PPO/HMO/WC	$44.65
Rate for Payer: UnitedHealthcare Community & State	$7.17
Rate for Payer: Wellpoint Medicaid Managed Care	$7.89

SC COR 2.4x14m SELFTAP40151496

Facility

$297.65

Hospital Charge Code	270636270
Hospital Revenue Code	278
Min. Negotiated Rate	$44.65
Max. Negotiated Rate	$72.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$65.48
Rate for Payer: Qualcare PPO/HMO/WC	$44.65

S. CERVISIAE IGA

Facility

$390.00

Service Code	HCPCS 86671
Hospital Charge Code	39900374
Hospital Revenue Code	302
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$33.32
Rate for Payer: Aetna Medicare Advantage	$39.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.22
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.25
Rate for Payer: Clover Medicare Advantage	$11.64
Rate for Payer: EmblemHealth Commercial	$36.75
Rate for Payer: Humana Medicare Advantage	$12.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.25
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	$9.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.25
Rate for Payer: Wellcare Medicare Advantage	$12.25
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

S. CERVISIAE IGA

Facility

$390.00

Service Code	HCPCS 86671
Hospital Charge Code	39900374
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

S. CERVISIAE IGG

Facility

$390.00

Service Code	HCPCS 86671
Hospital Charge Code	39900373
Hospital Revenue Code	302
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$33.32
Rate for Payer: Aetna Medicare Advantage	$39.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.22
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.25
Rate for Payer: Clover Medicare Advantage	$11.64
Rate for Payer: EmblemHealth Commercial	$36.75
Rate for Payer: Humana Medicare Advantage	$12.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.25
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	$9.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.25
Rate for Payer: Wellcare Medicare Advantage	$12.25
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

S. CERVISIAE IGG

Facility

$390.00

Service Code	HCPCS 86671
Hospital Charge Code	39900373
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SCEW BONE CORTICAL 5.0MMx40MM

Facility

$1,160.00

Service Code	HCPCS C1713
Hospital Charge Code	270656705
Hospital Revenue Code	278
Min. Negotiated Rate	$174.00
Max. Negotiated Rate	$280.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$232.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$280.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$255.20
Rate for Payer: Qualcare PPO/HMO/WC	$174.00

SCEW BONE CORTICAL 5.0MMx40MM

Facility

$1,160.00

Service Code	HCPCS C1713
Hospital Charge Code	270656705
Hospital Revenue Code	278
Min. Negotiated Rate	$27.96
Max. Negotiated Rate	$580.00
Rate for Payer: Aetna Commercial	$440.80
Rate for Payer: Aetna Medicare Advantage	$348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$295.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$295.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$232.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$295.80
Rate for Payer: Cigna Commercial	$580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$280.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$255.20
Rate for Payer: Qualcare PPO/HMO/WC	$174.00
Rate for Payer: UnitedHealthcare Community & State	$27.96
Rate for Payer: Wellpoint Medicaid Managed Care	$30.74

SCEW LCK T8 FL THS 2.4 X 22L

Facility

$1,316.85

Service Code	HCPCS C1713
Hospital Charge Code	270703687
Hospital Revenue Code	278
Min. Negotiated Rate	$197.53
Max. Negotiated Rate	$318.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.71
Rate for Payer: Qualcare PPO/HMO/WC	$197.53

SCEW LCK T8 FL THS 2.4 X 22L

Facility

$1,316.85

Service Code	HCPCS C1713
Hospital Charge Code	270703687
Hospital Revenue Code	278
Min. Negotiated Rate	$31.74
Max. Negotiated Rate	$658.42
Rate for Payer: Aetna Commercial	$500.40
Rate for Payer: Aetna Medicare Advantage	$395.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.80
Rate for Payer: Cigna Commercial	$658.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.71
Rate for Payer: Qualcare PPO/HMO/WC	$197.53
Rate for Payer: UnitedHealthcare Community & State	$31.74
Rate for Payer: Wellpoint Medicaid Managed Care	$34.90

SCHISTOSOMA AB

Facility

$390.00

Service Code	HCPCS 86682
Hospital Charge Code	39900378
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SCHISTOSOMA AB

Facility

$390.00

Service Code	HCPCS 86682
Hospital Charge Code	39900378
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$35.39
Rate for Payer: Aetna Medicare Advantage	$42.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.96
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$13.01
Rate for Payer: Clover Medicare Advantage	$12.36
Rate for Payer: EmblemHealth Commercial	$39.03
Rate for Payer: Humana Medicare Advantage	$13.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.01
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	$10.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.01
Rate for Payer: Wellcare Medicare Advantage	$13.01
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

Know your out-of-pocket cost for care.

All Charges