Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

COLONOSCOPY W/CONTROL BLEED

Facility

$7,639.30

Service Code	HCPCS 45382
Hospital Charge Code	16000459
Hospital Revenue Code	360
Min. Negotiated Rate	$1,145.89
Max. Negotiated Rate	$1,145.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,145.89

COLONOSCOPY W/CONTROL BLEED

Facility

$7,639.30

Service Code	HCPCS 45382
Hospital Charge Code	16000459
Hospital Revenue Code	360
Min. Negotiated Rate	$184.11
Max. Negotiated Rate	$5,311.00
Rate for Payer: Aetna Commercial	$3,866.86
Rate for Payer: Aetna Medicare Advantage	$4,606.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,131.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,131.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,421.64
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	$5,131.69
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: Cigna Medicare Advantage	$1,421.64
Rate for Payer: Clover Medicare Advantage	$1,350.56
Rate for Payer: EmblemHealth Commercial	$4,264.92
Rate for Payer: Humana Medicare Advantage	$1,464.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,421.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,291.79
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,145.89
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$184.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,421.64
Rate for Payer: Wellcare Medicare Advantage	$1,421.64
Rate for Payer: Wellpoint Medicaid Managed Care	$202.44

COLONOSCOPY W/FB REMOVAL

Facility

$13,705.00

Service Code	HCPCS 45379
Hospital Charge Code	16000588
Hospital Revenue Code	360
Min. Negotiated Rate	$2,055.75
Max. Negotiated Rate	$2,055.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,055.75

COLONOSCOPY W/FB REMOVAL

Facility

$13,705.00

Service Code	HCPCS 45379
Hospital Charge Code	16000588
Hospital Revenue Code	360
Min. Negotiated Rate	$330.29
Max. Negotiated Rate	$5,311.00
Rate for Payer: Aetna Commercial	$3,866.86
Rate for Payer: Aetna Medicare Advantage	$4,606.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,131.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,131.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,421.64
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	$5,131.69
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: Cigna Medicare Advantage	$1,421.64
Rate for Payer: Clover Medicare Advantage	$1,350.56
Rate for Payer: EmblemHealth Commercial	$4,264.92
Rate for Payer: Humana Medicare Advantage	$1,464.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,421.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,111.50
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,055.75
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$330.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,421.64
Rate for Payer: Wellcare Medicare Advantage	$1,421.64
Rate for Payer: Wellpoint Medicaid Managed Care	$363.18

COLONOSCOPY W/IRC***

Facility

$351.00

Hospital Charge Code	2300036
Hospital Revenue Code	759
Min. Negotiated Rate	$52.65
Max. Negotiated Rate	$52.65
Rate for Payer: Qualcare PPO/HMO/WC	$52.65

COLONOSCOPY W/IRC***

Facility

$351.00

Hospital Charge Code	2300036
Hospital Revenue Code	759
Min. Negotiated Rate	$8.46
Max. Negotiated Rate	$175.50
Rate for Payer: Aetna Commercial	$133.38
Rate for Payer: Aetna Medicare Advantage	$105.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.50
Rate for Payer: Cigna Commercial	$175.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.30
Rate for Payer: Qualcare PPO/HMO/WC	$52.65
Rate for Payer: UnitedHealthcare Community & State	$8.46
Rate for Payer: Wellpoint Medicaid Managed Care	$9.30

COLONOSCOPY W/POLYPECTOMY***

Facility

$816.00

Hospital Charge Code	2300044
Hospital Revenue Code	759
Min. Negotiated Rate	$122.40
Max. Negotiated Rate	$122.40
Rate for Payer: Qualcare PPO/HMO/WC	$122.40

COLONOSCOPY W/POLYPECTOMY***

Facility

$816.00

Hospital Charge Code	2300044
Hospital Revenue Code	759
Min. Negotiated Rate	$19.67
Max. Negotiated Rate	$408.00
Rate for Payer: Aetna Commercial	$310.08
Rate for Payer: Aetna Medicare Advantage	$244.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.08
Rate for Payer: Cigna Commercial	$408.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.80
Rate for Payer: Qualcare PPO/HMO/WC	$122.40
Rate for Payer: UnitedHealthcare Community & State	$19.67
Rate for Payer: Wellpoint Medicaid Managed Care	$21.62

COLONOSCP W/DECMPR SGMD VOLV**

Facility

$383.00

Hospital Charge Code	2300077
Hospital Revenue Code	759
Min. Negotiated Rate	$57.45
Max. Negotiated Rate	$57.45
Rate for Payer: Qualcare PPO/HMO/WC	$57.45

COLONOSCP W/DECMPR SGMD VOLV**

Facility

$383.00

Hospital Charge Code	2300077
Hospital Revenue Code	759
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$191.50
Rate for Payer: Aetna Commercial	$145.54
Rate for Payer: Aetna Medicare Advantage	$114.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.67
Rate for Payer: Cigna Commercial	$191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.90
Rate for Payer: Qualcare PPO/HMO/WC	$57.45
Rate for Payer: UnitedHealthcare Community & State	$9.23
Rate for Payer: Wellpoint Medicaid Managed Care	$10.15

COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK

Facility

$3,988.03

Service Code	CPT G0105
Hospital Revenue Code	750
Min. Negotiated Rate	$1,049.57
Max. Negotiated Rate	$3,988.03
Rate for Payer: Aetna Commercial	$3,005.08
Rate for Payer: Aetna Medicare Advantage	$3,579.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,988.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,988.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,104.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,988.03
Rate for Payer: Cigna Commercial	$2,214.60
Rate for Payer: Cigna Medicare Advantage	$1,104.81
Rate for Payer: Clover Medicare Advantage	$1,049.57
Rate for Payer: EmblemHealth Commercial	$3,314.43
Rate for Payer: Humana Medicare Advantage	$1,137.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,104.81
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,104.81
Rate for Payer: Wellcare Medicare Advantage	$1,104.81

COLORECTAL CA SCRN,COLONOSCOPY

Facility

$2,500.00

Service Code	HCPCS G0121
Hospital Charge Code	2300088
Hospital Revenue Code	750
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$3,988.03
Rate for Payer: Aetna Commercial	$3,005.08
Rate for Payer: Aetna Medicare Advantage	$3,579.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,988.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,988.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,104.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,988.03
Rate for Payer: Cigna Commercial	$2,214.60
Rate for Payer: Cigna Medicare Advantage	$1,104.81
Rate for Payer: Clover Medicare Advantage	$1,049.57
Rate for Payer: EmblemHealth Commercial	$3,314.43
Rate for Payer: Humana Medicare Advantage	$1,137.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,104.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.00
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,104.81
Rate for Payer: Wellcare Medicare Advantage	$1,104.81
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

COLORECTAL CA SCRN,COLONOSCOPY

Facility

$2,500.00

Service Code	HCPCS G0121
Hospital Charge Code	2300088
Hospital Revenue Code	750
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

COLOR PRINTER PAPER

Facility

$843.80

Hospital Charge Code	270656369
Hospital Revenue Code	271
Min. Negotiated Rate	$20.34
Max. Negotiated Rate	$421.90
Rate for Payer: Aetna Commercial	$320.64
Rate for Payer: Aetna Medicare Advantage	$253.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$215.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$215.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$215.17
Rate for Payer: Cigna Commercial	$421.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.14
Rate for Payer: Oxford Commercial	$168.76
Rate for Payer: Qualcare PPO/HMO/WC	$126.57
Rate for Payer: UnitedHealthcare Commercial	$168.76
Rate for Payer: UnitedHealthcare Community & State	$20.34
Rate for Payer: Wellpoint Medicaid Managed Care	$22.36

COLOR PRINTER PAPER

Facility

$843.80

Hospital Charge Code	270656369
Hospital Revenue Code	271
Min. Negotiated Rate	$126.57
Max. Negotiated Rate	$126.57
Rate for Payer: Qualcare PPO/HMO/WC	$126.57

COLOSTOMY

Facility

$134,093.30

Service Code	HCPCS 44320
Hospital Charge Code	16000976
Hospital Revenue Code	360
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$67,046.65
Rate for Payer: Aetna Commercial	$50,955.45
Rate for Payer: Aetna Medicare Advantage	$40,227.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34,193.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34,193.79
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	$34,193.79
Rate for Payer: Cigna Commercial	$67,046.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40,227.99
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$20,113.99
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$3,231.65
Rate for Payer: Wellpoint Medicaid Managed Care	$3,553.47

COLOSTOMY

Facility

$134,093.30

Service Code	HCPCS 44320
Hospital Charge Code	16000976
Hospital Revenue Code	360
Min. Negotiated Rate	$20,113.99
Max. Negotiated Rate	$20,113.99
Rate for Payer: Qualcare PPO/HMO/WC	$20,113.99

COLOSTOMY/ILEOSTMY SYS 020931*

Facility

$43.00

Hospital Charge Code	1605872
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

COLOSTOMY/ILEOSTMY SYS 020931*

Facility

$43.00

Hospital Charge Code	1605872
Hospital Revenue Code	272
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

COLOSTOMY/ILEOSTMY SYS 020932*

Facility

$43.00

Hospital Charge Code	1605880
Hospital Revenue Code	272
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

COLOSTOMY/ILEOSTMY SYS 020932*

Facility

$43.00

Hospital Charge Code	1605880
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

COLOSTOMY IRRIGATION

Facility

$110.00

Hospital Charge Code	8001331
Hospital Revenue Code	279
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

COLOSTOMY IRRIGATION

Facility

$110.00

Hospital Charge Code	8001331
Hospital Revenue Code	279
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.00
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$22.00
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

COLP CERVIX W BX & CURETT

Facility

$3,375.20

Service Code	HCPCS 57454
Hospital Charge Code	160000232
Hospital Revenue Code	360
Min. Negotiated Rate	$81.34
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	$1,012.56
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$506.28
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$81.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$362.03
Rate for Payer: Wellcare Medicare Advantage	$362.03
Rate for Payer: Wellpoint Medicaid Managed Care	$89.44

COLP CERVIX W BX & CURETT

Facility

$3,375.20

Service Code	HCPCS 57454
Hospital Charge Code	160000232
Hospital Revenue Code	360
Min. Negotiated Rate	$506.28
Max. Negotiated Rate	$506.28
Rate for Payer: Qualcare PPO/HMO/WC	$506.28

Know your out-of-pocket cost for care.

All Charges