Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$48,741.55

Service Code	HCPCS 36905
Hospital Charge Code	5100839
Hospital Revenue Code	361
Min. Negotiated Rate	$1,174.67
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,622.47
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,311.23
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,174.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,291.65

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$48,741.55

Service Code	HCPCS 36905
Hospital Charge Code	366836905
Hospital Revenue Code	361
Min. Negotiated Rate	$7,311.23
Max. Negotiated Rate	$7,311.23
Rate for Payer: Qualcare PPO/HMO/WC	$7,311.23

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$56,620.95

Service Code	HCPCS 36905
Hospital Charge Code	321036905
Hospital Revenue Code	361
Min. Negotiated Rate	$8,493.14
Max. Negotiated Rate	$8,493.14
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$48,741.55

Service Code	HCPCS 36905
Hospital Charge Code	366836905
Hospital Revenue Code	361
Min. Negotiated Rate	$1,174.67
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,622.47
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,311.23
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,174.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,291.65

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$48,741.55

Service Code	HCPCS 36905
Hospital Charge Code	7412060
Hospital Revenue Code	361
Min. Negotiated Rate	$1,174.67
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,622.47
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,311.23
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,174.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,291.65

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$56,620.95

Service Code	HCPCS 36905
Hospital Charge Code	321036905
Hospital Revenue Code	361
Min. Negotiated Rate	$1,364.56
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,986.28
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,364.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,500.46

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$48,741.55

Service Code	HCPCS 36905
Hospital Charge Code	2709026
Hospital Revenue Code	361
Min. Negotiated Rate	$1,174.67
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,622.47
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,311.23
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,174.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,291.65

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$56,620.95

Service Code	HCPCS 36905
Hospital Charge Code	2692131
Hospital Revenue Code	361
Min. Negotiated Rate	$8,493.14
Max. Negotiated Rate	$8,493.14
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$56,620.95

Service Code	HCPCS 36905
Hospital Charge Code	2692131
Hospital Revenue Code	361
Min. Negotiated Rate	$1,364.56
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,986.28
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,364.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,500.46

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$48,741.55

Service Code	HCPCS 36905
Hospital Charge Code	2709026
Hospital Revenue Code	361
Min. Negotiated Rate	$7,311.23
Max. Negotiated Rate	$7,311.23
Rate for Payer: Qualcare PPO/HMO/WC	$7,311.23

THROMB+TBA PERIPH DIALYSIS SEG

Facility

$48,741.55

Service Code	HCPCS 36905
Hospital Charge Code	7412060
Hospital Revenue Code	361
Min. Negotiated Rate	$7,311.23
Max. Negotiated Rate	$7,311.23
Rate for Payer: Qualcare PPO/HMO/WC	$7,311.23

THROMTOMY SET SPIRA VG ULTRA

Facility

$10,225.00

Hospital Charge Code	2709006918
Hospital Revenue Code	272
Min. Negotiated Rate	$246.42
Max. Negotiated Rate	$5,112.50
Rate for Payer: Aetna Commercial	$3,885.50
Rate for Payer: Aetna Medicare Advantage	$3,067.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,607.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,607.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,607.38
Rate for Payer: Cigna Commercial	$5,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,067.50
Rate for Payer: Oxford Commercial	$2,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,533.75
Rate for Payer: UnitedHealthcare Commercial	$2,045.00
Rate for Payer: UnitedHealthcare Community & State	$246.42
Rate for Payer: Wellpoint Medicaid Managed Care	$270.96

THROMTOMY SET SPIRA VG ULTRA

Facility

$10,225.00

Hospital Charge Code	2709006918
Hospital Revenue Code	272
Min. Negotiated Rate	$1,533.75
Max. Negotiated Rate	$1,533.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,533.75

THSCF-35-80-1.5-ROSEN

Facility

$94.65

Hospital Charge Code	270678328
Hospital Revenue Code	272
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$47.33
Rate for Payer: Aetna Commercial	$35.97
Rate for Payer: Aetna Medicare Advantage	$28.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.14
Rate for Payer: Cigna Commercial	$47.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.39
Rate for Payer: Oxford Commercial	$18.93
Rate for Payer: Qualcare PPO/HMO/WC	$14.20
Rate for Payer: UnitedHealthcare Commercial	$18.93
Rate for Payer: UnitedHealthcare Community & State	$2.28
Rate for Payer: Wellpoint Medicaid Managed Care	$2.51

THSCF-35-80-1.5-ROSEN

Facility

$94.65

Hospital Charge Code	270678328
Hospital Revenue Code	272
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$14.20
Rate for Payer: Qualcare PPO/HMO/WC	$14.20

Thumble Tab Accessory, Nano Fx

Facility

$1,000.00

Hospital Charge Code	270665969
Hospital Revenue Code	270
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

Thumble Tab Accessory, Nano Fx

Facility

$1,000.00

Hospital Charge Code	270665969
Hospital Revenue Code	270
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

THUMBWHEEL HII MICRO LENGTHENE

Facility

$1,234.65

Hospital Charge Code	270688810
Hospital Revenue Code	272
Min. Negotiated Rate	$185.20
Max. Negotiated Rate	$185.20
Rate for Payer: Qualcare PPO/HMO/WC	$185.20

THUMBWHEEL HII MICRO LENGTHENE

Facility

$1,234.65

Hospital Charge Code	270688810
Hospital Revenue Code	272
Min. Negotiated Rate	$29.76
Max. Negotiated Rate	$617.33
Rate for Payer: Aetna Commercial	$469.17
Rate for Payer: Aetna Medicare Advantage	$370.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$314.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$314.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$314.84
Rate for Payer: Cigna Commercial	$617.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.39
Rate for Payer: Oxford Commercial	$246.93
Rate for Payer: Qualcare PPO/HMO/WC	$185.20
Rate for Payer: UnitedHealthcare Commercial	$246.93
Rate for Payer: UnitedHealthcare Community & State	$29.76
Rate for Payer: Wellpoint Medicaid Managed Care	$32.72

THUMBWHEEL LENGTHENER MICRO HI

Facility

$1,234.65

Hospital Charge Code	270688788
Hospital Revenue Code	272
Min. Negotiated Rate	$185.20
Max. Negotiated Rate	$185.20
Rate for Payer: Qualcare PPO/HMO/WC	$185.20

THUMBWHEEL LENGTHENER MICRO HI

Facility

$1,234.65

Hospital Charge Code	270688788
Hospital Revenue Code	272
Min. Negotiated Rate	$29.76
Max. Negotiated Rate	$617.33
Rate for Payer: Aetna Commercial	$469.17
Rate for Payer: Aetna Medicare Advantage	$370.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$314.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$314.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$314.84
Rate for Payer: Cigna Commercial	$617.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.39
Rate for Payer: Oxford Commercial	$246.93
Rate for Payer: Qualcare PPO/HMO/WC	$185.20
Rate for Payer: UnitedHealthcare Commercial	$246.93
Rate for Payer: UnitedHealthcare Community & State	$29.76
Rate for Payer: Wellpoint Medicaid Managed Care	$32.72

THYMOL POWD 15MG

Facility

$47.40

Hospital Charge Code	60629159
Hospital Revenue Code	250
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$7.11
Rate for Payer: Qualcare PPO/HMO/WC	$7.11

THYMOL POWD 15MG

Facility

$47.40

Hospital Charge Code	60629159
Hospital Revenue Code	250
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$23.70
Rate for Payer: Aetna Commercial	$18.01
Rate for Payer: Aetna Medicare Advantage	$14.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.09
Rate for Payer: Cigna Commercial	$23.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.22
Rate for Payer: Oxford Commercial	$9.48
Rate for Payer: Qualcare PPO/HMO/WC	$7.11
Rate for Payer: UnitedHealthcare Commercial	$9.48
Rate for Payer: UnitedHealthcare Community & State	$1.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.26

THYRDCTMY AFTR PREV REM

Facility

$42,339.20

Service Code	HCPCS 60260
Hospital Charge Code	1600000690
Hospital Revenue Code	360
Min. Negotiated Rate	$1,020.37
Max. Negotiated Rate	$25,386.70
Rate for Payer: Aetna Commercial	$19,129.52
Rate for Payer: Aetna Medicare Advantage	$22,786.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,386.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,386.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,032.91
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	$25,386.70
Rate for Payer: Cigna Commercial	$14,097.46
Rate for Payer: Cigna Medicare Advantage	$7,032.91
Rate for Payer: Clover Medicare Advantage	$6,681.26
Rate for Payer: EmblemHealth Commercial	$21,098.73
Rate for Payer: Humana Medicare Advantage	$7,243.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,032.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,701.76
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,350.88
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$1,020.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,032.91
Rate for Payer: Wellcare Medicare Advantage	$7,032.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1,121.99

THYRDCTMY AFTR PREV REM

Facility

$42,339.20

Service Code	HCPCS 60260
Hospital Charge Code	1600000690
Hospital Revenue Code	360
Min. Negotiated Rate	$6,350.88
Max. Negotiated Rate	$6,350.88
Rate for Payer: Qualcare PPO/HMO/WC	$6,350.88

Know your out-of-pocket cost for care.

All Charges