Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CADASIL

Facility

$128.00

Hospital Charge Code	3035094J
Hospital Revenue Code	301
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.64
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

CADASIL

Facility

$128.00

Hospital Charge Code	3035094Q
Hospital Revenue Code	301
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CADASIL

Facility

$3,772.75

Service Code	HCPCS 81406
Hospital Charge Code	3035094
Hospital Revenue Code	310
Min. Negotiated Rate	$99.98
Max. Negotiated Rate	$1,886.38
Rate for Payer: Aetna Commercial	$769.43
Rate for Payer: Aetna Medicare Advantage	$916.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,021.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,021.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$282.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,021.11
Rate for Payer: Cigna Commercial	$1,886.38
Rate for Payer: Cigna Medicare Advantage	$282.88
Rate for Payer: Clover Medicare Advantage	$268.74
Rate for Payer: EmblemHealth Commercial	$848.64
Rate for Payer: Humana Medicare Advantage	$291.37
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$282.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,131.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$565.91
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$226.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$282.88
Rate for Payer: Wellcare Medicare Advantage	$282.88
Rate for Payer: Wellpoint Medicaid Managed Care	$99.98

CADASIL

Facility

$111.00

Hospital Charge Code	3035094A
Hospital Revenue Code	301
Min. Negotiated Rate	$16.65
Max. Negotiated Rate	$16.65
Rate for Payer: Qualcare PPO/HMO/WC	$16.65

CADASIL

Facility

$121.00

Hospital Charge Code	3035094V
Hospital Revenue Code	301
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

CADASIL

Facility

$121.00

Hospital Charge Code	3035094AD
Hospital Revenue Code	301
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.98
Rate for Payer: Aetna Medicare Advantage	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.86
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.92
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

CADASIL

Facility

$121.00

Hospital Charge Code	3035094AE
Hospital Revenue Code	301
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

CADASIL

Facility

$390.00

Hospital Charge Code	3035094X
Hospital Revenue Code	301
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

CADASIL

Facility

$128.00

Hospital Charge Code	3035094E
Hospital Revenue Code	301
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CADASIL

Facility

$128.00

Hospital Charge Code	3035094K
Hospital Revenue Code	301
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CADASIL

Facility

$128.00

Hospital Charge Code	3035094Q
Hospital Revenue Code	301
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.64
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

CADASIL

Facility

$121.00

Hospital Charge Code	3035094W
Hospital Revenue Code	301
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

CADASIL

Facility

$128.00

Hospital Charge Code	3035094L
Hospital Revenue Code	301
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CADASIL

Facility

$121.00

Hospital Charge Code	3035094AC
Hospital Revenue Code	301
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.98
Rate for Payer: Aetna Medicare Advantage	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.86
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.92
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

CADASIL

Facility

$121.00

Hospital Charge Code	3035094AB
Hospital Revenue Code	301
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.98
Rate for Payer: Aetna Medicare Advantage	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.86
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.92
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

CADASIL

Facility

$121.00

Hospital Charge Code	3035094T
Hospital Revenue Code	301
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.98
Rate for Payer: Aetna Medicare Advantage	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.86
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.92
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

CADASIL

Facility

$128.00

Hospital Charge Code	3035094B
Hospital Revenue Code	304
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.64
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

CADASIL

Facility

$128.00

Hospital Charge Code	3035094I
Hospital Revenue Code	301
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.64
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

CADASIL

Facility

$128.00

Hospital Charge Code	3035094D
Hospital Revenue Code	301
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.64
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

CADASIL

Facility

$121.00

Hospital Charge Code	3035094AF
Hospital Revenue Code	301
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.98
Rate for Payer: Aetna Medicare Advantage	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.86
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.92
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

CAD BREAST MRI

Facility

$1,038.00

Hospital Charge Code	4045C8937
Hospital Revenue Code	610
Min. Negotiated Rate	$155.70
Max. Negotiated Rate	$155.70
Rate for Payer: Qualcare PPO/HMO/WC	$155.70

CAD BREAST MRI

Facility

$1,038.00

Hospital Charge Code	4045C8937
Hospital Revenue Code	610
Min. Negotiated Rate	$25.02
Max. Negotiated Rate	$6,162.00
Rate for Payer: Aetna Commercial	$394.44
Rate for Payer: Aetna Medicare Advantage	$311.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$264.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$264.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$264.69
Rate for Payer: Cigna Commercial	$519.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.40
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.70
Rate for Payer: UnitedHealthcare Commercial	$6,162.00
Rate for Payer: UnitedHealthcare Community & State	$25.02
Rate for Payer: Wellpoint Medicaid Managed Care	$27.51

CAD-DIAGOSTIC MAMMOGRAPHY

Facility

$263.00

Service Code	HCPCS 77051
Hospital Charge Code	2008045
Hospital Revenue Code	401
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$1,916.00
Rate for Payer: Aetna Commercial	$99.94
Rate for Payer: Aetna Medicare Advantage	$78.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.06
Rate for Payer: Cigna Commercial	$131.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.90
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.45
Rate for Payer: UnitedHealthcare Commercial	$1,916.00
Rate for Payer: UnitedHealthcare Community & State	$6.34
Rate for Payer: Wellpoint Medicaid Managed Care	$6.97

CAD-DIAGOSTIC MAMMOGRAPHY

Facility

$263.00

Service Code	HCPCS 77051
Hospital Charge Code	2008045
Hospital Revenue Code	401
Min. Negotiated Rate	$39.45
Max. Negotiated Rate	$39.45
Rate for Payer: Qualcare PPO/HMO/WC	$39.45

CADEXOMER IODINE 0.9% GEL

Facility

$918.30

Service Code	NDC 40565012249
Hospital Charge Code	60630080
Hospital Revenue Code	250
Min. Negotiated Rate	$22.13
Max. Negotiated Rate	$459.15
Rate for Payer: Aetna Commercial	$348.95
Rate for Payer: Aetna Medicare Advantage	$275.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.17
Rate for Payer: Cigna Commercial	$459.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.49
Rate for Payer: Oxford Commercial	$183.66
Rate for Payer: Qualcare PPO/HMO/WC	$137.75
Rate for Payer: UnitedHealthcare Commercial	$183.66
Rate for Payer: UnitedHealthcare Community & State	$22.13
Rate for Payer: Wellpoint Medicaid Managed Care	$24.33

Know your out-of-pocket cost for care.

All Charges