Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

COLPOPEXY INTRAPERITONEAL

Facility

$42,389.30

Service Code	HCPCS 57283
Hospital Charge Code	1600000762
Hospital Revenue Code	360
Min. Negotiated Rate	$6,358.40
Max. Negotiated Rate	$6,358.40
Rate for Payer: Qualcare PPO/HMO/WC	$6,358.40

COLPOPEXY INTRAPERITONEAL

Facility

$42,389.30

Service Code	HCPCS 57283
Hospital Charge Code	1600000762
Hospital Revenue Code	360
Min. Negotiated Rate	$1,021.58
Max. Negotiated Rate	$31,800.48
Rate for Payer: Aetna Commercial	$23,962.47
Rate for Payer: Aetna Medicare Advantage	$28,543.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,800.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,800.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,809.73
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	$31,800.48
Rate for Payer: Cigna Commercial	$17,659.09
Rate for Payer: Cigna Medicare Advantage	$8,809.73
Rate for Payer: Clover Medicare Advantage	$8,369.24
Rate for Payer: EmblemHealth Commercial	$26,429.19
Rate for Payer: Humana Medicare Advantage	$9,074.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,809.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,716.79
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,358.40
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$1,021.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,809.73
Rate for Payer: Wellcare Medicare Advantage	$8,809.73
Rate for Payer: Wellpoint Medicaid Managed Care	$1,123.32

COLPOPEXY LAPAROSCOPY

Facility

$44,535.70

Service Code	HCPCS 57425
Hospital Charge Code	1600000793
Hospital Revenue Code	360
Min. Negotiated Rate	$6,680.35
Max. Negotiated Rate	$6,680.35
Rate for Payer: Qualcare PPO/HMO/WC	$6,680.35

COLPOPEXY LAPAROSCOPY

Facility

$44,535.70

Service Code	HCPCS 57425
Hospital Charge Code	1600000793
Hospital Revenue Code	360
Min. Negotiated Rate	$1,073.31
Max. Negotiated Rate	$45,585.17
Rate for Payer: Aetna Commercial	$34,349.57
Rate for Payer: Aetna Medicare Advantage	$40,916.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,585.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,585.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,628.52
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	$45,585.17
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: Cigna Medicare Advantage	$12,628.52
Rate for Payer: Clover Medicare Advantage	$11,997.09
Rate for Payer: EmblemHealth Commercial	$37,885.56
Rate for Payer: Humana Medicare Advantage	$13,007.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,628.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,360.71
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,680.35
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,073.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,628.52
Rate for Payer: Wellcare Medicare Advantage	$12,628.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1,180.20

COLPORRHAPHY SUTR INJ VAG

Facility

$1,668.50

Hospital Charge Code	5792235
Hospital Revenue Code	450
Min. Negotiated Rate	$44.22
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$634.03
Rate for Payer: Aetna Medicare Advantage	$500.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$425.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$425.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$425.47
Rate for Payer: Cigna Commercial	$834.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.28
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$44.22

COLPORRHAPHY SUTR INJ VAG

Facility

$1,668.50

Hospital Charge Code	5792235
Hospital Revenue Code	450
Min. Negotiated Rate	$250.28
Max. Negotiated Rate	$250.28
Rate for Payer: Qualcare PPO/HMO/WC	$250.28

COLPOSCOPY

Facility

$669.00

Service Code	HCPCS 57452
Hospital Charge Code	87502580
Hospital Revenue Code	761
Min. Negotiated Rate	$16.12
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	$118.66
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	$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	$240.18
Rate for Payer: Wellcare Medicare Advantage	$240.18
Rate for Payer: Wellpoint Medicaid Managed Care	$17.73

COLPOSCOPY

Facility

$669.00

Service Code	HCPCS 57452
Hospital Charge Code	87502580
Hospital Revenue Code	761
Min. Negotiated Rate	$100.35
Max. Negotiated Rate	$100.35
Rate for Payer: Qualcare PPO/HMO/WC	$100.35

COLPOSCOPY CERVIX

Facility

$613.00

Service Code	HCPCS 57452
Hospital Charge Code	87502180
Hospital Revenue Code	361
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$2,220.00
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	$1,016.00
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	$183.90
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.95
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$14.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$240.18
Rate for Payer: Wellcare Medicare Advantage	$240.18
Rate for Payer: Wellpoint Medicaid Managed Care	$16.24

COLPOSCOPY CERVIX

Facility

$613.00

Service Code	HCPCS 57452
Hospital Charge Code	87502180
Hospital Revenue Code	361
Min. Negotiated Rate	$91.95
Max. Negotiated Rate	$91.95
Rate for Payer: Qualcare PPO/HMO/WC	$91.95

COLPOSCOPY CERVIX/VAG W/BX

Facility

$1,573.30

Service Code	HCPCS 57455
Hospital Charge Code	412357455
Hospital Revenue Code	361
Min. Negotiated Rate	$37.92
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	$1,626.00
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	$471.99
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$236.00
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$37.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$362.03
Rate for Payer: Wellcare Medicare Advantage	$362.03
Rate for Payer: Wellpoint Medicaid Managed Care	$41.69

COLPOSCOPY CERVIX/VAG W/BX

Facility

$1,573.30

Service Code	HCPCS 57455
Hospital Charge Code	412357455
Hospital Revenue Code	361
Min. Negotiated Rate	$236.00
Max. Negotiated Rate	$236.00
Rate for Payer: Qualcare PPO/HMO/WC	$236.00

COLPOSCOPY W BIOPSY

Facility

$1,480.00

Service Code	HCPCS 57455
Hospital Charge Code	87502590
Hospital Revenue Code	761
Min. Negotiated Rate	$222.00
Max. Negotiated Rate	$222.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.00

COLPOSCOPY W BIOPSY

Facility

$1,480.00

Service Code	HCPCS 57455
Hospital Charge Code	87502590
Hospital Revenue Code	761
Min. Negotiated Rate	$35.67
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) NJ Health	$164.56
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	$444.00
Rate for Payer: Oxford Commercial	$296.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.00
Rate for Payer: UnitedHealthcare Commercial	$296.00
Rate for Payer: UnitedHealthcare Community & State	$35.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$362.03
Rate for Payer: Wellcare Medicare Advantage	$362.03
Rate for Payer: Wellpoint Medicaid Managed Care	$39.22

COLUMN

Facility

$4,750.00

Hospital Charge Code	270657733
Hospital Revenue Code	278
Min. Negotiated Rate	$114.47
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Community & State	$114.47
Rate for Payer: Wellpoint Medicaid Managed Care	$125.88

COLUMN

Facility

$4,750.00

Hospital Charge Code	270657733
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

COLUMN ASCARITE DESICAT 21506

Facility

$119.25

Hospital Charge Code	270600656
Hospital Revenue Code	270
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$59.62
Rate for Payer: Aetna Commercial	$45.31
Rate for Payer: Aetna Medicare Advantage	$35.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.41
Rate for Payer: Cigna Commercial	$59.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.77
Rate for Payer: Oxford Commercial	$23.85
Rate for Payer: Qualcare PPO/HMO/WC	$17.89
Rate for Payer: UnitedHealthcare Commercial	$23.85
Rate for Payer: UnitedHealthcare Community & State	$2.87
Rate for Payer: Wellpoint Medicaid Managed Care	$3.16

COLUMN ASCARITE DESICAT 21506

Facility

$119.25

Hospital Charge Code	270600656
Hospital Revenue Code	270
Min. Negotiated Rate	$17.89
Max. Negotiated Rate	$17.89
Rate for Payer: Qualcare PPO/HMO/WC	$17.89

COLUMN HYDROUS DESICAT 21501

Facility

$65.65

Hospital Charge Code	270600655
Hospital Revenue Code	272
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

COLUMN HYDROUS DESICAT 21501

Facility

$65.65

Hospital Charge Code	270600655
Hospital Revenue Code	272
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$32.83
Rate for Payer: Aetna Commercial	$24.95
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.70
Rate for Payer: Oxford Commercial	$13.13
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$13.13
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.74

COLUMN HYDROUS DESICAT 21503

Facility

$64.00

Hospital Charge Code	270600654
Hospital Revenue Code	270
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

COLUMN HYDROUS DESICAT 21503

Facility

$64.00

Hospital Charge Code	270600654
Hospital Revenue Code	270
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$24.32
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.20
Rate for Payer: Oxford Commercial	$12.80
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$12.80
Rate for Payer: UnitedHealthcare Community & State	$1.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1.70

COLUMN MEDICAL LP 3.5

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270687075
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

COLUMN MEDICAL LP 3.5

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270687075
Hospital Revenue Code	278
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Community & State	$180.15
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

COLY-MYCIN

Facility

$1,855.90

Service Code	NDC 63481042105
Hospital Charge Code	606390221
Hospital Revenue Code	250
Min. Negotiated Rate	$278.38
Max. Negotiated Rate	$278.38
Rate for Payer: Qualcare PPO/HMO/WC	$278.38

Know your out-of-pocket cost for care.

All Charges