Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BLASTOMYCES ANTIBODY

Facility

$148.00

Service Code	HCPCS 86612
Hospital Charge Code	38473069
Hospital Revenue Code	302
Min. Negotiated Rate	$22.20
Max. Negotiated Rate	$22.20
Rate for Payer: Qualcare PPO/HMO/WC	$22.20

BLD 4m RAD 12 CRV M4 1884012HR

Facility

$779.00

Hospital Charge Code	270640165
Hospital Revenue Code	272
Min. Negotiated Rate	$116.85
Max. Negotiated Rate	$116.85
Rate for Payer: Qualcare PPO/HMO/WC	$116.85

BLD 4m RAD 12 CRV M4 1884012HR

Facility

$779.00

Hospital Charge Code	270640165
Hospital Revenue Code	272
Min. Negotiated Rate	$18.77
Max. Negotiated Rate	$389.50
Rate for Payer: Aetna Commercial	$296.02
Rate for Payer: Aetna Medicare Advantage	$233.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.65
Rate for Payer: Cigna Commercial	$389.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.70
Rate for Payer: Oxford Commercial	$155.80
Rate for Payer: Qualcare PPO/HMO/WC	$116.85
Rate for Payer: UnitedHealthcare Commercial	$155.80
Rate for Payer: UnitedHealthcare Community & State	$18.77
Rate for Payer: Wellpoint Medicaid Managed Care	$20.64

BLD CT PLATELET AUTO

Facility

$390.00

Service Code	HCPCS 85049
Hospital Charge Code	401185049
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BLD CT PLATELET AUTO

Facility

$390.00

Service Code	HCPCS 85049
Hospital Charge Code	401185049
Hospital Revenue Code	300
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$12.19
Rate for Payer: Aetna Medicare Advantage	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.17
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.48
Rate for Payer: Clover Medicare Advantage	$4.26
Rate for Payer: EmblemHealth Commercial	$13.44
Rate for Payer: Humana Medicare Advantage	$4.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.48
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	$3.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.48
Rate for Payer: Wellcare Medicare Advantage	$4.48
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

BLD TYPE & RH***

Facility

$18.00

Hospital Charge Code	3010485
Hospital Revenue Code	309
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

BLD TYPE & RH***

Facility

$18.00

Hospital Charge Code	3010485
Hospital Revenue Code	309
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
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	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

BLD TYPE & RH***

Facility

$22.00

Service Code	HCPCS 86900
Hospital Charge Code	3000486
Hospital Revenue Code	309
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

BLD TYPE & RH***

Facility

$22.00

Service Code	HCPCS 86900
Hospital Charge Code	3000486
Hospital Revenue Code	309
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$8.13
Rate for Payer: Aetna Medicare Advantage	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.79
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$2.99
Rate for Payer: Clover Medicare Advantage	$2.84
Rate for Payer: EmblemHealth Commercial	$8.97
Rate for Payer: Humana Medicare Advantage	$3.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.99
Rate for Payer: Wellcare Medicare Advantage	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

BLD TYPE: RH PHENOTYPING

Facility

$159.00

Service Code	HCPCS 86906
Hospital Charge Code	38471074
Hospital Revenue Code	309
Min. Negotiated Rate	$23.85
Max. Negotiated Rate	$23.85
Rate for Payer: Qualcare PPO/HMO/WC	$23.85

BLD TYPE: RH PHENOTYPING

Facility

$159.00

Service Code	HCPCS 86906
Hospital Charge Code	38471074
Hospital Revenue Code	309
Min. Negotiated Rate	$3.87
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$21.08
Rate for Payer: Aetna Medicare Advantage	$25.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.98
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$7.75
Rate for Payer: Clover Medicare Advantage	$7.36
Rate for Payer: EmblemHealth Commercial	$23.25
Rate for Payer: Humana Medicare Advantage	$7.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.75
Rate for Payer: Wellcare Medicare Advantage	$7.75
Rate for Payer: Wellpoint Medicaid Managed Care	$4.21

BLEEDING TIME

Facility

$194.00

Service Code	HCPCS 85002
Hospital Charge Code	38478023
Hospital Revenue Code	301
Min. Negotiated Rate	$29.10
Max. Negotiated Rate	$29.10
Rate for Payer: Qualcare PPO/HMO/WC	$29.10

BLEEDING TIME

Facility

$194.00

Service Code	HCPCS 85002
Hospital Charge Code	38478023
Hospital Revenue Code	301
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$13.11
Rate for Payer: Aetna Medicare Advantage	$15.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.82
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	$17.40
Rate for Payer: Cigna Commercial	$97.00
Rate for Payer: Cigna Medicare Advantage	$4.82
Rate for Payer: Clover Medicare Advantage	$4.58
Rate for Payer: EmblemHealth Commercial	$14.46
Rate for Payer: Humana Medicare Advantage	$4.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.82
Rate for Payer: Wellcare Medicare Advantage	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.14

BLEEDING TIME (IVY)

Facility

$71.25

Service Code	HCPCS 85002
Hospital Charge Code	3002466
Hospital Revenue Code	301
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$10.69
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

BLEEDING TIME (IVY)

Facility

$71.25

Service Code	HCPCS 85002
Hospital Charge Code	3002466
Hospital Revenue Code	301
Min. Negotiated Rate	$1.89
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$13.11
Rate for Payer: Aetna Medicare Advantage	$15.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.82
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	$17.40
Rate for Payer: Cigna Commercial	$35.62
Rate for Payer: Cigna Medicare Advantage	$4.82
Rate for Payer: Clover Medicare Advantage	$4.58
Rate for Payer: EmblemHealth Commercial	$14.46
Rate for Payer: Humana Medicare Advantage	$4.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.82
Rate for Payer: Wellcare Medicare Advantage	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$1.89

BLENOXANE/15U

Facility

$991.00

Hospital Charge Code	60632571
Hospital Revenue Code	250
Min. Negotiated Rate	$23.88
Max. Negotiated Rate	$495.50
Rate for Payer: Aetna Commercial	$376.58
Rate for Payer: Aetna Medicare Advantage	$297.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.71
Rate for Payer: Cigna Commercial	$495.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$297.30
Rate for Payer: Oxford Commercial	$198.20
Rate for Payer: Qualcare PPO/HMO/WC	$148.65
Rate for Payer: UnitedHealthcare Commercial	$198.20
Rate for Payer: UnitedHealthcare Community & State	$23.88
Rate for Payer: Wellpoint Medicaid Managed Care	$26.26

BLENOXANE/15U

Facility

$991.00

Hospital Charge Code	60632571
Hospital Revenue Code	250
Min. Negotiated Rate	$148.65
Max. Negotiated Rate	$148.65
Rate for Payer: Qualcare PPO/HMO/WC	$148.65

BLEOMYCIN 15 UNITS INJ

Facility

$459.89

Service Code	HCPCS J9040
Hospital Charge Code	6000715
Hospital Revenue Code	636
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$229.94
Rate for Payer: Aetna Commercial	$174.76
Rate for Payer: Aetna Medicare Advantage	$137.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.27
Rate for Payer: Cigna Commercial	$229.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.29
Rate for Payer: Qualcare PPO/HMO/WC	$68.98
Rate for Payer: UnitedHealthcare Community & State	$11.08
Rate for Payer: Wellpoint Medicaid Managed Care	$12.19

BLEOMYCIN 15 UNITS INJ

Facility

$459.89

Service Code	HCPCS J9040
Hospital Charge Code	6000715
Hospital Revenue Code	636
Min. Negotiated Rate	$68.98
Max. Negotiated Rate	$111.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.29
Rate for Payer: Qualcare PPO/HMO/WC	$68.98

BLEPH-10 10% OPHTH/15ML

Facility

$65.00

Hospital Charge Code	60632572
Hospital Revenue Code	250
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

BLEPH-10 10% OPHTH/15ML

Facility

$65.00

Hospital Charge Code	60632572
Hospital Revenue Code	250
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$32.50
Rate for Payer: Aetna Commercial	$24.70
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$13.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$13.00
Rate for Payer: UnitedHealthcare Community & State	$1.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

BLEPH-10 10% OPHTH/5ML

Facility

$772.78

Service Code	NDC 11980001105
Hospital Charge Code	60632573
Hospital Revenue Code	250
Min. Negotiated Rate	$18.62
Max. Negotiated Rate	$386.39
Rate for Payer: Aetna Commercial	$293.66
Rate for Payer: Aetna Medicare Advantage	$231.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.06
Rate for Payer: Cigna Commercial	$386.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.83
Rate for Payer: Oxford Commercial	$154.56
Rate for Payer: Qualcare PPO/HMO/WC	$115.92
Rate for Payer: UnitedHealthcare Commercial	$154.56
Rate for Payer: UnitedHealthcare Community & State	$18.62
Rate for Payer: Wellpoint Medicaid Managed Care	$20.48

BLEPH-10 10% OPHTH/5ML

Facility

$772.78

Service Code	NDC 11980001105
Hospital Charge Code	60632573
Hospital Revenue Code	250
Min. Negotiated Rate	$115.92
Max. Negotiated Rate	$115.92
Rate for Payer: Qualcare PPO/HMO/WC	$115.92

BLEPH-10 OPHTH SOLU

Facility

$66.00

Hospital Charge Code	60635318
Hospital Revenue Code	250
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$25.08
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.80
Rate for Payer: Oxford Commercial	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$13.20
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

BLEPH-10 OPHTH SOLU

Facility

$66.00

Hospital Charge Code	60635318
Hospital Revenue Code	250
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

Know your out-of-pocket cost for care.

All Charges