Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ABDOMNAL AORTA W/ RUN-OFF

Facility

$6,122.00

Hospital Charge Code	2009050
Hospital Revenue Code	323
Min. Negotiated Rate	$147.54
Max. Negotiated Rate	$3,061.00
Rate for Payer: Aetna Commercial	$2,326.36
Rate for Payer: Aetna Medicare Advantage	$1,836.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,561.11
Rate for Payer: Cigna Commercial	$3,061.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.60
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$918.30
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$147.54
Rate for Payer: Wellpoint Medicaid Managed Care	$162.23

ABD PARACENTESIS

Facility

$3,961.60

Service Code	HCPCS 49082
Hospital Charge Code	16000275
Hospital Revenue Code	360
Min. Negotiated Rate	$594.24
Max. Negotiated Rate	$594.24
Rate for Payer: Qualcare PPO/HMO/WC	$594.24

ABD PARACENTESIS

Facility

$3,961.60

Service Code	HCPCS 49082
Hospital Charge Code	16000275
Hospital Revenue Code	360
Min. Negotiated Rate	$95.47
Max. Negotiated Rate	$5,311.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,889.52
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,188.48
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$594.24
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$95.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$104.98

ABD PARACENTESIS W/IMAGING

Facility

$6,050.94

Service Code	HCPCS 49083
Hospital Charge Code	16000173
Hospital Revenue Code	360
Min. Negotiated Rate	$907.64
Max. Negotiated Rate	$907.64
Rate for Payer: Qualcare PPO/HMO/WC	$907.64

ABD PARACENTESIS W/IMAGING

Facility

$6,050.94

Service Code	HCPCS 49083
Hospital Charge Code	16000173
Hospital Revenue Code	360
Min. Negotiated Rate	$145.83
Max. Negotiated Rate	$5,311.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,889.52
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.28
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$907.64
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$145.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$160.35

ABD PARACENTESIS W/IMG

Facility

$2,289.68

Service Code	HCPCS 49083
Hospital Charge Code	5770040
Hospital Revenue Code	450
Min. Negotiated Rate	$60.68
Max. Negotiated Rate	$3,889.52
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,889.52
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$686.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$343.45
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$60.68

ABD PARACENTESIS W/IMG

Facility

$2,289.68

Service Code	HCPCS 49083
Hospital Charge Code	5770040
Hospital Revenue Code	450
Min. Negotiated Rate	$343.45
Max. Negotiated Rate	$343.45
Rate for Payer: Qualcare PPO/HMO/WC	$343.45

ABD & PELVIS W/CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74177
Hospital Charge Code	2200047
Hospital Revenue Code	352
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

ABD & PELVIS W/CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74177
Hospital Charge Code	2200047
Hospital Revenue Code	352
Min. Negotiated Rate	$228.95
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$1,127.36
Rate for Payer: Aetna Medicare Advantage	$1,342.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$414.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$291.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,496.11
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: Cigna Medicare Advantage	$290.13
Rate for Payer: Clover Medicare Advantage	$393.75
Rate for Payer: EmblemHealth Commercial	$1,243.41
Rate for Payer: Humana Medicare Advantage	$426.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$414.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,850.00
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$228.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$414.47
Rate for Payer: Wellcare Medicare Advantage	$414.47
Rate for Payer: Wellpoint Medicaid Managed Care	$251.75

ABD & PELVIS W/O CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74176
Hospital Charge Code	2200054
Hospital Revenue Code	352
Min. Negotiated Rate	$184.11
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$198.43
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,850.00
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$228.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,837.38
Rate for Payer: Wellpoint Medicaid Managed Care	$251.75

ABD & PELVIS W/O CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74176
Hospital Charge Code	2200054
Hospital Revenue Code	352
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

ABDUCTION PILLOW SMALL SUB

Facility

$90.85

Hospital Charge Code	270659505
Hospital Revenue Code	270
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$45.42
Rate for Payer: Aetna Commercial	$34.52
Rate for Payer: Aetna Medicare Advantage	$27.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.17
Rate for Payer: Cigna Commercial	$45.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.25
Rate for Payer: Oxford Commercial	$18.17
Rate for Payer: Qualcare PPO/HMO/WC	$13.63
Rate for Payer: UnitedHealthcare Commercial	$18.17
Rate for Payer: UnitedHealthcare Community & State	$2.19
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

ABDUCTION PILLOW SMALL SUB

Facility

$90.85

Hospital Charge Code	270659505
Hospital Revenue Code	270
Min. Negotiated Rate	$13.63
Max. Negotiated Rate	$13.63
Rate for Payer: Qualcare PPO/HMO/WC	$13.63

ABELCET 100 MG INJ 20 ML

Facility

$569.00

Hospital Charge Code	60635330
Hospital Revenue Code	636
Min. Negotiated Rate	$13.71
Max. Negotiated Rate	$284.50
Rate for Payer: Aetna Commercial	$216.22
Rate for Payer: Aetna Medicare Advantage	$170.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.09
Rate for Payer: Cigna Commercial	$284.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.70
Rate for Payer: Qualcare PPO/HMO/WC	$85.35
Rate for Payer: UnitedHealthcare Community & State	$13.71
Rate for Payer: Wellpoint Medicaid Managed Care	$15.08

ABELCET 100 MG INJ 20 ML

Facility

$569.00

Hospital Charge Code	60635330
Hospital Revenue Code	636
Min. Negotiated Rate	$85.35
Max. Negotiated Rate	$137.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.70
Rate for Payer: Qualcare PPO/HMO/WC	$85.35

ABELCET 50 MG INJ 10 ML

Facility

$394.00

Hospital Charge Code	60635329
Hospital Revenue Code	636
Min. Negotiated Rate	$59.10
Max. Negotiated Rate	$95.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.35
Rate for Payer: Qualcare PPO/HMO/WC	$59.10

ABELCET 50 MG INJ 10 ML

Facility

$394.00

Hospital Charge Code	60635329
Hospital Revenue Code	636
Min. Negotiated Rate	$9.50
Max. Negotiated Rate	$197.00
Rate for Payer: Aetna Commercial	$149.72
Rate for Payer: Aetna Medicare Advantage	$118.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.47
Rate for Payer: Cigna Commercial	$197.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.35
Rate for Payer: Qualcare PPO/HMO/WC	$59.10
Rate for Payer: UnitedHealthcare Community & State	$9.50
Rate for Payer: Wellpoint Medicaid Managed Care	$10.44

ABG CO-OX AND SHOCK PANEL

Facility

$1,255.57

Service Code	HCPCS 82803
Hospital Charge Code	317082803
Hospital Revenue Code	300
Min. Negotiated Rate	$188.34
Max. Negotiated Rate	$188.34
Rate for Payer: Qualcare PPO/HMO/WC	$188.34

ABG CO-OX AND SHOCK PANEL

Facility

$1,255.57

Service Code	HCPCS 82803
Hospital Charge Code	317082803
Hospital Revenue Code	300
Min. Negotiated Rate	$20.86
Max. Negotiated Rate	$627.78
Rate for Payer: Aetna Commercial	$70.91
Rate for Payer: Aetna Medicare Advantage	$84.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.10
Rate for Payer: Cigna Commercial	$627.78
Rate for Payer: Cigna Medicare Advantage	$26.07
Rate for Payer: Clover Medicare Advantage	$24.77
Rate for Payer: EmblemHealth Commercial	$78.21
Rate for Payer: Humana Medicare Advantage	$26.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$376.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$188.34
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$20.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.07
Rate for Payer: Wellcare Medicare Advantage	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$33.27

ABILIFY,10MG TAB

Facility

$12.00

Hospital Charge Code	60635422
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

ABILIFY,10MG TAB

Facility

$12.00

Hospital Charge Code	60635422
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

ABILIFY,15MG,TAB

Facility

$12.00

Hospital Charge Code	60635423
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

ABILIFY,15MG,TAB

Facility

$12.00

Hospital Charge Code	60635423
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

ABILIFY 9.75MG/1.3ML VIAL

Facility

$6.00

Hospital Charge Code	60635643
Hospital Revenue Code	636
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$1.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

ABILIFY 9.75MG/1.3ML VIAL

Facility

$6.00

Hospital Charge Code	60635643
Hospital Revenue Code	636
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

Know your out-of-pocket cost for care.

All Charges