Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CFH WC COLPOSCOPY WITH BIOPSY

Facility

$863.00

Service Code	HCPCS 57454
Hospital Charge Code	83652139
Hospital Revenue Code	361
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$984.72
Rate for Payer: Aetna Medicare Advantage	$1,172.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,306.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,306.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$362.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,306.82
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: Cigna Medicare Advantage	$362.03
Rate for Payer: Clover Medicare Advantage	$343.93
Rate for Payer: EmblemHealth Commercial	$1,086.09
Rate for Payer: Humana Medicare Advantage	$372.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$362.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.90
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$129.45
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$20.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$362.03
Rate for Payer: Wellcare Medicare Advantage	$362.03
Rate for Payer: Wellpoint Medicaid Managed Care	$22.87

CFH WC C SECTION ONLY

Professional

Both

$8,085.00

Service Code	HCPCS 59514
Hospital Charge Code	83652233
Hospital Revenue Code	960
Min. Negotiated Rate	$358.20
Max. Negotiated Rate	$2,742.00
Rate for Payer: Aetna Commercial	$1,165.83
Rate for Payer: Aetna Medicare Advantage	$1,165.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,742.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,742.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,742.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,742.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,742.00
Rate for Payer: Cigna Commercial	$1,437.29
Rate for Payer: Cigna Medicare Advantage	$1,437.29
Rate for Payer: Fidelis All Plans	$748.91
Rate for Payer: Tricare Tricare	$1,250.89
Rate for Payer: UnitedHealthcare Commercial	$358.20
Rate for Payer: UnitedHealthcare Community & State	$358.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$358.20
Rate for Payer: Wellpoint Medicaid Managed Care	$768.33

CFH WC CURETTAGE,POSTPARTUM

Professional

Both

$1,300.00

Service Code	HCPCS 59160
Hospital Charge Code	83652209
Hospital Revenue Code	960
Min. Negotiated Rate	$418.92
Max. Negotiated Rate	$587.70
Rate for Payer: Aetna Medicare Advantage	$418.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$587.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$587.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$587.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$587.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$587.70
Rate for Payer: Cigna Commercial	$418.92
Rate for Payer: Cigna Medicare Advantage	$418.92

CFH WC EST.PT E&M MINIMAL

Facility

$311.00

Service Code	HCPCS 99211
Hospital Charge Code	83652403
Hospital Revenue Code	514
Min. Negotiated Rate	$46.65
Max. Negotiated Rate	$46.65
Rate for Payer: Qualcare PPO/HMO/WC	$46.65

CFH WC EST.PT E&M MINIMAL

Facility

$311.00

Service Code	HCPCS 99211
Hospital Charge Code	83652403
Hospital Revenue Code	514
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$155.50
Rate for Payer: Aetna Commercial	$118.18
Rate for Payer: Aetna Medicare Advantage	$93.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.31
Rate for Payer: Cigna Commercial	$155.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.30
Rate for Payer: Qualcare PPO/HMO/WC	$46.65
Rate for Payer: UnitedHealthcare Community & State	$7.50
Rate for Payer: Wellpoint Medicaid Managed Care	$8.24

CFH WC FAILED BAC ONLY

Professional

Both

$9,489.90

Service Code	HCPCS 59620
Hospital Charge Code	83652245
Hospital Revenue Code	960
Min. Negotiated Rate	$1,512.61
Max. Negotiated Rate	$1,512.61
Rate for Payer: Aetna Medicare Advantage	$1,512.61
Rate for Payer: UnitedHealthcare Commercial	$1,512.61
Rate for Payer: UnitedHealthcare Community & State	$1,512.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,512.61

CFH WC FETAL NON STRESS TEST

Facility

$1,898.40

Service Code	HCPCS 59025
Hospital Charge Code	83652197
Hospital Revenue Code	761
Min. Negotiated Rate	$284.76
Max. Negotiated Rate	$284.76
Rate for Payer: Qualcare PPO/HMO/WC	$284.76

CFH WC FETAL NON STRESS TEST

Facility

$1,898.40

Service Code	HCPCS 59025
Hospital Charge Code	83652197
Hospital Revenue Code	761
Min. Negotiated Rate	$45.75
Max. Negotiated Rate	$866.98
Rate for Payer: Aetna Commercial	$653.29
Rate for Payer: Aetna Medicare Advantage	$778.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$866.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$866.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$240.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$503.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$866.98
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: Cigna Medicare Advantage	$240.18
Rate for Payer: Clover Medicare Advantage	$228.17
Rate for Payer: EmblemHealth Commercial	$720.54
Rate for Payer: Humana Medicare Advantage	$247.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$240.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$569.52
Rate for Payer: Oxford Commercial	$379.68
Rate for Payer: Qualcare PPO/HMO/WC	$284.76
Rate for Payer: UnitedHealthcare Commercial	$379.68
Rate for Payer: UnitedHealthcare Community & State	$45.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$240.18
Rate for Payer: Wellcare Medicare Advantage	$240.18
Rate for Payer: Wellpoint Medicaid Managed Care	$50.31

CFH WC HEMOCULT-BLOOD OCULT-

Facility

$23.00

Service Code	HCPCS 82270
Hospital Charge Code	83652277
Hospital Revenue Code	301
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

CFH WC HEMOCULT-BLOOD OCULT-

Facility

$23.00

Service Code	HCPCS 82270
Hospital Charge Code	83652277
Hospital Revenue Code	301
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$11.91
Rate for Payer: Aetna Medicare Advantage	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.81
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: Cigna Medicare Advantage	$4.38
Rate for Payer: Clover Medicare Advantage	$4.16
Rate for Payer: EmblemHealth Commercial	$13.14
Rate for Payer: Humana Medicare Advantage	$4.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.38
Rate for Payer: Wellcare Medicare Advantage	$4.38
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

CFH WC I&D BARTHOLINS ABSCESS

Facility

$942.15

Service Code	HCPCS 56420
Hospital Charge Code	83652121
Hospital Revenue Code	761
Min. Negotiated Rate	$22.71
Max. Negotiated Rate	$866.98
Rate for Payer: Aetna Commercial	$653.29
Rate for Payer: Aetna Medicare Advantage	$778.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$866.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$866.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$240.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$866.98
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: Cigna Medicare Advantage	$240.18
Rate for Payer: Clover Medicare Advantage	$228.17
Rate for Payer: EmblemHealth Commercial	$720.54
Rate for Payer: Humana Medicare Advantage	$247.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$240.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$282.64
Rate for Payer: Oxford Commercial	$188.43
Rate for Payer: Qualcare PPO/HMO/WC	$141.32
Rate for Payer: UnitedHealthcare Commercial	$188.43
Rate for Payer: UnitedHealthcare Community & State	$22.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$240.18
Rate for Payer: Wellcare Medicare Advantage	$240.18
Rate for Payer: Wellpoint Medicaid Managed Care	$24.97

CFH WC I&D BARTHOLINS ABSCESS

Facility

$942.15

Service Code	HCPCS 56420
Hospital Charge Code	83652121
Hospital Revenue Code	761
Min. Negotiated Rate	$141.32
Max. Negotiated Rate	$141.32
Rate for Payer: Qualcare PPO/HMO/WC	$141.32

CFH WC IUD INSERTION

Facility

$376.00

Service Code	HCPCS 58300
Hospital Charge Code	83652163
Hospital Revenue Code	761
Min. Negotiated Rate	$9.06
Max. Negotiated Rate	$188.00
Rate for Payer: Aetna Commercial	$142.88
Rate for Payer: Aetna Medicare Advantage	$112.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.88
Rate for Payer: Cigna Commercial	$188.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.80
Rate for Payer: Oxford Commercial	$75.20
Rate for Payer: Qualcare PPO/HMO/WC	$56.40
Rate for Payer: UnitedHealthcare Commercial	$75.20
Rate for Payer: UnitedHealthcare Community & State	$9.06
Rate for Payer: Wellpoint Medicaid Managed Care	$9.96

CFH WC IUD INSERTION

Facility

$376.00

Service Code	HCPCS 58300
Hospital Charge Code	83652163
Hospital Revenue Code	761
Min. Negotiated Rate	$56.40
Max. Negotiated Rate	$56.40
Rate for Payer: Qualcare PPO/HMO/WC	$56.40

CFH WC IUD REMOVAL

Facility

$669.00

Service Code	HCPCS 58301
Hospital Charge Code	83652165
Hospital Revenue Code	761
Min. Negotiated Rate	$100.35
Max. Negotiated Rate	$100.35
Rate for Payer: Qualcare PPO/HMO/WC	$100.35

CFH WC IUD REMOVAL

Facility

$669.00

Service Code	HCPCS 58301
Hospital Charge Code	83652165
Hospital Revenue Code	761
Min. Negotiated Rate	$16.12
Max. Negotiated Rate	$1,306.82
Rate for Payer: Aetna Commercial	$984.72
Rate for Payer: Aetna Medicare Advantage	$1,172.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,306.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,306.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$362.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,306.82
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: Cigna Medicare Advantage	$362.03
Rate for Payer: Clover Medicare Advantage	$343.93
Rate for Payer: EmblemHealth Commercial	$1,086.09
Rate for Payer: Humana Medicare Advantage	$372.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$362.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.70
Rate for Payer: Oxford Commercial	$133.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.35
Rate for Payer: UnitedHealthcare Commercial	$133.80
Rate for Payer: UnitedHealthcare Community & State	$16.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$362.03
Rate for Payer: Wellcare Medicare Advantage	$362.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.73

CFH WC LAPAROSCOPY, DX ONLY

Professional

Both

$692.00

Service Code	HCPCS 49320
Hospital Charge Code	83652109
Hospital Revenue Code	960
Min. Negotiated Rate	$35.18
Max. Negotiated Rate	$35.18
Rate for Payer: Aetna Commercial	$35.18
Rate for Payer: Aetna Medicare Advantage	$35.18

CFH WC NP OV E&M COMPLEX

Facility

$1,003.00

Service Code	HCPCS 99205
Hospital Charge Code	83652401
Hospital Revenue Code	514
Min. Negotiated Rate	$150.45
Max. Negotiated Rate	$150.45
Rate for Payer: Qualcare PPO/HMO/WC	$150.45

CFH WC NP OV E&M COMPLEX

Facility

$1,003.00

Service Code	HCPCS 99205
Hospital Charge Code	83652401
Hospital Revenue Code	514
Min. Negotiated Rate	$24.17
Max. Negotiated Rate	$501.50
Rate for Payer: Aetna Commercial	$381.14
Rate for Payer: Aetna Medicare Advantage	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.76
Rate for Payer: Cigna Commercial	$501.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.90
Rate for Payer: Qualcare PPO/HMO/WC	$150.45
Rate for Payer: UnitedHealthcare Community & State	$24.17
Rate for Payer: Wellpoint Medicaid Managed Care	$26.58

CFH WC NP OV E&M COMPREHENSIVE

Facility

$1,068.20

Service Code	HCPCS 99204
Hospital Charge Code	83652399
Hospital Revenue Code	514
Min. Negotiated Rate	$25.74
Max. Negotiated Rate	$534.10
Rate for Payer: Aetna Commercial	$405.92
Rate for Payer: Aetna Medicare Advantage	$320.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.39
Rate for Payer: Cigna Commercial	$534.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.46
Rate for Payer: Qualcare PPO/HMO/WC	$160.23
Rate for Payer: UnitedHealthcare Community & State	$25.74
Rate for Payer: Wellpoint Medicaid Managed Care	$28.31

CFH WC NP OV E&M COMPREHENSIVE

Facility

$1,068.20

Service Code	HCPCS 99204
Hospital Charge Code	83652399
Hospital Revenue Code	514
Min. Negotiated Rate	$160.23
Max. Negotiated Rate	$160.23
Rate for Payer: Qualcare PPO/HMO/WC	$160.23

CFH WC PAP SMEAR

Facility

$390.00

Service Code	HCPCS Q0091
Hospital Charge Code	83652537
Hospital Revenue Code	923
Min. Negotiated Rate	$9.40
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	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.36
Rate for Payer: Wellcare Medicare Advantage	$34.36
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CFH WC PAP SMEAR

Facility

$390.00

Service Code	HCPCS Q0091
Hospital Charge Code	83652537
Hospital Revenue Code	923
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CFH WC PPD

Facility

$390.00

Service Code	HCPCS 86580
Hospital Charge Code	83652285
Hospital Revenue Code	302
Min. Negotiated Rate	$7.74
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) NJ Health	$7.74
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	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.36
Rate for Payer: Wellcare Medicare Advantage	$34.36
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CFH WC PPD

Facility

$390.00

Service Code	HCPCS 86580
Hospital Charge Code	83652285
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges