Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CARD TOMOGRAPHIC MULT STUDIES

Facility

$6,315.40

Service Code	HCPCS 78452
Hospital Charge Code	36540005
Hospital Revenue Code	341
Min. Negotiated Rate	$947.31
Max. Negotiated Rate	$947.31
Rate for Payer: Qualcare PPO/HMO/WC	$947.31

CARDURA TAB 8 MG

Facility

$4.00

Hospital Charge Code	60635341
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

CARDURA TAB 8 MG

Facility

$4.00

Hospital Charge Code	60635341
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

CARD US STRESS ECHO/CONTRAST

Facility

$3,311.10

Hospital Charge Code	5308010
Hospital Revenue Code	483
Min. Negotiated Rate	$79.80
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,258.22
Rate for Payer: Aetna Medicare Advantage	$993.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$844.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$844.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$844.33
Rate for Payer: Cigna Commercial	$1,655.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$993.33
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$496.67
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$79.80
Rate for Payer: Wellpoint Medicaid Managed Care	$87.74

CARD US STRESS ECHO/CONTRAST

Facility

$3,311.10

Hospital Charge Code	5308010
Hospital Revenue Code	483
Min. Negotiated Rate	$496.67
Max. Negotiated Rate	$496.67
Rate for Payer: Qualcare PPO/HMO/WC	$496.67

CARD US STRESS ECHO/CONTRAST

Facility

$5,900.00

Hospital Charge Code	74117073
Hospital Revenue Code	483
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$2,950.00
Rate for Payer: Aetna Commercial	$2,242.00
Rate for Payer: Aetna Medicare Advantage	$1,770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,504.50
Rate for Payer: Cigna Commercial	$2,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.00
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$142.19
Rate for Payer: Wellpoint Medicaid Managed Care	$156.35

CARD US STRESS ECHO/CONTRAST

Facility

$3,311.10

Hospital Charge Code	74115073
Hospital Revenue Code	483
Min. Negotiated Rate	$496.67
Max. Negotiated Rate	$496.67
Rate for Payer: Qualcare PPO/HMO/WC	$496.67

CARD US STRESS ECHO/CONTRAST

Facility

$3,311.10

Hospital Charge Code	74116073
Hospital Revenue Code	483
Min. Negotiated Rate	$79.80
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,258.22
Rate for Payer: Aetna Medicare Advantage	$993.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$844.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$844.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$844.33
Rate for Payer: Cigna Commercial	$1,655.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$993.33
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$496.67
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$79.80
Rate for Payer: Wellpoint Medicaid Managed Care	$87.74

CARD US STRESS ECHO/CONTRAST

Facility

$3,311.10

Hospital Charge Code	74115073
Hospital Revenue Code	483
Min. Negotiated Rate	$79.80
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,258.22
Rate for Payer: Aetna Medicare Advantage	$993.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$844.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$844.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$844.33
Rate for Payer: Cigna Commercial	$1,655.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$993.33
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$496.67
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$79.80
Rate for Payer: Wellpoint Medicaid Managed Care	$87.74

CARD US STRESS ECHO/CONTRAST

Facility

$3,311.10

Hospital Charge Code	74116073
Hospital Revenue Code	483
Min. Negotiated Rate	$496.67
Max. Negotiated Rate	$496.67
Rate for Payer: Qualcare PPO/HMO/WC	$496.67

CARD US STRESS ECHO/CONTRAST

Facility

$5,900.00

Hospital Charge Code	74117073
Hospital Revenue Code	483
Min. Negotiated Rate	$885.00
Max. Negotiated Rate	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00

CARD US TEE/CONTRAST

Facility

$3,311.10

Hospital Charge Code	5308005
Hospital Revenue Code	483
Min. Negotiated Rate	$79.80
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,258.22
Rate for Payer: Aetna Medicare Advantage	$993.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$844.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$844.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$844.33
Rate for Payer: Cigna Commercial	$1,655.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$993.33
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$496.67
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$79.80
Rate for Payer: Wellpoint Medicaid Managed Care	$87.74

CARD US TEE/CONTRAST

Facility

$3,311.10

Hospital Charge Code	5308005
Hospital Revenue Code	483
Min. Negotiated Rate	$496.67
Max. Negotiated Rate	$496.67
Rate for Payer: Qualcare PPO/HMO/WC	$496.67

CARISOPRODOL ASP TAB 200/325MG

Facility

$13.65

Hospital Charge Code	60627480
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$5.19
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.09
Rate for Payer: Oxford Commercial	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$2.73
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

CARISOPRODOL ASP TAB 200/325MG

Facility

$13.65

Hospital Charge Code	60627480
Hospital Revenue Code	250
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

CARNITINE AMP IV 1GM

Facility

$256.65

Hospital Charge Code	6010490
Hospital Revenue Code	250
Min. Negotiated Rate	$38.50
Max. Negotiated Rate	$38.50
Rate for Payer: Qualcare PPO/HMO/WC	$38.50

CARNITINE AMP IV 1GM

Facility

$256.65

Hospital Charge Code	6010490
Hospital Revenue Code	250
Min. Negotiated Rate	$6.19
Max. Negotiated Rate	$128.32
Rate for Payer: Aetna Commercial	$97.53
Rate for Payer: Aetna Medicare Advantage	$77.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.45
Rate for Payer: Cigna Commercial	$128.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.00
Rate for Payer: Oxford Commercial	$51.33
Rate for Payer: Qualcare PPO/HMO/WC	$38.50
Rate for Payer: UnitedHealthcare Commercial	$51.33
Rate for Payer: UnitedHealthcare Community & State	$6.19
Rate for Payer: Wellpoint Medicaid Managed Care	$6.80

CARNITINE (FREE & TOTAL)

Facility

$646.00

Service Code	HCPCS 82379
Hospital Charge Code	38472923
Hospital Revenue Code	301
Min. Negotiated Rate	$96.90
Max. Negotiated Rate	$96.90
Rate for Payer: Qualcare PPO/HMO/WC	$96.90

CARNITINE (FREE & TOTAL)

Facility

$646.00

Service Code	HCPCS 82379
Hospital Charge Code	38472923
Hospital Revenue Code	301
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$323.00
Rate for Payer: Aetna Commercial	$45.89
Rate for Payer: Aetna Medicare Advantage	$54.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.90
Rate for Payer: Cigna Commercial	$323.00
Rate for Payer: Cigna Medicare Advantage	$16.87
Rate for Payer: Clover Medicare Advantage	$16.03
Rate for Payer: EmblemHealth Commercial	$50.61
Rate for Payer: Humana Medicare Advantage	$17.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.90
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.87
Rate for Payer: Wellcare Medicare Advantage	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$17.12

CARNITINE TOTAL PANEL A

Facility

$167.25

Service Code	HCPCS 82379
Hospital Charge Code	3009867A
Hospital Revenue Code	301
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$25.09
Rate for Payer: Qualcare PPO/HMO/WC	$25.09

CARNITINE TOTAL PANEL A

Facility

$167.25

Service Code	HCPCS 82379
Hospital Charge Code	3009867A
Hospital Revenue Code	301
Min. Negotiated Rate	$4.43
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.89
Rate for Payer: Aetna Medicare Advantage	$54.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.90
Rate for Payer: Cigna Commercial	$83.62
Rate for Payer: Cigna Medicare Advantage	$16.87
Rate for Payer: Clover Medicare Advantage	$16.03
Rate for Payer: EmblemHealth Commercial	$50.61
Rate for Payer: Humana Medicare Advantage	$17.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.09
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.87
Rate for Payer: Wellcare Medicare Advantage	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$4.43

CARNITINE TOTAL PANEL B

Facility

$167.25

Service Code	HCPCS 82379
Hospital Charge Code	3009867B
Hospital Revenue Code	301
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$25.09
Rate for Payer: Qualcare PPO/HMO/WC	$25.09

CARNITINE TOTAL PANEL B

Facility

$167.25

Service Code	HCPCS 82379
Hospital Charge Code	3009867B
Hospital Revenue Code	301
Min. Negotiated Rate	$4.43
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.89
Rate for Payer: Aetna Medicare Advantage	$54.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.90
Rate for Payer: Cigna Commercial	$83.62
Rate for Payer: Cigna Medicare Advantage	$16.87
Rate for Payer: Clover Medicare Advantage	$16.03
Rate for Payer: EmblemHealth Commercial	$50.61
Rate for Payer: Humana Medicare Advantage	$17.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.09
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.87
Rate for Payer: Wellcare Medicare Advantage	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$4.43

CARNITOR 1GM LEVOCRNTNE 5ML VL

Facility

$19.30

Service Code	HCPCS J1955
Hospital Charge Code	6000382
Hospital Revenue Code	636
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$4.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.67
Rate for Payer: Qualcare PPO/HMO/WC	$2.90

CARNITOR 1GM LEVOCRNTNE 5ML VL

Facility

$19.30

Service Code	HCPCS J1955
Hospital Charge Code	6000382
Hospital Revenue Code	636
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$9.65
Rate for Payer: Aetna Commercial	$7.33
Rate for Payer: Aetna Medicare Advantage	$5.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.92
Rate for Payer: Cigna Commercial	$9.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.67
Rate for Payer: Qualcare PPO/HMO/WC	$2.90
Rate for Payer: UnitedHealthcare Community & State	$0.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

Know your out-of-pocket cost for care.

All Charges