Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

URINARY DIVERSON*******

Facility

$140.00

Hospital Charge Code	8001349
Hospital Revenue Code	279
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$70.00
Rate for Payer: Aetna Commercial	$53.20
Rate for Payer: Aetna Medicare Advantage	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.70
Rate for Payer: Cigna Commercial	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.00
Rate for Payer: Oxford Commercial	$28.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00
Rate for Payer: UnitedHealthcare Commercial	$28.00
Rate for Payer: UnitedHealthcare Community & State	$3.37
Rate for Payer: Wellpoint Medicaid Managed Care	$3.71

URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$6,351.65

Service Code	APR-DRG 4651
Min. Negotiated Rate	$6,227.11
Max. Negotiated Rate	$6,351.65
Rate for Payer: UnitedHealthcare Community & State	$6,227.11
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,351.65
Rate for Payer: Wellpoint Medicaid Managed Care	$6,227.11

URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$7,644.90

Service Code	APR-DRG 4652
Min. Negotiated Rate	$7,495.00
Max. Negotiated Rate	$7,644.90
Rate for Payer: UnitedHealthcare Community & State	$7,495.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,644.90
Rate for Payer: Wellpoint Medicaid Managed Care	$7,495.00

URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$21,278.93

Service Code	APR-DRG 4654
Min. Negotiated Rate	$20,861.70
Max. Negotiated Rate	$21,278.93
Rate for Payer: UnitedHealthcare Community & State	$20,861.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,278.93
Rate for Payer: Wellpoint Medicaid Managed Care	$20,861.70

URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$12,633.02

Service Code	APR-DRG 4653
Min. Negotiated Rate	$12,385.31
Max. Negotiated Rate	$12,633.02
Rate for Payer: UnitedHealthcare Community & State	$12,385.31
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,633.02
Rate for Payer: Wellpoint Medicaid Managed Care	$12,385.31

URINARY STONES WITH MCC

Facility

$45,590.53

Service Code	MSDRG 693
Min. Negotiated Rate	$13,881.73
Max. Negotiated Rate	$45,590.53
Rate for Payer: Aetna Commercial	$31,583.21
Rate for Payer: Aetna Medicare Advantage	$45,590.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,030.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,030.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,612.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33,030.62
Rate for Payer: Cigna Commercial	$25,160.97
Rate for Payer: Cigna Medicare Advantage	$14,612.35
Rate for Payer: Clover Medicare Advantage	$13,881.73
Rate for Payer: EmblemHealth Commercial	$43,837.05
Rate for Payer: Humana Medicare Advantage	$15,050.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,612.35
Rate for Payer: Oxford Commercial	$18,083.53
Rate for Payer: UnitedHealthcare Commercial	$31,710.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,612.35
Rate for Payer: Wellcare Medicare Advantage	$14,612.35

URINARY STONES WITHOUT MCC

Facility

$27,399.87

Service Code	MSDRG 694
Min. Negotiated Rate	$8,342.91
Max. Negotiated Rate	$27,399.87
Rate for Payer: Aetna Commercial	$19,084.16
Rate for Payer: Aetna Medicare Advantage	$27,399.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18,143.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18,143.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,782.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18,143.58
Rate for Payer: Cigna Commercial	$14,628.73
Rate for Payer: Cigna Medicare Advantage	$8,782.01
Rate for Payer: Clover Medicare Advantage	$8,342.91
Rate for Payer: EmblemHealth Commercial	$26,346.03
Rate for Payer: Humana Medicare Advantage	$9,045.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,782.01
Rate for Payer: Oxford Commercial	$10,513.86
Rate for Payer: UnitedHealthcare Commercial	$18,436.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,782.01
Rate for Payer: Wellcare Medicare Advantage	$8,782.01

URINE COLLECTION FEE

Facility

$120.00

Service Code	HCPCS 81002
Hospital Charge Code	3008607
Hospital Revenue Code	300
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

URINE COLLECTION FEE

Facility

$120.00

Service Code	HCPCS 81002
Hospital Charge Code	3008607
Hospital Revenue Code	300
Min. Negotiated Rate	$1.94
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	$60.00
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	$36.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
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	$3.18

URINE CULTURE

Facility

$305.20

Service Code	HCPCS 87086
Hospital Charge Code	38475020
Hospital Revenue Code	306
Min. Negotiated Rate	$45.78
Max. Negotiated Rate	$45.78
Rate for Payer: Qualcare PPO/HMO/WC	$45.78

URINE CULTURE

Facility

$305.20

Service Code	HCPCS 87086
Hospital Charge Code	38475020
Hospital Revenue Code	306
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$152.60
Rate for Payer: Aetna Commercial	$21.95
Rate for Payer: Aetna Medicare Advantage	$26.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.13
Rate for Payer: Cigna Commercial	$152.60
Rate for Payer: Cigna Medicare Advantage	$8.07
Rate for Payer: Clover Medicare Advantage	$7.67
Rate for Payer: EmblemHealth Commercial	$24.21
Rate for Payer: Humana Medicare Advantage	$8.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.56
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.78
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.07
Rate for Payer: Wellcare Medicare Advantage	$8.07
Rate for Payer: Wellpoint Medicaid Managed Care	$8.09

URINE CYTOLOGY

Facility

$264.85

Service Code	HCPCS 88104
Hospital Charge Code	3005350
Hospital Revenue Code	311
Min. Negotiated Rate	$7.02
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$120.69
Rate for Payer: Aetna Medicare Advantage	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.16
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$44.37
Rate for Payer: Clover Medicare Advantage	$42.15
Rate for Payer: EmblemHealth Commercial	$133.11
Rate for Payer: Humana Medicare Advantage	$45.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.73
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$61.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.37
Rate for Payer: Wellcare Medicare Advantage	$44.37
Rate for Payer: Wellpoint Medicaid Managed Care	$7.02

URINE CYTOLOGY

Facility

$264.85

Service Code	HCPCS 88104
Hospital Charge Code	3005350
Hospital Revenue Code	311
Min. Negotiated Rate	$39.73
Max. Negotiated Rate	$39.73
Rate for Payer: Qualcare PPO/HMO/WC	$39.73

URINE DIP STICK

Facility

$390.00

Service Code	HCPCS 81002
Hospital Charge Code	5780265
Hospital Revenue Code	307
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$195.00
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	$195.00
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	$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	$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	$10.34

URINE DIP STICK

Facility

$390.00

Service Code	HCPCS 81002
Hospital Charge Code	5780265
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

URINE DIPSTICK, NON-AUTOM W MI

Facility

$24.85

Service Code	HCPCS 81000
Hospital Charge Code	2500368
Hospital Revenue Code	307
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

URINE DIPSTICK, NON-AUTOM W MI

Facility

$24.85

Service Code	HCPCS 81000
Hospital Charge Code	2500368
Hospital Revenue Code	307
Min. Negotiated Rate	$0.66
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	$12.43
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	$7.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
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	$0.66

URINE DRUG SCR COLLECTION FEE

Facility

$20.00

Hospital Charge Code	3000347
Hospital Revenue Code	301
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

URINE DRUG SCR COLLECTION FEE

Facility

$20.00

Hospital Charge Code	3000347
Hospital Revenue Code	301
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$7.60
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

URINE DRUG SCRN-COC-CHAIN STDY

Facility

$79.00

Hospital Charge Code	3010311
Hospital Revenue Code	301
Min. Negotiated Rate	$11.85
Max. Negotiated Rate	$11.85
Rate for Payer: Qualcare PPO/HMO/WC	$11.85

URINE DRUG SCRN-COC-CHAIN STDY

Facility

$79.00

Hospital Charge Code	3010311
Hospital Revenue Code	301
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$30.02
Rate for Payer: Aetna Medicare Advantage	$23.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.14
Rate for Payer: Cigna Commercial	$39.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.90
Rate for Payer: Wellpoint Medicaid Managed Care	$2.09

URINE METER

Facility

$38.62

Hospital Charge Code	270649245
Hospital Revenue Code	272
Min. Negotiated Rate	$5.79
Max. Negotiated Rate	$5.79
Rate for Payer: Qualcare PPO/HMO/WC	$5.79

URINE METER

Facility

$38.62

Hospital Charge Code	270649245
Hospital Revenue Code	272
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$19.31
Rate for Payer: Aetna Commercial	$14.68
Rate for Payer: Aetna Medicare Advantage	$11.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.85
Rate for Payer: Cigna Commercial	$19.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.59
Rate for Payer: Oxford Commercial	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$5.79
Rate for Payer: UnitedHealthcare Commercial	$7.72
Rate for Payer: UnitedHealthcare Community & State	$0.93
Rate for Payer: Wellpoint Medicaid Managed Care	$1.02

URINE NIDA DRUG TEST***

Facility

$82.00

Hospital Charge Code	3010345
Hospital Revenue Code	301
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$12.30
Rate for Payer: Qualcare PPO/HMO/WC	$12.30

URINE NIDA DRUG TEST***

Facility

$82.00

Hospital Charge Code	3010345
Hospital Revenue Code	301
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$31.16
Rate for Payer: Aetna Medicare Advantage	$24.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.91
Rate for Payer: Cigna Commercial	$41.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.98
Rate for Payer: Wellpoint Medicaid Managed Care	$2.17

Know your out-of-pocket cost for care.

All Charges