Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TAMP OAT SZ 7

Facility

$970.00

Hospital Charge Code	270677740
Hospital Revenue Code	272
Min. Negotiated Rate	$23.38
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$368.60
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.00
Rate for Payer: Oxford Commercial	$194.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Commercial	$194.00
Rate for Payer: UnitedHealthcare Community & State	$23.38
Rate for Payer: Wellpoint Medicaid Managed Care	$25.70

TAMP OAT SZ 8

Facility

$970.00

Hospital Charge Code	270677741
Hospital Revenue Code	272
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$145.50
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TAMP OAT SZ 8

Facility

$970.00

Hospital Charge Code	270677741
Hospital Revenue Code	272
Min. Negotiated Rate	$23.38
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$368.60
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.00
Rate for Payer: Oxford Commercial	$194.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Commercial	$194.00
Rate for Payer: UnitedHealthcare Community & State	$23.38
Rate for Payer: Wellpoint Medicaid Managed Care	$25.70

TAMP OAT SZ 9

Facility

$970.00

Hospital Charge Code	270677742
Hospital Revenue Code	272
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$145.50
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TAMP OAT SZ 9

Facility

$970.00

Hospital Charge Code	270677742
Hospital Revenue Code	272
Min. Negotiated Rate	$23.38
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$368.60
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.00
Rate for Payer: Oxford Commercial	$194.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Commercial	$194.00
Rate for Payer: UnitedHealthcare Community & State	$23.38
Rate for Payer: Wellpoint Medicaid Managed Care	$25.70

TAMSULOSIN 0.4 MG CAP

Facility

$50.45

Service Code	NDC 597016601
Hospital Charge Code	60628762
Hospital Revenue Code	250
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$7.57
Rate for Payer: Qualcare PPO/HMO/WC	$7.57

TAMSULOSIN 0.4 MG CAP

Facility

$50.45

Service Code	NDC 597016601
Hospital Charge Code	60628762
Hospital Revenue Code	250
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$25.23
Rate for Payer: Aetna Commercial	$19.17
Rate for Payer: Aetna Medicare Advantage	$15.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.86
Rate for Payer: Cigna Commercial	$25.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.13
Rate for Payer: Oxford Commercial	$10.09
Rate for Payer: Qualcare PPO/HMO/WC	$7.57
Rate for Payer: UnitedHealthcare Commercial	$10.09
Rate for Payer: UnitedHealthcare Community & State	$1.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1.34

T AND B LYMPHOCYTES

Facility

$111.25

Service Code	HCPCS 86359
Hospital Charge Code	3008707A
Hospital Revenue Code	302
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$136.19
Rate for Payer: Aetna Commercial	$102.63
Rate for Payer: Aetna Medicare Advantage	$122.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.19
Rate for Payer: Cigna Commercial	$55.62
Rate for Payer: Cigna Medicare Advantage	$37.73
Rate for Payer: Clover Medicare Advantage	$35.84
Rate for Payer: EmblemHealth Commercial	$113.19
Rate for Payer: Humana Medicare Advantage	$38.86
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$37.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$30.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$37.73
Rate for Payer: Wellcare Medicare Advantage	$37.73
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

T AND B LYMPHOCYTES

Facility

$111.25

Service Code	HCPCS 86359
Hospital Charge Code	3008707A
Hospital Revenue Code	302
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$16.69
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

T AND B LYMPHOCYTES

Facility

$177.50

Service Code	HCPCS 86360
Hospital Charge Code	3008707C
Hospital Revenue Code	302
Min. Negotiated Rate	$4.70
Max. Negotiated Rate	$169.58
Rate for Payer: Aetna Commercial	$127.79
Rate for Payer: Aetna Medicare Advantage	$152.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$46.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.58
Rate for Payer: Cigna Commercial	$88.75
Rate for Payer: Cigna Medicare Advantage	$46.98
Rate for Payer: Clover Medicare Advantage	$44.63
Rate for Payer: EmblemHealth Commercial	$140.94
Rate for Payer: Humana Medicare Advantage	$48.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$46.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.62
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$37.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$46.98
Rate for Payer: Wellcare Medicare Advantage	$46.98
Rate for Payer: Wellpoint Medicaid Managed Care	$4.70

T AND B LYMPHOCYTES

Facility

$177.50

Service Code	HCPCS 86360
Hospital Charge Code	3008707C
Hospital Revenue Code	302
Min. Negotiated Rate	$26.62
Max. Negotiated Rate	$26.62
Rate for Payer: Qualcare PPO/HMO/WC	$26.62

T AND B LYMPHOCYTES

Facility

$120.00

Service Code	HCPCS 86360
Hospital Charge Code	3008707B
Hospital Revenue Code	302
Min. Negotiated Rate	$3.18
Max. Negotiated Rate	$169.58
Rate for Payer: Aetna Commercial	$127.79
Rate for Payer: Aetna Medicare Advantage	$152.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$46.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.58
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: Cigna Medicare Advantage	$46.98
Rate for Payer: Clover Medicare Advantage	$44.63
Rate for Payer: EmblemHealth Commercial	$140.94
Rate for Payer: Humana Medicare Advantage	$48.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$46.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$37.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$46.98
Rate for Payer: Wellcare Medicare Advantage	$46.98
Rate for Payer: Wellpoint Medicaid Managed Care	$3.18

T AND B LYMPHOCYTES

Facility

$120.00

Service Code	HCPCS 86360
Hospital Charge Code	3008707B
Hospital Revenue Code	302
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	303511102
Hospital Revenue Code	510
Min. Negotiated Rate	$155.17
Max. Negotiated Rate	$155.17
Rate for Payer: Qualcare PPO/HMO/WC	$155.17

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	303511102
Hospital Revenue Code	510
Min. Negotiated Rate	$24.93
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.35
Rate for Payer: Qualcare PPO/HMO/WC	$155.17
Rate for Payer: UnitedHealthcare Community & State	$24.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$27.41

TANGENTIAL BX SKIN 1ST LESION

Facility

$9,500.00

Service Code	HCPCS 11102
Hospital Charge Code	404311102
Hospital Revenue Code	361
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	395011102
Hospital Revenue Code	761
Min. Negotiated Rate	$24.93
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.35
Rate for Payer: Oxford Commercial	$206.90
Rate for Payer: Qualcare PPO/HMO/WC	$155.17
Rate for Payer: UnitedHealthcare Commercial	$206.90
Rate for Payer: UnitedHealthcare Community & State	$24.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$27.41

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	395011102
Hospital Revenue Code	761
Min. Negotiated Rate	$155.17
Max. Negotiated Rate	$155.17
Rate for Payer: Qualcare PPO/HMO/WC	$155.17

TANGENTIAL BX SKIN 1ST LESION

Facility

$9,500.00

Service Code	HCPCS 11102
Hospital Charge Code	404311102
Hospital Revenue Code	361
Min. Negotiated Rate	$228.95
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
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	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,850.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$228.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$251.75

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	412311102
Hospital Revenue Code	361
Min. Negotiated Rate	$24.93
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
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	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.35
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.17
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$24.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$27.41

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	450211102
Hospital Revenue Code	761
Min. Negotiated Rate	$155.17
Max. Negotiated Rate	$155.17
Rate for Payer: Qualcare PPO/HMO/WC	$155.17

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	450211102
Hospital Revenue Code	761
Min. Negotiated Rate	$24.93
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.35
Rate for Payer: Oxford Commercial	$206.90
Rate for Payer: Qualcare PPO/HMO/WC	$155.17
Rate for Payer: UnitedHealthcare Commercial	$206.90
Rate for Payer: UnitedHealthcare Community & State	$24.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$27.41

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	412311102
Hospital Revenue Code	361
Min. Negotiated Rate	$155.17
Max. Negotiated Rate	$155.17
Rate for Payer: Qualcare PPO/HMO/WC	$155.17

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	450211103
Hospital Revenue Code	761
Min. Negotiated Rate	$77.59
Max. Negotiated Rate	$77.59
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	450211103
Hospital Revenue Code	761
Min. Negotiated Rate	$12.47
Max. Negotiated Rate	$258.62
Rate for Payer: Aetna Commercial	$196.56
Rate for Payer: Aetna Medicare Advantage	$155.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.90
Rate for Payer: Cigna Commercial	$258.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.18
Rate for Payer: Oxford Commercial	$103.45
Rate for Payer: Qualcare PPO/HMO/WC	$77.59
Rate for Payer: UnitedHealthcare Commercial	$103.45
Rate for Payer: UnitedHealthcare Community & State	$12.47
Rate for Payer: Wellpoint Medicaid Managed Care	$13.71

Know your out-of-pocket cost for care.

All Charges