Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

Abilify Maintena 300mg/ml inj

Facility

$9,554.27

Service Code	HCPCS J0401
Hospital Charge Code	606390240
Hospital Revenue Code	636
Min. Negotiated Rate	$6.91
Max. Negotiated Rate	$2,312.13
Rate for Payer: Aetna Commercial	$19.77
Rate for Payer: Aetna Medicare Advantage	$23.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.24
Rate for Payer: Cigna Medicare Advantage	$7.27
Rate for Payer: Clover Medicare Advantage	$6.91
Rate for Payer: EmblemHealth Commercial	$21.81
Rate for Payer: Humana Medicare Advantage	$7.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,312.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,433.14
Rate for Payer: UnitedHealthcare Community & State	$230.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.27
Rate for Payer: Wellcare Medicare Advantage	$7.27
Rate for Payer: Wellpoint Medicaid Managed Care	$253.19

Abilify Maintena 300mg/ml inj

Facility

$9,554.27

Service Code	HCPCS J0401
Hospital Charge Code	606390240
Hospital Revenue Code	636
Min. Negotiated Rate	$1,433.14
Max. Negotiated Rate	$2,312.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,312.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,433.14

Abilify Maintena 400mg/ml inj

Facility

$12,739.05

Service Code	HCPCS J0401
Hospital Charge Code	606390241
Hospital Revenue Code	636
Min. Negotiated Rate	$1,910.86
Max. Negotiated Rate	$3,082.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,082.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,910.86

Abilify Maintena 400mg/ml inj

Facility

$12,739.05

Service Code	HCPCS J0401
Hospital Charge Code	606390241
Hospital Revenue Code	636
Min. Negotiated Rate	$6.91
Max. Negotiated Rate	$3,082.85
Rate for Payer: Aetna Commercial	$19.77
Rate for Payer: Aetna Medicare Advantage	$23.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.24
Rate for Payer: Cigna Medicare Advantage	$7.27
Rate for Payer: Clover Medicare Advantage	$6.91
Rate for Payer: EmblemHealth Commercial	$21.81
Rate for Payer: Humana Medicare Advantage	$7.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,082.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,910.86
Rate for Payer: UnitedHealthcare Community & State	$307.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.27
Rate for Payer: Wellcare Medicare Advantage	$7.27
Rate for Payer: Wellpoint Medicaid Managed Care	$337.58

ABILIFY ORAL 1MG/ML SOL

Facility

$47.37

Service Code	NDC 60505040405
Hospital Charge Code	6063943045
Hospital Revenue Code	250
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$7.11
Rate for Payer: Qualcare PPO/HMO/WC	$7.11

ABILIFY ORAL 1MG/ML SOL

Facility

$47.37

Service Code	NDC 60505040405
Hospital Charge Code	6063943045
Hospital Revenue Code	250
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$23.68
Rate for Payer: Aetna Commercial	$18.00
Rate for Payer: Aetna Medicare Advantage	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.08
Rate for Payer: Cigna Commercial	$23.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.21
Rate for Payer: Oxford Commercial	$9.47
Rate for Payer: Qualcare PPO/HMO/WC	$7.11
Rate for Payer: UnitedHealthcare Commercial	$9.47
Rate for Payer: UnitedHealthcare Community & State	$1.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.26

ABLATE HEART DYSRHYTHM FOCUS

Facility

$34,545.48

Service Code	HCPCS 93650
Hospital Charge Code	69008136
Hospital Revenue Code	481
Min. Negotiated Rate	$5,181.82
Max. Negotiated Rate	$5,181.82
Rate for Payer: Qualcare PPO/HMO/WC	$5,181.82

ABLATE HEART DYSRHYTHM FOCUS

Facility

$34,545.48

Service Code	HCPCS 93650
Hospital Charge Code	69008136
Hospital Revenue Code	481
Min. Negotiated Rate	$832.55
Max. Negotiated Rate	$33,448.24
Rate for Payer: Aetna Commercial	$25,204.09
Rate for Payer: Aetna Medicare Advantage	$30,022.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,448.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,448.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,266.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33,448.24
Rate for Payer: Cigna Commercial	$18,574.08
Rate for Payer: Cigna Medicare Advantage	$9,266.21
Rate for Payer: Clover Medicare Advantage	$8,802.90
Rate for Payer: EmblemHealth Commercial	$27,798.63
Rate for Payer: Humana Medicare Advantage	$9,544.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,266.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,363.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,181.82
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$832.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,266.21
Rate for Payer: Wellcare Medicare Advantage	$9,266.21
Rate for Payer: Wellpoint Medicaid Managed Care	$915.46

ABLATE INF TURBINATE SUBMUC BL

Facility

$16,164.25

Service Code	HCPCS 30802
Hospital Charge Code	1600000517
Hospital Revenue Code	360
Min. Negotiated Rate	$389.56
Max. Negotiated Rate	$6,653.83
Rate for Payer: Aetna Commercial	$5,013.83
Rate for Payer: Aetna Medicare Advantage	$5,972.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,653.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,653.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,843.32
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	$6,653.83
Rate for Payer: Cigna Commercial	$3,694.94
Rate for Payer: Cigna Medicare Advantage	$1,843.32
Rate for Payer: Clover Medicare Advantage	$1,751.15
Rate for Payer: EmblemHealth Commercial	$5,529.96
Rate for Payer: Humana Medicare Advantage	$1,898.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,843.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,849.27
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,424.64
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$389.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,843.32
Rate for Payer: Wellcare Medicare Advantage	$1,843.32
Rate for Payer: Wellpoint Medicaid Managed Care	$428.35

ABLATE INF TURBINATE SUBMUC BL

Facility

$16,164.25

Service Code	HCPCS 30802
Hospital Charge Code	1600000517
Hospital Revenue Code	360
Min. Negotiated Rate	$2,424.64
Max. Negotiated Rate	$2,424.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,424.64

ABLATE INF TURBINATE SUPERF

Facility

$6,474.80

Service Code	HCPCS 30801
Hospital Charge Code	1600000315
Hospital Revenue Code	360
Min. Negotiated Rate	$156.04
Max. Negotiated Rate	$6,653.83
Rate for Payer: Aetna Commercial	$5,013.83
Rate for Payer: Aetna Medicare Advantage	$5,972.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,653.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,653.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,843.32
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	$6,653.83
Rate for Payer: Cigna Commercial	$3,694.94
Rate for Payer: Cigna Medicare Advantage	$1,843.32
Rate for Payer: Clover Medicare Advantage	$1,751.15
Rate for Payer: EmblemHealth Commercial	$5,529.96
Rate for Payer: Humana Medicare Advantage	$1,898.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,843.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,942.44
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$971.22
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$156.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,843.32
Rate for Payer: Wellcare Medicare Advantage	$1,843.32
Rate for Payer: Wellpoint Medicaid Managed Care	$171.58

ABLATE INF TURBINATE SUPERF

Facility

$6,474.80

Service Code	HCPCS 30801
Hospital Charge Code	1600000315
Hospital Revenue Code	360
Min. Negotiated Rate	$971.22
Max. Negotiated Rate	$971.22
Rate for Payer: Qualcare PPO/HMO/WC	$971.22

ABLATION INSTRUMENT 10/15MM

Facility

$15,975.00

Hospital Charge Code	270670689
Hospital Revenue Code	272
Min. Negotiated Rate	$2,396.25
Max. Negotiated Rate	$2,396.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25

ABLATION INSTRUMENT 10/15MM

Facility

$15,975.00

Hospital Charge Code	270670689
Hospital Revenue Code	272
Min. Negotiated Rate	$385.00
Max. Negotiated Rate	$7,987.50
Rate for Payer: Aetna Commercial	$6,070.50
Rate for Payer: Aetna Medicare Advantage	$4,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,073.62
Rate for Payer: Cigna Commercial	$7,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,792.50
Rate for Payer: Oxford Commercial	$3,195.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25
Rate for Payer: UnitedHealthcare Commercial	$3,195.00
Rate for Payer: UnitedHealthcare Community & State	$385.00
Rate for Payer: Wellpoint Medicaid Managed Care	$423.34

ABLATION INSTRUMENT 5/10MM

Facility

$15,975.00

Hospital Charge Code	270670690
Hospital Revenue Code	272
Min. Negotiated Rate	$2,396.25
Max. Negotiated Rate	$2,396.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25

ABLATION INSTRUMENT 5/10MM

Facility

$15,975.00

Hospital Charge Code	270670690
Hospital Revenue Code	272
Min. Negotiated Rate	$385.00
Max. Negotiated Rate	$7,987.50
Rate for Payer: Aetna Commercial	$6,070.50
Rate for Payer: Aetna Medicare Advantage	$4,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,073.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,073.62
Rate for Payer: Cigna Commercial	$7,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,792.50
Rate for Payer: Oxford Commercial	$3,195.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,396.25
Rate for Payer: UnitedHealthcare Commercial	$3,195.00
Rate for Payer: UnitedHealthcare Community & State	$385.00
Rate for Payer: Wellpoint Medicaid Managed Care	$423.34

ABLATOR 50 APOLLO

Facility

$1,300.00

Hospital Charge Code	270687981
Hospital Revenue Code	272
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

ABLATOR 50 APOLLO

Facility

$1,300.00

Hospital Charge Code	270687981
Hospital Revenue Code	272
Min. Negotiated Rate	$31.33
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$494.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.00
Rate for Payer: Oxford Commercial	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00
Rate for Payer: UnitedHealthcare Commercial	$260.00
Rate for Payer: UnitedHealthcare Community & State	$31.33
Rate for Payer: Wellpoint Medicaid Managed Care	$34.45

ABLATOR 50D APOLLO RF

Facility

$1,250.00

Hospital Charge Code	270693449
Hospital Revenue Code	272
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$250.00
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

ABLATOR 50D APOLLO RF

Facility

$1,250.00

Hospital Charge Code	270693449
Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

ABLATOR ASPIRATING 3MM 50DEG

Facility

$875.00

Hospital Charge Code	270671807
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

ABLATOR ASPIRATING 3MM 50DEG

Facility

$875.00

Hospital Charge Code	270671807
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

ABLATOR ASPIRATING 3MM 90DEG

Facility

$875.00

Hospital Charge Code	270671806
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

ABLATOR ASPIRATING 3MM 90DEG

Facility

$875.00

Hospital Charge Code	270671806
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

ABLATOR HOOK 90DEG

Facility

$575.00

Hospital Charge Code	270671808
Hospital Revenue Code	272
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.50
Rate for Payer: Oxford Commercial	$115.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Commercial	$115.00
Rate for Payer: UnitedHealthcare Community & State	$13.86
Rate for Payer: Wellpoint Medicaid Managed Care	$15.24

Know your out-of-pocket cost for care.

All Charges