Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCHISTOSOMA AB IGG FMI

Facility

$88.75

Service Code	HCPCS 86682
Hospital Charge Code	39708007
Hospital Revenue Code	302
Min. Negotiated Rate	$13.31
Max. Negotiated Rate	$13.31
Rate for Payer: Qualcare PPO/HMO/WC	$13.31

SCHISTOSOMA AB IGG FMI

Facility

$88.75

Service Code	HCPCS 86682
Hospital Charge Code	39708007
Hospital Revenue Code	302
Min. Negotiated Rate	$2.35
Max. Negotiated Rate	$124.00
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	$44.38
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	$26.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.31
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	$2.35

SCHISTOSOMIASIS,URINE I

Facility

$390.00

Service Code	HCPCS 87015
Hospital Charge Code	39990124A
Hospital Revenue Code	309
Min. Negotiated Rate	$5.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$18.17
Rate for Payer: Aetna Medicare Advantage	$21.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.11
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$6.68
Rate for Payer: Clover Medicare Advantage	$6.35
Rate for Payer: EmblemHealth Commercial	$20.04
Rate for Payer: Humana Medicare Advantage	$6.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.68
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	$5.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.68
Rate for Payer: Wellcare Medicare Advantage	$6.68
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

SCHISTOSOMIASIS,URINE I

Facility

$390.00

Service Code	HCPCS 87015
Hospital Charge Code	39990124A
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SCHISTOSOMIASIS,URINE II

Facility

$390.00

Service Code	HCPCS 87210
Hospital Charge Code	39990124B
Hospital Revenue Code	309
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$15.83
Rate for Payer: Aetna Medicare Advantage	$18.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.01
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.82
Rate for Payer: Clover Medicare Advantage	$5.53
Rate for Payer: EmblemHealth Commercial	$17.46
Rate for Payer: Humana Medicare Advantage	$5.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.82
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	$4.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.82
Rate for Payer: Wellcare Medicare Advantage	$5.82
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

SCHISTOSOMIASIS,URINE II

Facility

$390.00

Service Code	HCPCS 87210
Hospital Charge Code	39990124B
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS

Facility

$13,323.72

Service Code	APR-DRG 7503
Min. Negotiated Rate	$13,062.47
Max. Negotiated Rate	$13,323.72
Rate for Payer: UnitedHealthcare Community & State	$13,062.47
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,323.72
Rate for Payer: Wellpoint Medicaid Managed Care	$13,062.47

SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS

Facility

$6,540.59

Service Code	APR-DRG 7501
Min. Negotiated Rate	$6,412.34
Max. Negotiated Rate	$6,540.59
Rate for Payer: UnitedHealthcare Community & State	$6,412.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,540.59
Rate for Payer: Wellpoint Medicaid Managed Care	$6,412.34

SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS

Facility

$29,679.65

Service Code	APR-DRG 7504
Min. Negotiated Rate	$29,097.70
Max. Negotiated Rate	$29,679.65
Rate for Payer: UnitedHealthcare Community & State	$29,097.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,679.65
Rate for Payer: Wellpoint Medicaid Managed Care	$29,097.70

SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS

Facility

$8,303.71

Service Code	APR-DRG 7502
Min. Negotiated Rate	$8,140.89
Max. Negotiated Rate	$8,303.71
Rate for Payer: UnitedHealthcare Community & State	$8,140.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,303.71
Rate for Payer: Wellpoint Medicaid Managed Care	$8,140.89

SCISSOR 5X35 SHAFT LENG CB030

Facility

$280.50

Hospital Charge Code	270642078
Hospital Revenue Code	272
Min. Negotiated Rate	$6.76
Max. Negotiated Rate	$140.25
Rate for Payer: Aetna Commercial	$106.59
Rate for Payer: Aetna Medicare Advantage	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.53
Rate for Payer: Cigna Commercial	$140.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.15
Rate for Payer: Oxford Commercial	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$42.08
Rate for Payer: UnitedHealthcare Commercial	$56.10
Rate for Payer: UnitedHealthcare Community & State	$6.76
Rate for Payer: Wellpoint Medicaid Managed Care	$7.43

SCISSOR 5X35 SHAFT LENG CB030

Facility

$280.50

Hospital Charge Code	270642078
Hospital Revenue Code	272
Min. Negotiated Rate	$42.08
Max. Negotiated Rate	$42.08
Rate for Payer: Qualcare PPO/HMO/WC	$42.08

SCISSOR KNAPP IRIS 5/5

Facility

$500.00

Hospital Charge Code	270659128
Hospital Revenue Code	272
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

SCISSOR KNAPP IRIS 5/5

Facility

$500.00

Hospital Charge Code	270659128
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCISSOR MAYO 6 3/4 STD BLADE

Facility

$280.00

Hospital Charge Code	270659126
Hospital Revenue Code	272
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

SCISSOR MAYO 6 3/4 STD BLADE

Facility

$280.00

Hospital Charge Code	270659126
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$106.40
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.00
Rate for Payer: Oxford Commercial	$56.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Commercial	$56.00
Rate for Payer: UnitedHealthcare Community & State	$6.75
Rate for Payer: Wellpoint Medicaid Managed Care	$7.42

SCISSORS CVD 5MM W.UNIPL DCS12

Facility

$1,046.45

Hospital Charge Code	270608759
Hospital Revenue Code	272
Min. Negotiated Rate	$156.97
Max. Negotiated Rate	$156.97
Rate for Payer: Qualcare PPO/HMO/WC	$156.97

SCISSORS CVD 5MM W.UNIPL DCS12

Facility

$1,046.45

Hospital Charge Code	270608759
Hospital Revenue Code	272
Min. Negotiated Rate	$25.22
Max. Negotiated Rate	$523.23
Rate for Payer: Aetna Commercial	$397.65
Rate for Payer: Aetna Medicare Advantage	$313.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$266.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$266.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$266.84
Rate for Payer: Cigna Commercial	$523.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.94
Rate for Payer: Oxford Commercial	$209.29
Rate for Payer: Qualcare PPO/HMO/WC	$156.97
Rate for Payer: UnitedHealthcare Commercial	$209.29
Rate for Payer: UnitedHealthcare Community & State	$25.22
Rate for Payer: Wellpoint Medicaid Managed Care	$27.73

SCISSORS ENDOPATH CRVD 5MM

Facility

$274.17

Hospital Charge Code	270658494
Hospital Revenue Code	272
Min. Negotiated Rate	$6.61
Max. Negotiated Rate	$137.09
Rate for Payer: Aetna Commercial	$104.18
Rate for Payer: Aetna Medicare Advantage	$82.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.91
Rate for Payer: Cigna Commercial	$137.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.25
Rate for Payer: Oxford Commercial	$54.83
Rate for Payer: Qualcare PPO/HMO/WC	$41.13
Rate for Payer: UnitedHealthcare Commercial	$54.83
Rate for Payer: UnitedHealthcare Community & State	$6.61
Rate for Payer: Wellpoint Medicaid Managed Care	$7.27

SCISSORS ENDOPATH CRVD 5MM

Facility

$274.17

Hospital Charge Code	270658494
Hospital Revenue Code	272
Min. Negotiated Rate	$41.13
Max. Negotiated Rate	$41.13
Rate for Payer: Qualcare PPO/HMO/WC	$41.13

SCISSORS HOOK STRAIGHT 3.4

Facility

$4,541.70

Hospital Charge Code	270665789
Hospital Revenue Code	272
Min. Negotiated Rate	$109.45
Max. Negotiated Rate	$2,270.85
Rate for Payer: Aetna Commercial	$1,725.85
Rate for Payer: Aetna Medicare Advantage	$1,362.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,158.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,158.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,158.13
Rate for Payer: Cigna Commercial	$2,270.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,362.51
Rate for Payer: Oxford Commercial	$908.34
Rate for Payer: Qualcare PPO/HMO/WC	$681.25
Rate for Payer: UnitedHealthcare Commercial	$908.34
Rate for Payer: UnitedHealthcare Community & State	$109.45
Rate for Payer: Wellpoint Medicaid Managed Care	$120.36

SCISSORS HOOK STRAIGHT 3.4

Facility

$4,541.70

Hospital Charge Code	270665789
Hospital Revenue Code	272
Min. Negotiated Rate	$681.25
Max. Negotiated Rate	$681.25
Rate for Payer: Qualcare PPO/HMO/WC	$681.25

SCISSORS INSERT CURVED 36CM

Facility

$250.00

Hospital Charge Code	270662674
Hospital Revenue Code	270
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.00
Rate for Payer: Oxford Commercial	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$50.00
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

SCISSORS INSERT CURVED 36CM

Facility

$250.00

Hospital Charge Code	270662674
Hospital Revenue Code	270
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

SCISSORS IRIS STRAIGHT

Facility

$2,301.20

Hospital Charge Code	270658502
Hospital Revenue Code	272
Min. Negotiated Rate	$345.18
Max. Negotiated Rate	$345.18
Rate for Payer: Qualcare PPO/HMO/WC	$345.18

Know your out-of-pocket cost for care.

All Charges