Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

URINE PREGNANCY TEST

Facility

$414.40

Service Code	HCPCS 81025
Hospital Charge Code	411081025
Hospital Revenue Code	300
Min. Negotiated Rate	$5.81
Max. Negotiated Rate	$207.20
Rate for Payer: Aetna Commercial	$23.42
Rate for Payer: Aetna Medicare Advantage	$27.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.61
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	$31.08
Rate for Payer: Cigna Commercial	$207.20
Rate for Payer: Cigna Medicare Advantage	$8.61
Rate for Payer: Clover Medicare Advantage	$8.18
Rate for Payer: EmblemHealth Commercial	$25.83
Rate for Payer: Humana Medicare Advantage	$8.87
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.16
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.61
Rate for Payer: Wellcare Medicare Advantage	$8.61
Rate for Payer: Wellpoint Medicaid Managed Care	$10.98

URINE PREGNANCY TEST

Facility

$414.40

Service Code	HCPCS 81025
Hospital Charge Code	411081025
Hospital Revenue Code	300
Min. Negotiated Rate	$62.16
Max. Negotiated Rate	$62.16
Rate for Payer: Qualcare PPO/HMO/WC	$62.16

URINE SPECIMEN COLLECTOR 24HR

Facility

$35.00

Hospital Charge Code	270331678
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$17.50
Rate for Payer: Aetna Commercial	$13.30
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.50
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$7.00
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

URINE SPECIMEN COLLECTOR 24HR

Facility

$35.00

Hospital Charge Code	270331678
Hospital Revenue Code	272
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

URINE STRIP

Facility

$3.20

Hospital Charge Code	60628756
Hospital Revenue Code	259
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$1.60
Rate for Payer: Aetna Commercial	$1.22
Rate for Payer: Aetna Medicare Advantage	$0.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.82
Rate for Payer: Cigna Commercial	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.96
Rate for Payer: Oxford Commercial	$0.64
Rate for Payer: Qualcare PPO/HMO/WC	$0.48
Rate for Payer: UnitedHealthcare Commercial	$0.64
Rate for Payer: UnitedHealthcare Community & State	$0.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

URINE STRIP

Facility

$3.20

Hospital Charge Code	60628756
Hospital Revenue Code	259
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

URINE TOTAL PROTEIN

Facility

$450.29

Service Code	HCPCS 84156
Hospital Charge Code	401084156
Hospital Revenue Code	301
Min. Negotiated Rate	$67.54
Max. Negotiated Rate	$67.54
Rate for Payer: Qualcare PPO/HMO/WC	$67.54

URINE TOTAL PROTEIN

Facility

$450.29

Service Code	HCPCS 84156
Hospital Charge Code	401084156
Hospital Revenue Code	301
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$225.15
Rate for Payer: Aetna Commercial	$9.98
Rate for Payer: Aetna Medicare Advantage	$11.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.25
Rate for Payer: Cigna Commercial	$225.15
Rate for Payer: Cigna Medicare Advantage	$3.67
Rate for Payer: Clover Medicare Advantage	$3.49
Rate for Payer: EmblemHealth Commercial	$11.01
Rate for Payer: Humana Medicare Advantage	$3.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.54
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.67
Rate for Payer: Wellcare Medicare Advantage	$3.67
Rate for Payer: Wellpoint Medicaid Managed Care	$11.93

URINE TOX AMPHETAMINE

Facility

$656.39

Service Code	HCPCS 80324
Hospital Charge Code	3038531A
Hospital Revenue Code	301
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$328.19
Rate for Payer: Aetna Commercial	$249.43
Rate for Payer: Aetna Medicare Advantage	$196.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.38
Rate for Payer: Cigna Commercial	$328.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.46
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$17.62
Rate for Payer: Wellpoint Medicaid Managed Care	$17.39

URINE TOX AMPHETAMINE

Facility

$656.39

Service Code	HCPCS 80324
Hospital Charge Code	3038531A
Hospital Revenue Code	301
Min. Negotiated Rate	$98.46
Max. Negotiated Rate	$98.46
Rate for Payer: Qualcare PPO/HMO/WC	$98.46

URINE TOX BARBITUATE

Facility

$656.39

Service Code	HCPCS 80345
Hospital Charge Code	3038531B
Hospital Revenue Code	301
Min. Negotiated Rate	$98.46
Max. Negotiated Rate	$98.46
Rate for Payer: Qualcare PPO/HMO/WC	$98.46

URINE TOX BARBITUATE

Facility

$656.39

Service Code	HCPCS 80345
Hospital Charge Code	3038531B
Hospital Revenue Code	301
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$328.19
Rate for Payer: Aetna Commercial	$249.43
Rate for Payer: Aetna Medicare Advantage	$196.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.38
Rate for Payer: Cigna Commercial	$328.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.46
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$17.39

URINE TOX BENZODIAZEPINE

Facility

$656.39

Service Code	HCPCS 80346
Hospital Charge Code	3038531I
Hospital Revenue Code	301
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$328.19
Rate for Payer: Aetna Commercial	$249.43
Rate for Payer: Aetna Medicare Advantage	$196.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.38
Rate for Payer: Cigna Commercial	$328.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.46
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$20.96
Rate for Payer: Wellpoint Medicaid Managed Care	$17.39

URINE TOX BENZODIAZEPINE

Facility

$656.39

Service Code	HCPCS 80346
Hospital Charge Code	3038531I
Hospital Revenue Code	301
Min. Negotiated Rate	$98.46
Max. Negotiated Rate	$98.46
Rate for Payer: Qualcare PPO/HMO/WC	$98.46

URINE TOX CANNABANOID NATURAL

Facility

$656.39

Service Code	HCPCS 80349
Hospital Charge Code	3038531C
Hospital Revenue Code	301
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$328.19
Rate for Payer: Aetna Commercial	$249.43
Rate for Payer: Aetna Medicare Advantage	$196.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.38
Rate for Payer: Cigna Commercial	$328.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.46
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$17.39

URINE TOX CANNABANOID NATURAL

Facility

$656.39

Service Code	HCPCS 80349
Hospital Charge Code	3038531C
Hospital Revenue Code	301
Min. Negotiated Rate	$98.46
Max. Negotiated Rate	$98.46
Rate for Payer: Qualcare PPO/HMO/WC	$98.46

URINE TOX COCAINE

Facility

$656.39

Service Code	HCPCS 80353
Hospital Charge Code	3038531D
Hospital Revenue Code	301
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$328.19
Rate for Payer: Aetna Commercial	$249.43
Rate for Payer: Aetna Medicare Advantage	$196.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.38
Rate for Payer: Cigna Commercial	$328.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.46
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$17.39

URINE TOX COCAINE

Facility

$656.39

Service Code	HCPCS 80353
Hospital Charge Code	3038531D
Hospital Revenue Code	301
Min. Negotiated Rate	$98.46
Max. Negotiated Rate	$98.46
Rate for Payer: Qualcare PPO/HMO/WC	$98.46

URINE TOX METHADONE

Facility

$656.39

Service Code	HCPCS 80358
Hospital Charge Code	3038531E
Hospital Revenue Code	301
Min. Negotiated Rate	$98.46
Max. Negotiated Rate	$98.46
Rate for Payer: Qualcare PPO/HMO/WC	$98.46

URINE TOX METHADONE

Facility

$656.39

Service Code	HCPCS 80358
Hospital Charge Code	3038531E
Hospital Revenue Code	301
Min. Negotiated Rate	$16.48
Max. Negotiated Rate	$328.19
Rate for Payer: Aetna Commercial	$249.43
Rate for Payer: Aetna Medicare Advantage	$196.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.38
Rate for Payer: Cigna Commercial	$328.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.46
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.48
Rate for Payer: Wellpoint Medicaid Managed Care	$17.39

URINE TOX OPIATES

Facility

$656.39

Service Code	HCPCS 80361
Hospital Charge Code	3038531F
Hospital Revenue Code	301
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$328.19
Rate for Payer: Aetna Commercial	$249.43
Rate for Payer: Aetna Medicare Advantage	$196.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.38
Rate for Payer: Cigna Commercial	$328.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.46
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$17.39

URINE TOX OPIATES

Facility

$656.39

Service Code	HCPCS 80361
Hospital Charge Code	3038531F
Hospital Revenue Code	301
Min. Negotiated Rate	$98.46
Max. Negotiated Rate	$98.46
Rate for Payer: Qualcare PPO/HMO/WC	$98.46

URINE TOX PCP

Facility

$656.39

Service Code	HCPCS 83992
Hospital Charge Code	3038531G
Hospital Revenue Code	301
Min. Negotiated Rate	$98.46
Max. Negotiated Rate	$98.46
Rate for Payer: Qualcare PPO/HMO/WC	$98.46

URINE TOX PCP

Facility

$656.39

Service Code	HCPCS 83992
Hospital Charge Code	3038531G
Hospital Revenue Code	301
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$328.19
Rate for Payer: Aetna Commercial	$249.43
Rate for Payer: Aetna Medicare Advantage	$196.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.38
Rate for Payer: Cigna Commercial	$328.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.46
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$18.00
Rate for Payer: Wellpoint Medicaid Managed Care	$17.39

URINLYSIS DIP STICK/TAB REAGEN

Facility

$18.00

Service Code	HCPCS 81002
Hospital Charge Code	38477015
Hospital Revenue Code	307
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

Know your out-of-pocket cost for care.

All Charges