Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TOWER OPEN SHUNT

Facility

$2,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270692305
Hospital Revenue Code	278
Min. Negotiated Rate	$61.45
Max. Negotiated Rate	$1,275.00
Rate for Payer: Aetna Commercial	$969.00
Rate for Payer: Aetna Medicare Advantage	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$650.25
Rate for Payer: Cigna Commercial	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$617.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$561.00
Rate for Payer: Qualcare PPO/HMO/WC	$382.50
Rate for Payer: UnitedHealthcare Community & State	$61.45
Rate for Payer: Wellpoint Medicaid Managed Care	$67.58

TOWER OPEN SHUNT

Facility

$2,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270692305
Hospital Revenue Code	278
Min. Negotiated Rate	$382.50
Max. Negotiated Rate	$617.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$617.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$561.00
Rate for Payer: Qualcare PPO/HMO/WC	$382.50

TOWNLEY FEMUR CALIPER 4

Facility

$783.65

Hospital Charge Code	270665868
Hospital Revenue Code	270
Min. Negotiated Rate	$18.89
Max. Negotiated Rate	$391.82
Rate for Payer: Aetna Commercial	$297.79
Rate for Payer: Aetna Medicare Advantage	$235.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.83
Rate for Payer: Cigna Commercial	$391.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.09
Rate for Payer: Oxford Commercial	$156.73
Rate for Payer: Qualcare PPO/HMO/WC	$117.55
Rate for Payer: UnitedHealthcare Commercial	$156.73
Rate for Payer: UnitedHealthcare Community & State	$18.89
Rate for Payer: Wellpoint Medicaid Managed Care	$20.77

TOWNLEY FEMUR CALIPER 4

Facility

$783.65

Hospital Charge Code	270665868
Hospital Revenue Code	270
Min. Negotiated Rate	$117.55
Max. Negotiated Rate	$117.55
Rate for Payer: Qualcare PPO/HMO/WC	$117.55

TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES

Facility

$9,295.72

Service Code	APR-DRG 8163
Min. Negotiated Rate	$9,113.45
Max. Negotiated Rate	$9,295.72
Rate for Payer: UnitedHealthcare Community & State	$9,113.45
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,295.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9,113.45

TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES

Facility

$17,476.86

Service Code	APR-DRG 8164
Min. Negotiated Rate	$17,134.18
Max. Negotiated Rate	$17,476.86
Rate for Payer: UnitedHealthcare Community & State	$17,134.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,476.86
Rate for Payer: Wellpoint Medicaid Managed Care	$17,134.18

TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES

Facility

$6,467.79

Service Code	APR-DRG 8161
Min. Negotiated Rate	$6,340.97
Max. Negotiated Rate	$6,467.79
Rate for Payer: UnitedHealthcare Community & State	$6,340.97
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,467.79
Rate for Payer: Wellpoint Medicaid Managed Care	$6,340.97

TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES

Facility

$7,004.03

Service Code	APR-DRG 8162
Min. Negotiated Rate	$6,866.70
Max. Negotiated Rate	$7,004.03
Rate for Payer: UnitedHealthcare Community & State	$6,866.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,004.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6,866.70

TOXOCARA ANTIBODY

Facility

$268.85

Service Code	HCPCS 86682
Hospital Charge Code	3009701
Hospital Revenue Code	302
Min. Negotiated Rate	$40.33
Max. Negotiated Rate	$40.33
Rate for Payer: Qualcare PPO/HMO/WC	$40.33

TOXOCARA ANTIBODY

Facility

$268.85

Service Code	HCPCS 86682
Hospital Charge Code	3009701
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

TOXOPLASMA AB, IGG

Facility

$339.00

Service Code	HCPCS 86777
Hospital Charge Code	38476049
Hospital Revenue Code	302
Min. Negotiated Rate	$8.98
Max. Negotiated Rate	$169.50
Rate for Payer: Aetna Commercial	$39.14
Rate for Payer: Aetna Medicare Advantage	$46.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.94
Rate for Payer: Cigna Commercial	$169.50
Rate for Payer: Cigna Medicare Advantage	$14.39
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Medicare Advantage	$14.39
Rate for Payer: Wellpoint Medicaid Managed Care	$8.98

TOXOPLASMA AB, IGG

Facility

$339.00

Service Code	HCPCS 86777
Hospital Charge Code	38476049
Hospital Revenue Code	302
Min. Negotiated Rate	$50.85
Max. Negotiated Rate	$50.85
Rate for Payer: Qualcare PPO/HMO/WC	$50.85

TOXOPLASMA AB (IGG) CSF

Facility

$131.25

Service Code	HCPCS 86777
Hospital Charge Code	3035134
Hospital Revenue Code	302
Min. Negotiated Rate	$3.48
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.14
Rate for Payer: Aetna Medicare Advantage	$46.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.94
Rate for Payer: Cigna Commercial	$65.62
Rate for Payer: Cigna Medicare Advantage	$14.39
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Medicare Advantage	$14.39
Rate for Payer: Wellpoint Medicaid Managed Care	$3.48

TOXOPLASMA AB (IGG) CSF

Facility

$131.25

Service Code	HCPCS 86777
Hospital Charge Code	3035134
Hospital Revenue Code	302
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$19.69
Rate for Payer: Qualcare PPO/HMO/WC	$19.69

TOXOPLASMA AB,IGM

Facility

$311.00

Service Code	HCPCS 86778
Hospital Charge Code	38476050
Hospital Revenue Code	302
Min. Negotiated Rate	$46.65
Max. Negotiated Rate	$46.65
Rate for Payer: Qualcare PPO/HMO/WC	$46.65

TOXOPLASMA AB,IGM

Facility

$311.00

Service Code	HCPCS 86778
Hospital Charge Code	38476050
Hospital Revenue Code	302
Min. Negotiated Rate	$8.24
Max. Negotiated Rate	$155.50
Rate for Payer: Aetna Commercial	$39.20
Rate for Payer: Aetna Medicare Advantage	$46.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.02
Rate for Payer: Cigna Commercial	$155.50
Rate for Payer: Cigna Medicare Advantage	$14.41
Rate for Payer: Clover Medicare Advantage	$13.69
Rate for Payer: EmblemHealth Commercial	$43.23
Rate for Payer: Humana Medicare Advantage	$14.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.41
Rate for Payer: Wellcare Medicare Advantage	$14.41
Rate for Payer: Wellpoint Medicaid Managed Care	$8.24

TOXOPLASMA GONDII AB IGM

Facility

$99.00

Service Code	HCPCS 86778
Hospital Charge Code	39900256
Hospital Revenue Code	302
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$14.85
Rate for Payer: Qualcare PPO/HMO/WC	$14.85

TOXOPLASMA GONDII AB IGM

Facility

$99.00

Service Code	HCPCS 86778
Hospital Charge Code	39900256
Hospital Revenue Code	302
Min. Negotiated Rate	$2.62
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.20
Rate for Payer: Aetna Medicare Advantage	$46.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.02
Rate for Payer: Cigna Commercial	$49.50
Rate for Payer: Cigna Medicare Advantage	$14.41
Rate for Payer: Clover Medicare Advantage	$13.69
Rate for Payer: EmblemHealth Commercial	$43.23
Rate for Payer: Humana Medicare Advantage	$14.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.41
Rate for Payer: Wellcare Medicare Advantage	$14.41
Rate for Payer: Wellpoint Medicaid Managed Care	$2.62

TOXOPLASMA GONDII AB, IGM, QN

Facility

$141.65

Service Code	HCPCS 86778
Hospital Charge Code	3004413
Hospital Revenue Code	302
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

TOXOPLASMA GONDII AB, IGM, QN

Facility

$141.65

Service Code	HCPCS 86778
Hospital Charge Code	3004413
Hospital Revenue Code	302
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.20
Rate for Payer: Aetna Medicare Advantage	$46.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.02
Rate for Payer: Cigna Commercial	$70.83
Rate for Payer: Cigna Medicare Advantage	$14.41
Rate for Payer: Clover Medicare Advantage	$13.69
Rate for Payer: EmblemHealth Commercial	$43.23
Rate for Payer: Humana Medicare Advantage	$14.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.41
Rate for Payer: Wellcare Medicare Advantage	$14.41
Rate for Payer: Wellpoint Medicaid Managed Care	$3.75

TOXOPLASMA GONDII DNA RTPCR

Facility

$151.41

Service Code	HCPCS 87798
Hospital Charge Code	401387798B
Hospital Revenue Code	306
Min. Negotiated Rate	$22.71
Max. Negotiated Rate	$22.71
Rate for Payer: Qualcare PPO/HMO/WC	$22.71

TOXOPLASMA GONDII DNA RTPCR

Facility

$151.41

Service Code	HCPCS 87798
Hospital Charge Code	401387798B
Hospital Revenue Code	306
Min. Negotiated Rate	$4.01
Max. Negotiated Rate	$153.02
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.66
Rate for Payer: Cigna Commercial	$75.70
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.42
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.71
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$4.01

TOXOPLASMA GONDII IGG CSF

Facility

$390.00

Service Code	HCPCS 86777
Hospital Charge Code	39900255
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$39.14
Rate for Payer: Aetna Medicare Advantage	$46.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.94
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.39
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.39
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	$11.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Medicare Advantage	$14.39
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

TOXOPLASMA GONDII IGG CSF

Facility

$390.00

Service Code	HCPCS 86777
Hospital Charge Code	39900255
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TOXOPLASMA GONDII PCR CSF

Facility

$482.51

Service Code	HCPCS 87799
Hospital Charge Code	401387799B
Hospital Revenue Code	306
Min. Negotiated Rate	$12.79
Max. Negotiated Rate	$241.25
Rate for Payer: Aetna Commercial	$116.52
Rate for Payer: Aetna Medicare Advantage	$138.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.64
Rate for Payer: Cigna Commercial	$241.25
Rate for Payer: Cigna Medicare Advantage	$42.84
Rate for Payer: Clover Medicare Advantage	$40.70
Rate for Payer: EmblemHealth Commercial	$128.52
Rate for Payer: Humana Medicare Advantage	$44.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.38
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$34.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84
Rate for Payer: Wellcare Medicare Advantage	$42.84
Rate for Payer: Wellpoint Medicaid Managed Care	$12.79

Know your out-of-pocket cost for care.

All Charges