Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STRONGYLOIDES ANTIBODY IgG

Facility

$215.98

Service Code	HCPCS 86682
Hospital Charge Code	401186682A
Hospital Revenue Code	300
Min. Negotiated Rate	$32.40
Max. Negotiated Rate	$32.40
Rate for Payer: Qualcare PPO/HMO/WC	$32.40

STRONGYLOIDES ANTIBODY IgG

Facility

$215.98

Service Code	HCPCS 86682
Hospital Charge Code	401186682A
Hospital Revenue Code	300
Min. Negotiated Rate	$5.72
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	$107.99
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	$64.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.40
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	$5.72

STRONGYLOIDES IGG, ELISA

Facility

$268.85

Service Code	HCPCS 86682
Hospital Charge Code	3038133
Hospital Revenue Code	302
Min. Negotiated Rate	$40.33
Max. Negotiated Rate	$40.33
Rate for Payer: Qualcare PPO/HMO/WC	$40.33

STRONGYLOIDES IGG, ELISA

Facility

$268.85

Service Code	HCPCS 86682
Hospital Charge Code	3038133
Hospital Revenue Code	302
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$134.43
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	$134.43
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	$80.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.33
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	$7.12

STRORITE TAB

Facility

$2.50

Hospital Charge Code	60629861
Hospital Revenue Code	250
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$0.38
Rate for Payer: Qualcare PPO/HMO/WC	$0.38

STRORITE TAB

Facility

$2.50

Hospital Charge Code	60629861
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.25
Rate for Payer: Aetna Commercial	$0.95
Rate for Payer: Aetna Medicare Advantage	$0.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.64
Rate for Payer: Cigna Commercial	$1.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.75
Rate for Payer: Oxford Commercial	$0.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.38
Rate for Payer: UnitedHealthcare Commercial	$0.50
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.07

STROVITE PLUS TABS

Facility

$1.00

Hospital Charge Code	60634747
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.38
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.30
Rate for Payer: Oxford Commercial	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.20
Rate for Payer: UnitedHealthcare Community & State	$0.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.03

STROVITE PLUS TABS

Facility

$1.00

Hospital Charge Code	60634747
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

STROVITE TABS

Facility

$4.00

Service Code	NDC 48107004904
Hospital Charge Code	60634746
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

STROVITE TABS

Facility

$4.00

Service Code	NDC 48107004904
Hospital Charge Code	60634746
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

STR REM RGT8 MM 30CM RS X 70CM

Facility

$5,650.00

Service Code	HCPCS C1768
Hospital Charge Code	270658078
Hospital Revenue Code	278
Min. Negotiated Rate	$847.50
Max. Negotiated Rate	$1,367.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,367.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,243.00
Rate for Payer: Qualcare PPO/HMO/WC	$847.50

STR REM RGT8 MM 30CM RS X 70CM

Facility

$5,650.00

Service Code	HCPCS C1768
Hospital Charge Code	270658078
Hospital Revenue Code	278
Min. Negotiated Rate	$136.16
Max. Negotiated Rate	$2,825.00
Rate for Payer: Aetna Commercial	$2,147.00
Rate for Payer: Aetna Medicare Advantage	$1,695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,440.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,440.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,440.75
Rate for Payer: Cigna Commercial	$2,825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,367.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,243.00
Rate for Payer: Qualcare PPO/HMO/WC	$847.50
Rate for Payer: UnitedHealthcare Community & State	$136.16
Rate for Payer: Wellpoint Medicaid Managed Care	$149.72

STR SI FOR ULCR WND INJ,MLPERF

Facility

$17,925.50

Service Code	HCPCS 44603
Hospital Charge Code	1600000490
Hospital Revenue Code	360
Min. Negotiated Rate	$2,688.82
Max. Negotiated Rate	$2,688.82
Rate for Payer: Qualcare PPO/HMO/WC	$2,688.82

STR SI FOR ULCR WND INJ,MLPERF

Facility

$17,925.50

Service Code	HCPCS 44603
Hospital Charge Code	1600000490
Hospital Revenue Code	360
Min. Negotiated Rate	$432.00
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$6,811.69
Rate for Payer: Aetna Medicare Advantage	$5,377.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,571.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,571.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,571.00
Rate for Payer: Cigna Commercial	$8,962.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,377.65
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,688.82
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$432.00
Rate for Payer: Wellpoint Medicaid Managed Care	$475.03

STRT. MOSQUITO CLAMP

Facility

$46.60

Hospital Charge Code	270657048
Hospital Revenue Code	270
Min. Negotiated Rate	$6.99
Max. Negotiated Rate	$6.99
Rate for Payer: Qualcare PPO/HMO/WC	$6.99

STRT. MOSQUITO CLAMP

Facility

$46.60

Hospital Charge Code	270657048
Hospital Revenue Code	270
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$23.30
Rate for Payer: Aetna Commercial	$17.71
Rate for Payer: Aetna Medicare Advantage	$13.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.88
Rate for Payer: Cigna Commercial	$23.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.98
Rate for Payer: Oxford Commercial	$9.32
Rate for Payer: Qualcare PPO/HMO/WC	$6.99
Rate for Payer: UnitedHealthcare Commercial	$9.32
Rate for Payer: UnitedHealthcare Community & State	$1.12
Rate for Payer: Wellpoint Medicaid Managed Care	$1.23

STRT STEM EXT15MM DI 145 100MM

Facility

$6,690.00

Service Code	HCPCS C1776
Hospital Charge Code	270686881
Hospital Revenue Code	278
Min. Negotiated Rate	$161.23
Max. Negotiated Rate	$3,345.00
Rate for Payer: Aetna Commercial	$2,542.20
Rate for Payer: Aetna Medicare Advantage	$2,007.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,705.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,705.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,338.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,705.95
Rate for Payer: Cigna Commercial	$3,345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,618.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,471.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,003.50
Rate for Payer: UnitedHealthcare Community & State	$161.23
Rate for Payer: Wellpoint Medicaid Managed Care	$177.28

STRT STEM EXT15MM DI 145 100MM

Facility

$6,690.00

Service Code	HCPCS C1776
Hospital Charge Code	270686881
Hospital Revenue Code	278
Min. Negotiated Rate	$1,003.50
Max. Negotiated Rate	$1,618.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,338.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,618.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,471.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,003.50

STRUT CORTICAL TIBIAL 20x200MM

Facility

$2,872.50

Service Code	HCPCS C1776
Hospital Charge Code	270675966
Hospital Revenue Code	278
Min. Negotiated Rate	$430.88
Max. Negotiated Rate	$695.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$574.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$631.95
Rate for Payer: Qualcare PPO/HMO/WC	$430.88

STRUT CORTICAL TIBIAL 20x200MM

Facility

$2,872.50

Service Code	HCPCS C1776
Hospital Charge Code	270675966
Hospital Revenue Code	278
Min. Negotiated Rate	$69.23
Max. Negotiated Rate	$1,436.25
Rate for Payer: Aetna Commercial	$1,091.55
Rate for Payer: Aetna Medicare Advantage	$861.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$732.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$732.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$574.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$732.49
Rate for Payer: Cigna Commercial	$1,436.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$631.95
Rate for Payer: Qualcare PPO/HMO/WC	$430.88
Rate for Payer: UnitedHealthcare Community & State	$69.23
Rate for Payer: Wellpoint Medicaid Managed Care	$76.12

STRUT FEM CORTL THIRDS 850486

Facility

$3,293.50

Hospital Charge Code	270633403
Hospital Revenue Code	272
Min. Negotiated Rate	$494.02
Max. Negotiated Rate	$494.02
Rate for Payer: Qualcare PPO/HMO/WC	$494.02

STRUT FEM CORTL THIRDS 850486

Facility

$3,293.50

Hospital Charge Code	270633403
Hospital Revenue Code	272
Min. Negotiated Rate	$79.37
Max. Negotiated Rate	$1,646.75
Rate for Payer: Aetna Commercial	$1,251.53
Rate for Payer: Aetna Medicare Advantage	$988.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$839.84
Rate for Payer: Cigna Commercial	$1,646.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$988.05
Rate for Payer: Oxford Commercial	$658.70
Rate for Payer: Qualcare PPO/HMO/WC	$494.02
Rate for Payer: UnitedHealthcare Commercial	$658.70
Rate for Payer: UnitedHealthcare Community & State	$79.37
Rate for Payer: Wellpoint Medicaid Managed Care	$87.28

STRUT FEMORAL CORTICAL 20CM

Facility

$4,540.00

Hospital Charge Code	270645276
Hospital Revenue Code	278
Min. Negotiated Rate	$109.41
Max. Negotiated Rate	$2,270.00
Rate for Payer: Aetna Commercial	$1,725.20
Rate for Payer: Aetna Medicare Advantage	$1,362.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,157.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,157.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$908.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,157.70
Rate for Payer: Cigna Commercial	$2,270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,098.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$998.80
Rate for Payer: Qualcare PPO/HMO/WC	$681.00
Rate for Payer: UnitedHealthcare Community & State	$109.41
Rate for Payer: Wellpoint Medicaid Managed Care	$120.31

STRUT FEMORAL CORTICAL 20CM

Facility

$4,540.00

Hospital Charge Code	270645276
Hospital Revenue Code	278
Min. Negotiated Rate	$681.00
Max. Negotiated Rate	$1,098.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$908.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,098.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$998.80
Rate for Payer: Qualcare PPO/HMO/WC	$681.00

STRUT FIBULAR 10CM LONG

Facility

$4,400.00

Hospital Charge Code	270663749
Hospital Revenue Code	270
Min. Negotiated Rate	$660.00
Max. Negotiated Rate	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$660.00

Know your out-of-pocket cost for care.

All Charges