Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BIT ZIM DR PIOLET 3.5 22533237

Facility

$920.00

Hospital Charge Code	270618078
Hospital Revenue Code	272
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$138.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

BIT ZIM DR PIOLET 3.7 22533337

Facility

$805.65

Hospital Charge Code	270618077
Hospital Revenue Code	272
Min. Negotiated Rate	$19.42
Max. Negotiated Rate	$402.82
Rate for Payer: Aetna Commercial	$306.15
Rate for Payer: Aetna Medicare Advantage	$241.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.44
Rate for Payer: Cigna Commercial	$402.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.69
Rate for Payer: Oxford Commercial	$161.13
Rate for Payer: Qualcare PPO/HMO/WC	$120.85
Rate for Payer: UnitedHealthcare Commercial	$161.13
Rate for Payer: UnitedHealthcare Community & State	$19.42
Rate for Payer: Wellpoint Medicaid Managed Care	$21.35

BIT ZIM DR PIOLET 3.7 22533337

Facility

$805.65

Hospital Charge Code	270618077
Hospital Revenue Code	272
Min. Negotiated Rate	$120.85
Max. Negotiated Rate	$120.85
Rate for Payer: Qualcare PPO/HMO/WC	$120.85

BIT ZIM DR QC 1.1MM 241011

Facility

$152.85

Hospital Charge Code	270601279
Hospital Revenue Code	272
Min. Negotiated Rate	$22.93
Max. Negotiated Rate	$22.93
Rate for Payer: Qualcare PPO/HMO/WC	$22.93

BIT ZIM DR QC 1.1MM 241011

Facility

$152.85

Hospital Charge Code	270601279
Hospital Revenue Code	272
Min. Negotiated Rate	$3.68
Max. Negotiated Rate	$76.42
Rate for Payer: Aetna Commercial	$58.08
Rate for Payer: Aetna Medicare Advantage	$45.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.98
Rate for Payer: Cigna Commercial	$76.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.85
Rate for Payer: Oxford Commercial	$30.57
Rate for Payer: Qualcare PPO/HMO/WC	$22.93
Rate for Payer: UnitedHealthcare Commercial	$30.57
Rate for Payer: UnitedHealthcare Community & State	$3.68
Rate for Payer: Wellpoint Medicaid Managed Care	$4.05

BIT ZIM DR QC 1.5MM 241015

Facility

$152.85

Hospital Charge Code	270610159
Hospital Revenue Code	272
Min. Negotiated Rate	$3.68
Max. Negotiated Rate	$76.42
Rate for Payer: Aetna Commercial	$58.08
Rate for Payer: Aetna Medicare Advantage	$45.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.98
Rate for Payer: Cigna Commercial	$76.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.85
Rate for Payer: Oxford Commercial	$30.57
Rate for Payer: Qualcare PPO/HMO/WC	$22.93
Rate for Payer: UnitedHealthcare Commercial	$30.57
Rate for Payer: UnitedHealthcare Community & State	$3.68
Rate for Payer: Wellpoint Medicaid Managed Care	$4.05

BIT ZIM DR QC 1.5MM 241015

Facility

$152.85

Hospital Charge Code	270610159
Hospital Revenue Code	272
Min. Negotiated Rate	$22.93
Max. Negotiated Rate	$22.93
Rate for Payer: Qualcare PPO/HMO/WC	$22.93

BIT ZIM DR QC 2.5MM 241025

Facility

$299.25

Hospital Charge Code	270601276
Hospital Revenue Code	272
Min. Negotiated Rate	$44.89
Max. Negotiated Rate	$44.89
Rate for Payer: Qualcare PPO/HMO/WC	$44.89

BIT ZIM DR QC 2.5MM 241025

Facility

$299.25

Hospital Charge Code	270601276
Hospital Revenue Code	272
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$149.62
Rate for Payer: Aetna Commercial	$113.72
Rate for Payer: Aetna Medicare Advantage	$89.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.31
Rate for Payer: Cigna Commercial	$149.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.78
Rate for Payer: Oxford Commercial	$59.85
Rate for Payer: Qualcare PPO/HMO/WC	$44.89
Rate for Payer: UnitedHealthcare Commercial	$59.85
Rate for Payer: UnitedHealthcare Community & State	$7.21
Rate for Payer: Wellpoint Medicaid Managed Care	$7.93

BIT ZIM DR QC 3.5/195MM 241036

Facility

$224.00

Hospital Charge Code	270620811
Hospital Revenue Code	272
Min. Negotiated Rate	$33.60
Max. Negotiated Rate	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$33.60

BIT ZIM DR QC 3.5/195MM 241036

Facility

$224.00

Hospital Charge Code	270620811
Hospital Revenue Code	272
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$112.00
Rate for Payer: Aetna Commercial	$85.12
Rate for Payer: Aetna Medicare Advantage	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.12
Rate for Payer: Cigna Commercial	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: Oxford Commercial	$44.80
Rate for Payer: Qualcare PPO/HMO/WC	$33.60
Rate for Payer: UnitedHealthcare Commercial	$44.80
Rate for Payer: UnitedHealthcare Community & State	$5.40
Rate for Payer: Wellpoint Medicaid Managed Care	$5.94

BIT ZIM DR QC 3.5MM 241035

Facility

$256.00

Hospital Charge Code	270601278
Hospital Revenue Code	272
Min. Negotiated Rate	$6.17
Max. Negotiated Rate	$128.00
Rate for Payer: Aetna Commercial	$97.28
Rate for Payer: Aetna Medicare Advantage	$76.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.28
Rate for Payer: Cigna Commercial	$128.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.80
Rate for Payer: Oxford Commercial	$51.20
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$51.20
Rate for Payer: UnitedHealthcare Community & State	$6.17
Rate for Payer: Wellpoint Medicaid Managed Care	$6.78

BIT ZIM DR QC 3.5MM 241035

Facility

$256.00

Hospital Charge Code	270601278
Hospital Revenue Code	272
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

BIT ZIM DR QC 4.5/145MM 241045

Facility

$248.85

Hospital Charge Code	270605981
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$124.42
Rate for Payer: Aetna Commercial	$94.56
Rate for Payer: Aetna Medicare Advantage	$74.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.46
Rate for Payer: Cigna Commercial	$124.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.66
Rate for Payer: Oxford Commercial	$49.77
Rate for Payer: Qualcare PPO/HMO/WC	$37.33
Rate for Payer: UnitedHealthcare Commercial	$49.77
Rate for Payer: UnitedHealthcare Community & State	$6.00
Rate for Payer: Wellpoint Medicaid Managed Care	$6.59

BIT ZIM DR QC 4.5/145MM 241045

Facility

$248.85

Hospital Charge Code	270605981
Hospital Revenue Code	272
Min. Negotiated Rate	$37.33
Max. Negotiated Rate	$37.33
Rate for Payer: Qualcare PPO/HMO/WC	$37.33

BK/JC VIRUS DNA,QL PCR I

Facility

$390.00

Service Code	HCPCS 8779891
Hospital Charge Code	39990118A
Hospital Revenue Code	306
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

BK/JC VIRUS DNA,QL PCR I

Facility

$390.00

Service Code	HCPCS 8779891
Hospital Charge Code	39990118A
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BK/JC VIRUS DNA,QL PCR II

Facility

$390.00

Service Code	HCPCS 8779891
Hospital Charge Code	39990118B
Hospital Revenue Code	306
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

BK/JC VIRUS DNA,QL PCR II

Facility

$390.00

Service Code	HCPCS 8779891
Hospital Charge Code	39990118B
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BK VIRUS DNA,QL RT-PCR,PL

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	39900404
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BK VIRUS DNA,QL RT-PCR,PL

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	39900404
Hospital Revenue Code	306
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.66
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
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	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

BK VIRUS DNA,QN,RT-PCR

Facility

$390.00

Service Code	HCPCS 87799
Hospital Charge Code	39900306
Hospital Revenue Code	306
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$116.52
Rate for Payer: Aetna Medicare Advantage	$138.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.64
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$42.84
Rate for Payer: Clover Medicare Advantage	$40.70
Rate for Payer: EmblemHealth Commercial	$128.52
Rate for Payer: Humana Medicare Advantage	$44.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42.84
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	$34.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84
Rate for Payer: Wellcare Medicare Advantage	$42.84
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

BK VIRUS DNA,QN,RT-PCR

Facility

$390.00

Service Code	HCPCS 87799
Hospital Charge Code	39900306
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BLADDER INSTILLATION

Facility

$1,252.20

Service Code	HCPCS 51720
Hospital Charge Code	93500001
Hospital Revenue Code	761
Min. Negotiated Rate	$30.18
Max. Negotiated Rate	$2,990.31
Rate for Payer: Aetna Commercial	$2,253.28
Rate for Payer: Aetna Medicare Advantage	$2,684.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,990.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,990.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$828.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,990.31
Rate for Payer: Cigna Commercial	$1,660.53
Rate for Payer: Cigna Medicare Advantage	$828.41
Rate for Payer: Clover Medicare Advantage	$786.99
Rate for Payer: EmblemHealth Commercial	$2,485.23
Rate for Payer: Humana Medicare Advantage	$853.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$828.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.66
Rate for Payer: Oxford Commercial	$250.44
Rate for Payer: Qualcare PPO/HMO/WC	$187.83
Rate for Payer: UnitedHealthcare Commercial	$250.44
Rate for Payer: UnitedHealthcare Community & State	$30.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$828.41
Rate for Payer: Wellcare Medicare Advantage	$828.41
Rate for Payer: Wellpoint Medicaid Managed Care	$33.18

BLADDER INSTILLATION

Facility

$1,252.20

Service Code	HCPCS 51720
Hospital Charge Code	93500001
Hospital Revenue Code	761
Min. Negotiated Rate	$187.83
Max. Negotiated Rate	$187.83
Rate for Payer: Qualcare PPO/HMO/WC	$187.83

Know your out-of-pocket cost for care.

All Charges