Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CHOLECYSTCTMY,W CHOLANGIGRPHY

Facility

$12,472.00

Service Code	HCPCS 47605
Hospital Charge Code	16000984
Hospital Revenue Code	360
Min. Negotiated Rate	$1,870.80
Max. Negotiated Rate	$1,870.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,870.80

CHOLECYSTCTMY W EXP OF CMN DCT

Facility

$13,892.20

Service Code	HCPCS 47610
Hospital Charge Code	160000252
Hospital Revenue Code	360
Min. Negotiated Rate	$2,083.83
Max. Negotiated Rate	$2,083.83
Rate for Payer: Qualcare PPO/HMO/WC	$2,083.83

CHOLECYSTCTMY W EXP OF CMN DCT

Facility

$13,892.20

Service Code	HCPCS 47610
Hospital Charge Code	160000252
Hospital Revenue Code	360
Min. Negotiated Rate	$334.80
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,279.04
Rate for Payer: Aetna Medicare Advantage	$4,167.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,542.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,542.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,542.51
Rate for Payer: Cigna Commercial	$6,946.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,167.66
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,083.83
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$334.80
Rate for Payer: Wellpoint Medicaid Managed Care	$368.14

CHOLECYSTECTOMY

Facility

$21,499.76

Service Code	APR-DRG 2633
Min. Negotiated Rate	$21,078.20
Max. Negotiated Rate	$21,499.76
Rate for Payer: UnitedHealthcare Community & State	$21,078.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,499.76
Rate for Payer: Wellpoint Medicaid Managed Care	$21,078.20

CHOLECYSTECTOMY

Facility

$16,993.04

Service Code	APR-DRG 2632
Min. Negotiated Rate	$16,659.84
Max. Negotiated Rate	$16,993.04
Rate for Payer: UnitedHealthcare Community & State	$16,659.84
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,993.04
Rate for Payer: Wellpoint Medicaid Managed Care	$16,659.84

CHOLECYSTECTOMY

Facility

$13,453.95

Service Code	APR-DRG 2631
Min. Negotiated Rate	$13,190.15
Max. Negotiated Rate	$13,453.95
Rate for Payer: UnitedHealthcare Community & State	$13,190.15
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,453.95
Rate for Payer: Wellpoint Medicaid Managed Care	$13,190.15

CHOLECYSTECTOMY

Facility

$40,226.54

Service Code	APR-DRG 2634
Min. Negotiated Rate	$39,437.78
Max. Negotiated Rate	$40,226.54
Rate for Payer: UnitedHealthcare Community & State	$39,437.78
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$40,226.54
Rate for Payer: Wellpoint Medicaid Managed Care	$39,437.78

CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC

Facility

$68,933.22

Service Code	MSDRG 415
Min. Negotiated Rate	$20,989.28
Max. Negotiated Rate	$68,933.22
Rate for Payer: Aetna Commercial	$47,622.30
Rate for Payer: Aetna Medicare Advantage	$68,933.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46,056.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46,056.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,093.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46,056.78
Rate for Payer: Cigna Commercial	$38,676.22
Rate for Payer: Cigna Medicare Advantage	$22,093.98
Rate for Payer: Clover Medicare Advantage	$20,989.28
Rate for Payer: EmblemHealth Commercial	$66,281.94
Rate for Payer: Humana Medicare Advantage	$22,756.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22,093.98
Rate for Payer: Oxford Commercial	$27,797.12
Rate for Payer: UnitedHealthcare Commercial	$48,743.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,093.98
Rate for Payer: Wellcare Medicare Advantage	$22,093.98

CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC

Facility

$117,283.20

Service Code	MSDRG 414
Min. Negotiated Rate	$35,711.23
Max. Negotiated Rate	$117,283.20
Rate for Payer: Aetna Commercial	$80,844.25
Rate for Payer: Aetna Medicare Advantage	$117,283.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82,111.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82,111.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37,590.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82,111.33
Rate for Payer: Cigna Commercial	$66,670.50
Rate for Payer: Cigna Medicare Advantage	$37,590.77
Rate for Payer: Clover Medicare Advantage	$35,711.23
Rate for Payer: EmblemHealth Commercial	$112,772.31
Rate for Payer: Humana Medicare Advantage	$38,718.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$37,590.77
Rate for Payer: Oxford Commercial	$47,916.97
Rate for Payer: UnitedHealthcare Commercial	$84,023.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$37,590.77
Rate for Payer: Wellcare Medicare Advantage	$37,590.77

CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC

Facility

$46,198.18

Service Code	MSDRG 416
Min. Negotiated Rate	$14,066.75
Max. Negotiated Rate	$46,198.18
Rate for Payer: Aetna Commercial	$32,000.75
Rate for Payer: Aetna Medicare Advantage	$46,198.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,169.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,169.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,807.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,169.74
Rate for Payer: Cigna Commercial	$25,512.80
Rate for Payer: Cigna Medicare Advantage	$14,807.11
Rate for Payer: Clover Medicare Advantage	$14,066.75
Rate for Payer: EmblemHealth Commercial	$44,421.33
Rate for Payer: Humana Medicare Advantage	$15,251.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,807.11
Rate for Payer: Oxford Commercial	$18,336.38
Rate for Payer: UnitedHealthcare Commercial	$32,153.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,807.11
Rate for Payer: Wellcare Medicare Advantage	$14,807.11

CHOLECYSTECTOMY,OPEN

Facility

$11,857.60

Service Code	HCPCS 47600
Hospital Charge Code	16000983
Hospital Revenue Code	360
Min. Negotiated Rate	$285.77
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$4,505.89
Rate for Payer: Aetna Medicare Advantage	$3,557.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,023.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,023.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,023.69
Rate for Payer: Cigna Commercial	$5,928.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,557.28
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,778.64
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$285.77
Rate for Payer: Wellpoint Medicaid Managed Care	$314.23

CHOLECYSTECTOMY,OPEN

Facility

$11,857.60

Service Code	HCPCS 47600
Hospital Charge Code	16000983
Hospital Revenue Code	360
Min. Negotiated Rate	$1,778.64
Max. Negotiated Rate	$1,778.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,778.64

CHOLECYSTECTOMY WITH C.D.E. WITH CC

Facility

$70,090.39

Service Code	MSDRG 412
Min. Negotiated Rate	$21,341.63
Max. Negotiated Rate	$70,090.39
Rate for Payer: Aetna Commercial	$48,417.44
Rate for Payer: Aetna Medicare Advantage	$70,090.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48,150.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48,150.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,464.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48,150.27
Rate for Payer: Cigna Commercial	$39,346.18
Rate for Payer: Cigna Medicare Advantage	$22,464.87
Rate for Payer: Clover Medicare Advantage	$21,341.63
Rate for Payer: EmblemHealth Commercial	$67,394.61
Rate for Payer: Humana Medicare Advantage	$23,138.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22,464.87
Rate for Payer: Oxford Commercial	$28,278.62
Rate for Payer: UnitedHealthcare Commercial	$49,587.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,464.87
Rate for Payer: Wellcare Medicare Advantage	$22,464.87

CHOLECYSTECTOMY WITH C.D.E. WITH MCC

Facility

$108,902.20

Service Code	MSDRG 411
Min. Negotiated Rate	$33,159.32
Max. Negotiated Rate	$108,902.20
Rate for Payer: Aetna Commercial	$75,085.54
Rate for Payer: Aetna Medicare Advantage	$108,902.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70,713.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70,713.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34,904.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70,713.44
Rate for Payer: Cigna Commercial	$61,817.96
Rate for Payer: Cigna Medicare Advantage	$34,904.55
Rate for Payer: Clover Medicare Advantage	$33,159.32
Rate for Payer: EmblemHealth Commercial	$104,713.65
Rate for Payer: Humana Medicare Advantage	$35,951.69
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34,904.55
Rate for Payer: Oxford Commercial	$44,429.39
Rate for Payer: UnitedHealthcare Commercial	$77,908.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$34,904.55
Rate for Payer: Wellcare Medicare Advantage	$34,904.55

CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC

Facility

$55,804.20

Service Code	MSDRG 413
Min. Negotiated Rate	$16,991.66
Max. Negotiated Rate	$55,804.20
Rate for Payer: Aetna Commercial	$38,601.16
Rate for Payer: Aetna Medicare Advantage	$55,804.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,124.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,124.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,885.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,124.11
Rate for Payer: Cigna Commercial	$31,074.60
Rate for Payer: Cigna Medicare Advantage	$17,885.96
Rate for Payer: Clover Medicare Advantage	$16,991.66
Rate for Payer: EmblemHealth Commercial	$53,657.88
Rate for Payer: Humana Medicare Advantage	$18,422.54
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17,885.96
Rate for Payer: Oxford Commercial	$22,333.72
Rate for Payer: UnitedHealthcare Commercial	$39,162.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,885.96
Rate for Payer: Wellcare Medicare Advantage	$17,885.96

CHOLEDYL/200MG/TAB

Facility

$3.00

Hospital Charge Code	60632697
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

CHOLEDYL/200MG/TAB

Facility

$3.00

Hospital Charge Code	60632697
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

CHOLERA INJECTION 8U/IM

Facility

$40.35

Hospital Charge Code	60628807
Hospital Revenue Code	250
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$20.18
Rate for Payer: Aetna Commercial	$15.33
Rate for Payer: Aetna Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.29
Rate for Payer: Cigna Commercial	$20.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.11
Rate for Payer: Oxford Commercial	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$6.05
Rate for Payer: UnitedHealthcare Commercial	$8.07
Rate for Payer: UnitedHealthcare Community & State	$0.97
Rate for Payer: Wellpoint Medicaid Managed Care	$1.07

CHOLERA INJECTION 8U/IM

Facility

$40.35

Hospital Charge Code	60628807
Hospital Revenue Code	250
Min. Negotiated Rate	$6.05
Max. Negotiated Rate	$6.05
Rate for Payer: Qualcare PPO/HMO/WC	$6.05

CHOLESTEROL

Facility

$278.00

Service Code	HCPCS 82465
Hospital Charge Code	38472194
Hospital Revenue Code	301
Min. Negotiated Rate	$41.70
Max. Negotiated Rate	$41.70
Rate for Payer: Qualcare PPO/HMO/WC	$41.70

CHOLESTEROL

Facility

$278.00

Service Code	HCPCS 82465
Hospital Charge Code	38472194
Hospital Revenue Code	301
Min. Negotiated Rate	$3.48
Max. Negotiated Rate	$139.00
Rate for Payer: Aetna Commercial	$11.83
Rate for Payer: Aetna Medicare Advantage	$14.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.35
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	$15.70
Rate for Payer: Cigna Commercial	$139.00
Rate for Payer: Cigna Medicare Advantage	$4.35
Rate for Payer: Clover Medicare Advantage	$4.13
Rate for Payer: EmblemHealth Commercial	$13.05
Rate for Payer: Humana Medicare Advantage	$4.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.35
Rate for Payer: Wellcare Medicare Advantage	$4.35
Rate for Payer: Wellpoint Medicaid Managed Care	$7.37

CHOLESTEROL

Facility

$52.85

Service Code	HCPCS 82465CF
Hospital Charge Code	8200307RS
Hospital Revenue Code	301
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$7.93
Rate for Payer: Qualcare PPO/HMO/WC	$7.93

CHOLESTEROL

Facility

$52.85

Service Code	HCPCS 82465CF
Hospital Charge Code	8200307RS
Hospital Revenue Code	301
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$20.08
Rate for Payer: Aetna Medicare Advantage	$15.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.48
Rate for Payer: Cigna Commercial	$26.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.93
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

CHOLESTEROL,FLUID

Facility

$278.00

Service Code	HCPCS 82465
Hospital Charge Code	38479015
Hospital Revenue Code	301
Min. Negotiated Rate	$3.48
Max. Negotiated Rate	$139.00
Rate for Payer: Aetna Commercial	$11.83
Rate for Payer: Aetna Medicare Advantage	$14.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.35
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	$15.70
Rate for Payer: Cigna Commercial	$139.00
Rate for Payer: Cigna Medicare Advantage	$4.35
Rate for Payer: Clover Medicare Advantage	$4.13
Rate for Payer: EmblemHealth Commercial	$13.05
Rate for Payer: Humana Medicare Advantage	$4.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.35
Rate for Payer: Wellcare Medicare Advantage	$4.35
Rate for Payer: Wellpoint Medicaid Managed Care	$7.37

CHOLESTEROL,FLUID

Facility

$278.00

Service Code	HCPCS 82465
Hospital Charge Code	38479015
Hospital Revenue Code	301
Min. Negotiated Rate	$41.70
Max. Negotiated Rate	$41.70
Rate for Payer: Qualcare PPO/HMO/WC	$41.70

Know your out-of-pocket cost for care.

All Charges