Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BLOCK TIB FULL AUG TIB 67MM

Facility

$5,550.00

Service Code	HCPCS C1776
Hospital Charge Code	270694499
Hospital Revenue Code	278
Min. Negotiated Rate	$133.75
Max. Negotiated Rate	$2,775.00
Rate for Payer: Aetna Commercial	$2,109.00
Rate for Payer: Aetna Medicare Advantage	$1,665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,415.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,415.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,415.25
Rate for Payer: Cigna Commercial	$2,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,343.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,221.00
Rate for Payer: Qualcare PPO/HMO/WC	$832.50
Rate for Payer: UnitedHealthcare Community & State	$133.75
Rate for Payer: Wellpoint Medicaid Managed Care	$147.07

BLOCK TRI-CORTICAL 3.0-3.9CM

Facility

$4,125.00

Hospital Charge Code	270677704
Hospital Revenue Code	272
Min. Negotiated Rate	$618.75
Max. Negotiated Rate	$618.75
Rate for Payer: Qualcare PPO/HMO/WC	$618.75

BLOCK TRI-CORTICAL 3.0-3.9CM

Facility

$4,125.00

Hospital Charge Code	270677704
Hospital Revenue Code	272
Min. Negotiated Rate	$99.41
Max. Negotiated Rate	$2,062.50
Rate for Payer: Aetna Commercial	$1,567.50
Rate for Payer: Aetna Medicare Advantage	$1,237.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,051.88
Rate for Payer: Cigna Commercial	$2,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,237.50
Rate for Payer: Oxford Commercial	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$618.75
Rate for Payer: UnitedHealthcare Commercial	$825.00
Rate for Payer: UnitedHealthcare Community & State	$99.41
Rate for Payer: Wellpoint Medicaid Managed Care	$109.31

BLOCK ZIM 13/15 20 7871-01-20

Facility

$1,656.85

Hospital Charge Code	270622362
Hospital Revenue Code	278
Min. Negotiated Rate	$39.93
Max. Negotiated Rate	$828.42
Rate for Payer: Aetna Commercial	$629.60
Rate for Payer: Aetna Medicare Advantage	$497.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$331.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$422.50
Rate for Payer: Cigna Commercial	$828.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$400.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$364.51
Rate for Payer: Qualcare PPO/HMO/WC	$248.53
Rate for Payer: UnitedHealthcare Community & State	$39.93
Rate for Payer: Wellpoint Medicaid Managed Care	$43.91

BLOCK ZIM 13/15 20 7871-01-20

Facility

$1,656.85

Hospital Charge Code	270622362
Hospital Revenue Code	278
Min. Negotiated Rate	$248.53
Max. Negotiated Rate	$400.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$331.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$400.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$364.51
Rate for Payer: Qualcare PPO/HMO/WC	$248.53

BLOOD - ADM

Facility

$20.00

Hospital Charge Code	3200011
Hospital Revenue Code	391
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

BLOOD - ADM

Facility

$20.00

Hospital Charge Code	3200011
Hospital Revenue Code	391
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$7.60
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.00
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

BLOOD ADMIN/TRANSF (NSG DEPT)

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	38471065
Hospital Revenue Code	391
Min. Negotiated Rate	$33.83
Max. Negotiated Rate	$1,891.95
Rate for Payer: Aetna Commercial	$1,425.63
Rate for Payer: Aetna Medicare Advantage	$1,698.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,891.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,891.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$524.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,891.95
Rate for Payer: Cigna Commercial	$1,050.61
Rate for Payer: Cigna Medicare Advantage	$524.13
Rate for Payer: Clover Medicare Advantage	$497.92
Rate for Payer: EmblemHealth Commercial	$1,572.39
Rate for Payer: Humana Medicare Advantage	$539.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$524.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.12
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.56
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$33.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$524.13
Rate for Payer: Wellcare Medicare Advantage	$524.13
Rate for Payer: Wellpoint Medicaid Managed Care	$37.20

BLOOD ADMIN/TRANSF (NSG DEPT)

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	38471065
Hospital Revenue Code	391
Min. Negotiated Rate	$210.56
Max. Negotiated Rate	$210.56
Rate for Payer: Qualcare PPO/HMO/WC	$210.56

BLOOD/CLOT PATCH, LUMB EPI INJ

Facility

$3,450.90

Hospital Charge Code	93082086
Hospital Revenue Code	361
Min. Negotiated Rate	$517.63
Max. Negotiated Rate	$517.63
Rate for Payer: Qualcare PPO/HMO/WC	$517.63

BLOOD/CLOT PATCH, LUMB EPI INJ

Facility

$3,450.90

Hospital Charge Code	93082086
Hospital Revenue Code	361
Min. Negotiated Rate	$83.17
Max. Negotiated Rate	$1,725.45
Rate for Payer: Aetna Commercial	$1,311.34
Rate for Payer: Aetna Medicare Advantage	$1,035.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$879.98
Rate for Payer: Cigna Commercial	$1,725.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,035.27
Rate for Payer: Qualcare PPO/HMO/WC	$517.63
Rate for Payer: UnitedHealthcare Community & State	$83.17
Rate for Payer: Wellpoint Medicaid Managed Care	$91.45

BLOOD/CLOT PATCH, LUMB EPI INJ

Facility

$3,107.20

Service Code	HCPCS 62273
Hospital Charge Code	84506010
Hospital Revenue Code	361
Min. Negotiated Rate	$466.08
Max. Negotiated Rate	$466.08
Rate for Payer: Qualcare PPO/HMO/WC	$466.08

BLOOD/CLOT PATCH, LUMB EPI INJ

Facility

$3,107.20

Service Code	HCPCS 62273
Hospital Charge Code	84506010
Hospital Revenue Code	361
Min. Negotiated Rate	$74.88
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,281.02
Rate for Payer: Aetna Medicare Advantage	$2,717.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$838.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,027.13
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: Cigna Medicare Advantage	$838.61
Rate for Payer: Clover Medicare Advantage	$796.68
Rate for Payer: EmblemHealth Commercial	$2,515.83
Rate for Payer: Humana Medicare Advantage	$863.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$838.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$932.16
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$466.08
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$74.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$82.34

BLOOD COLLECTION 25 SAFTY LOC

Facility

$4.20

Hospital Charge Code	270651617
Hospital Revenue Code	272
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.10
Rate for Payer: Aetna Commercial	$1.60
Rate for Payer: Aetna Medicare Advantage	$1.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.07
Rate for Payer: Cigna Commercial	$2.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.26
Rate for Payer: Oxford Commercial	$0.84
Rate for Payer: Qualcare PPO/HMO/WC	$0.63
Rate for Payer: UnitedHealthcare Commercial	$0.84
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

BLOOD COLLECTION 25 SAFTY LOC

Facility

$4.20

Hospital Charge Code	270651617
Hospital Revenue Code	272
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$0.63
Rate for Payer: Qualcare PPO/HMO/WC	$0.63

BLOOD COLLECTION KIT

Facility

$195.00

Hospital Charge Code	270653930
Hospital Revenue Code	272
Min. Negotiated Rate	$4.70
Max. Negotiated Rate	$97.50
Rate for Payer: Aetna Commercial	$74.10
Rate for Payer: Aetna Medicare Advantage	$58.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.73
Rate for Payer: Cigna Commercial	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Oxford Commercial	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.25
Rate for Payer: UnitedHealthcare Commercial	$39.00
Rate for Payer: UnitedHealthcare Community & State	$4.70
Rate for Payer: Wellpoint Medicaid Managed Care	$5.17

BLOOD COLLECTION KIT

Facility

$195.00

Hospital Charge Code	270653930
Hospital Revenue Code	272
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$29.25
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

BLOOD COLLECTION SET *****

Facility

$10.00

Hospital Charge Code	7000664
Hospital Revenue Code	279
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$3.80
Rate for Payer: Aetna Medicare Advantage	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.55
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.00
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$2.00
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

BLOOD COLLECTION SET *****

Facility

$10.00

Hospital Charge Code	7000664
Hospital Revenue Code	279
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

BLOOD COLLECTION SET ANGEL WNG

Facility

$3.29

Hospital Charge Code	270649769
Hospital Revenue Code	270
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$0.49
Rate for Payer: Qualcare PPO/HMO/WC	$0.49

BLOOD COLLECTION SET ANGEL WNG

Facility

$3.29

Hospital Charge Code	270649769
Hospital Revenue Code	270
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$1.65
Rate for Payer: Aetna Commercial	$1.25
Rate for Payer: Aetna Medicare Advantage	$0.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.84
Rate for Payer: Cigna Commercial	$1.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.99
Rate for Payer: Oxford Commercial	$0.66
Rate for Payer: Qualcare PPO/HMO/WC	$0.49
Rate for Payer: UnitedHealthcare Commercial	$0.66
Rate for Payer: UnitedHealthcare Community & State	$0.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.09

BLOOD COLLECTION SET MALE ADPT

Facility

$4.53

Hospital Charge Code	270650195
Hospital Revenue Code	270
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$0.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.68

BLOOD COLLECTION SET MALE ADPT

Facility

$4.53

Hospital Charge Code	270650195
Hospital Revenue Code	270
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.27
Rate for Payer: Aetna Commercial	$1.72
Rate for Payer: Aetna Medicare Advantage	$1.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.16
Rate for Payer: Cigna Commercial	$2.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.36
Rate for Payer: Oxford Commercial	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.68
Rate for Payer: UnitedHealthcare Commercial	$0.91
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

BLOOD CONSERVATION SYSTEM

Facility

$2,715.38

Hospital Charge Code	27065822
Hospital Revenue Code	278
Min. Negotiated Rate	$407.31
Max. Negotiated Rate	$657.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$543.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$657.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$597.38
Rate for Payer: Qualcare PPO/HMO/WC	$407.31

BLOOD CONSERVATION SYSTEM

Facility

$835.63

Hospital Charge Code	270655822
Hospital Revenue Code	272
Min. Negotiated Rate	$20.14
Max. Negotiated Rate	$417.81
Rate for Payer: Aetna Commercial	$317.54
Rate for Payer: Aetna Medicare Advantage	$250.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$213.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$213.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$213.09
Rate for Payer: Cigna Commercial	$417.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.69
Rate for Payer: Oxford Commercial	$167.13
Rate for Payer: Qualcare PPO/HMO/WC	$125.34
Rate for Payer: UnitedHealthcare Commercial	$167.13
Rate for Payer: UnitedHealthcare Community & State	$20.14
Rate for Payer: Wellpoint Medicaid Managed Care	$22.14

Know your out-of-pocket cost for care.

All Charges