Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408LT
Hospital Charge Code	404632408L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408
Hospital Charge Code	404232408
Hospital Revenue Code	361
Min. Negotiated Rate	$204.83
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,549.70
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$204.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$225.22

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408
Hospital Charge Code	404232408
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 3240850
Hospital Charge Code	404632408B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408
Hospital Charge Code	404632408
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408
Hospital Charge Code	404332408
Hospital Revenue Code	361
Min. Negotiated Rate	$204.83
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,549.70
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$204.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$225.22

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408LT
Hospital Charge Code	321032408L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408LT
Hospital Charge Code	321032408L
Hospital Revenue Code	361
Min. Negotiated Rate	$204.83
Max. Negotiated Rate	$4,249.50
Rate for Payer: Aetna Commercial	$3,229.62
Rate for Payer: Aetna Medicare Advantage	$2,549.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.24
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	$2,167.24
Rate for Payer: Cigna Commercial	$4,249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,549.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85
Rate for Payer: UnitedHealthcare Community & State	$204.83
Rate for Payer: Wellpoint Medicaid Managed Care	$225.22

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408RT
Hospital Charge Code	321032408R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408
Hospital Charge Code	404632408
Hospital Revenue Code	361
Min. Negotiated Rate	$204.83
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,549.70
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$204.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$225.22

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 3240850
Hospital Charge Code	321032408B
Hospital Revenue Code	361
Min. Negotiated Rate	$204.83
Max. Negotiated Rate	$4,249.50
Rate for Payer: Aetna Commercial	$3,229.62
Rate for Payer: Aetna Medicare Advantage	$2,549.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.24
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	$2,167.24
Rate for Payer: Cigna Commercial	$4,249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,549.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85
Rate for Payer: UnitedHealthcare Community & State	$204.83
Rate for Payer: Wellpoint Medicaid Managed Care	$225.22

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408RT
Hospital Charge Code	321032408R
Hospital Revenue Code	361
Min. Negotiated Rate	$204.83
Max. Negotiated Rate	$4,249.50
Rate for Payer: Aetna Commercial	$3,229.62
Rate for Payer: Aetna Medicare Advantage	$2,549.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.24
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	$2,167.24
Rate for Payer: Cigna Commercial	$4,249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,549.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85
Rate for Payer: UnitedHealthcare Community & State	$204.83
Rate for Payer: Wellpoint Medicaid Managed Care	$225.22

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 3240850
Hospital Charge Code	404632408B
Hospital Revenue Code	361
Min. Negotiated Rate	$204.83
Max. Negotiated Rate	$4,249.50
Rate for Payer: Aetna Commercial	$3,229.62
Rate for Payer: Aetna Medicare Advantage	$2,549.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.24
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	$2,167.24
Rate for Payer: Cigna Commercial	$4,249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,549.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85
Rate for Payer: UnitedHealthcare Community & State	$204.83
Rate for Payer: Wellpoint Medicaid Managed Care	$225.22

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408
Hospital Charge Code	321032408
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408
Hospital Charge Code	321032408
Hospital Revenue Code	361
Min. Negotiated Rate	$204.83
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,549.70
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$204.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$225.22

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408RT
Hospital Charge Code	404632408R
Hospital Revenue Code	361
Min. Negotiated Rate	$204.83
Max. Negotiated Rate	$4,249.50
Rate for Payer: Aetna Commercial	$3,229.62
Rate for Payer: Aetna Medicare Advantage	$2,549.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.24
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	$2,167.24
Rate for Payer: Cigna Commercial	$4,249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,549.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85
Rate for Payer: UnitedHealthcare Community & State	$204.83
Rate for Payer: Wellpoint Medicaid Managed Care	$225.22

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408RT
Hospital Charge Code	404632408R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 3240850
Hospital Charge Code	321032408B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NDL BX LNG/MED PERQ W/IMG

Facility

$8,499.00

Service Code	HCPCS 32408
Hospital Charge Code	404332408
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.85
Max. Negotiated Rate	$1,274.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.85

CORE NEEDLE BX EQUIPMENT

Facility

$237.00

Hospital Charge Code	2008135
Hospital Revenue Code	272
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$35.55
Rate for Payer: Qualcare PPO/HMO/WC	$35.55

CORE NEEDLE BX EQUIPMENT

Facility

$237.00

Hospital Charge Code	2008135
Hospital Revenue Code	272
Min. Negotiated Rate	$5.71
Max. Negotiated Rate	$118.50
Rate for Payer: Aetna Commercial	$90.06
Rate for Payer: Aetna Medicare Advantage	$71.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.44
Rate for Payer: Cigna Commercial	$118.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.10
Rate for Payer: Oxford Commercial	$47.40
Rate for Payer: Qualcare PPO/HMO/WC	$35.55
Rate for Payer: UnitedHealthcare Commercial	$47.40
Rate for Payer: UnitedHealthcare Community & State	$5.71
Rate for Payer: Wellpoint Medicaid Managed Care	$6.28

CORETRAK 40MM EXF

Facility

$11,710.00

Hospital Charge Code	270685123
Hospital Revenue Code	272
Min. Negotiated Rate	$1,756.50
Max. Negotiated Rate	$1,756.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,756.50

CORETRAK 40MM EXF

Facility

$11,710.00

Hospital Charge Code	270685123
Hospital Revenue Code	272
Min. Negotiated Rate	$282.21
Max. Negotiated Rate	$5,855.00
Rate for Payer: Aetna Commercial	$4,449.80
Rate for Payer: Aetna Medicare Advantage	$3,513.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,986.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,986.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,986.05
Rate for Payer: Cigna Commercial	$5,855.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,513.00
Rate for Payer: Oxford Commercial	$2,342.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,756.50
Rate for Payer: UnitedHealthcare Commercial	$2,342.00
Rate for Payer: UnitedHealthcare Community & State	$282.21
Rate for Payer: Wellpoint Medicaid Managed Care	$310.31

CORETRAK STERIPACK D 40MM

Facility

$15,786.00

Hospital Charge Code	270702950
Hospital Revenue Code	270
Min. Negotiated Rate	$2,367.90
Max. Negotiated Rate	$2,367.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,367.90

CORETRAK STERIPACK D 40MM

Facility

$15,786.00

Hospital Charge Code	270702950
Hospital Revenue Code	270
Min. Negotiated Rate	$380.44
Max. Negotiated Rate	$7,893.00
Rate for Payer: Aetna Commercial	$5,998.68
Rate for Payer: Aetna Medicare Advantage	$4,735.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,025.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,025.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,025.43
Rate for Payer: Cigna Commercial	$7,893.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,735.80
Rate for Payer: Oxford Commercial	$3,157.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,367.90
Rate for Payer: UnitedHealthcare Commercial	$3,157.20
Rate for Payer: UnitedHealthcare Community & State	$380.44
Rate for Payer: Wellpoint Medicaid Managed Care	$418.33

Know your out-of-pocket cost for care.

All Charges