Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CT BIOPSY PANCREAS

Facility

$4,880.92

Service Code	HCPCS 77012
Hospital Charge Code	2205330
Hospital Revenue Code	350
Min. Negotiated Rate	$732.14
Max. Negotiated Rate	$732.14
Rate for Payer: Qualcare PPO/HMO/WC	$732.14

CT BIOPSY PANCREAS

Facility

$4,880.92

Service Code	HCPCS 77012
Hospital Charge Code	2205330
Hospital Revenue Code	350
Min. Negotiated Rate	$117.63
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$1,854.75
Rate for Payer: Aetna Medicare Advantage	$1,464.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,244.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,244.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,244.63
Rate for Payer: Cigna Commercial	$2,440.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,464.28
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$732.14
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$117.63
Rate for Payer: Wellpoint Medicaid Managed Care	$129.34

CT BIOPSY PLEURA LEFT

Facility

$4,880.92

Service Code	HCPCS 77012
Hospital Charge Code	2205331
Hospital Revenue Code	350
Min. Negotiated Rate	$732.14
Max. Negotiated Rate	$732.14
Rate for Payer: Qualcare PPO/HMO/WC	$732.14

CT BIOPSY PLEURA LEFT

Facility

$4,880.92

Service Code	HCPCS 77012
Hospital Charge Code	2205331
Hospital Revenue Code	350
Min. Negotiated Rate	$117.63
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$1,854.75
Rate for Payer: Aetna Medicare Advantage	$1,464.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,244.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,244.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,244.63
Rate for Payer: Cigna Commercial	$2,440.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,464.28
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$732.14
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$117.63
Rate for Payer: Wellpoint Medicaid Managed Care	$129.34

CT BIOPSY PLEURA RIGHT

Facility

$4,880.92

Service Code	HCPCS 77012
Hospital Charge Code	2205332
Hospital Revenue Code	350
Min. Negotiated Rate	$732.14
Max. Negotiated Rate	$732.14
Rate for Payer: Qualcare PPO/HMO/WC	$732.14

CT BIOPSY PLEURA RIGHT

Facility

$4,880.92

Service Code	HCPCS 77012
Hospital Charge Code	2205332
Hospital Revenue Code	350
Min. Negotiated Rate	$117.63
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$1,854.75
Rate for Payer: Aetna Medicare Advantage	$1,464.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,244.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,244.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,244.63
Rate for Payer: Cigna Commercial	$2,440.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,464.28
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$732.14
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$117.63
Rate for Payer: Wellpoint Medicaid Managed Care	$129.34

CT BIOPSY RENAL LEFT

Facility

$4,880.92

Service Code	HCPCS 77012
Hospital Charge Code	2205333
Hospital Revenue Code	350
Min. Negotiated Rate	$117.63
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$1,854.75
Rate for Payer: Aetna Medicare Advantage	$1,464.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,244.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,244.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,244.63
Rate for Payer: Cigna Commercial	$2,440.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,464.28
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$732.14
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$117.63
Rate for Payer: Wellpoint Medicaid Managed Care	$129.34

CT BIOPSY RENAL LEFT

Facility

$4,880.92

Service Code	HCPCS 77012
Hospital Charge Code	2205333
Hospital Revenue Code	350
Min. Negotiated Rate	$732.14
Max. Negotiated Rate	$732.14
Rate for Payer: Qualcare PPO/HMO/WC	$732.14

CT BIOPSY RENAL RIGHT

Facility

$4,880.92

Service Code	HCPCS 77012
Hospital Charge Code	2205334
Hospital Revenue Code	350
Min. Negotiated Rate	$117.63
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$1,854.75
Rate for Payer: Aetna Medicare Advantage	$1,464.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,244.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,244.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,244.63
Rate for Payer: Cigna Commercial	$2,440.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,464.28
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$732.14
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$117.63
Rate for Payer: Wellpoint Medicaid Managed Care	$129.34

CT BIOPSY RENAL RIGHT

Facility

$4,880.92

Service Code	HCPCS 77012
Hospital Charge Code	2205334
Hospital Revenue Code	350
Min. Negotiated Rate	$732.14
Max. Negotiated Rate	$732.14
Rate for Payer: Qualcare PPO/HMO/WC	$732.14

CT BONE DENSITY*****

Facility

$351.00

Service Code	HCPCS 76070
Hospital Charge Code	2200459
Hospital Revenue Code	359
Min. Negotiated Rate	$8.46
Max. Negotiated Rate	$3,354.00
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: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.65
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$8.46
Rate for Payer: Wellpoint Medicaid Managed Care	$9.30

CT BONE DENSITY*****

Facility

$351.00

Service Code	HCPCS 76070
Hospital Charge Code	2200459
Hospital Revenue Code	359
Min. Negotiated Rate	$52.65
Max. Negotiated Rate	$52.65
Rate for Payer: Qualcare PPO/HMO/WC	$52.65

CT BONE DENSITY APP SKELETON

Facility

$564.95

Service Code	HCPCS 77078
Hospital Charge Code	2205336
Hospital Revenue Code	350
Min. Negotiated Rate	$84.74
Max. Negotiated Rate	$84.74
Rate for Payer: Qualcare PPO/HMO/WC	$84.74

CT BONE DENSITY APP SKELETON

Facility

$564.95

Service Code	HCPCS 77078
Hospital Charge Code	2205336
Hospital Revenue Code	350
Min. Negotiated Rate	$13.62
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$281.22
Rate for Payer: Aetna Medicare Advantage	$334.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$103.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.21
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: Cigna Medicare Advantage	$72.37
Rate for Payer: Clover Medicare Advantage	$98.22
Rate for Payer: EmblemHealth Commercial	$310.17
Rate for Payer: Humana Medicare Advantage	$106.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$103.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.49
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.74
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$13.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$103.39
Rate for Payer: Wellcare Medicare Advantage	$103.39
Rate for Payer: Wellpoint Medicaid Managed Care	$14.97

CT BONE DENSITY AXIAL-GL

Facility

$479.08

Service Code	HCPCS 77078
Hospital Charge Code	85000295
Hospital Revenue Code	350
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$281.22
Rate for Payer: Aetna Medicare Advantage	$334.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$103.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.21
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: Cigna Medicare Advantage	$72.37
Rate for Payer: Clover Medicare Advantage	$98.22
Rate for Payer: EmblemHealth Commercial	$310.17
Rate for Payer: Humana Medicare Advantage	$106.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$103.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.72
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.86
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$11.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$103.39
Rate for Payer: Wellcare Medicare Advantage	$103.39
Rate for Payer: Wellpoint Medicaid Managed Care	$12.70

CT BONE DENSITY AXIAL-GL

Facility

$479.08

Service Code	HCPCS 77078
Hospital Charge Code	85000295
Hospital Revenue Code	350
Min. Negotiated Rate	$71.86
Max. Negotiated Rate	$71.86
Rate for Payer: Qualcare PPO/HMO/WC	$71.86

CT BONE DENSITY AXIAL-PC

Facility

$64.35

Service Code	HCPCS 7707826
Hospital Charge Code	85000305
Hospital Revenue Code	350
Min. Negotiated Rate	$9.65
Max. Negotiated Rate	$9.65
Rate for Payer: Qualcare PPO/HMO/WC	$9.65

CT BONE DENSITY AXIAL-PC

Facility

$64.35

Service Code	HCPCS 7707826
Hospital Charge Code	85000305
Hospital Revenue Code	350
Min. Negotiated Rate	$1.55
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$24.45
Rate for Payer: Aetna Medicare Advantage	$19.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.41
Rate for Payer: Cigna Commercial	$32.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.30
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.65
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$1.55
Rate for Payer: Wellpoint Medicaid Managed Care	$1.71

CT BONE DENSITY AXIAL SKELETON

Facility

$564.95

Service Code	HCPCS 77078
Hospital Charge Code	2205335
Hospital Revenue Code	350
Min. Negotiated Rate	$13.62
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$281.22
Rate for Payer: Aetna Medicare Advantage	$334.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$103.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.21
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: Cigna Medicare Advantage	$72.37
Rate for Payer: Clover Medicare Advantage	$98.22
Rate for Payer: EmblemHealth Commercial	$310.17
Rate for Payer: Humana Medicare Advantage	$106.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$103.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.49
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.74
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$13.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$103.39
Rate for Payer: Wellcare Medicare Advantage	$103.39
Rate for Payer: Wellpoint Medicaid Managed Care	$14.97

CT BONE DENSITY AXIAL SKELETON

Facility

$564.95

Service Code	HCPCS 77078
Hospital Charge Code	2205335
Hospital Revenue Code	350
Min. Negotiated Rate	$84.74
Max. Negotiated Rate	$84.74
Rate for Payer: Qualcare PPO/HMO/WC	$84.74

CT BONE DENSITY AXIAL-TC

Facility

$423.65

Service Code	HCPCS 77078TC
Hospital Charge Code	85000300
Hospital Revenue Code	350
Min. Negotiated Rate	$10.21
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$160.99
Rate for Payer: Aetna Medicare Advantage	$127.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.03
Rate for Payer: Cigna Commercial	$211.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.09
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.55
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$10.21
Rate for Payer: Wellpoint Medicaid Managed Care	$11.23

CT BONE DENSITY AXIAL-TC

Facility

$423.65

Service Code	HCPCS 77078TC
Hospital Charge Code	85000300
Hospital Revenue Code	350
Min. Negotiated Rate	$63.55
Max. Negotiated Rate	$63.55
Rate for Payer: Qualcare PPO/HMO/WC	$63.55

CT BONE MARROW BX BUNDLE

Facility

$9,500.00

Service Code	HCPCS 38221
Hospital Charge Code	2205490
Hospital Revenue Code	361
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CT BONE MARROW BX BUNDLE

Facility

$9,500.00

Service Code	HCPCS 38221
Hospital Charge Code	2205490
Hospital Revenue Code	361
Min. Negotiated Rate	$228.95
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	$2,850.00
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$228.95
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	$251.75

CT BRONCHO SCREENING

Facility

$880.85

Service Code	HCPCS 71250
Hospital Charge Code	2200086
Hospital Revenue Code	352
Min. Negotiated Rate	$132.13
Max. Negotiated Rate	$132.13
Rate for Payer: Qualcare PPO/HMO/WC	$132.13

Know your out-of-pocket cost for care.

All Charges