Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

URIC ACID SERUM PANEL***

Facility

$17.60

Service Code	HCPCS 84550
Hospital Charge Code	3002672P
Hospital Revenue Code	301
Min. Negotiated Rate	$2.64
Max. Negotiated Rate	$2.64
Rate for Payer: Qualcare PPO/HMO/WC	$2.64

URIC ACID SERUM PANEL***

Facility

$17.60

Service Code	HCPCS 84550
Hospital Charge Code	3002672P
Hospital Revenue Code	301
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$12.29
Rate for Payer: Aetna Medicare Advantage	$14.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$8.80
Rate for Payer: Cigna Medicare Advantage	$4.52
Rate for Payer: Clover Medicare Advantage	$4.29
Rate for Payer: EmblemHealth Commercial	$13.56
Rate for Payer: Humana Medicare Advantage	$4.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.64
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.52
Rate for Payer: Wellcare Medicare Advantage	$4.52
Rate for Payer: Wellpoint Medicaid Managed Care	$0.47

URIC ACID, SYNOVIAL FLUID

Facility

$32.65

Service Code	HCPCS 84560
Hospital Charge Code	39900146
Hospital Revenue Code	301
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$13.82
Rate for Payer: Aetna Medicare Advantage	$16.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.34
Rate for Payer: Cigna Commercial	$16.32
Rate for Payer: Cigna Medicare Advantage	$5.08
Rate for Payer: Clover Medicare Advantage	$4.83
Rate for Payer: EmblemHealth Commercial	$15.24
Rate for Payer: Humana Medicare Advantage	$5.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.90
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.08
Rate for Payer: Wellcare Medicare Advantage	$5.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

URIC ACID, SYNOVIAL FLUID

Facility

$32.65

Service Code	HCPCS 84560
Hospital Charge Code	39900146
Hospital Revenue Code	301
Min. Negotiated Rate	$4.90
Max. Negotiated Rate	$4.90
Rate for Payer: Qualcare PPO/HMO/WC	$4.90

URIC ACID, SYNOVIAL FLUID

Facility

$63.25

Service Code	HCPCS 84560
Hospital Charge Code	3009733
Hospital Revenue Code	301
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$9.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

URIC ACID, SYNOVIAL FLUID

Facility

$63.25

Service Code	HCPCS 84560
Hospital Charge Code	3009733
Hospital Revenue Code	301
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$13.82
Rate for Payer: Aetna Medicare Advantage	$16.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.34
Rate for Payer: Cigna Commercial	$31.62
Rate for Payer: Cigna Medicare Advantage	$5.08
Rate for Payer: Clover Medicare Advantage	$4.83
Rate for Payer: EmblemHealth Commercial	$15.24
Rate for Payer: Humana Medicare Advantage	$5.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.08
Rate for Payer: Wellcare Medicare Advantage	$5.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.68

URIC ACID,URINE

Facility

$227.00

Service Code	HCPCS 84560
Hospital Charge Code	38472659
Hospital Revenue Code	301
Min. Negotiated Rate	$34.05
Max. Negotiated Rate	$34.05
Rate for Payer: Qualcare PPO/HMO/WC	$34.05

URIC ACID,URINE

Facility

$227.00

Service Code	HCPCS 84560
Hospital Charge Code	38472659
Hospital Revenue Code	301
Min. Negotiated Rate	$4.06
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$13.82
Rate for Payer: Aetna Medicare Advantage	$16.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.34
Rate for Payer: Cigna Commercial	$113.50
Rate for Payer: Cigna Medicare Advantage	$5.08
Rate for Payer: Clover Medicare Advantage	$4.83
Rate for Payer: EmblemHealth Commercial	$15.24
Rate for Payer: Humana Medicare Advantage	$5.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.08
Rate for Payer: Wellcare Medicare Advantage	$5.08
Rate for Payer: Wellpoint Medicaid Managed Care	$6.02

URIC ACID, URINE, RANDOM

Facility

$63.25

Service Code	HCPCS 84560
Hospital Charge Code	3032109
Hospital Revenue Code	301
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$13.82
Rate for Payer: Aetna Medicare Advantage	$16.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.34
Rate for Payer: Cigna Commercial	$31.62
Rate for Payer: Cigna Medicare Advantage	$5.08
Rate for Payer: Clover Medicare Advantage	$4.83
Rate for Payer: EmblemHealth Commercial	$15.24
Rate for Payer: Humana Medicare Advantage	$5.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.08
Rate for Payer: Wellcare Medicare Advantage	$5.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.68

URIC ACID, URINE, RANDOM

Facility

$63.25

Service Code	HCPCS 84560
Hospital Charge Code	3032109
Hospital Revenue Code	301
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$9.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

URINAL

Facility

$4.85

Hospital Charge Code	270302505
Hospital Revenue Code	270
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$0.73
Rate for Payer: Qualcare PPO/HMO/WC	$0.73

URINAL

Facility

$4.85

Hospital Charge Code	270302505
Hospital Revenue Code	270
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.42
Rate for Payer: Aetna Commercial	$1.84
Rate for Payer: Aetna Medicare Advantage	$1.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.24
Rate for Payer: Cigna Commercial	$2.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.73
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

URINAL MALE W/COVER

Facility

$1.32

Hospital Charge Code	270649244
Hospital Revenue Code	270
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.20

URINAL MALE W/COVER

Facility

$1.32

Hospital Charge Code	270649244
Hospital Revenue Code	270
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.66
Rate for Payer: Aetna Commercial	$0.50
Rate for Payer: Aetna Medicare Advantage	$0.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.34
Rate for Payer: Cigna Commercial	$0.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.40
Rate for Payer: Oxford Commercial	$0.26
Rate for Payer: Qualcare PPO/HMO/WC	$0.20
Rate for Payer: UnitedHealthcare Commercial	$0.26
Rate for Payer: UnitedHealthcare Community & State	$0.03
Rate for Payer: Wellpoint Medicaid Managed Care	$0.03

URINALYSIS, AUTO WITH MICRO

Facility

$462.00

Service Code	HCPCS 81001
Hospital Charge Code	38477033
Hospital Revenue Code	307
Min. Negotiated Rate	$69.30
Max. Negotiated Rate	$69.30
Rate for Payer: Qualcare PPO/HMO/WC	$69.30

URINALYSIS, AUTO WITH MICRO

Facility

$462.00

Service Code	HCPCS 81001
Hospital Charge Code	38477033
Hospital Revenue Code	307
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$231.00
Rate for Payer: Aetna Commercial	$8.62
Rate for Payer: Aetna Medicare Advantage	$10.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.44
Rate for Payer: Cigna Commercial	$231.00
Rate for Payer: Cigna Medicare Advantage	$3.17
Rate for Payer: Clover Medicare Advantage	$3.01
Rate for Payer: EmblemHealth Commercial	$9.51
Rate for Payer: Humana Medicare Advantage	$3.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.17
Rate for Payer: Wellcare Medicare Advantage	$3.17
Rate for Payer: Wellpoint Medicaid Managed Care	$12.24

URINALYSIS, AUTO W/O MICRO

Facility

$253.40

Service Code	HCPCS 81003
Hospital Charge Code	38477007
Hospital Revenue Code	307
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$126.70
Rate for Payer: Aetna Commercial	$6.12
Rate for Payer: Aetna Medicare Advantage	$7.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.12
Rate for Payer: Cigna Commercial	$126.70
Rate for Payer: Cigna Medicare Advantage	$2.25
Rate for Payer: Clover Medicare Advantage	$2.14
Rate for Payer: EmblemHealth Commercial	$6.75
Rate for Payer: Humana Medicare Advantage	$2.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.02
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.01
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.25
Rate for Payer: Wellcare Medicare Advantage	$2.25
Rate for Payer: Wellpoint Medicaid Managed Care	$6.72

URINALYSIS, AUTO W/O MICRO

Facility

$253.40

Service Code	HCPCS 81003
Hospital Charge Code	38477007
Hospital Revenue Code	307
Min. Negotiated Rate	$38.01
Max. Negotiated Rate	$38.01
Rate for Payer: Qualcare PPO/HMO/WC	$38.01

URINALYSIS COMPLETE*****

Facility

$1.32

Service Code	HCPCS 81000
Hospital Charge Code	9600031
Hospital Revenue Code	309
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.20

URINALYSIS COMPLETE*****

Facility

$1.32

Service Code	HCPCS 81000
Hospital Charge Code	9600031
Hospital Revenue Code	309
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$10.93
Rate for Payer: Aetna Medicare Advantage	$13.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.51
Rate for Payer: Cigna Commercial	$0.66
Rate for Payer: Cigna Medicare Advantage	$4.02
Rate for Payer: Clover Medicare Advantage	$3.82
Rate for Payer: EmblemHealth Commercial	$12.06
Rate for Payer: Humana Medicare Advantage	$4.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.02
Rate for Payer: Wellcare Medicare Advantage	$4.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.03

URINALYSIS DIP TEST

Facility

$16.00

Service Code	HCPCS 81002
Hospital Charge Code	3002681
Hospital Revenue Code	307
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$9.47
Rate for Payer: Aetna Medicare Advantage	$11.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.56
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: Cigna Medicare Advantage	$3.48
Rate for Payer: Clover Medicare Advantage	$3.31
Rate for Payer: EmblemHealth Commercial	$10.44
Rate for Payer: Humana Medicare Advantage	$3.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.48
Rate for Payer: Wellcare Medicare Advantage	$3.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

URINALYSIS DIP TEST

Facility

$16.00

Service Code	HCPCS 81002
Hospital Charge Code	3002681
Hospital Revenue Code	307
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

URINALYSIS, ROUTINE

Facility

$655.28

Service Code	HCPCS 81003
Hospital Charge Code	3002680
Hospital Revenue Code	307
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$327.64
Rate for Payer: Aetna Commercial	$6.12
Rate for Payer: Aetna Medicare Advantage	$7.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.12
Rate for Payer: Cigna Commercial	$327.64
Rate for Payer: Cigna Medicare Advantage	$2.25
Rate for Payer: Clover Medicare Advantage	$2.14
Rate for Payer: EmblemHealth Commercial	$6.75
Rate for Payer: Humana Medicare Advantage	$2.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.58
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.29
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.25
Rate for Payer: Wellcare Medicare Advantage	$2.25
Rate for Payer: Wellpoint Medicaid Managed Care	$17.36

URINALYSIS, ROUTINE

Facility

$655.28

Service Code	HCPCS 81003
Hospital Charge Code	3002680
Hospital Revenue Code	307
Min. Negotiated Rate	$98.29
Max. Negotiated Rate	$98.29
Rate for Payer: Qualcare PPO/HMO/WC	$98.29

URINARY DIVERSON*******

Facility

$140.00

Hospital Charge Code	8001349
Hospital Revenue Code	279
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

Know your out-of-pocket cost for care.

All Charges