Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCLRSL INTRPLRL AERSL TAL PWDR

Facility

$6,710.00

Hospital Charge Code	270643368
Hospital Revenue Code	270
Min. Negotiated Rate	$161.71
Max. Negotiated Rate	$3,355.00
Rate for Payer: Aetna Commercial	$2,549.80
Rate for Payer: Aetna Medicare Advantage	$2,013.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,711.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,711.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,711.05
Rate for Payer: Cigna Commercial	$3,355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,013.00
Rate for Payer: Oxford Commercial	$1,342.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,006.50
Rate for Payer: UnitedHealthcare Commercial	$1,342.00
Rate for Payer: UnitedHealthcare Community & State	$161.71
Rate for Payer: Wellpoint Medicaid Managed Care	$177.81

SCLRSL INTRPLRL AERSL TAL PWDR

Facility

$6,710.00

Hospital Charge Code	270643368
Hospital Revenue Code	270
Min. Negotiated Rate	$1,006.50
Max. Negotiated Rate	$1,006.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,006.50

SCNDRY REPR RUPT ACHILLES TNDN

Facility

$44,916.00

Service Code	HCPCS 27654
Hospital Charge Code	16000893
Hospital Revenue Code	360
Min. Negotiated Rate	$6,737.40
Max. Negotiated Rate	$6,737.40
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40

SCNDRY REPR RUPT ACHILLES TNDN

Facility

$44,916.00

Service Code	HCPCS 27654
Hospital Charge Code	16000893
Hospital Revenue Code	360
Min. Negotiated Rate	$1,082.48
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,474.80
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$1,082.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,190.27

SCOLIOSIS SERIES

Facility

$335.00

Hospital Charge Code	94061063
Hospital Revenue Code	320
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$127.30
Rate for Payer: Aetna Medicare Advantage	$100.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.42
Rate for Payer: Cigna Commercial	$167.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.25
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$8.07
Rate for Payer: Wellpoint Medicaid Managed Care	$8.88

SCOLIOSIS SERIES

Facility

$335.00

Hospital Charge Code	94061063
Hospital Revenue Code	320
Min. Negotiated Rate	$50.25
Max. Negotiated Rate	$50.25
Rate for Payer: Qualcare PPO/HMO/WC	$50.25

SCOOP GALLSTONE DESJARDINS 6MM

Facility

$784.20

Hospital Charge Code	270689562
Hospital Revenue Code	272
Min. Negotiated Rate	$117.63
Max. Negotiated Rate	$117.63
Rate for Payer: Qualcare PPO/HMO/WC	$117.63

SCOOP GALLSTONE DESJARDINS 6MM

Facility

$784.20

Hospital Charge Code	270689562
Hospital Revenue Code	272
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$392.10
Rate for Payer: Aetna Commercial	$298.00
Rate for Payer: Aetna Medicare Advantage	$235.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.97
Rate for Payer: Cigna Commercial	$392.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.26
Rate for Payer: Oxford Commercial	$156.84
Rate for Payer: Qualcare PPO/HMO/WC	$117.63
Rate for Payer: UnitedHealthcare Commercial	$156.84
Rate for Payer: UnitedHealthcare Community & State	$18.90
Rate for Payer: Wellpoint Medicaid Managed Care	$20.78

SCOOP GALLSTONE DESJARDINS 7MM

Facility

$784.20

Hospital Charge Code	270689563
Hospital Revenue Code	272
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$392.10
Rate for Payer: Aetna Commercial	$298.00
Rate for Payer: Aetna Medicare Advantage	$235.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.97
Rate for Payer: Cigna Commercial	$392.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.26
Rate for Payer: Oxford Commercial	$156.84
Rate for Payer: Qualcare PPO/HMO/WC	$117.63
Rate for Payer: UnitedHealthcare Commercial	$156.84
Rate for Payer: UnitedHealthcare Community & State	$18.90
Rate for Payer: Wellpoint Medicaid Managed Care	$20.78

SCOOP GALLSTONE DESJARDINS 7MM

Facility

$784.20

Hospital Charge Code	270689563
Hospital Revenue Code	272
Min. Negotiated Rate	$117.63
Max. Negotiated Rate	$117.63
Rate for Payer: Qualcare PPO/HMO/WC	$117.63

SCOOP GALLSTONE DESJARDINS 8MM

Facility

$784.20

Hospital Charge Code	270689564
Hospital Revenue Code	272
Min. Negotiated Rate	$117.63
Max. Negotiated Rate	$117.63
Rate for Payer: Qualcare PPO/HMO/WC	$117.63

SCOOP GALLSTONE DESJARDINS 8MM

Facility

$784.20

Hospital Charge Code	270689564
Hospital Revenue Code	272
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$392.10
Rate for Payer: Aetna Commercial	$298.00
Rate for Payer: Aetna Medicare Advantage	$235.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.97
Rate for Payer: Cigna Commercial	$392.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.26
Rate for Payer: Oxford Commercial	$156.84
Rate for Payer: Qualcare PPO/HMO/WC	$117.63
Rate for Payer: UnitedHealthcare Commercial	$156.84
Rate for Payer: UnitedHealthcare Community & State	$18.90
Rate for Payer: Wellpoint Medicaid Managed Care	$20.78

SCOOP GALLSTONE DESJARDINS 9MM

Facility

$784.20

Hospital Charge Code	270689565
Hospital Revenue Code	272
Min. Negotiated Rate	$117.63
Max. Negotiated Rate	$117.63
Rate for Payer: Qualcare PPO/HMO/WC	$117.63

SCOOP GALLSTONE DESJARDINS 9MM

Facility

$784.20

Hospital Charge Code	270689565
Hospital Revenue Code	272
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$392.10
Rate for Payer: Aetna Commercial	$298.00
Rate for Payer: Aetna Medicare Advantage	$235.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.97
Rate for Payer: Cigna Commercial	$392.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.26
Rate for Payer: Oxford Commercial	$156.84
Rate for Payer: Qualcare PPO/HMO/WC	$117.63
Rate for Payer: UnitedHealthcare Commercial	$156.84
Rate for Payer: UnitedHealthcare Community & State	$18.90
Rate for Payer: Wellpoint Medicaid Managed Care	$20.78

SCOPE 4 RHINOLARYNGO SLIM

Facility

$850.00

Hospital Charge Code	270688726
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.00
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$170.00
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

SCOPE 4 RHINOLARYNGO SLIM

Facility

$850.00

Hospital Charge Code	270688726
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCOPE NANONEEDLE 125MM

Facility

$2,625.00

Service Code	HCPCS A4649
Hospital Charge Code	270699064
Hospital Revenue Code	272
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$393.75
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

SCOPE NANONEEDLE 125MM

Facility

$2,625.00

Service Code	HCPCS A4649
Hospital Charge Code	270699064
Hospital Revenue Code	272
Min. Negotiated Rate	$63.26
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$787.50
Rate for Payer: Oxford Commercial	$525.00
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Commercial	$525.00
Rate for Payer: UnitedHealthcare Community & State	$63.26
Rate for Payer: Wellpoint Medicaid Managed Care	$69.56

SCOPE SPYGLASS

Facility

$3,950.00

Hospital Charge Code	270664632
Hospital Revenue Code	272
Min. Negotiated Rate	$592.50
Max. Negotiated Rate	$592.50
Rate for Payer: Qualcare PPO/HMO/WC	$592.50

SCOPE SPYGLASS

Facility

$3,950.00

Hospital Charge Code	270664632
Hospital Revenue Code	272
Min. Negotiated Rate	$95.19
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$1,501.00
Rate for Payer: Aetna Medicare Advantage	$1,185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,007.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,007.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,007.25
Rate for Payer: Cigna Commercial	$1,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,185.00
Rate for Payer: Oxford Commercial	$790.00
Rate for Payer: Qualcare PPO/HMO/WC	$592.50
Rate for Payer: UnitedHealthcare Commercial	$790.00
Rate for Payer: UnitedHealthcare Community & State	$95.19
Rate for Payer: Wellpoint Medicaid Managed Care	$104.67

SCOPE TOTE

Facility

$9.00

Hospital Charge Code	270658304
Hospital Revenue Code	270
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

SCOPE TOTE

Facility

$9.00

Hospital Charge Code	270658304
Hospital Revenue Code	270
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

SCOPOLAMINE 0.4 MG/ML INJ

Facility

$19.25

Hospital Charge Code	60628945
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.62
Rate for Payer: Aetna Commercial	$7.32
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.91
Rate for Payer: Cigna Commercial	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.78
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.89
Rate for Payer: UnitedHealthcare Commercial	$3.85
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

SCOPOLAMINE 0.4 MG/ML INJ

Facility

$19.25

Hospital Charge Code	60628945
Hospital Revenue Code	250
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

SCOPOLAMINE 1.5 MG/24 HR TDM

Facility

$40.13

Service Code	NDC 67434604
Hospital Charge Code	60629044
Hospital Revenue Code	250
Min. Negotiated Rate	$6.02
Max. Negotiated Rate	$6.02
Rate for Payer: Qualcare PPO/HMO/WC	$6.02

Know your out-of-pocket cost for care.

All Charges