Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

YANKAUER SUCTION TIP W/O TUBE

Facility

$1.60

Hospital Charge Code	270654175S
Hospital Revenue Code	270
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.24
Rate for Payer: Qualcare PPO/HMO/WC	$0.24

YANKAUER SUCTION TIP W/O TUBE

Facility

$1.60

Hospital Charge Code	270654175N
Hospital Revenue Code	270
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.80
Rate for Payer: Aetna Commercial	$0.61
Rate for Payer: Aetna Medicare Advantage	$0.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.41
Rate for Payer: Cigna Commercial	$0.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.48
Rate for Payer: Oxford Commercial	$0.32
Rate for Payer: Qualcare PPO/HMO/WC	$0.24
Rate for Payer: UnitedHealthcare Commercial	$0.32
Rate for Payer: UnitedHealthcare Community & State	$0.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.04

YANKAUER SUCTION TIP W/O TUBE

Facility

$1.60

Hospital Charge Code	270654175N
Hospital Revenue Code	270
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.24
Rate for Payer: Qualcare PPO/HMO/WC	$0.24

YANKAUER SUCTION TIP W/O TUBE

Facility

$1.60

Hospital Charge Code	270654175
Hospital Revenue Code	272
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.80
Rate for Payer: Aetna Commercial	$0.61
Rate for Payer: Aetna Medicare Advantage	$0.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.41
Rate for Payer: Cigna Commercial	$0.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.48
Rate for Payer: Oxford Commercial	$0.32
Rate for Payer: Qualcare PPO/HMO/WC	$0.24
Rate for Payer: UnitedHealthcare Commercial	$0.32
Rate for Payer: UnitedHealthcare Community & State	$0.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.04

YANKAUER SUCTION TIP W/O TUBE

Facility

$1.60

Hospital Charge Code	270654175S
Hospital Revenue Code	270
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.80
Rate for Payer: Aetna Commercial	$0.61
Rate for Payer: Aetna Medicare Advantage	$0.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.41
Rate for Payer: Cigna Commercial	$0.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.48
Rate for Payer: Oxford Commercial	$0.32
Rate for Payer: Qualcare PPO/HMO/WC	$0.24
Rate for Payer: UnitedHealthcare Commercial	$0.32
Rate for Payer: UnitedHealthcare Community & State	$0.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.04

YANKAUER SUCTION TIP W/O TUBE

Facility

$1.60

Hospital Charge Code	270654175
Hospital Revenue Code	272
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.24
Rate for Payer: Qualcare PPO/HMO/WC	$0.24

Y CHROMOSOME MICRODELETN

Facility

$2,375.00

Service Code	HCPCS 81403
Hospital Charge Code	39900029
Hospital Revenue Code	310
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$356.25
Rate for Payer: Qualcare PPO/HMO/WC	$356.25

Y CHROMOSOME MICRODELETN

Facility

$2,375.00

Service Code	HCPCS 81403
Hospital Charge Code	39900029
Hospital Revenue Code	310
Min. Negotiated Rate	$62.94
Max. Negotiated Rate	$1,187.50
Rate for Payer: Aetna Commercial	$503.74
Rate for Payer: Aetna Medicare Advantage	$600.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$668.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$668.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$185.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$668.52
Rate for Payer: Cigna Commercial	$1,187.50
Rate for Payer: Cigna Medicare Advantage	$185.20
Rate for Payer: Clover Medicare Advantage	$175.94
Rate for Payer: EmblemHealth Commercial	$555.60
Rate for Payer: Humana Medicare Advantage	$190.76
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$185.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$712.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$356.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$148.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$185.20
Rate for Payer: Wellcare Medicare Advantage	$185.20
Rate for Payer: Wellpoint Medicaid Managed Care	$62.94

YEAST ID

Facility

$390.00

Service Code	HCPCS 87106
Hospital Charge Code	39900266
Hospital Revenue Code	309
Min. Negotiated Rate	$8.26
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$28.07
Rate for Payer: Aetna Medicare Advantage	$33.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.25
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$10.32
Rate for Payer: Clover Medicare Advantage	$9.80
Rate for Payer: EmblemHealth Commercial	$30.96
Rate for Payer: Humana Medicare Advantage	$10.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.32
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	$8.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.32
Rate for Payer: Wellcare Medicare Advantage	$10.32
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

YEAST ID

Facility

$390.00

Service Code	HCPCS 87106
Hospital Charge Code	39900266
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

YELLOW JACKET IGE

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3035143
Hospital Revenue Code	305
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

YELLOW JACKET IGE

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3035143
Hospital Revenue Code	305
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

YERSINIA CULTURE, I

Facility

$64.85

Service Code	HCPCS 87046
Hospital Charge Code	39990051A
Hospital Revenue Code	309
Min. Negotiated Rate	$9.73
Max. Negotiated Rate	$9.73
Rate for Payer: Qualcare PPO/HMO/WC	$9.73

YERSINIA CULTURE, I

Facility

$64.85

Service Code	HCPCS 87046
Hospital Charge Code	39990051A
Hospital Revenue Code	309
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$25.68
Rate for Payer: Aetna Medicare Advantage	$30.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.08
Rate for Payer: Cigna Commercial	$32.42
Rate for Payer: Cigna Medicare Advantage	$9.44
Rate for Payer: Clover Medicare Advantage	$8.97
Rate for Payer: EmblemHealth Commercial	$28.32
Rate for Payer: Humana Medicare Advantage	$9.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.73
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.44
Rate for Payer: Wellcare Medicare Advantage	$9.44
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

YERSINIA CULTURE, II

Facility

$45.60

Service Code	HCPCS 87081
Hospital Charge Code	39990051B
Hospital Revenue Code	309
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$18.03
Rate for Payer: Aetna Medicare Advantage	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.93
Rate for Payer: Cigna Commercial	$22.80
Rate for Payer: Cigna Medicare Advantage	$6.63
Rate for Payer: Clover Medicare Advantage	$6.30
Rate for Payer: EmblemHealth Commercial	$19.89
Rate for Payer: Humana Medicare Advantage	$6.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.68
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.84
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.63
Rate for Payer: Wellcare Medicare Advantage	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$1.21

YERSINIA CULTURE, II

Facility

$45.60

Service Code	HCPCS 87081
Hospital Charge Code	39990051B
Hospital Revenue Code	309
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$6.84
Rate for Payer: Qualcare PPO/HMO/WC	$6.84

Y-MESH ALYTE

Facility

$4,590.00

Service Code	HCPCS C1763
Hospital Charge Code	270672887
Hospital Revenue Code	278
Min. Negotiated Rate	$110.62
Max. Negotiated Rate	$2,295.00
Rate for Payer: Aetna Commercial	$1,744.20
Rate for Payer: Aetna Medicare Advantage	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,170.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,170.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$918.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,170.45
Rate for Payer: Cigna Commercial	$2,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,110.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,009.80
Rate for Payer: Qualcare PPO/HMO/WC	$688.50
Rate for Payer: UnitedHealthcare Community & State	$110.62
Rate for Payer: Wellpoint Medicaid Managed Care	$121.64

Y-MESH ALYTE

Facility

$4,590.00

Service Code	HCPCS C1763
Hospital Charge Code	270672887
Hospital Revenue Code	278
Min. Negotiated Rate	$688.50
Max. Negotiated Rate	$1,110.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$918.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,110.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,009.80
Rate for Payer: Qualcare PPO/HMO/WC	$688.50

YO AB SCR W/REFL TITER,WB

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900367
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

YO AB SCR W/REFL TITER,WB

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900367
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
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	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

YO AUTOANTIBODY (ANTI-YO AB)SC

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3008364
Hospital Revenue Code	302
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

YO AUTOANTIBODY (ANTI-YO AB)SC

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3008364
Hospital Revenue Code	302
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

YOKE OSS REINFORCE

Facility

$5,685.00

Service Code	HCPCS C1776
Hospital Charge Code	270638566
Hospital Revenue Code	278
Min. Negotiated Rate	$137.01
Max. Negotiated Rate	$2,842.50
Rate for Payer: Aetna Commercial	$2,160.30
Rate for Payer: Aetna Medicare Advantage	$1,705.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,449.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,449.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,449.67
Rate for Payer: Cigna Commercial	$2,842.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,375.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,250.70
Rate for Payer: Qualcare PPO/HMO/WC	$852.75
Rate for Payer: UnitedHealthcare Community & State	$137.01
Rate for Payer: Wellpoint Medicaid Managed Care	$150.65

YOKE OSS REINFORCE

Facility

$5,685.00

Service Code	HCPCS C1776
Hospital Charge Code	270638566
Hospital Revenue Code	278
Min. Negotiated Rate	$852.75
Max. Negotiated Rate	$1,375.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,375.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,250.70
Rate for Payer: Qualcare PPO/HMO/WC	$852.75

Y-PLATE 1.5MM 3HOLE/8HOLE

Facility

$967.15

Service Code	HCPCS C1713
Hospital Charge Code	270654817
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

Know your out-of-pocket cost for care.

All Charges