Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CAP GROSHONG CONN & INJ (DB***

Facility

$30.25

Hospital Charge Code	8002891
Hospital Revenue Code	279
Min. Negotiated Rate	$4.54
Max. Negotiated Rate	$4.54
Rate for Payer: Qualcare PPO/HMO/WC	$4.54

CAP GROSHONG CONN & INJ (DBL**

Facility

$30.25

Hospital Charge Code	8002883
Hospital Revenue Code	279
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$15.12
Rate for Payer: Aetna Commercial	$11.49
Rate for Payer: Aetna Medicare Advantage	$9.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.71
Rate for Payer: Cigna Commercial	$15.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.07
Rate for Payer: Oxford Commercial	$6.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.54
Rate for Payer: UnitedHealthcare Commercial	$6.05
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

CAP GROSHONG CONN & INJ (DBL**

Facility

$30.25

Hospital Charge Code	8002883
Hospital Revenue Code	279
Min. Negotiated Rate	$4.54
Max. Negotiated Rate	$4.54
Rate for Payer: Qualcare PPO/HMO/WC	$4.54

CAP GROSHONG CONN & INJ SNGL**

Facility

$30.25

Hospital Charge Code	8002875
Hospital Revenue Code	279
Min. Negotiated Rate	$4.54
Max. Negotiated Rate	$4.54
Rate for Payer: Qualcare PPO/HMO/WC	$4.54

CAP GROSHONG CONN & INJ SNGL**

Facility

$30.25

Hospital Charge Code	8002875
Hospital Revenue Code	279
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$15.12
Rate for Payer: Aetna Commercial	$11.49
Rate for Payer: Aetna Medicare Advantage	$9.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.71
Rate for Payer: Cigna Commercial	$15.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.07
Rate for Payer: Oxford Commercial	$6.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.54
Rate for Payer: UnitedHealthcare Commercial	$6.05
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

CAP GROSHONG INJECTION***

Facility

$9.00

Hospital Charge Code	8002867
Hospital Revenue Code	279
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

CAP GROSHONG INJECTION***

Facility

$9.00

Hospital Charge Code	8002867
Hospital Revenue Code	279
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

CAPHOSOL RINSE

Facility

$5.76

Service Code	NDC 50930009808
Hospital Charge Code	6063943071
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.88
Rate for Payer: Aetna Commercial	$2.19
Rate for Payer: Aetna Medicare Advantage	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.47
Rate for Payer: Cigna Commercial	$2.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.73
Rate for Payer: Oxford Commercial	$1.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.86
Rate for Payer: UnitedHealthcare Commercial	$1.15
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

CAPHOSOL RINSE

Facility

$5.76

Service Code	NDC 50930009808
Hospital Charge Code	6063943071
Hospital Revenue Code	250
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$0.86
Rate for Payer: Qualcare PPO/HMO/WC	$0.86

CAPILLARY BLOOD DRAW/HEELSTICK

Facility

$14.00

Hospital Charge Code	83092031
Hospital Revenue Code	300
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

CAPILLARY BLOOD DRAW/HEELSTICK

Facility

$14.00

Hospital Charge Code	83092031
Hospital Revenue Code	300
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$5.32
Rate for Payer: Aetna Medicare Advantage	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.57
Rate for Payer: Cigna Commercial	$7.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

CAPILLARY BLOOD DRAW/HEELSTICK

Facility

$14.00

Hospital Charge Code	83091021
Hospital Revenue Code	300
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

CAPILLARY BLOOD DRAW/HEELSTICK

Facility

$14.00

Hospital Charge Code	83091021
Hospital Revenue Code	300
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$5.32
Rate for Payer: Aetna Medicare Advantage	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.57
Rate for Payer: Cigna Commercial	$7.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

CAPILLARY COLLECTION

Facility

$14.00

Service Code	HCPCS 36416
Hospital Charge Code	39708024A
Hospital Revenue Code	300
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$5.32
Rate for Payer: Aetna Medicare Advantage	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.57
Rate for Payer: Cigna Commercial	$7.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

CAPILLARY COLLECTION

Facility

$14.00

Service Code	HCPCS 36416
Hospital Charge Code	39708024A
Hospital Revenue Code	300
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

CAP INJECTION/HEPARIN LOCK***

Facility

$9.00

Hospital Charge Code	7000532
Hospital Revenue Code	279
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

CAP INJECTION/HEPARIN LOCK***

Facility

$9.00

Hospital Charge Code	7000532
Hospital Revenue Code	279
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

CAP INJ/HEPAR LOCK EXT NF1310

Facility

$24.10

Hospital Charge Code	270041086
Hospital Revenue Code	270
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$12.05
Rate for Payer: Aetna Commercial	$9.16
Rate for Payer: Aetna Medicare Advantage	$7.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.23
Rate for Payer: Oxford Commercial	$4.82
Rate for Payer: Qualcare PPO/HMO/WC	$3.62
Rate for Payer: UnitedHealthcare Commercial	$4.82
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

CAP INJ/HEPAR LOCK EXT NF1310

Facility

$24.10

Hospital Charge Code	270041086
Hospital Revenue Code	270
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$3.62
Rate for Payer: Qualcare PPO/HMO/WC	$3.62

CAP INJ/HEPAR LOCK NF9100

Facility

$5.91

Hospital Charge Code	270041085
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.96
Rate for Payer: Aetna Commercial	$2.25
Rate for Payer: Aetna Medicare Advantage	$1.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.51
Rate for Payer: Cigna Commercial	$2.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.77
Rate for Payer: Oxford Commercial	$1.18
Rate for Payer: Qualcare PPO/HMO/WC	$0.89
Rate for Payer: UnitedHealthcare Commercial	$1.18
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

CAP INJ/HEPAR LOCK NF9100

Facility

$5.91

Hospital Charge Code	270041085
Hospital Revenue Code	272
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$0.89
Rate for Payer: Qualcare PPO/HMO/WC	$0.89

CAPIO DEVICE

Facility

$418.00

Hospital Charge Code	270335481
Hospital Revenue Code	278
Min. Negotiated Rate	$62.70
Max. Negotiated Rate	$101.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$91.96
Rate for Payer: Qualcare PPO/HMO/WC	$62.70

CAPIO DEVICE

Facility

$418.00

Hospital Charge Code	270335481
Hospital Revenue Code	278
Min. Negotiated Rate	$10.07
Max. Negotiated Rate	$209.00
Rate for Payer: Aetna Commercial	$158.84
Rate for Payer: Aetna Medicare Advantage	$125.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.59
Rate for Payer: Cigna Commercial	$209.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$91.96
Rate for Payer: Qualcare PPO/HMO/WC	$62.70
Rate for Payer: UnitedHealthcare Community & State	$10.07
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CAPIO SUTURE

Facility

$73.00

Hospital Charge Code	270335482
Hospital Revenue Code	278
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$36.50
Rate for Payer: Aetna Commercial	$27.74
Rate for Payer: Aetna Medicare Advantage	$21.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.61
Rate for Payer: Cigna Commercial	$36.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.06
Rate for Payer: Qualcare PPO/HMO/WC	$10.95
Rate for Payer: UnitedHealthcare Community & State	$1.76
Rate for Payer: Wellpoint Medicaid Managed Care	$1.93

CAPIO SUTURE

Facility

$73.00

Hospital Charge Code	270335482
Hospital Revenue Code	278
Min. Negotiated Rate	$10.95
Max. Negotiated Rate	$17.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.06
Rate for Payer: Qualcare PPO/HMO/WC	$10.95

Know your out-of-pocket cost for care.

All Charges