Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3237M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3020M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$37.31
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$588.24
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.40
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$37.31
Rate for Payer: Wellpoint Medicaid Managed Care	$41.02

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	4229M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3121M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3247M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$37.31
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$588.24
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.40
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$37.31
Rate for Payer: Wellpoint Medicaid Managed Care	$41.02

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3190M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3120M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$37.31
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$588.24
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.40
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$37.31
Rate for Payer: Wellpoint Medicaid Managed Care	$41.02

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	4201M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3246M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3230M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$37.31
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$588.24
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.40
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$37.31
Rate for Payer: Wellpoint Medicaid Managed Care	$41.02

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3230M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3042M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$37.31
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$588.24
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.40
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$37.31
Rate for Payer: Wellpoint Medicaid Managed Care	$41.02

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3080M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	4229M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$37.31
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$588.24
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.40
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$37.31
Rate for Payer: Wellpoint Medicaid Managed Care	$41.02

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3049M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$37.31
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$588.24
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.40
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$37.31
Rate for Payer: Wellpoint Medicaid Managed Care	$41.02

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3082M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3190M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$37.31
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$588.24
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.40
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$37.31
Rate for Payer: Wellpoint Medicaid Managed Care	$41.02

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3034M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3234M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$37.31
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$588.24
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.40
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$37.31
Rate for Payer: Wellpoint Medicaid Managed Care	$41.02

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3050M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3237M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$37.31
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$588.24
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.40
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$37.31
Rate for Payer: Wellpoint Medicaid Managed Care	$41.02

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	4201M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$37.31
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$588.24
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.40
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$37.31
Rate for Payer: Wellpoint Medicaid Managed Care	$41.02

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3240M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3235M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$232.20
Max. Negotiated Rate	$232.20
Rate for Payer: Qualcare PPO/HMO/WC	$232.20

BAMLANIVIMAB INFUS & MONITOR

Facility

$1,548.00

Service Code	HCPCS M0239
Hospital Charge Code	3235M0239
Hospital Revenue Code	771
Min. Negotiated Rate	$37.31
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$588.24
Rate for Payer: Aetna Medicare Advantage	$464.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.74
Rate for Payer: Cigna Commercial	$774.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.40
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.20
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$37.31
Rate for Payer: Wellpoint Medicaid Managed Care	$41.02

Know your out-of-pocket cost for care.

All Charges