Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BROMPHENIRAMINE-PPA TAB CR

Facility

$3.85

Hospital Charge Code	60627217
Hospital Revenue Code	251
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

BROMPHENIRAMINE-PPA TAB CR

Facility

$3.85

Hospital Charge Code	60627217
Hospital Revenue Code	251
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.46
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.16
Rate for Payer: Oxford Commercial	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$0.77
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

BROMPHEN PHENYL ELX 4OZ

Facility

$34.60

Hospital Charge Code	6000749
Hospital Revenue Code	251
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$5.19
Rate for Payer: Qualcare PPO/HMO/WC	$5.19

BROMPHEN PHENYL ELX 4OZ

Facility

$34.60

Hospital Charge Code	6000749
Hospital Revenue Code	251
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$17.30
Rate for Payer: Aetna Commercial	$13.15
Rate for Payer: Aetna Medicare Advantage	$10.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.82
Rate for Payer: Cigna Commercial	$17.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.38
Rate for Payer: Oxford Commercial	$6.92
Rate for Payer: Qualcare PPO/HMO/WC	$5.19
Rate for Payer: UnitedHealthcare Commercial	$6.92
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.92

BRONCH EMBUS SAMPLING 3/> NODE

Facility

$21,709.85

Service Code	HCPCS 31653
Hospital Charge Code	1600000448
Hospital Revenue Code	360
Min. Negotiated Rate	$523.21
Max. Negotiated Rate	$15,988.70
Rate for Payer: Aetna Commercial	$12,047.89
Rate for Payer: Aetna Medicare Advantage	$14,351.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,988.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,988.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,429.37
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	$15,988.70
Rate for Payer: Cigna Commercial	$8,878.66
Rate for Payer: Cigna Medicare Advantage	$4,429.37
Rate for Payer: Clover Medicare Advantage	$4,207.90
Rate for Payer: EmblemHealth Commercial	$13,288.11
Rate for Payer: Humana Medicare Advantage	$4,562.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,429.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,512.95
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,256.48
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$523.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,429.37
Rate for Payer: Wellcare Medicare Advantage	$4,429.37
Rate for Payer: Wellpoint Medicaid Managed Care	$575.31

BRONCH EMBUS SAMPLING 3/> NODE

Facility

$21,709.85

Service Code	HCPCS 31653
Hospital Charge Code	1600000448
Hospital Revenue Code	360
Min. Negotiated Rate	$3,256.48
Max. Negotiated Rate	$3,256.48
Rate for Payer: Qualcare PPO/HMO/WC	$3,256.48

BRONCHIOLITIS AND RSV PNEUMONIA

Facility

$19,688.14

Service Code	APR-DRG 1384
Min. Negotiated Rate	$19,302.10
Max. Negotiated Rate	$19,688.14
Rate for Payer: UnitedHealthcare Community & State	$19,302.10
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,688.14
Rate for Payer: Wellpoint Medicaid Managed Care	$19,302.10

BRONCHIOLITIS AND RSV PNEUMONIA

Facility

$3,573.49

Service Code	APR-DRG 1381
Min. Negotiated Rate	$3,503.42
Max. Negotiated Rate	$3,573.49
Rate for Payer: UnitedHealthcare Community & State	$3,503.42
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$3,573.49
Rate for Payer: Wellpoint Medicaid Managed Care	$3,503.42

BRONCHIOLITIS AND RSV PNEUMONIA

Facility

$5,203.86

Service Code	APR-DRG 1382
Min. Negotiated Rate	$5,101.82
Max. Negotiated Rate	$5,203.86
Rate for Payer: UnitedHealthcare Community & State	$5,101.82
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,203.86
Rate for Payer: Wellpoint Medicaid Managed Care	$5,101.82

BRONCHIOLITIS AND RSV PNEUMONIA

Facility

$8,317.73

Service Code	APR-DRG 1383
Min. Negotiated Rate	$8,154.64
Max. Negotiated Rate	$8,317.73
Rate for Payer: UnitedHealthcare Community & State	$8,154.64
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,317.73
Rate for Payer: Wellpoint Medicaid Managed Care	$8,154.64

BRONCHITIS AND ASTHMA WITH CC/MCC

Facility

$33,524.87

Service Code	MSDRG 202
Min. Negotiated Rate	$10,207.89
Max. Negotiated Rate	$33,524.87
Rate for Payer: Aetna Commercial	$23,292.74
Rate for Payer: Aetna Medicare Advantage	$33,524.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,330.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,330.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10,745.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,330.56
Rate for Payer: Cigna Commercial	$18,175.04
Rate for Payer: Cigna Medicare Advantage	$10,745.15
Rate for Payer: Clover Medicare Advantage	$10,207.89
Rate for Payer: EmblemHealth Commercial	$32,235.45
Rate for Payer: Humana Medicare Advantage	$11,067.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10,745.15
Rate for Payer: Oxford Commercial	$13,062.64
Rate for Payer: UnitedHealthcare Commercial	$22,905.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$10,745.15
Rate for Payer: Wellcare Medicare Advantage	$10,745.15

BRONCHITIS AND ASTHMA WITHOUT CC/MCC

Facility

$23,789.56

Service Code	MSDRG 203
Min. Negotiated Rate	$7,243.62
Max. Negotiated Rate	$23,789.56
Rate for Payer: Aetna Commercial	$16,603.47
Rate for Payer: Aetna Medicare Advantage	$23,789.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,050.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,050.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,624.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16,050.09
Rate for Payer: Cigna Commercial	$12,538.38
Rate for Payer: Cigna Medicare Advantage	$7,624.86
Rate for Payer: Clover Medicare Advantage	$7,243.62
Rate for Payer: EmblemHealth Commercial	$22,874.58
Rate for Payer: Humana Medicare Advantage	$7,853.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,624.86
Rate for Payer: Oxford Commercial	$9,011.50
Rate for Payer: UnitedHealthcare Commercial	$15,801.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,624.86
Rate for Payer: Wellcare Medicare Advantage	$7,624.86

BRONCHO CYTOLOGY BRUSH

Facility

$307.00

Hospital Charge Code	270331590
Hospital Revenue Code	272
Min. Negotiated Rate	$46.05
Max. Negotiated Rate	$46.05
Rate for Payer: Qualcare PPO/HMO/WC	$46.05

BRONCHO CYTOLOGY BRUSH

Facility

$307.00

Hospital Charge Code	270331590
Hospital Revenue Code	272
Min. Negotiated Rate	$7.40
Max. Negotiated Rate	$153.50
Rate for Payer: Aetna Commercial	$116.66
Rate for Payer: Aetna Medicare Advantage	$92.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.28
Rate for Payer: Cigna Commercial	$153.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.10
Rate for Payer: Oxford Commercial	$61.40
Rate for Payer: Qualcare PPO/HMO/WC	$46.05
Rate for Payer: UnitedHealthcare Commercial	$61.40
Rate for Payer: UnitedHealthcare Community & State	$7.40
Rate for Payer: Wellpoint Medicaid Managed Care	$8.14

BRONCHOSCOPE ASCOPE 4 LARGE

Facility

$7,850.00

Hospital Charge Code	270686017
Hospital Revenue Code	272
Min. Negotiated Rate	$189.19
Max. Negotiated Rate	$3,925.00
Rate for Payer: Aetna Commercial	$2,983.00
Rate for Payer: Aetna Medicare Advantage	$2,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,001.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,001.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,001.75
Rate for Payer: Cigna Commercial	$3,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,355.00
Rate for Payer: Oxford Commercial	$1,570.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,177.50
Rate for Payer: UnitedHealthcare Commercial	$1,570.00
Rate for Payer: UnitedHealthcare Community & State	$189.19
Rate for Payer: Wellpoint Medicaid Managed Care	$208.03

BRONCHOSCOPE ASCOPE 4 LARGE

Facility

$7,850.00

Hospital Charge Code	270686017
Hospital Revenue Code	272
Min. Negotiated Rate	$1,177.50
Max. Negotiated Rate	$1,177.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,177.50

BRONCHOSCOPE ASCOPE 4 REGULAR

Facility

$6,825.00

Hospital Charge Code	270686016
Hospital Revenue Code	272
Min. Negotiated Rate	$1,023.75
Max. Negotiated Rate	$1,023.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.75

BRONCHOSCOPE ASCOPE 4 REGULAR

Facility

$6,825.00

Hospital Charge Code	270686016
Hospital Revenue Code	272
Min. Negotiated Rate	$164.48
Max. Negotiated Rate	$3,412.50
Rate for Payer: Aetna Commercial	$2,593.50
Rate for Payer: Aetna Medicare Advantage	$2,047.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,740.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,740.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,740.38
Rate for Payer: Cigna Commercial	$3,412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,047.50
Rate for Payer: Oxford Commercial	$1,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.75
Rate for Payer: UnitedHealthcare Commercial	$1,365.00
Rate for Payer: UnitedHealthcare Community & State	$164.48
Rate for Payer: Wellpoint Medicaid Managed Care	$180.86

BRONCHOSCOPE ASCOPE 4 SLIM

Facility

$6,825.00

Hospital Charge Code	270686015
Hospital Revenue Code	272
Min. Negotiated Rate	$1,023.75
Max. Negotiated Rate	$1,023.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.75

BRONCHOSCOPE ASCOPE 4 SLIM

Facility

$6,825.00

Hospital Charge Code	270686015
Hospital Revenue Code	272
Min. Negotiated Rate	$164.48
Max. Negotiated Rate	$3,412.50
Rate for Payer: Aetna Commercial	$2,593.50
Rate for Payer: Aetna Medicare Advantage	$2,047.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,740.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,740.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,740.38
Rate for Payer: Cigna Commercial	$3,412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,047.50
Rate for Payer: Oxford Commercial	$1,365.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.75
Rate for Payer: UnitedHealthcare Commercial	$1,365.00
Rate for Payer: UnitedHealthcare Community & State	$164.48
Rate for Payer: Wellpoint Medicaid Managed Care	$180.86

BRONCHOSCOPY

Facility

$5,294.80

Service Code	HCPCS 31622
Hospital Charge Code	1600000370
Hospital Revenue Code	360
Min. Negotiated Rate	$794.22
Max. Negotiated Rate	$794.22
Rate for Payer: Qualcare PPO/HMO/WC	$794.22

BRONCHOSCOPY

Facility

$5,294.80

Service Code	HCPCS 31622
Hospital Charge Code	1600000370
Hospital Revenue Code	360
Min. Negotiated Rate	$127.60
Max. Negotiated Rate	$7,632.96
Rate for Payer: Aetna Commercial	$5,751.63
Rate for Payer: Aetna Medicare Advantage	$6,851.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,114.57
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	$7,632.96
Rate for Payer: Cigna Commercial	$4,238.63
Rate for Payer: Cigna Medicare Advantage	$2,114.57
Rate for Payer: Clover Medicare Advantage	$2,008.84
Rate for Payer: EmblemHealth Commercial	$6,343.71
Rate for Payer: Humana Medicare Advantage	$2,178.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,114.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,588.44
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$794.22
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$127.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$514.28
Rate for Payer: Wellpoint Medicaid Managed Care	$504.20

BRONCHOSCOPY

Facility

$5,294.80

Service Code	HCPCS 31622
Hospital Charge Code	1600000275
Hospital Revenue Code	360
Min. Negotiated Rate	$127.60
Max. Negotiated Rate	$7,632.96
Rate for Payer: Aetna Commercial	$5,751.63
Rate for Payer: Aetna Medicare Advantage	$6,851.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,114.57
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	$7,632.96
Rate for Payer: Cigna Commercial	$4,238.63
Rate for Payer: Cigna Medicare Advantage	$2,114.57
Rate for Payer: Clover Medicare Advantage	$2,008.84
Rate for Payer: EmblemHealth Commercial	$6,343.71
Rate for Payer: Humana Medicare Advantage	$2,178.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,114.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,588.44
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$794.22
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$127.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$514.28
Rate for Payer: Wellpoint Medicaid Managed Care	$504.20

BRONCHOSCOPY

Facility

$5,294.80

Service Code	HCPCS 31622
Hospital Charge Code	1600000275
Hospital Revenue Code	360
Min. Negotiated Rate	$794.22
Max. Negotiated Rate	$794.22
Rate for Payer: Qualcare PPO/HMO/WC	$794.22

BRONCHOSCOPY DX W/WO CELL WASH

Facility

$4,632.10

Service Code	HCPCS 31622
Hospital Charge Code	9501275
Hospital Revenue Code	361
Min. Negotiated Rate	$111.63
Max. Negotiated Rate	$7,632.96
Rate for Payer: Aetna Commercial	$5,751.63
Rate for Payer: Aetna Medicare Advantage	$6,851.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,114.57
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	$7,632.96
Rate for Payer: Cigna Commercial	$4,238.63
Rate for Payer: Cigna Medicare Advantage	$2,114.57
Rate for Payer: Clover Medicare Advantage	$2,008.84
Rate for Payer: EmblemHealth Commercial	$6,343.71
Rate for Payer: Humana Medicare Advantage	$2,178.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,114.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,389.63
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$694.82
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$111.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$514.28
Rate for Payer: Wellpoint Medicaid Managed Care	$504.20

Know your out-of-pocket cost for care.

All Charges