Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

BRONCHOSCOPY/LUNG BX EACH

Facility

$11,302.80

Service Code	HCPCS 31628
Hospital Charge Code	1600000487
Hospital Revenue Code	360
Min. Negotiated Rate	$1,695.42
Max. Negotiated Rate	$1,695.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,695.42

BRONCHOSCOPY/LUNG BX EACH

Facility

$11,302.80

Service Code	HCPCS 31628
Hospital Charge Code	1600000487
Hospital Revenue Code	360
Min. Negotiated Rate	$272.40
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	$1,016.00
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	$3,390.84
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,695.42
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$272.40
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	$299.52

BRONCHOSCOPY W/BAL

Facility

$6,293.60

Service Code	HCPCS 31624
Hospital Charge Code	1600000354
Hospital Revenue Code	360
Min. Negotiated Rate	$944.04
Max. Negotiated Rate	$944.04
Rate for Payer: Qualcare PPO/HMO/WC	$944.04

BRONCHOSCOPY W/BAL

Facility

$6,293.60

Service Code	HCPCS 31624
Hospital Charge Code	1600000354
Hospital Revenue Code	360
Min. Negotiated Rate	$151.68
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	$1,016.00
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	$1,888.08
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$944.04
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$151.68
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	$4,594.28
Rate for Payer: Wellpoint Medicaid Managed Care	$4,504.20

BRONCH W/BRUSHING

Facility

$6,293.60

Service Code	HCPCS 31623
Hospital Charge Code	1600000253
Hospital Revenue Code	360
Min. Negotiated Rate	$944.04
Max. Negotiated Rate	$944.04
Rate for Payer: Qualcare PPO/HMO/WC	$944.04

BRONCH W/BRUSHING

Facility

$6,293.60

Service Code	HCPCS 31623
Hospital Charge Code	1600000253
Hospital Revenue Code	360
Min. Negotiated Rate	$151.68
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	$1,016.00
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	$1,888.08
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$944.04
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$151.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare Medicare Advantage	$2,114.57
Rate for Payer: Wellpoint Medicaid Managed Care	$166.78

BRONDECON/16OZ

Facility

$23.00

Hospital Charge Code	60634585
Hospital Revenue Code	250
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$8.74
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.90
Rate for Payer: Oxford Commercial	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$4.60
Rate for Payer: UnitedHealthcare Community & State	$0.55
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

BRONDECON/16OZ

Facility

$23.00

Hospital Charge Code	60634585
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

BRONDECON/TAB

Facility

$3.00

Hospital Charge Code	60632583
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

BRONDECON/TAB

Facility

$3.00

Hospital Charge Code	60632583
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

BRONKEPHRINE INJ/1ML AMP

Facility

$490.00

Hospital Charge Code	60634314
Hospital Revenue Code	250
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$73.50
Rate for Payer: Qualcare PPO/HMO/WC	$73.50

BRONKEPHRINE INJ/1ML AMP

Facility

$490.00

Hospital Charge Code	60634314
Hospital Revenue Code	250
Min. Negotiated Rate	$11.81
Max. Negotiated Rate	$245.00
Rate for Payer: Aetna Commercial	$186.20
Rate for Payer: Aetna Medicare Advantage	$147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.95
Rate for Payer: Cigna Commercial	$245.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.00
Rate for Payer: Oxford Commercial	$98.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.50
Rate for Payer: UnitedHealthcare Commercial	$98.00
Rate for Payer: UnitedHealthcare Community & State	$11.81
Rate for Payer: Wellpoint Medicaid Managed Care	$12.98

BRONKOSOL 1%/30ML

Facility

$184.00

Hospital Charge Code	60632584
Hospital Revenue Code	250
Min. Negotiated Rate	$4.43
Max. Negotiated Rate	$92.00
Rate for Payer: Aetna Commercial	$69.92
Rate for Payer: Aetna Medicare Advantage	$55.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.92
Rate for Payer: Cigna Commercial	$92.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.20
Rate for Payer: Oxford Commercial	$36.80
Rate for Payer: Qualcare PPO/HMO/WC	$27.60
Rate for Payer: UnitedHealthcare Commercial	$36.80
Rate for Payer: UnitedHealthcare Community & State	$4.43
Rate for Payer: Wellpoint Medicaid Managed Care	$4.88

BRONKOSOL 1%/30ML

Facility

$184.00

Hospital Charge Code	60632584
Hospital Revenue Code	250
Min. Negotiated Rate	$27.60
Max. Negotiated Rate	$27.60
Rate for Payer: Qualcare PPO/HMO/WC	$27.60

BROVANA 15MCG/2ML INH

Facility

$27.00

Hospital Charge Code	60635692
Hospital Revenue Code	250
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

BROVANA 15MCG/2ML INH

Facility

$27.00

Hospital Charge Code	60635692
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$10.26
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.10
Rate for Payer: Oxford Commercial	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$5.40
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.72

BRSH SML WNDR CHNNL BX00711616

Facility

$125.00

Hospital Charge Code	270645088
Hospital Revenue Code	272
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

BRSH SML WNDR CHNNL BX00711616

Facility

$125.00

Hospital Charge Code	270645088
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

BRUCELLA AB(IGG,IGM)W/RFL I

Facility

$390.00

Service Code	HCPCS 8662291
Hospital Charge Code	39990087A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BRUCELLA AB(IGG,IGM)W/RFL I

Facility

$390.00

Service Code	HCPCS 8662291
Hospital Charge Code	39990087A
Hospital Revenue Code	302
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

BRUCELLA AB(IGG,IGM)W/RFL II

Facility

$390.00

Service Code	HCPCS 8662291
Hospital Charge Code	39990087B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BRUCELLA AB(IGG,IGM)W/RFL II

Facility

$390.00

Service Code	HCPCS 8662291
Hospital Charge Code	39990087B
Hospital Revenue Code	302
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

BRUCELLA ABORTUS IGM EIA

Facility

$71.25

Service Code	HCPCS 86622
Hospital Charge Code	3006545
Hospital Revenue Code	302
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$10.69
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

BRUCELLA ABORTUS IGM EIA

Facility

$71.25

Service Code	HCPCS 86622
Hospital Charge Code	3006545
Hospital Revenue Code	302
Min. Negotiated Rate	$1.89
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$24.29
Rate for Payer: Aetna Medicare Advantage	$28.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.93
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	$32.23
Rate for Payer: Cigna Commercial	$35.62
Rate for Payer: Cigna Medicare Advantage	$8.93
Rate for Payer: Clover Medicare Advantage	$8.48
Rate for Payer: EmblemHealth Commercial	$26.79
Rate for Payer: Humana Medicare Advantage	$9.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.93
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	$7.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.93
Rate for Payer: Wellcare Medicare Advantage	$8.93
Rate for Payer: Wellpoint Medicaid Managed Care	$1.89

Know your out-of-pocket cost for care.

All Charges