Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

THALLIUM BLOOD

Facility

$152.25

Service Code	HCPCS 83018
Hospital Charge Code	3000364
Hospital Revenue Code	301
Min. Negotiated Rate	$4.03
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$59.73
Rate for Payer: Aetna Medicare Advantage	$71.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.27
Rate for Payer: Cigna Commercial	$76.12
Rate for Payer: Cigna Medicare Advantage	$21.96
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.84
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$17.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Medicare Advantage	$21.96
Rate for Payer: Wellpoint Medicaid Managed Care	$4.03

THALLIUM BLOOD

Facility

$390.00

Service Code	HCPCS 83018
Hospital Charge Code	39900456
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

THALLIUM BLOOD

Facility

$390.00

Service Code	HCPCS 83018
Hospital Charge Code	39900456
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$59.73
Rate for Payer: Aetna Medicare Advantage	$71.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.27
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$21.96
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$17.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Medicare Advantage	$21.96
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

THALLIUM, SERUM

Facility

$234.00

Service Code	HCPCS 83018
Hospital Charge Code	38472933
Hospital Revenue Code	301
Min. Negotiated Rate	$6.20
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$59.73
Rate for Payer: Aetna Medicare Advantage	$71.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.27
Rate for Payer: Cigna Commercial	$117.00
Rate for Payer: Cigna Medicare Advantage	$21.96
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$17.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Medicare Advantage	$21.96
Rate for Payer: Wellpoint Medicaid Managed Care	$6.20

THALLIUM, SERUM

Facility

$234.00

Service Code	HCPCS 83018
Hospital Charge Code	38472933
Hospital Revenue Code	301
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$35.10
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

THALLIUM, URINE

Facility

$234.00

Service Code	HCPCS 83018
Hospital Charge Code	38472932
Hospital Revenue Code	301
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$35.10
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

THALLIUM, URINE

Facility

$234.00

Service Code	HCPCS 83018
Hospital Charge Code	38472932
Hospital Revenue Code	301
Min. Negotiated Rate	$6.20
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$59.73
Rate for Payer: Aetna Medicare Advantage	$71.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.27
Rate for Payer: Cigna Commercial	$117.00
Rate for Payer: Cigna Medicare Advantage	$21.96
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$17.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Medicare Advantage	$21.96
Rate for Payer: Wellpoint Medicaid Managed Care	$6.20

THALLOUS CHLORIDE FLOOD

Facility

$51.45

Hospital Charge Code	270658186
Hospital Revenue Code	270
Min. Negotiated Rate	$7.72
Max. Negotiated Rate	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$7.72

THALLOUS CHLORIDE FLOOD

Facility

$51.45

Hospital Charge Code	270658186
Hospital Revenue Code	270
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$25.73
Rate for Payer: Aetna Commercial	$19.55
Rate for Payer: Aetna Medicare Advantage	$15.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.12
Rate for Payer: Cigna Commercial	$25.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.44
Rate for Payer: Oxford Commercial	$10.29
Rate for Payer: Qualcare PPO/HMO/WC	$7.72
Rate for Payer: UnitedHealthcare Commercial	$10.29
Rate for Payer: UnitedHealthcare Community & State	$1.24
Rate for Payer: Wellpoint Medicaid Managed Care	$1.36

THALLOUS CL PER MCI

Facility

$67.00

Hospital Charge Code	4509090
Hospital Revenue Code	343
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

THALLOUS CL PER MCI

Facility

$67.00

Hospital Charge Code	4509090
Hospital Revenue Code	343
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: Qualcare PPO/HMO/WC	$10.05
Rate for Payer: UnitedHealthcare Community & State	$1.61
Rate for Payer: Wellpoint Medicaid Managed Care	$1.78

T-HANDLE DRIVER

Facility

$7,220.00

Hospital Charge Code	270690628
Hospital Revenue Code	272
Min. Negotiated Rate	$1,083.00
Max. Negotiated Rate	$1,083.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.00

T-HANDLE DRIVER

Facility

$7,220.00

Hospital Charge Code	270690628
Hospital Revenue Code	272
Min. Negotiated Rate	$174.00
Max. Negotiated Rate	$3,610.00
Rate for Payer: Aetna Commercial	$2,743.60
Rate for Payer: Aetna Medicare Advantage	$2,166.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,841.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,841.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,841.10
Rate for Payer: Cigna Commercial	$3,610.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,166.00
Rate for Payer: Oxford Commercial	$1,444.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.00
Rate for Payer: UnitedHealthcare Commercial	$1,444.00
Rate for Payer: UnitedHealthcare Community & State	$174.00
Rate for Payer: Wellpoint Medicaid Managed Care	$191.33

T HANDLE SCREW DRIVER 6MM

Facility

$2,990.00

Hospital Charge Code	270686004
Hospital Revenue Code	272
Min. Negotiated Rate	$448.50
Max. Negotiated Rate	$448.50
Rate for Payer: Qualcare PPO/HMO/WC	$448.50

T HANDLE SCREW DRIVER 6MM

Facility

$2,990.00

Hospital Charge Code	270686004
Hospital Revenue Code	272
Min. Negotiated Rate	$72.06
Max. Negotiated Rate	$1,495.00
Rate for Payer: Aetna Commercial	$1,136.20
Rate for Payer: Aetna Medicare Advantage	$897.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$762.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$762.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$762.45
Rate for Payer: Cigna Commercial	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$897.00
Rate for Payer: Oxford Commercial	$598.00
Rate for Payer: Qualcare PPO/HMO/WC	$448.50
Rate for Payer: UnitedHealthcare Commercial	$598.00
Rate for Payer: UnitedHealthcare Community & State	$72.06
Rate for Payer: Wellpoint Medicaid Managed Care	$79.23

THAWING PROC, FROZEN BLD PROD

Facility

$100.00

Service Code	HCPCS 86927
Hospital Charge Code	3100153
Hospital Revenue Code	300
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$730.60
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$730.60
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

THAWING PROC, FROZEN BLD PROD

Facility

$100.00

Service Code	HCPCS 86927
Hospital Charge Code	3100153
Hospital Revenue Code	300
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

The Captivator COLD Single-use

Facility

$75.00

Hospital Charge Code	270688073
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

The Captivator COLD Single-use

Facility

$75.00

Hospital Charge Code	270688073
Hospital Revenue Code	272
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

The Klassic Knee System -Femur

Facility

$7,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270685965
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

The Klassic Knee System -Femur

Facility

$7,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270685965
Hospital Revenue Code	278
Min. Negotiated Rate	$168.70
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,660.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00
Rate for Payer: UnitedHealthcare Community & State	$168.70
Rate for Payer: Wellpoint Medicaid Managed Care	$185.50

T-HELPER/SUPPRESSOR

Facility

$299.00

Service Code	HCPCS 88182
Hospital Charge Code	38479113
Hospital Revenue Code	311
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$44.85
Rate for Payer: Qualcare PPO/HMO/WC	$44.85

T-HELPER/SUPPRESSOR

Facility

$299.00

Service Code	HCPCS 88182
Hospital Charge Code	38479113
Hospital Revenue Code	311
Min. Negotiated Rate	$7.92
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) 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	$89.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.85
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$136.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.91
Rate for Payer: Wellcare Medicare Advantage	$61.91
Rate for Payer: Wellpoint Medicaid Managed Care	$7.92

THEMAL TIP W/DRAPE

Facility

$52.00

Hospital Charge Code	270335721
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

THEMAL TIP W/DRAPE

Facility

$52.00

Hospital Charge Code	270335721
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

Know your out-of-pocket cost for care.

All Charges