Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BARIATRIC PADS

Facility

$875.00

Hospital Charge Code	270692091
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

BARICITINIB 2MG TABLET

Facility

$494.46

Service Code	NDC 2418230
Hospital Charge Code	606390390
Hospital Revenue Code	250
Min. Negotiated Rate	$11.92
Max. Negotiated Rate	$247.23
Rate for Payer: Aetna Commercial	$187.89
Rate for Payer: Aetna Medicare Advantage	$148.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.09
Rate for Payer: Cigna Commercial	$247.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.34
Rate for Payer: Oxford Commercial	$98.89
Rate for Payer: Qualcare PPO/HMO/WC	$74.17
Rate for Payer: UnitedHealthcare Commercial	$98.89
Rate for Payer: UnitedHealthcare Community & State	$11.92
Rate for Payer: Wellpoint Medicaid Managed Care	$13.10

BARICITINIB 2MG TABLET

Facility

$494.46

Service Code	NDC 2418230
Hospital Charge Code	606390390
Hospital Revenue Code	250
Min. Negotiated Rate	$74.17
Max. Negotiated Rate	$74.17
Rate for Payer: Qualcare PPO/HMO/WC	$74.17

BARIUM ENEMA

Facility

$1,041.00

Service Code	HCPCS 74270
Hospital Charge Code	94061145
Hospital Revenue Code	320
Min. Negotiated Rate	$156.15
Max. Negotiated Rate	$156.15
Rate for Payer: Qualcare PPO/HMO/WC	$156.15

BARIUM ENEMA

Facility

$1,041.00

Service Code	HCPCS 74270
Hospital Charge Code	94061145
Hospital Revenue Code	320
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$566.79
Rate for Payer: Aetna Medicare Advantage	$675.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$208.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.19
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: Cigna Medicare Advantage	$145.87
Rate for Payer: Clover Medicare Advantage	$197.96
Rate for Payer: EmblemHealth Commercial	$625.14
Rate for Payer: Humana Medicare Advantage	$214.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$208.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.30
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.15
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$25.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellpoint Medicaid Managed Care	$27.59

BARIUM ENEMA (BARIUMKIT)

Facility

$95.14

Service Code	NDC 32909080401
Hospital Charge Code	606380032
Hospital Revenue Code	250
Min. Negotiated Rate	$14.27
Max. Negotiated Rate	$14.27
Rate for Payer: Qualcare PPO/HMO/WC	$14.27

BARIUM ENEMA (BARIUMKIT)

Facility

$95.14

Service Code	NDC 32909080401
Hospital Charge Code	606380032
Hospital Revenue Code	250
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$47.57
Rate for Payer: Aetna Commercial	$36.15
Rate for Payer: Aetna Medicare Advantage	$28.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.26
Rate for Payer: Cigna Commercial	$47.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.54
Rate for Payer: Oxford Commercial	$19.03
Rate for Payer: Qualcare PPO/HMO/WC	$14.27
Rate for Payer: UnitedHealthcare Commercial	$19.03
Rate for Payer: UnitedHealthcare Community & State	$2.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2.52

BARIUM ENEMA DBL CONT

Facility

$1,528.00

Service Code	HCPCS 74280
Hospital Charge Code	94061147
Hospital Revenue Code	320
Min. Negotiated Rate	$229.20
Max. Negotiated Rate	$229.20
Rate for Payer: Qualcare PPO/HMO/WC	$229.20

BARIUM ENEMA DBL CONT

Facility

$1,528.00

Service Code	HCPCS 74280
Hospital Charge Code	94061147
Hospital Revenue Code	320
Min. Negotiated Rate	$36.82
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$566.79
Rate for Payer: Aetna Medicare Advantage	$675.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$208.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.19
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: Cigna Medicare Advantage	$145.87
Rate for Payer: Clover Medicare Advantage	$197.96
Rate for Payer: EmblemHealth Commercial	$625.14
Rate for Payer: Humana Medicare Advantage	$214.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$208.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$458.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$229.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$36.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88
Rate for Payer: Wellpoint Medicaid Managed Care	$40.49

BARIUM SULFATE 6GM/VL 1730

Facility

$380.00

Hospital Charge Code	270615177
Hospital Revenue Code	272
Min. Negotiated Rate	$9.16
Max. Negotiated Rate	$190.00
Rate for Payer: Aetna Commercial	$144.40
Rate for Payer: Aetna Medicare Advantage	$114.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.90
Rate for Payer: Cigna Commercial	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.00
Rate for Payer: Oxford Commercial	$76.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.00
Rate for Payer: UnitedHealthcare Commercial	$76.00
Rate for Payer: UnitedHealthcare Community & State	$9.16
Rate for Payer: Wellpoint Medicaid Managed Care	$10.07

BARIUM SULFATE 6GM/VL 1730

Facility

$380.00

Hospital Charge Code	270615177
Hospital Revenue Code	272
Min. Negotiated Rate	$57.00
Max. Negotiated Rate	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.00

BARIUM SULFATE LIQUID POLIBAR

Facility

$72.89

Hospital Charge Code	270651458
Hospital Revenue Code	270
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$36.45
Rate for Payer: Aetna Commercial	$27.70
Rate for Payer: Aetna Medicare Advantage	$21.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.59
Rate for Payer: Cigna Commercial	$36.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.87
Rate for Payer: Oxford Commercial	$14.58
Rate for Payer: Qualcare PPO/HMO/WC	$10.93
Rate for Payer: UnitedHealthcare Commercial	$14.58
Rate for Payer: UnitedHealthcare Community & State	$1.76
Rate for Payer: Wellpoint Medicaid Managed Care	$1.93

BARIUM SULFATE LIQUID POLIBAR

Facility

$72.89

Hospital Charge Code	270651458
Hospital Revenue Code	270
Min. Negotiated Rate	$10.93
Max. Negotiated Rate	$10.93
Rate for Payer: Qualcare PPO/HMO/WC	$10.93

BARIUM SULFATE SUSP

Facility

$451.78

Service Code	NDC 32909016802
Hospital Charge Code	606390050
Hospital Revenue Code	250
Min. Negotiated Rate	$10.89
Max. Negotiated Rate	$225.89
Rate for Payer: Aetna Commercial	$171.68
Rate for Payer: Aetna Medicare Advantage	$135.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.20
Rate for Payer: Cigna Commercial	$225.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.53
Rate for Payer: Oxford Commercial	$90.36
Rate for Payer: Qualcare PPO/HMO/WC	$67.77
Rate for Payer: UnitedHealthcare Commercial	$90.36
Rate for Payer: UnitedHealthcare Community & State	$10.89
Rate for Payer: Wellpoint Medicaid Managed Care	$11.97

BARIUM SULFATE SUSP

Facility

$451.78

Service Code	NDC 32909016802
Hospital Charge Code	606390050
Hospital Revenue Code	250
Min. Negotiated Rate	$67.77
Max. Negotiated Rate	$67.77
Rate for Payer: Qualcare PPO/HMO/WC	$67.77

BARIUM SULFATE SUSPENSION 450M

Facility

$728.09

Service Code	NDC 32909071503
Hospital Charge Code	60631127
Hospital Revenue Code	250
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$364.05
Rate for Payer: Aetna Commercial	$276.67
Rate for Payer: Aetna Medicare Advantage	$218.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.66
Rate for Payer: Cigna Commercial	$364.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.43
Rate for Payer: Oxford Commercial	$145.62
Rate for Payer: Qualcare PPO/HMO/WC	$109.21
Rate for Payer: UnitedHealthcare Commercial	$145.62
Rate for Payer: UnitedHealthcare Community & State	$17.55
Rate for Payer: Wellpoint Medicaid Managed Care	$19.29

BARIUM SULFATE SUSPENSION 450M

Facility

$728.09

Service Code	NDC 32909071503
Hospital Charge Code	60631127
Hospital Revenue Code	250
Min. Negotiated Rate	$109.21
Max. Negotiated Rate	$109.21
Rate for Payer: Qualcare PPO/HMO/WC	$109.21

BAR KLS ERICH ARCH 38-690-00

Facility

$178.45

Hospital Charge Code	270612047
Hospital Revenue Code	272
Min. Negotiated Rate	$26.77
Max. Negotiated Rate	$26.77
Rate for Payer: Qualcare PPO/HMO/WC	$26.77

BAR KLS ERICH ARCH 38-690-00

Facility

$178.45

Hospital Charge Code	270612047
Hospital Revenue Code	272
Min. Negotiated Rate	$4.30
Max. Negotiated Rate	$89.22
Rate for Payer: Aetna Commercial	$67.81
Rate for Payer: Aetna Medicare Advantage	$53.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.50
Rate for Payer: Cigna Commercial	$89.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.53
Rate for Payer: Oxford Commercial	$35.69
Rate for Payer: Qualcare PPO/HMO/WC	$26.77
Rate for Payer: UnitedHealthcare Commercial	$35.69
Rate for Payer: UnitedHealthcare Community & State	$4.30
Rate for Payer: Wellpoint Medicaid Managed Care	$4.73

BARLEY (F6) IGE

Facility

$35.85

Service Code	HCPCS 86003
Hospital Charge Code	39900187
Hospital Revenue Code	305
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$17.93
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.38
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

BARLEY (F6) IGE

Facility

$35.85

Service Code	HCPCS 86003
Hospital Charge Code	39900187
Hospital Revenue Code	305
Min. Negotiated Rate	$5.38
Max. Negotiated Rate	$5.38
Rate for Payer: Qualcare PPO/HMO/WC	$5.38

BARREL BUR 5.0MM 12 FLUTE

Facility

$190.00

Hospital Charge Code	270657642
Hospital Revenue Code	272
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

BARREL BUR 5.0MM 12 FLUTE

Facility

$190.00

Hospital Charge Code	270657642
Hospital Revenue Code	272
Min. Negotiated Rate	$4.58
Max. Negotiated Rate	$95.00
Rate for Payer: Aetna Commercial	$72.20
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.00
Rate for Payer: Oxford Commercial	$38.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$38.00
Rate for Payer: UnitedHealthcare Community & State	$4.58
Rate for Payer: Wellpoint Medicaid Managed Care	$5.04

BARREL BUR 5.5MM

Facility

$200.00

Hospital Charge Code	270668405
Hospital Revenue Code	272
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.00
Rate for Payer: Oxford Commercial	$40.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$40.00
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

BARREL BUR 5.5MM

Facility

$200.00

Hospital Charge Code	270668405
Hospital Revenue Code	272
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

Know your out-of-pocket cost for care.

All Charges