Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STREPTOZOCIN 1 G INJ

Facility

$744.60

Hospital Charge Code	60627407
Hospital Revenue Code	636
Min. Negotiated Rate	$17.94
Max. Negotiated Rate	$372.30
Rate for Payer: Aetna Commercial	$282.95
Rate for Payer: Aetna Medicare Advantage	$223.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.87
Rate for Payer: Cigna Commercial	$372.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.19
Rate for Payer: Qualcare PPO/HMO/WC	$111.69
Rate for Payer: UnitedHealthcare Community & State	$17.94
Rate for Payer: Wellpoint Medicaid Managed Care	$19.73

STREPTOZOCIN 1 G INJ

Facility

$744.60

Hospital Charge Code	60627407
Hospital Revenue Code	636
Min. Negotiated Rate	$111.69
Max. Negotiated Rate	$180.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.19
Rate for Payer: Qualcare PPO/HMO/WC	$111.69

STREPTOZOCIN 1GM

Facility

$612.50

Hospital Charge Code	6000228
Hospital Revenue Code	636
Min. Negotiated Rate	$14.76
Max. Negotiated Rate	$306.25
Rate for Payer: Aetna Commercial	$232.75
Rate for Payer: Aetna Medicare Advantage	$183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.19
Rate for Payer: Cigna Commercial	$306.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.22
Rate for Payer: Qualcare PPO/HMO/WC	$91.88
Rate for Payer: UnitedHealthcare Community & State	$14.76
Rate for Payer: Wellpoint Medicaid Managed Care	$16.23

STREPTOZOCIN 1GM

Facility

$612.50

Hospital Charge Code	6000228
Hospital Revenue Code	636
Min. Negotiated Rate	$91.88
Max. Negotiated Rate	$148.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.22
Rate for Payer: Qualcare PPO/HMO/WC	$91.88

STREPTOZYME

Facility

$141.65

Service Code	HCPCS 86403
Hospital Charge Code	3006731
Hospital Revenue Code	302
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

STREPTOZYME

Facility

$141.65

Service Code	HCPCS 86403
Hospital Charge Code	3006731
Hospital Revenue Code	302
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$31.39
Rate for Payer: Aetna Medicare Advantage	$37.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.66
Rate for Payer: Cigna Commercial	$70.83
Rate for Payer: Cigna Medicare Advantage	$11.54
Rate for Payer: Clover Medicare Advantage	$10.96
Rate for Payer: EmblemHealth Commercial	$34.62
Rate for Payer: Humana Medicare Advantage	$11.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.54
Rate for Payer: Wellcare Medicare Advantage	$11.54
Rate for Payer: Wellpoint Medicaid Managed Care	$3.75

STREPTOZYME SCR W/REFL(SERUM)

Facility

$16.83

Service Code	HCPCS 86403
Hospital Charge Code	397080018
Hospital Revenue Code	302
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$31.39
Rate for Payer: Aetna Medicare Advantage	$37.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.66
Rate for Payer: Cigna Commercial	$8.41
Rate for Payer: Cigna Medicare Advantage	$11.54
Rate for Payer: Clover Medicare Advantage	$10.96
Rate for Payer: EmblemHealth Commercial	$34.62
Rate for Payer: Humana Medicare Advantage	$11.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.52
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.54
Rate for Payer: Wellcare Medicare Advantage	$11.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

STREPTOZYME SCR W/REFL(SERUM)

Facility

$16.83

Service Code	HCPCS 86403
Hospital Charge Code	397080018
Hospital Revenue Code	302
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$2.52
Rate for Payer: Qualcare PPO/HMO/WC	$2.52

STRESS 600/TAB

Facility

$3.00

Hospital Charge Code	60633923
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

STRESS 600/TAB

Facility

$3.00

Hospital Charge Code	60633923
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

STRESS ECHO

Facility

$5,900.00

Service Code	HCPCS 93350
Hospital Charge Code	74116026
Hospital Revenue Code	483
Min. Negotiated Rate	$885.00
Max. Negotiated Rate	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00

STRESS ECHO

Facility

$5,900.00

Service Code	HCPCS 93350
Hospital Charge Code	74115026
Hospital Revenue Code	483
Min. Negotiated Rate	$885.00
Max. Negotiated Rate	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00

STRESS ECHO

Facility

$2,389.00

Service Code	HCPCS 93350
Hospital Charge Code	36540012
Hospital Revenue Code	483
Min. Negotiated Rate	$358.35
Max. Negotiated Rate	$358.35
Rate for Payer: Qualcare PPO/HMO/WC	$358.35

STRESS ECHO

Facility

$5,900.00

Service Code	HCPCS 93350
Hospital Charge Code	74115026
Hospital Revenue Code	483
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$964.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$649.16
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.00
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$142.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$156.35

STRESS ECHO

Facility

$2,389.00

Service Code	HCPCS 93350
Hospital Charge Code	36540012
Hospital Revenue Code	483
Min. Negotiated Rate	$57.57
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$964.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$649.16
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$716.70
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$358.35
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$57.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$63.31

STRESS ECHO

Facility

$5,900.00

Service Code	HCPCS 93350
Hospital Charge Code	74117026
Hospital Revenue Code	483
Min. Negotiated Rate	$885.00
Max. Negotiated Rate	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00

STRESS ECHO

Facility

$5,900.00

Service Code	HCPCS 93350
Hospital Charge Code	74117026
Hospital Revenue Code	483
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$964.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$649.16
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.00
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$142.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$156.35

STRESS ECHO

Facility

$5,900.00

Service Code	HCPCS 93350
Hospital Charge Code	5307010
Hospital Revenue Code	483
Min. Negotiated Rate	$885.00
Max. Negotiated Rate	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00

STRESS ECHO

Facility

$5,900.00

Service Code	HCPCS 93350
Hospital Charge Code	5307010
Hospital Revenue Code	483
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$964.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$649.16
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.00
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$142.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$156.35

STRESS ECHO

Facility

$5,900.00

Service Code	HCPCS 93350
Hospital Charge Code	74116026
Hospital Revenue Code	483
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$964.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$649.16
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.00
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$142.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$156.35

STRESS ECHO WITH CONTRAST

Facility

$5,900.00

Service Code	HCPCS 93351
Hospital Charge Code	36540020
Hospital Revenue Code	483
Min. Negotiated Rate	$885.00
Max. Negotiated Rate	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00

STRESS ECHO WITH CONTRAST

Facility

$5,900.00

Service Code	HCPCS 93351
Hospital Charge Code	36540020
Hospital Revenue Code	483
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$270.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$649.16
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.00
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$142.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$156.35

STRESS LEXISCAN THALLIUM

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	94053040
Hospital Revenue Code	482
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

STRESS LEXISCAN THALLIUM

Facility

$11,000.00

Service Code	HCPCS 93017
Hospital Charge Code	94053040
Hospital Revenue Code	482
Min. Negotiated Rate	$243.69
Max. Negotiated Rate	$4,924.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$592.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$925.96
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,300.00
Rate for Payer: Oxford Commercial	$2,807.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00
Rate for Payer: UnitedHealthcare Commercial	$4,924.00
Rate for Payer: UnitedHealthcare Community & State	$265.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$291.50

STRESS TAB W/FE

Facility

$3.00

Hospital Charge Code	60634440
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

Know your out-of-pocket cost for care.

All Charges