Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BUN

Facility

$65.65

Service Code	HCPCS 84520
Hospital Charge Code	8200333RS
Hospital Revenue Code	301
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

BUNION CORRECT W JNT RESCTIMPL

Facility

$31,049.10

Service Code	HCPCS 28291
Hospital Charge Code	16000428
Hospital Revenue Code	360
Min. Negotiated Rate	$748.28
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,314.73
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,657.36
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$748.28
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$822.80

BUNION CORRECT W JNT RESCTIMPL

Facility

$31,049.10

Service Code	HCPCS 28291
Hospital Charge Code	16000428
Hospital Revenue Code	360
Min. Negotiated Rate	$4,657.36
Max. Negotiated Rate	$4,657.36
Rate for Payer: Qualcare PPO/HMO/WC	$4,657.36

BUNION CRRCT W/MTRSLBNE INC-LT

Facility

$10,580.92

Service Code	HCPCS 28296
Hospital Charge Code	16000182
Hospital Revenue Code	360
Min. Negotiated Rate	$1,587.14
Max. Negotiated Rate	$1,587.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,587.14

BUNION CRRCT W/MTRSLBNE INC-LT

Facility

$10,580.92

Service Code	HCPCS 28296
Hospital Charge Code	16000182
Hospital Revenue Code	360
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,174.28
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,587.14
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$255.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$280.39

BUNIONECTMY W/O ARTHRPLST-UNLA

Facility

$31,049.10

Service Code	HCPCS 28292
Hospital Charge Code	16000236
Hospital Revenue Code	360
Min. Negotiated Rate	$748.28
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,314.73
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,657.36
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$748.28
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$822.80

BUNIONECTMY W/O ARTHRPLST-UNLA

Facility

$31,049.10

Service Code	HCPCS 28292
Hospital Charge Code	16000236
Hospital Revenue Code	360
Min. Negotiated Rate	$4,657.36
Max. Negotiated Rate	$4,657.36
Rate for Payer: Qualcare PPO/HMO/WC	$4,657.36

BUN POST

Facility

$65.65

Service Code	HCPCS 84520
Hospital Charge Code	8200334RS
Hospital Revenue Code	301
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

BUN POST

Facility

$390.00

Service Code	HCPCS 84520
Hospital Charge Code	3002665
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BUN POST

Facility

$390.00

Service Code	HCPCS 84520
Hospital Charge Code	3002665
Hospital Revenue Code	301
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$10.74
Rate for Payer: Aetna Medicare Advantage	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.26
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$3.95
Rate for Payer: Clover Medicare Advantage	$3.75
Rate for Payer: EmblemHealth Commercial	$11.85
Rate for Payer: Humana Medicare Advantage	$4.07
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.95
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	$3.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.95
Rate for Payer: Wellcare Medicare Advantage	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

BUN POST

Facility

$65.65

Service Code	HCPCS 84520
Hospital Charge Code	8200334RS
Hospital Revenue Code	301
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$10.74
Rate for Payer: Aetna Medicare Advantage	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.26
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: Cigna Medicare Advantage	$3.95
Rate for Payer: Clover Medicare Advantage	$3.75
Rate for Payer: EmblemHealth Commercial	$11.85
Rate for Payer: Humana Medicare Advantage	$4.07
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.95
Rate for Payer: Wellcare Medicare Advantage	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.74

BUN,POST-DIAL

Facility

$208.00

Service Code	HCPCS 84520
Hospital Charge Code	38479004
Hospital Revenue Code	301
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$31.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.20

BUN,POST-DIAL

Facility

$208.00

Service Code	HCPCS 84520
Hospital Charge Code	38479004
Hospital Revenue Code	301
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$10.74
Rate for Payer: Aetna Medicare Advantage	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.26
Rate for Payer: Cigna Commercial	$104.00
Rate for Payer: Cigna Medicare Advantage	$3.95
Rate for Payer: Clover Medicare Advantage	$3.75
Rate for Payer: EmblemHealth Commercial	$11.85
Rate for Payer: Humana Medicare Advantage	$4.07
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.95
Rate for Payer: Wellcare Medicare Advantage	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$5.51

BUN,PRE-DIAL

Facility

$208.00

Service Code	HCPCS 84520
Hospital Charge Code	38479003
Hospital Revenue Code	301
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$10.74
Rate for Payer: Aetna Medicare Advantage	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.26
Rate for Payer: Cigna Commercial	$104.00
Rate for Payer: Cigna Medicare Advantage	$3.95
Rate for Payer: Clover Medicare Advantage	$3.75
Rate for Payer: EmblemHealth Commercial	$11.85
Rate for Payer: Humana Medicare Advantage	$4.07
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.95
Rate for Payer: Wellcare Medicare Advantage	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$5.51

BUN,PRE-DIAL

Facility

$208.00

Service Code	HCPCS 84520
Hospital Charge Code	38479003
Hospital Revenue Code	301
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$31.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.20

BUN (UREA NITROGEN)

Facility

$208.00

Service Code	HCPCS 84520
Hospital Charge Code	38472145
Hospital Revenue Code	301
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$10.74
Rate for Payer: Aetna Medicare Advantage	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.26
Rate for Payer: Cigna Commercial	$104.00
Rate for Payer: Cigna Medicare Advantage	$3.95
Rate for Payer: Clover Medicare Advantage	$3.75
Rate for Payer: EmblemHealth Commercial	$11.85
Rate for Payer: Humana Medicare Advantage	$4.07
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.95
Rate for Payer: Wellcare Medicare Advantage	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$5.51

BUN (UREA NITROGEN)

Facility

$208.00

Service Code	HCPCS 84520
Hospital Charge Code	38472145
Hospital Revenue Code	301
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$31.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.20

BUN,URINE RANDOM

Facility

$160.00

Service Code	HCPCS 84540
Hospital Charge Code	38479005
Hospital Revenue Code	301
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

BUN,URINE RANDOM

Facility

$160.00

Service Code	HCPCS 84540
Hospital Charge Code	38479005
Hospital Revenue Code	301
Min. Negotiated Rate	$4.24
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.12
Rate for Payer: Aetna Medicare Advantage	$18.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.07
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: Cigna Medicare Advantage	$5.56
Rate for Payer: Clover Medicare Advantage	$5.28
Rate for Payer: EmblemHealth Commercial	$16.68
Rate for Payer: Humana Medicare Advantage	$5.73
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.56
Rate for Payer: Wellcare Medicare Advantage	$5.56
Rate for Payer: Wellpoint Medicaid Managed Care	$4.24

BUPIV 0.5% EPI 1 200000 (50ML

Facility

$106.20

Service Code	NDC 63323046357
Hospital Charge Code	6063943067
Hospital Revenue Code	250
Min. Negotiated Rate	$15.93
Max. Negotiated Rate	$15.93
Rate for Payer: Qualcare PPO/HMO/WC	$15.93

BUPIV 0.5% EPI 1 200000 (50ML

Facility

$106.20

Service Code	NDC 63323046357
Hospital Charge Code	6063943067
Hospital Revenue Code	250
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$53.10
Rate for Payer: Aetna Commercial	$40.36
Rate for Payer: Aetna Medicare Advantage	$31.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.08
Rate for Payer: Cigna Commercial	$53.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.86
Rate for Payer: Oxford Commercial	$21.24
Rate for Payer: Qualcare PPO/HMO/WC	$15.93
Rate for Payer: UnitedHealthcare Commercial	$21.24
Rate for Payer: UnitedHealthcare Community & State	$2.56
Rate for Payer: Wellpoint Medicaid Managed Care	$2.81

BUPIVAACAINE 0.75% 10ML

Facility

$5.00

Hospital Charge Code	60635708
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

BUPIVAACAINE 0.75% 10ML

Facility

$5.00

Hospital Charge Code	60635708
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

BUPIVACAINE 0.25% INJ (30ML)

Facility

$14.87

Service Code	NDC 409115902
Hospital Charge Code	6006639
Hospital Revenue Code	250
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$2.23
Rate for Payer: Qualcare PPO/HMO/WC	$2.23

BUPIVACAINE 0.25% INJ (30ML)

Facility

$14.87

Service Code	NDC 409115902
Hospital Charge Code	6006639
Hospital Revenue Code	250
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.43
Rate for Payer: Aetna Commercial	$5.65
Rate for Payer: Aetna Medicare Advantage	$4.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.79
Rate for Payer: Cigna Commercial	$7.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.46
Rate for Payer: Oxford Commercial	$2.97
Rate for Payer: Qualcare PPO/HMO/WC	$2.23
Rate for Payer: UnitedHealthcare Commercial	$2.97
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.39

Know your out-of-pocket cost for care.

All Charges