Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CARDENE/20MG/CAP

Facility

$6.00

Hospital Charge Code	60632625
Hospital Revenue Code	250
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	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

CARDENE/20MG/CAP

Facility

$6.00

Hospital Charge Code	60632625
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

CARDENE/30MG/CAP

Facility

$6.00

Hospital Charge Code	60632627
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

CARDENE/30MG/CAP

Facility

$6.00

Hospital Charge Code	60632626
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

CARDENE/30MG/CAP

Facility

$6.00

Hospital Charge Code	60632626
Hospital Revenue Code	250
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	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

CARDENE/30MG/CAP

Facility

$6.00

Hospital Charge Code	60632627
Hospital Revenue Code	250
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	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

CARDENE IV 25MG

Facility

$147.00

Hospital Charge Code	60635173
Hospital Revenue Code	250
Min. Negotiated Rate	$3.54
Max. Negotiated Rate	$73.50
Rate for Payer: Aetna Commercial	$55.86
Rate for Payer: Aetna Medicare Advantage	$44.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.48
Rate for Payer: Cigna Commercial	$73.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.10
Rate for Payer: Oxford Commercial	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$22.05
Rate for Payer: UnitedHealthcare Commercial	$29.40
Rate for Payer: UnitedHealthcare Community & State	$3.54
Rate for Payer: Wellpoint Medicaid Managed Care	$3.90

CARDENE IV 25MG

Facility

$147.00

Hospital Charge Code	60635173
Hospital Revenue Code	250
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$22.05
Rate for Payer: Qualcare PPO/HMO/WC	$22.05

CARDENE IV 25MG AMP

Facility

$773.00

Hospital Charge Code	60635691
Hospital Revenue Code	250
Min. Negotiated Rate	$115.95
Max. Negotiated Rate	$115.95
Rate for Payer: Qualcare PPO/HMO/WC	$115.95

CARDENE IV 25MG AMP

Facility

$773.00

Hospital Charge Code	60635691
Hospital Revenue Code	250
Min. Negotiated Rate	$18.63
Max. Negotiated Rate	$386.50
Rate for Payer: Aetna Commercial	$293.74
Rate for Payer: Aetna Medicare Advantage	$231.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.12
Rate for Payer: Cigna Commercial	$386.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.90
Rate for Payer: Oxford Commercial	$154.60
Rate for Payer: Qualcare PPO/HMO/WC	$115.95
Rate for Payer: UnitedHealthcare Commercial	$154.60
Rate for Payer: UnitedHealthcare Community & State	$18.63
Rate for Payer: Wellpoint Medicaid Managed Care	$20.48

CARDIAC ARREST AND SHOCK

Facility

$6,969.56

Service Code	APR-DRG 1962
Min. Negotiated Rate	$6,832.90
Max. Negotiated Rate	$6,969.56
Rate for Payer: UnitedHealthcare Community & State	$6,832.90
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,969.56
Rate for Payer: Wellpoint Medicaid Managed Care	$6,832.90

CARDIAC ARREST AND SHOCK

Facility

$20,234.58

Service Code	APR-DRG 1964
Min. Negotiated Rate	$19,837.82
Max. Negotiated Rate	$20,234.58
Rate for Payer: UnitedHealthcare Community & State	$19,837.82
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,234.58
Rate for Payer: Wellpoint Medicaid Managed Care	$19,837.82

CARDIAC ARREST AND SHOCK

Facility

$4,983.02

Service Code	APR-DRG 1961
Min. Negotiated Rate	$4,885.31
Max. Negotiated Rate	$4,983.02
Rate for Payer: UnitedHealthcare Community & State	$4,885.31
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,983.02
Rate for Payer: Wellpoint Medicaid Managed Care	$4,885.31

CARDIAC ARREST AND SHOCK

Facility

$11,014.16

Service Code	APR-DRG 1963
Min. Negotiated Rate	$10,798.20
Max. Negotiated Rate	$11,014.16
Rate for Payer: UnitedHealthcare Community & State	$10,798.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,014.16
Rate for Payer: Wellpoint Medicaid Managed Care	$10,798.20

CARDIAC ARREST, UNEXPLAINED WITH CC

Facility

$22,626.02

Service Code	MSDRG 297
Min. Negotiated Rate	$6,889.33
Max. Negotiated Rate	$22,626.02
Rate for Payer: Aetna Commercial	$15,804.00
Rate for Payer: Aetna Medicare Advantage	$22,626.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,251.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16,980.53
Rate for Payer: Cigna Commercial	$11,668.18
Rate for Payer: Cigna Medicare Advantage	$7,251.93
Rate for Payer: Clover Medicare Advantage	$6,889.33
Rate for Payer: EmblemHealth Commercial	$21,755.79
Rate for Payer: Humana Medicare Advantage	$7,469.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,251.93
Rate for Payer: Oxford Commercial	$8,386.08
Rate for Payer: UnitedHealthcare Commercial	$14,705.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,251.93
Rate for Payer: Wellcare Medicare Advantage	$7,251.93

CARDIAC ARREST, UNEXPLAINED WITH MCC

Facility

$52,617.24

Service Code	MSDRG 296
Min. Negotiated Rate	$16,021.27
Max. Negotiated Rate	$52,617.24
Rate for Payer: Aetna Commercial	$36,411.35
Rate for Payer: Aetna Medicare Advantage	$52,617.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37,217.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37,217.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,864.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37,217.60
Rate for Payer: Cigna Commercial	$29,229.40
Rate for Payer: Cigna Medicare Advantage	$16,864.50
Rate for Payer: Clover Medicare Advantage	$16,021.27
Rate for Payer: EmblemHealth Commercial	$50,593.50
Rate for Payer: Humana Medicare Advantage	$17,370.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,864.50
Rate for Payer: Oxford Commercial	$21,007.56
Rate for Payer: UnitedHealthcare Commercial	$36,837.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,864.50
Rate for Payer: Wellcare Medicare Advantage	$16,864.50

CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC

Facility

$16,843.66

Service Code	MSDRG 298
Min. Negotiated Rate	$5,128.68
Max. Negotiated Rate	$16,843.66
Rate for Payer: Aetna Commercial	$11,830.82
Rate for Payer: Aetna Medicare Advantage	$16,843.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,234.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,234.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5,398.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,234.84
Rate for Payer: Cigna Commercial	$8,516.74
Rate for Payer: Cigna Medicare Advantage	$5,398.61
Rate for Payer: Clover Medicare Advantage	$5,128.68
Rate for Payer: EmblemHealth Commercial	$16,195.83
Rate for Payer: Humana Medicare Advantage	$5,560.57
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5,398.61
Rate for Payer: Oxford Commercial	$6,121.10
Rate for Payer: UnitedHealthcare Commercial	$10,733.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$5,398.61
Rate for Payer: Wellcare Medicare Advantage	$5,398.61

CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS

Facility

$19,804.35

Service Code	APR-DRG 2014
Min. Negotiated Rate	$19,416.03
Max. Negotiated Rate	$19,804.35
Rate for Payer: UnitedHealthcare Community & State	$19,416.03
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,804.35
Rate for Payer: Wellpoint Medicaid Managed Care	$19,416.03

CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS

Facility

$7,139.37

Service Code	APR-DRG 2012
Min. Negotiated Rate	$6,999.38
Max. Negotiated Rate	$7,139.37
Rate for Payer: UnitedHealthcare Community & State	$6,999.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,139.37
Rate for Payer: Wellpoint Medicaid Managed Care	$6,999.38

CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS

Facility

$5,525.62

Service Code	APR-DRG 2011
Min. Negotiated Rate	$5,417.27
Max. Negotiated Rate	$5,525.62
Rate for Payer: UnitedHealthcare Community & State	$5,417.27
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,525.62
Rate for Payer: Wellpoint Medicaid Managed Care	$5,417.27

CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS

Facility

$10,867.39

Service Code	APR-DRG 2013
Min. Negotiated Rate	$10,654.30
Max. Negotiated Rate	$10,867.39
Rate for Payer: UnitedHealthcare Community & State	$10,654.30
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,867.39
Rate for Payer: Wellpoint Medicaid Managed Care	$10,654.30

CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC

Facility

$25,913.13

Service Code	MSDRG 309
Min. Negotiated Rate	$7,890.22
Max. Negotiated Rate	$25,913.13
Rate for Payer: Aetna Commercial	$18,062.58
Rate for Payer: Aetna Medicare Advantage	$25,913.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,213.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,213.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,305.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,213.14
Rate for Payer: Cigna Commercial	$13,767.89
Rate for Payer: Cigna Medicare Advantage	$8,305.49
Rate for Payer: Clover Medicare Advantage	$7,890.22
Rate for Payer: EmblemHealth Commercial	$24,916.47
Rate for Payer: Humana Medicare Advantage	$8,554.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,305.49
Rate for Payer: Oxford Commercial	$9,895.17
Rate for Payer: UnitedHealthcare Commercial	$17,351.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,305.49
Rate for Payer: Wellcare Medicare Advantage	$8,305.49

CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC

Facility

$41,049.37

Service Code	MSDRG 308
Min. Negotiated Rate	$12,499.01
Max. Negotiated Rate	$41,049.37
Rate for Payer: Aetna Commercial	$28,462.92
Rate for Payer: Aetna Medicare Advantage	$41,049.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,913.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,913.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,156.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,913.20
Rate for Payer: Cigna Commercial	$22,531.66
Rate for Payer: Cigna Medicare Advantage	$13,156.85
Rate for Payer: Clover Medicare Advantage	$12,499.01
Rate for Payer: EmblemHealth Commercial	$39,470.55
Rate for Payer: Humana Medicare Advantage	$13,551.56
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,156.85
Rate for Payer: Oxford Commercial	$16,193.80
Rate for Payer: UnitedHealthcare Commercial	$28,396.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,156.85
Rate for Payer: Wellcare Medicare Advantage	$13,156.85

CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC

Facility

$20,431.38

Service Code	MSDRG 310
Min. Negotiated Rate	$6,221.09
Max. Negotiated Rate	$20,431.38
Rate for Payer: Aetna Commercial	$14,295.99
Rate for Payer: Aetna Medicare Advantage	$20,431.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,793.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,793.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,548.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,793.55
Rate for Payer: Cigna Commercial	$10,594.00
Rate for Payer: Cigna Medicare Advantage	$6,548.52
Rate for Payer: Clover Medicare Advantage	$6,221.09
Rate for Payer: EmblemHealth Commercial	$19,645.56
Rate for Payer: Humana Medicare Advantage	$6,744.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,548.52
Rate for Payer: Oxford Commercial	$7,614.05
Rate for Payer: UnitedHealthcare Commercial	$13,351.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,548.52
Rate for Payer: Wellcare Medicare Advantage	$6,548.52

CARDIAC CATHETERIZATION****

Facility

$5,130.00

Service Code	HCPCS 99999
Hospital Charge Code	5100011
Hospital Revenue Code	481
Min. Negotiated Rate	$769.50
Max. Negotiated Rate	$769.50
Rate for Payer: Qualcare PPO/HMO/WC	$769.50

Know your out-of-pocket cost for care.

All Charges