Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CALCIUM,TOTAL

Facility

$145.00

Service Code	HCPCS 82310
Hospital Charge Code	38472149
Hospital Revenue Code	301
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$21.75
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

CALCIUM UNDECYLENATE POWD 10%

Facility

$13.45

Hospital Charge Code	60628333
Hospital Revenue Code	250
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$6.72
Rate for Payer: Aetna Commercial	$5.11
Rate for Payer: Aetna Medicare Advantage	$4.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.43
Rate for Payer: Cigna Commercial	$6.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.04
Rate for Payer: Oxford Commercial	$2.69
Rate for Payer: Qualcare PPO/HMO/WC	$2.02
Rate for Payer: UnitedHealthcare Commercial	$2.69
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

CALCIUM UNDECYLENATE POWD 10%

Facility

$13.45

Hospital Charge Code	60628333
Hospital Revenue Code	250
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$2.02
Rate for Payer: Qualcare PPO/HMO/WC	$2.02

CALCIUM, URINE

Facility

$52.00

Service Code	HCPCS 82340
Hospital Charge Code	3000585
Hospital Revenue Code	301
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$16.40
Rate for Payer: Aetna Medicare Advantage	$19.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.77
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$5.73
Rate for Payer: EmblemHealth Commercial	$18.09
Rate for Payer: Humana Medicare Advantage	$6.21
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.03
Rate for Payer: Wellcare Medicare Advantage	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

CALCIUM, URINE

Facility

$52.00

Service Code	HCPCS 82340
Hospital Charge Code	3000585
Hospital Revenue Code	301
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

CALCIUM, URINE

Facility

$517.00

Service Code	HCPCS 82340
Hospital Charge Code	38472152
Hospital Revenue Code	301
Min. Negotiated Rate	$77.55
Max. Negotiated Rate	$77.55
Rate for Payer: Qualcare PPO/HMO/WC	$77.55

CALCIUM, URINE

Facility

$517.00

Service Code	HCPCS 82340
Hospital Charge Code	38472152
Hospital Revenue Code	301
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$258.50
Rate for Payer: Aetna Commercial	$16.40
Rate for Payer: Aetna Medicare Advantage	$19.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.77
Rate for Payer: Cigna Commercial	$258.50
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$5.73
Rate for Payer: EmblemHealth Commercial	$18.09
Rate for Payer: Humana Medicare Advantage	$6.21
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$77.55
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.03
Rate for Payer: Wellcare Medicare Advantage	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$13.70

CALCIUM WITH MODIFIER CD

Facility

$54.45

Service Code	HCPCS 82310
Hospital Charge Code	8200303RS
Hospital Revenue Code	301
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$8.17

CALCIUM WITH MODIFIER CD

Facility

$54.45

Service Code	HCPCS 82310
Hospital Charge Code	8200303RS
Hospital Revenue Code	301
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.04
Rate for Payer: Aetna Medicare Advantage	$16.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.16
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	$18.63
Rate for Payer: Cigna Commercial	$27.23
Rate for Payer: Cigna Medicare Advantage	$5.16
Rate for Payer: Clover Medicare Advantage	$4.90
Rate for Payer: EmblemHealth Commercial	$15.48
Rate for Payer: Humana Medicare Advantage	$5.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.17
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.16
Rate for Payer: Wellcare Medicare Advantage	$5.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.44

CALCIUM WITH MODIFIER CE

Facility

$54.45

Service Code	HCPCS 82310CE
Hospital Charge Code	8200304RS
Hospital Revenue Code	301
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$20.69
Rate for Payer: Aetna Medicare Advantage	$16.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.88
Rate for Payer: Cigna Commercial	$27.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.17
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.31
Rate for Payer: Wellpoint Medicaid Managed Care	$1.44

CALCIUM WITH MODIFIER CE

Facility

$54.45

Service Code	HCPCS 82310CE
Hospital Charge Code	8200304RS
Hospital Revenue Code	301
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$8.17

CALCULUS QUANT CHEMICAL

Facility

$91.00

Service Code	HCPCS 82360
Hospital Charge Code	38477109
Hospital Revenue Code	301
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$35.01
Rate for Payer: Aetna Medicare Advantage	$41.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.46
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: Cigna Medicare Advantage	$12.87
Rate for Payer: Clover Medicare Advantage	$12.23
Rate for Payer: EmblemHealth Commercial	$38.61
Rate for Payer: Humana Medicare Advantage	$13.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.87
Rate for Payer: Wellcare Medicare Advantage	$12.87
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

CALCULUS QUANT CHEMICAL

Facility

$91.00

Service Code	HCPCS 82360
Hospital Charge Code	38477109
Hospital Revenue Code	301
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

CALIBRATED DRILL 4.3MM SHORT

Facility

$800.00

Hospital Charge Code	270663170
Hospital Revenue Code	270
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.00
Rate for Payer: Oxford Commercial	$160.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$160.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$21.20

CALIBRATED DRILL 4.3MM SHORT

Facility

$800.00

Hospital Charge Code	270663170
Hospital Revenue Code	270
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

CALIBRATED DRILL BIT 4.2X145MM

Facility

$2,270.00

Hospital Charge Code	270703862
Hospital Revenue Code	272
Min. Negotiated Rate	$340.50
Max. Negotiated Rate	$340.50
Rate for Payer: Qualcare PPO/HMO/WC	$340.50

CALIBRATED DRILL BIT 4.2X145MM

Facility

$2,270.00

Hospital Charge Code	270703862
Hospital Revenue Code	272
Min. Negotiated Rate	$54.71
Max. Negotiated Rate	$1,135.00
Rate for Payer: Aetna Commercial	$862.60
Rate for Payer: Aetna Medicare Advantage	$681.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.85
Rate for Payer: Cigna Commercial	$1,135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$681.00
Rate for Payer: Oxford Commercial	$454.00
Rate for Payer: Qualcare PPO/HMO/WC	$340.50
Rate for Payer: UnitedHealthcare Commercial	$454.00
Rate for Payer: UnitedHealthcare Community & State	$54.71
Rate for Payer: Wellpoint Medicaid Managed Care	$60.16

CALIBRATED DRILL BIT 4.3

Facility

$1,550.00

Hospital Charge Code	270657812
Hospital Revenue Code	272
Min. Negotiated Rate	$37.35
Max. Negotiated Rate	$775.00
Rate for Payer: Aetna Commercial	$589.00
Rate for Payer: Aetna Medicare Advantage	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.25
Rate for Payer: Cigna Commercial	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$465.00
Rate for Payer: Oxford Commercial	$310.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.50
Rate for Payer: UnitedHealthcare Commercial	$310.00
Rate for Payer: UnitedHealthcare Community & State	$37.35
Rate for Payer: Wellpoint Medicaid Managed Care	$41.08

CALIBRATED DRILL BIT 4.3

Facility

$1,550.00

Hospital Charge Code	270657812
Hospital Revenue Code	272
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$232.50
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

CALIBRATION VALIDATION PRODUCT

Facility

$24.00

Hospital Charge Code	270658860
Hospital Revenue Code	270
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$9.12
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.20
Rate for Payer: Oxford Commercial	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$4.80
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

CALIBRATION VALIDATION PRODUCT

Facility

$24.00

Hospital Charge Code	270658860
Hospital Revenue Code	270
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

CALOTTE FULL DUR SHP-555-CLT12

Facility

$6,200.00

Hospital Charge Code	270620695
Hospital Revenue Code	272
Min. Negotiated Rate	$149.42
Max. Negotiated Rate	$3,100.00
Rate for Payer: Aetna Commercial	$2,356.00
Rate for Payer: Aetna Medicare Advantage	$1,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,581.00
Rate for Payer: Cigna Commercial	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,860.00
Rate for Payer: Oxford Commercial	$1,240.00
Rate for Payer: Qualcare PPO/HMO/WC	$930.00
Rate for Payer: UnitedHealthcare Commercial	$1,240.00
Rate for Payer: UnitedHealthcare Community & State	$149.42
Rate for Payer: Wellpoint Medicaid Managed Care	$164.30

CALOTTE FULL DUR SHP-555-CLT12

Facility

$6,200.00

Hospital Charge Code	270620695
Hospital Revenue Code	272
Min. Negotiated Rate	$930.00
Max. Negotiated Rate	$930.00
Rate for Payer: Qualcare PPO/HMO/WC	$930.00

CALPORTECTIN, STOOL

Facility

$134.90

Service Code	HCPCS 83993
Hospital Charge Code	39900117
Hospital Revenue Code	301
Min. Negotiated Rate	$20.23
Max. Negotiated Rate	$20.23
Rate for Payer: Qualcare PPO/HMO/WC	$20.23

CALPORTECTIN, STOOL

Facility

$134.90

Service Code	HCPCS 83993
Hospital Charge Code	39900117
Hospital Revenue Code	301
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$53.39
Rate for Payer: Aetna Medicare Advantage	$63.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.86
Rate for Payer: Cigna Commercial	$67.45
Rate for Payer: Cigna Medicare Advantage	$19.63
Rate for Payer: Clover Medicare Advantage	$18.65
Rate for Payer: EmblemHealth Commercial	$58.89
Rate for Payer: Humana Medicare Advantage	$20.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.47
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.23
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.63
Rate for Payer: Wellcare Medicare Advantage	$19.63
Rate for Payer: Wellpoint Medicaid Managed Care	$3.57

Know your out-of-pocket cost for care.

All Charges