Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

Swallowing Goal Status CM

Facility

$0.01

Service Code	HCPCS G8997GNCM
Hospital Charge Code	74204049CM
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

Swallowing Goal Status CM

Facility

$0.01

Service Code	HCPCS G8997GNCM
Hospital Charge Code	74204049CM
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SWALLOWING GOAL STATUS CN

Facility

$0.01

Service Code	HCPCS G8997GNCN
Hospital Charge Code	74204049CN
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SWALLOWING GOAL STATUS CN

Facility

$0.01

Service Code	HCPCS G8997GNCN
Hospital Charge Code	74204049CN
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SWAN GANZ 7FR TD 131F7

Facility

$450.00

Hospital Charge Code	270604687
Hospital Revenue Code	272
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.00
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$90.00
Rate for Payer: UnitedHealthcare Community & State	$10.85
Rate for Payer: Wellpoint Medicaid Managed Care	$11.93

SWAN GANZ 7FR TD 131F7

Facility

$450.00

Hospital Charge Code	270604687
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SWAN GANZ CATH 8.5F

Facility

$2,068.70

Service Code	HCPCS C1894
Hospital Charge Code	270692366
Hospital Revenue Code	278
Min. Negotiated Rate	$310.31
Max. Negotiated Rate	$500.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$413.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$455.11
Rate for Payer: Qualcare PPO/HMO/WC	$310.31

SWAN GANZ CATH 8.5F

Facility

$2,068.70

Service Code	HCPCS C1894
Hospital Charge Code	270692366
Hospital Revenue Code	278
Min. Negotiated Rate	$49.86
Max. Negotiated Rate	$1,034.35
Rate for Payer: Aetna Commercial	$786.11
Rate for Payer: Aetna Medicare Advantage	$620.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$527.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$527.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$413.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$527.52
Rate for Payer: Cigna Commercial	$1,034.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$455.11
Rate for Payer: Qualcare PPO/HMO/WC	$310.31
Rate for Payer: UnitedHealthcare Community & State	$49.86
Rate for Payer: Wellpoint Medicaid Managed Care	$54.82

SWAN-GANZ PACEPORT ***********

Facility

$271.00

Hospital Charge Code	8003105
Hospital Revenue Code	279
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$135.50
Rate for Payer: Aetna Commercial	$102.98
Rate for Payer: Aetna Medicare Advantage	$81.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.11
Rate for Payer: Cigna Commercial	$135.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.30
Rate for Payer: Oxford Commercial	$54.20
Rate for Payer: Qualcare PPO/HMO/WC	$40.65
Rate for Payer: UnitedHealthcare Commercial	$54.20
Rate for Payer: UnitedHealthcare Community & State	$6.53
Rate for Payer: Wellpoint Medicaid Managed Care	$7.18

SWAN-GANZ PACEPORT ***********

Facility

$271.00

Hospital Charge Code	8003105
Hospital Revenue Code	279
Min. Negotiated Rate	$40.65
Max. Negotiated Rate	$40.65
Rate for Payer: Qualcare PPO/HMO/WC	$40.65

SWANSON HINGE TOE SIZE L

Facility

$5,850.00

Hospital Charge Code	270656828
Hospital Revenue Code	278
Min. Negotiated Rate	$877.50
Max. Negotiated Rate	$1,415.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,415.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,287.00
Rate for Payer: Qualcare PPO/HMO/WC	$877.50

SWANSON HINGE TOE SIZE L

Facility

$5,850.00

Hospital Charge Code	270656828
Hospital Revenue Code	278
Min. Negotiated Rate	$140.99
Max. Negotiated Rate	$2,925.00
Rate for Payer: Aetna Commercial	$2,223.00
Rate for Payer: Aetna Medicare Advantage	$1,755.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,491.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,491.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,491.75
Rate for Payer: Cigna Commercial	$2,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,415.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,287.00
Rate for Payer: Qualcare PPO/HMO/WC	$877.50
Rate for Payer: UnitedHealthcare Community & State	$140.99
Rate for Payer: Wellpoint Medicaid Managed Care	$155.03

SWANSON TOE

Facility

$1,211.00

Hospital Charge Code	270664024
Hospital Revenue Code	278
Min. Negotiated Rate	$181.65
Max. Negotiated Rate	$293.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$266.42
Rate for Payer: Qualcare PPO/HMO/WC	$181.65

SWANSON TOE

Facility

$1,211.00

Hospital Charge Code	270664024
Hospital Revenue Code	278
Min. Negotiated Rate	$29.19
Max. Negotiated Rate	$605.50
Rate for Payer: Aetna Commercial	$460.18
Rate for Payer: Aetna Medicare Advantage	$363.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.81
Rate for Payer: Cigna Commercial	$605.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$266.42
Rate for Payer: Qualcare PPO/HMO/WC	$181.65
Rate for Payer: UnitedHealthcare Community & State	$29.19
Rate for Payer: Wellpoint Medicaid Managed Care	$32.09

SWBSTCK CHLORAPRP SGLAP 1.75ml

Facility

$2.75

Hospital Charge Code	270643109
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$0.41
Rate for Payer: Qualcare PPO/HMO/WC	$0.41

SWBSTCK CHLORAPRP SGLAP 1.75ml

Facility

$2.75

Hospital Charge Code	270643109
Hospital Revenue Code	272
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.38
Rate for Payer: Aetna Commercial	$1.04
Rate for Payer: Aetna Medicare Advantage	$0.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.70
Rate for Payer: Cigna Commercial	$1.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.83
Rate for Payer: Oxford Commercial	$0.55
Rate for Payer: Qualcare PPO/HMO/WC	$0.41
Rate for Payer: UnitedHealthcare Commercial	$0.55
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.07

SWEATBANDS 100/PK

Facility

$2.05

Hospital Charge Code	270650503
Hospital Revenue Code	272
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$1.02
Rate for Payer: Aetna Commercial	$0.78
Rate for Payer: Aetna Medicare Advantage	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.52
Rate for Payer: Cigna Commercial	$1.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.62
Rate for Payer: Oxford Commercial	$0.41
Rate for Payer: Qualcare PPO/HMO/WC	$0.31
Rate for Payer: UnitedHealthcare Commercial	$0.41
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

SWEATBANDS 100/PK

Facility

$2.05

Hospital Charge Code	270650503
Hospital Revenue Code	272
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.31
Rate for Payer: Qualcare PPO/HMO/WC	$0.31

SWEAT CHLORIDE

Facility

$289.00

Service Code	HCPCS 89230
Hospital Charge Code	38472612
Hospital Revenue Code	300
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$223.48
Rate for Payer: Aetna Commercial	$168.40
Rate for Payer: Aetna Medicare Advantage	$200.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.48
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$61.91
Rate for Payer: Clover Medicare Advantage	$58.81
Rate for Payer: EmblemHealth Commercial	$185.73
Rate for Payer: Humana Medicare Advantage	$63.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$61.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.91
Rate for Payer: Wellcare Medicare Advantage	$61.91
Rate for Payer: Wellpoint Medicaid Managed Care	$7.66

SWEAT CHLORIDE

Facility

$289.00

Service Code	HCPCS 89230
Hospital Charge Code	38472612
Hospital Revenue Code	300
Min. Negotiated Rate	$43.35
Max. Negotiated Rate	$43.35
Rate for Payer: Qualcare PPO/HMO/WC	$43.35

SWEAT TEST

Facility

$373.00

Service Code	HCPCS 99199
Hospital Charge Code	3030632
Hospital Revenue Code	309
Min. Negotiated Rate	$8.99
Max. Negotiated Rate	$186.50
Rate for Payer: Aetna Commercial	$141.74
Rate for Payer: Aetna Medicare Advantage	$111.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.11
Rate for Payer: Cigna Commercial	$186.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.95
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.99
Rate for Payer: Wellpoint Medicaid Managed Care	$9.88

SWEAT TEST

Facility

$373.00

Service Code	HCPCS 99199
Hospital Charge Code	3030632
Hospital Revenue Code	309
Min. Negotiated Rate	$55.95
Max. Negotiated Rate	$55.95
Rate for Payer: Qualcare PPO/HMO/WC	$55.95

SWEETCHEEKSGLUCOSEGEL40%3ML

Facility

$67.00

Service Code	NDC 54758000628
Hospital Charge Code	606390533
Hospital Revenue Code	250
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$33.50
Rate for Payer: Aetna Commercial	$25.46
Rate for Payer: Aetna Medicare Advantage	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.09
Rate for Payer: Cigna Commercial	$33.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.10
Rate for Payer: Oxford Commercial	$13.40
Rate for Payer: Qualcare PPO/HMO/WC	$10.05
Rate for Payer: UnitedHealthcare Commercial	$13.40
Rate for Payer: UnitedHealthcare Community & State	$1.61
Rate for Payer: Wellpoint Medicaid Managed Care	$1.78

SWEETCHEEKSGLUCOSEGEL40%3ML

Facility

$67.00

Service Code	NDC 54758000628
Hospital Charge Code	606390533
Hospital Revenue Code	250
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

SWEET-EASE 200 PIECES

Facility

$540.75

Hospital Charge Code	270654567
Hospital Revenue Code	272
Min. Negotiated Rate	$13.03
Max. Negotiated Rate	$270.38
Rate for Payer: Aetna Commercial	$205.49
Rate for Payer: Aetna Medicare Advantage	$162.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.89
Rate for Payer: Cigna Commercial	$270.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.22
Rate for Payer: Oxford Commercial	$108.15
Rate for Payer: Qualcare PPO/HMO/WC	$81.11
Rate for Payer: UnitedHealthcare Commercial	$108.15
Rate for Payer: UnitedHealthcare Community & State	$13.03
Rate for Payer: Wellpoint Medicaid Managed Care	$14.33

Know your out-of-pocket cost for care.

All Charges