Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TOXOPLASMA GONDII PCR CSF

Facility

$482.51

Service Code	HCPCS 87799
Hospital Charge Code	401387799B
Hospital Revenue Code	306
Min. Negotiated Rate	$72.38
Max. Negotiated Rate	$72.38
Rate for Payer: Qualcare PPO/HMO/WC	$72.38

TOXOPLASMA IGG AB

Facility

$131.25

Service Code	HCPCS 86777
Hospital Charge Code	3004405
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 IGG AB

Facility

$131.25

Service Code	HCPCS 86777
Hospital Charge Code	3004405
Hospital Revenue Code	302
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$19.69
Rate for Payer: Qualcare PPO/HMO/WC	$19.69

TOXOPLASMA IGG/IGM

Facility

$233.65

Hospital Charge Code	3004411
Hospital Revenue Code	301
Min. Negotiated Rate	$5.63
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$88.79
Rate for Payer: Aetna Medicare Advantage	$70.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.58
Rate for Payer: Cigna Commercial	$116.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.63
Rate for Payer: Wellpoint Medicaid Managed Care	$6.19

TOXOPLASMA IGG/IGM

Facility

$233.65

Hospital Charge Code	3004411
Hospital Revenue Code	301
Min. Negotiated Rate	$35.05
Max. Negotiated Rate	$35.05
Rate for Payer: Qualcare PPO/HMO/WC	$35.05

TOXOPLASMA IGG,IGM I

Facility

$390.00

Service Code	HCPCS 86777
Hospital Charge Code	39980146A
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 IGG,IGM I

Facility

$390.00

Service Code	HCPCS 86777
Hospital Charge Code	39980146A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TOXOPLASMA IGG,IGM II

Facility

$390.00

Service Code	HCPCS 86778
Hospital Charge Code	39990146B
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
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	$195.00
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	$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	$11.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.41
Rate for Payer: Wellcare Medicare Advantage	$14.41
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

TOXOPLASMA IGG,IGM II

Facility

$390.00

Service Code	HCPCS 86778
Hospital Charge Code	39990146B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

T-PC SWIVEL ADT 12x4x54 215158

Facility

$80.90

Hospital Charge Code	270633995
Hospital Revenue Code	272
Min. Negotiated Rate	$12.13
Max. Negotiated Rate	$12.13
Rate for Payer: Qualcare PPO/HMO/WC	$12.13

T-PC SWIVEL ADT 12x4x54 215158

Facility

$80.90

Hospital Charge Code	270633995
Hospital Revenue Code	272
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$40.45
Rate for Payer: Aetna Commercial	$30.74
Rate for Payer: Aetna Medicare Advantage	$24.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.63
Rate for Payer: Cigna Commercial	$40.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.27
Rate for Payer: Oxford Commercial	$16.18
Rate for Payer: Qualcare PPO/HMO/WC	$12.13
Rate for Payer: UnitedHealthcare Commercial	$16.18
Rate for Payer: UnitedHealthcare Community & State	$1.95
Rate for Payer: Wellpoint Medicaid Managed Care	$2.14

T-PLATE 1.5MM 3HOLE/8HOLE

Facility

$967.15

Service Code	HCPCS C1713
Hospital Charge Code	270654815
Hospital Revenue Code	278
Min. Negotiated Rate	$145.07
Max. Negotiated Rate	$234.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$212.77
Rate for Payer: Qualcare PPO/HMO/WC	$145.07

T-PLATE 1.5MM 3HOLE/8HOLE

Facility

$967.15

Service Code	HCPCS C1713
Hospital Charge Code	270654815
Hospital Revenue Code	278
Min. Negotiated Rate	$23.31
Max. Negotiated Rate	$483.57
Rate for Payer: Aetna Commercial	$367.52
Rate for Payer: Aetna Medicare Advantage	$290.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$246.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$246.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$246.62
Rate for Payer: Cigna Commercial	$483.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$212.77
Rate for Payer: Qualcare PPO/HMO/WC	$145.07
Rate for Payer: UnitedHealthcare Community & State	$23.31
Rate for Payer: Wellpoint Medicaid Managed Care	$25.63

T-PLATE 1.5MM 4HOLE/8HOLE

Facility

$1,007.35

Service Code	HCPCS C1713
Hospital Charge Code	270654816
Hospital Revenue Code	278
Min. Negotiated Rate	$151.10
Max. Negotiated Rate	$243.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$221.62
Rate for Payer: Qualcare PPO/HMO/WC	$151.10

T-PLATE 1.5MM 4HOLE/8HOLE

Facility

$1,007.35

Service Code	HCPCS C1713
Hospital Charge Code	270654816
Hospital Revenue Code	278
Min. Negotiated Rate	$24.28
Max. Negotiated Rate	$503.68
Rate for Payer: Aetna Commercial	$382.79
Rate for Payer: Aetna Medicare Advantage	$302.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.87
Rate for Payer: Cigna Commercial	$503.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$221.62
Rate for Payer: Qualcare PPO/HMO/WC	$151.10
Rate for Payer: UnitedHealthcare Community & State	$24.28
Rate for Payer: Wellpoint Medicaid Managed Care	$26.69

T-PLATE 2.0MM 2HOLE/8HOLE

Facility

$1,037.55

Service Code	HCPCS C1713
Hospital Charge Code	270654826
Hospital Revenue Code	278
Min. Negotiated Rate	$25.00
Max. Negotiated Rate	$518.77
Rate for Payer: Aetna Commercial	$394.27
Rate for Payer: Aetna Medicare Advantage	$311.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$264.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$264.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$207.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$264.58
Rate for Payer: Cigna Commercial	$518.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$251.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$228.26
Rate for Payer: Qualcare PPO/HMO/WC	$155.63
Rate for Payer: UnitedHealthcare Community & State	$25.00
Rate for Payer: Wellpoint Medicaid Managed Care	$27.50

T-PLATE 2.0MM 2HOLE/8HOLE

Facility

$1,037.55

Service Code	HCPCS C1713
Hospital Charge Code	270654826
Hospital Revenue Code	278
Min. Negotiated Rate	$155.63
Max. Negotiated Rate	$251.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$207.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$251.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$228.26
Rate for Payer: Qualcare PPO/HMO/WC	$155.63

T-PLATE 2.0MM 3HOLE/8HOLE

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270654827
Hospital Revenue Code	278
Min. Negotiated Rate	$164.54
Max. Negotiated Rate	$265.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$164.54

T-PLATE 2.0MM 3HOLE/8HOLE

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270654827
Hospital Revenue Code	278
Min. Negotiated Rate	$26.44
Max. Negotiated Rate	$548.48
Rate for Payer: Aetna Commercial	$416.84
Rate for Payer: Aetna Medicare Advantage	$329.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$279.72
Rate for Payer: Cigna Commercial	$548.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$164.54
Rate for Payer: UnitedHealthcare Community & State	$26.44
Rate for Payer: Wellpoint Medicaid Managed Care	$29.07

TPLATE 2.0 TITANIUM 3-H 447233

Facility

$1,030.00

Hospital Charge Code	270634475
Hospital Revenue Code	272
Min. Negotiated Rate	$154.50
Max. Negotiated Rate	$154.50
Rate for Payer: Qualcare PPO/HMO/WC	$154.50

TPLATE 2.0 TITANIUM 3-H 447233

Facility

$1,030.00

Hospital Charge Code	270634475
Hospital Revenue Code	272
Min. Negotiated Rate	$24.82
Max. Negotiated Rate	$515.00
Rate for Payer: Aetna Commercial	$391.40
Rate for Payer: Aetna Medicare Advantage	$309.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$262.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$262.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$262.65
Rate for Payer: Cigna Commercial	$515.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$309.00
Rate for Payer: Oxford Commercial	$206.00
Rate for Payer: Qualcare PPO/HMO/WC	$154.50
Rate for Payer: UnitedHealthcare Commercial	$206.00
Rate for Payer: UnitedHealthcare Community & State	$24.82
Rate for Payer: Wellpoint Medicaid Managed Care	$27.30

T-PLATE 2.0x18MM 2HOLE 18MM

Facility

$234.85

Service Code	HCPCS C1713
Hospital Charge Code	270604348
Hospital Revenue Code	278
Min. Negotiated Rate	$35.23
Max. Negotiated Rate	$56.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$51.67
Rate for Payer: Qualcare PPO/HMO/WC	$35.23

T-PLATE 2.0x18MM 2HOLE 18MM

Facility

$234.85

Service Code	HCPCS C1713
Hospital Charge Code	270604348
Hospital Revenue Code	278
Min. Negotiated Rate	$5.66
Max. Negotiated Rate	$117.42
Rate for Payer: Aetna Commercial	$89.24
Rate for Payer: Aetna Medicare Advantage	$70.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.89
Rate for Payer: Cigna Commercial	$117.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$51.67
Rate for Payer: Qualcare PPO/HMO/WC	$35.23
Rate for Payer: UnitedHealthcare Community & State	$5.66
Rate for Payer: Wellpoint Medicaid Managed Care	$6.22

T-PLATE 2.4MM 2HOLE/8HOLE

Facility

$1,103.15

Service Code	HCPCS C1713
Hospital Charge Code	270654860
Hospital Revenue Code	278
Min. Negotiated Rate	$165.47
Max. Negotiated Rate	$266.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.69
Rate for Payer: Qualcare PPO/HMO/WC	$165.47

T-PLATE 2.4MM 2HOLE/8HOLE

Facility

$1,103.15

Service Code	HCPCS C1713
Hospital Charge Code	270654860
Hospital Revenue Code	278
Min. Negotiated Rate	$26.59
Max. Negotiated Rate	$551.58
Rate for Payer: Aetna Commercial	$419.20
Rate for Payer: Aetna Medicare Advantage	$330.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$281.30
Rate for Payer: Cigna Commercial	$551.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.69
Rate for Payer: Qualcare PPO/HMO/WC	$165.47
Rate for Payer: UnitedHealthcare Community & State	$26.59
Rate for Payer: Wellpoint Medicaid Managed Care	$29.23

Know your out-of-pocket cost for care.

All Charges