Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

URINLYSIS DIP STICK/TAB REAGEN

Facility

$18.00

Service Code	HCPCS 81002
Hospital Charge Code	38477015
Hospital Revenue Code	307
Min. Negotiated Rate	$0.48
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	$9.00
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	$5.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
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	$0.48

URISED/TAB

Facility

$3.00

Hospital Charge Code	60634115
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

URISED/TAB

Facility

$3.00

Hospital Charge Code	60634115
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

URISPAS/100MG/TAB

Facility

$3.00

Hospital Charge Code	60634407
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

URISPAS/100MG/TAB

Facility

$3.00

Hospital Charge Code	60634407
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

UR MICROALBUMIN QNT

Facility

$390.00

Service Code	HCPCS 82043
Hospital Charge Code	3038548A
Hospital Revenue Code	307
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$15.72
Rate for Payer: Aetna Medicare Advantage	$18.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.86
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.78
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.78
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	$4.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.78
Rate for Payer: Wellcare Medicare Advantage	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

UR MICROALBUMIN QNT

Facility

$390.00

Service Code	HCPCS 82043
Hospital Charge Code	3038548A
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

UROBILINOGEN URINE

Facility

$118.00

Service Code	HCPCS 84580
Hospital Charge Code	38473127
Hospital Revenue Code	301
Min. Negotiated Rate	$17.70
Max. Negotiated Rate	$17.70
Rate for Payer: Qualcare PPO/HMO/WC	$17.70

UROBILINOGEN URINE

Facility

$118.00

Service Code	HCPCS 84580
Hospital Charge Code	38473127
Hospital Revenue Code	301
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$25.98
Rate for Payer: Aetna Medicare Advantage	$30.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.47
Rate for Payer: Cigna Commercial	$59.00
Rate for Payer: Cigna Medicare Advantage	$9.55
Rate for Payer: Clover Medicare Advantage	$9.07
Rate for Payer: EmblemHealth Commercial	$28.65
Rate for Payer: Humana Medicare Advantage	$9.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.55
Rate for Payer: Wellcare Medicare Advantage	$9.55
Rate for Payer: Wellpoint Medicaid Managed Care	$3.13

UROBILINOGEN (URINE QUAL)

Facility

$32.00

Service Code	HCPCS 84578
Hospital Charge Code	3002706
Hospital Revenue Code	301
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

UROBILINOGEN (URINE QUAL)

Facility

$32.00

Service Code	HCPCS 84578
Hospital Charge Code	3002706
Hospital Revenue Code	301
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.14
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: Cigna Medicare Advantage	$4.47
Rate for Payer: Clover Medicare Advantage	$4.25
Rate for Payer: EmblemHealth Commercial	$13.41
Rate for Payer: Humana Medicare Advantage	$4.60
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.47
Rate for Payer: Wellcare Medicare Advantage	$4.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

UROBILINOGEN,URINE,QUALITATIVE

Facility

$23.00

Service Code	HCPCS 84578
Hospital Charge Code	38477016
Hospital Revenue Code	301
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.14
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: Cigna Medicare Advantage	$4.47
Rate for Payer: Clover Medicare Advantage	$4.25
Rate for Payer: EmblemHealth Commercial	$13.41
Rate for Payer: Humana Medicare Advantage	$4.60
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.47
Rate for Payer: Wellcare Medicare Advantage	$4.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

UROBILINOGEN,URINE,QUALITATIVE

Facility

$23.00

Service Code	HCPCS 84578
Hospital Charge Code	38477016
Hospital Revenue Code	301
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

UROCULT

Facility

$14.00

Hospital Charge Code	270335184
Hospital Revenue Code	272
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

UROCULT

Facility

$14.00

Hospital Charge Code	270335184
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$7.00
Rate for Payer: Aetna Commercial	$5.32
Rate for Payer: Aetna Medicare Advantage	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.57
Rate for Payer: Cigna Commercial	$7.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.20
Rate for Payer: Oxford Commercial	$2.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$2.80
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

UROFORCE BALLOON 8MM X 6CM

Facility

$1,002.10

Service Code	HCPCS C1726
Hospital Charge Code	270682486
Hospital Revenue Code	278
Min. Negotiated Rate	$150.31
Max. Negotiated Rate	$242.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.46
Rate for Payer: Qualcare PPO/HMO/WC	$150.31

UROFORCE BALLOON 8MM X 6CM

Facility

$1,002.10

Service Code	HCPCS C1726
Hospital Charge Code	270682486
Hospital Revenue Code	278
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$501.05
Rate for Payer: Aetna Commercial	$380.80
Rate for Payer: Aetna Medicare Advantage	$300.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.54
Rate for Payer: Cigna Commercial	$501.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.46
Rate for Payer: Qualcare PPO/HMO/WC	$150.31
Rate for Payer: UnitedHealthcare Community & State	$24.15
Rate for Payer: Wellpoint Medicaid Managed Care	$26.56

UROKINASE 250,000 UNITS INJ

Facility

$2,692.10

Hospital Charge Code	60627541
Hospital Revenue Code	636
Min. Negotiated Rate	$64.88
Max. Negotiated Rate	$1,346.05
Rate for Payer: Aetna Commercial	$1,023.00
Rate for Payer: Aetna Medicare Advantage	$807.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$686.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$686.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$686.49
Rate for Payer: Cigna Commercial	$1,346.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$651.49
Rate for Payer: Qualcare PPO/HMO/WC	$403.81
Rate for Payer: UnitedHealthcare Community & State	$64.88
Rate for Payer: Wellpoint Medicaid Managed Care	$71.34

UROKINASE 250,000 UNITS INJ

Facility

$2,692.10

Hospital Charge Code	60627541
Hospital Revenue Code	636
Min. Negotiated Rate	$403.81
Max. Negotiated Rate	$651.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$651.49
Rate for Payer: Qualcare PPO/HMO/WC	$403.81

UROKINASE 5000 UNITS/ML INJ

Facility

$74.50

Hospital Charge Code	6008536
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$37.25
Rate for Payer: Aetna Commercial	$28.31
Rate for Payer: Aetna Medicare Advantage	$22.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.00
Rate for Payer: Cigna Commercial	$37.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.35
Rate for Payer: Oxford Commercial	$14.90
Rate for Payer: Qualcare PPO/HMO/WC	$11.18
Rate for Payer: UnitedHealthcare Commercial	$14.90
Rate for Payer: UnitedHealthcare Community & State	$1.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1.97

UROKINASE 5000 UNITS/ML INJ

Facility

$74.50

Hospital Charge Code	6008536
Hospital Revenue Code	250
Min. Negotiated Rate	$11.18
Max. Negotiated Rate	$11.18
Rate for Payer: Qualcare PPO/HMO/WC	$11.18

UROKINASE 500 IU

Facility

$255.00

Hospital Charge Code	60634775
Hospital Revenue Code	250
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$96.90
Rate for Payer: Aetna Medicare Advantage	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.03
Rate for Payer: Cigna Commercial	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.50
Rate for Payer: Oxford Commercial	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.25
Rate for Payer: UnitedHealthcare Commercial	$51.00
Rate for Payer: UnitedHealthcare Community & State	$6.15
Rate for Payer: Wellpoint Medicaid Managed Care	$6.76

UROKINASE 500 IU

Facility

$255.00

Hospital Charge Code	60634775
Hospital Revenue Code	250
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$38.25
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

UROKINASE INJ 250,000U 5ML

Facility

$3,025.95

Hospital Charge Code	6010201
Hospital Revenue Code	636
Min. Negotiated Rate	$453.89
Max. Negotiated Rate	$732.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.28
Rate for Payer: Qualcare PPO/HMO/WC	$453.89

UROKINASE INJ 250,000U 5ML

Facility

$3,025.95

Hospital Charge Code	6010201
Hospital Revenue Code	636
Min. Negotiated Rate	$72.93
Max. Negotiated Rate	$1,512.97
Rate for Payer: Aetna Commercial	$1,149.86
Rate for Payer: Aetna Medicare Advantage	$907.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$771.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$771.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$771.62
Rate for Payer: Cigna Commercial	$1,512.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.28
Rate for Payer: Qualcare PPO/HMO/WC	$453.89
Rate for Payer: UnitedHealthcare Community & State	$72.93
Rate for Payer: Wellpoint Medicaid Managed Care	$80.19

Know your out-of-pocket cost for care.

All Charges