Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CFH IMPLANT INSERTION

Facility

$715.00

Service Code	HCPCS 11981
Hospital Charge Code	83652635
Hospital Revenue Code	761
Min. Negotiated Rate	$17.23
Max. Negotiated Rate	$570.55
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.50
Rate for Payer: Oxford Commercial	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$107.25
Rate for Payer: UnitedHealthcare Commercial	$143.00
Rate for Payer: UnitedHealthcare Community & State	$17.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$361.89
Rate for Payer: Wellpoint Medicaid Managed Care	$18.95

CFH IMPLANT INSERTION

Facility

$715.00

Service Code	HCPCS 11981
Hospital Charge Code	83652063
Hospital Revenue Code	761
Min. Negotiated Rate	$107.25
Max. Negotiated Rate	$107.25
Rate for Payer: Qualcare PPO/HMO/WC	$107.25

CFH IMPLANT INSERTION

Facility

$715.00

Service Code	HCPCS 11981
Hospital Charge Code	83652635
Hospital Revenue Code	761
Min. Negotiated Rate	$107.25
Max. Negotiated Rate	$107.25
Rate for Payer: Qualcare PPO/HMO/WC	$107.25

CFH IMPLANT REMOVAL

Facility

$2,081.00

Service Code	HCPCS 11976
Hospital Charge Code	83652065
Hospital Revenue Code	761
Min. Negotiated Rate	$50.15
Max. Negotiated Rate	$3,036.77
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,036.77
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.30
Rate for Payer: Oxford Commercial	$416.20
Rate for Payer: Qualcare PPO/HMO/WC	$312.15
Rate for Payer: UnitedHealthcare Commercial	$416.20
Rate for Payer: UnitedHealthcare Community & State	$50.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$55.15

CFH IMPLANT REMOVAL

Facility

$2,081.00

Service Code	HCPCS 11976
Hospital Charge Code	83652065
Hospital Revenue Code	761
Min. Negotiated Rate	$312.15
Max. Negotiated Rate	$312.15
Rate for Payer: Qualcare PPO/HMO/WC	$312.15

CFH INR STRIP

Facility

$176.40

Service Code	HCPCS 85610
Hospital Charge Code	83652281
Hospital Revenue Code	305
Min. Negotiated Rate	$3.43
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$11.67
Rate for Payer: Aetna Medicare Advantage	$13.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.29
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	$15.49
Rate for Payer: Cigna Commercial	$88.20
Rate for Payer: Cigna Medicare Advantage	$4.29
Rate for Payer: Clover Medicare Advantage	$4.08
Rate for Payer: EmblemHealth Commercial	$12.87
Rate for Payer: Humana Medicare Advantage	$4.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.46
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.29
Rate for Payer: Wellcare Medicare Advantage	$4.29
Rate for Payer: Wellpoint Medicaid Managed Care	$4.67

CFH INR STRIP

Facility

$176.40

Service Code	HCPCS 85610
Hospital Charge Code	83652281
Hospital Revenue Code	305
Min. Negotiated Rate	$26.46
Max. Negotiated Rate	$26.46
Rate for Payer: Qualcare PPO/HMO/WC	$26.46

CFH MIRENA IUD

Facility

$284.00

Hospital Charge Code	83652650
Hospital Revenue Code	636
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$68.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.73
Rate for Payer: Qualcare PPO/HMO/WC	$42.60

CFH MIRENA IUD

Facility

$284.00

Hospital Charge Code	83652650
Hospital Revenue Code	636
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$142.00
Rate for Payer: Aetna Commercial	$107.92
Rate for Payer: Aetna Medicare Advantage	$85.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.42
Rate for Payer: Cigna Commercial	$142.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.73
Rate for Payer: Qualcare PPO/HMO/WC	$42.60
Rate for Payer: UnitedHealthcare Community & State	$6.84
Rate for Payer: Wellpoint Medicaid Managed Care	$7.53

CFH NITRO SL 0.4MG TAB

Facility

$2.00

Hospital Charge Code	83652670
Hospital Revenue Code	637
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

CFH NITRO SL 0.4MG TAB

Facility

$2.00

Hospital Charge Code	83652670
Hospital Revenue Code	637
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.76
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.60
Rate for Payer: Oxford Commercial	$0.40
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$0.40
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

CFH PAP SMEAR

Facility

$143.00

Service Code	HCPCS Q0091
Hospital Charge Code	83652640
Hospital Revenue Code	770
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$124.03
Rate for Payer: Aetna Commercial	$93.46
Rate for Payer: Aetna Medicare Advantage	$111.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.03
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: Cigna Medicare Advantage	$34.36
Rate for Payer: Clover Medicare Advantage	$32.64
Rate for Payer: EmblemHealth Commercial	$103.08
Rate for Payer: Humana Medicare Advantage	$35.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.90
Rate for Payer: Oxford Commercial	$28.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.45
Rate for Payer: UnitedHealthcare Commercial	$28.60
Rate for Payer: UnitedHealthcare Community & State	$3.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.36
Rate for Payer: Wellcare Medicare Advantage	$34.36
Rate for Payer: Wellpoint Medicaid Managed Care	$3.79

CFH PAP SMEAR

Facility

$143.00

Service Code	HCPCS Q0091
Hospital Charge Code	83652640
Hospital Revenue Code	770
Min. Negotiated Rate	$21.45
Max. Negotiated Rate	$21.45
Rate for Payer: Qualcare PPO/HMO/WC	$21.45

CFH PAP SMEAR

Facility

$35.00

Service Code	HCPCS 88142
Hospital Charge Code	83652289
Hospital Revenue Code	311
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$55.11
Rate for Payer: Aetna Medicare Advantage	$65.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.13
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: Cigna Medicare Advantage	$20.26
Rate for Payer: Clover Medicare Advantage	$19.25
Rate for Payer: EmblemHealth Commercial	$60.78
Rate for Payer: Humana Medicare Advantage	$20.87
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$16.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.26
Rate for Payer: Wellcare Medicare Advantage	$20.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

CFH PAP SMEAR

Facility

$35.00

Service Code	HCPCS 88142
Hospital Charge Code	83652289
Hospital Revenue Code	311
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

CFH PARAGARD IUD

Facility

$174.00

Service Code	HCPCS J7300
Hospital Charge Code	83652645
Hospital Revenue Code	636
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$42.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.11
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

CFH PARAGARD IUD

Facility

$174.00

Service Code	HCPCS J7300
Hospital Charge Code	83652645
Hospital Revenue Code	636
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$66.12
Rate for Payer: Aetna Medicare Advantage	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.11
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Community & State	$4.19
Rate for Payer: Wellpoint Medicaid Managed Care	$4.61

CFH PED PREV EST PT 1 TO 4 YRS

Facility

$175.00

Service Code	HCPCS 99392
Hospital Charge Code	83652485
Hospital Revenue Code	515
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

CFH PED PREV EST PT 1 TO 4 YRS

Facility

$175.00

Service Code	HCPCS 99392
Hospital Charge Code	83652485
Hospital Revenue Code	515
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

CFH PED PREV EST PT<1 YEAR OLD

Facility

$175.00

Service Code	HCPCS 99391
Hospital Charge Code	83652483
Hospital Revenue Code	515
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

CFH PED PREV EST PT<1 YEAR OLD

Facility

$175.00

Service Code	HCPCS 99391
Hospital Charge Code	83652483
Hospital Revenue Code	515
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

CFH PROFEE: HSP DISCH<=30 MN

Professional

Both

$221.07

Service Code	HCPCS 99238
Hospital Charge Code	83652431
Hospital Revenue Code	960
Min. Negotiated Rate	$22.96
Max. Negotiated Rate	$158.30
Rate for Payer: Aetna Commercial	$77.88
Rate for Payer: Aetna Medicare Advantage	$85.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.96
Rate for Payer: Cigna Commercial	$154.08
Rate for Payer: Cigna Medicare Advantage	$154.08
Rate for Payer: Clover Medicare Advantage	$84.24
Rate for Payer: EmblemHealth Commercial	$85.04
Rate for Payer: Fidelis All Plans	$50.72
Rate for Payer: Healthfirst NY All Plans	$27.01
Rate for Payer: Humana Medicare Advantage	$82.80
Rate for Payer: Marpai Administrators LLC Commercial	$84.42
Rate for Payer: MetroPlus Health All Plans	$27.01
Rate for Payer: Molina Healthcare All Plans	$27.01
Rate for Payer: Oscar Health Commercial	$158.30
Rate for Payer: Tricare Tricare	$77.36
Rate for Payer: UnitedHealthcare Commercial	$80.41
Rate for Payer: UnitedHealthcare Community & State	$80.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$80.41
Rate for Payer: Wellpoint Medicaid Managed Care	$78.17

CFH PROFEE: HSP DISCH>30 MN

Professional

Both

$174.00

Service Code	HCPCS 99239
Hospital Charge Code	83652433
Hospital Revenue Code	960
Min. Negotiated Rate	$38.71
Max. Negotiated Rate	$233.14
Rate for Payer: Aetna Commercial	$132.85
Rate for Payer: Aetna Medicare Advantage	$86.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$58.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.07
Rate for Payer: Cigna Commercial	$207.97
Rate for Payer: Cigna Medicare Advantage	$207.97
Rate for Payer: Clover Medicare Advantage	$114.39
Rate for Payer: Elderplan Medicare Advantage	$115.54
Rate for Payer: EmblemHealth Commercial	$59.29
Rate for Payer: Fidelis All Plans	$76.35
Rate for Payer: Healthfirst NY All Plans	$38.71
Rate for Payer: Humana Medicare Advantage	$107.77
Rate for Payer: Local 1199 Commercial	$86.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.98
Rate for Payer: Marpai Administrators LLC Commercial	$123.04
Rate for Payer: MetroPlus Health All Plans	$38.71
Rate for Payer: Molina Healthcare All Plans	$38.71
Rate for Payer: Oscar Health Commercial	$233.14
Rate for Payer: UnitedHealthcare Commercial	$83.56
Rate for Payer: UnitedHealthcare Community & State	$83.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$83.56
Rate for Payer: Wellpoint Medicaid Managed Care	$118.53

CFH RW BRONCHODILATOR ADMIN

Facility

$171.00

Service Code	HCPCS 94664
Hospital Charge Code	83652381
Hospital Revenue Code	419
Min. Negotiated Rate	$25.65
Max. Negotiated Rate	$25.65
Rate for Payer: Qualcare PPO/HMO/WC	$25.65

CFH RW BRONCHODILATOR ADMIN

Facility

$171.00

Service Code	HCPCS 94664
Hospital Charge Code	83652381
Hospital Revenue Code	419
Min. Negotiated Rate	$4.12
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$707.61
Rate for Payer: Aetna Medicare Advantage	$842.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$939.06
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: Cigna Medicare Advantage	$260.15
Rate for Payer: Clover Medicare Advantage	$247.14
Rate for Payer: EmblemHealth Commercial	$780.45
Rate for Payer: Humana Medicare Advantage	$267.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$260.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.30
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.65
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$4.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$4.53

Know your out-of-pocket cost for care.

All Charges