Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

CT CARDIAC CONGENITAL

Facility

$1,555.10

Service Code	HCPCS 75573
Hospital Charge Code	2208010
Hospital Revenue Code	352
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$1,127.36
Rate for Payer: Aetna Medicare Advantage	$1,342.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$414.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$343.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,496.11
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: Cigna Medicare Advantage	$290.13
Rate for Payer: Clover Medicare Advantage	$393.75
Rate for Payer: EmblemHealth Commercial	$1,243.41
Rate for Payer: Humana Medicare Advantage	$426.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$414.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.53
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$233.26
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$37.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$414.47
Rate for Payer: Wellcare Medicare Advantage	$414.47
Rate for Payer: Wellpoint Medicaid Managed Care	$41.21

CT CARDIAC CONGENITAL

Facility

$1,555.10

Service Code	HCPCS 75573
Hospital Charge Code	2208010
Hospital Revenue Code	352
Min. Negotiated Rate	$233.26
Max. Negotiated Rate	$233.26
Rate for Payer: Qualcare PPO/HMO/WC	$233.26

CT CARDIAC CORONARY CALCIUM

Facility

$521.15

Service Code	HCPCS 75571
Hospital Charge Code	2208001
Hospital Revenue Code	352
Min. Negotiated Rate	$12.56
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	$82.26
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	$156.34
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.17
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$12.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$103.39
Rate for Payer: Wellcare Medicare Advantage	$103.39
Rate for Payer: Wellpoint Medicaid Managed Care	$13.81

CT CARDIAC CORONARY CALCIUM

Facility

$521.15

Service Code	HCPCS 75571
Hospital Charge Code	2208001
Hospital Revenue Code	352
Min. Negotiated Rate	$78.17
Max. Negotiated Rate	$78.17
Rate for Payer: Qualcare PPO/HMO/WC	$78.17

CT CARDIAC CORONARY CTA

Facility

$1,555.10

Service Code	HCPCS 75574
Hospital Charge Code	2207005
Hospital Revenue Code	352
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$1,127.36
Rate for Payer: Aetna Medicare Advantage	$1,342.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$414.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,496.11
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: Cigna Medicare Advantage	$290.13
Rate for Payer: Clover Medicare Advantage	$393.75
Rate for Payer: EmblemHealth Commercial	$1,243.41
Rate for Payer: Humana Medicare Advantage	$426.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$414.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.53
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$233.26
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$37.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$414.47
Rate for Payer: Wellcare Medicare Advantage	$414.47
Rate for Payer: Wellpoint Medicaid Managed Care	$41.21

CT CARDIAC CORONARY CTA

Facility

$1,555.10

Service Code	HCPCS 75574
Hospital Charge Code	2207005
Hospital Revenue Code	352
Min. Negotiated Rate	$233.26
Max. Negotiated Rate	$233.26
Rate for Payer: Qualcare PPO/HMO/WC	$233.26

CT CARDIAC SCORING

Facility

$880.85

Service Code	HCPCS 71250
Hospital Charge Code	2200110
Hospital Revenue Code	352
Min. Negotiated Rate	$132.13
Max. Negotiated Rate	$132.13
Rate for Payer: Qualcare PPO/HMO/WC	$132.13

CT CARDIAC SCORING

Facility

$880.85

Service Code	HCPCS 71250
Hospital Charge Code	2200110
Hospital Revenue Code	352
Min. Negotiated Rate	$21.23
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$264.25
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.13
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$21.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$23.34

CT CARDIAC SRUCT MORPHOLOGY

Facility

$1,555.10

Service Code	HCPCS 75572
Hospital Charge Code	2208005
Hospital Revenue Code	352
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$1,127.36
Rate for Payer: Aetna Medicare Advantage	$1,342.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$414.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,496.11
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: Cigna Medicare Advantage	$290.13
Rate for Payer: Clover Medicare Advantage	$393.75
Rate for Payer: EmblemHealth Commercial	$1,243.41
Rate for Payer: Humana Medicare Advantage	$426.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$414.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.53
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$233.26
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$37.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$414.47
Rate for Payer: Wellcare Medicare Advantage	$414.47
Rate for Payer: Wellpoint Medicaid Managed Care	$41.21

CT CARDIAC SRUCT MORPHOLOGY

Facility

$1,555.10

Service Code	HCPCS 75572
Hospital Charge Code	2208005
Hospital Revenue Code	352
Min. Negotiated Rate	$233.26
Max. Negotiated Rate	$233.26
Rate for Payer: Qualcare PPO/HMO/WC	$233.26

CT CERE PRFU ALYS C+W/CT/CTA

Facility

$1,041.90

Service Code	HCPCS 70473
Hospital Charge Code	404370473
Hospital Revenue Code	359
Min. Negotiated Rate	$25.11
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$566.79
Rate for Payer: Aetna Medicare Advantage	$675.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$208.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.19
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: Cigna Medicare Advantage	$145.87
Rate for Payer: Clover Medicare Advantage	$197.96
Rate for Payer: EmblemHealth Commercial	$625.14
Rate for Payer: Humana Medicare Advantage	$214.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$208.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.57
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.28
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$25.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellpoint Medicaid Managed Care	$27.61

CT CERE PRFU ALYS C+W/CT/CTA

Facility

$1,041.90

Service Code	HCPCS 70473
Hospital Charge Code	404370473
Hospital Revenue Code	359
Min. Negotiated Rate	$156.28
Max. Negotiated Rate	$156.28
Rate for Payer: Qualcare PPO/HMO/WC	$156.28

CT CERE PRFU ALYSC+WCT/CTA

Facility

$1,041.90

Service Code	HCPCS 70472
Hospital Charge Code	404370472
Hospital Revenue Code	359
Min. Negotiated Rate	$156.28
Max. Negotiated Rate	$156.28
Rate for Payer: Qualcare PPO/HMO/WC	$156.28

CT CERE PRFU ALYSC+WCT/CTA

Facility

$1,041.90

Service Code	HCPCS 70472
Hospital Charge Code	404370472
Hospital Revenue Code	359
Min. Negotiated Rate	$25.11
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$395.92
Rate for Payer: Aetna Medicare Advantage	$312.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$265.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$265.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$265.68
Rate for Payer: Cigna Commercial	$520.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.57
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.28
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$25.11
Rate for Payer: Wellpoint Medicaid Managed Care	$27.61

CT CERVICAL SPINE W/O & W C

Facility

$5,288.50

Service Code	HCPCS 72127
Hospital Charge Code	2200139
Hospital Revenue Code	352
Min. Negotiated Rate	$793.27
Max. Negotiated Rate	$793.27
Rate for Payer: Qualcare PPO/HMO/WC	$793.27

CT CERVICAL SPINE W/O & W C

Facility

$5,288.50

Service Code	HCPCS 72127
Hospital Charge Code	2200139
Hospital Revenue Code	352
Min. Negotiated Rate	$127.45
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$566.79
Rate for Payer: Aetna Medicare Advantage	$675.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$208.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$338.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.19
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: Cigna Medicare Advantage	$145.87
Rate for Payer: Clover Medicare Advantage	$197.96
Rate for Payer: EmblemHealth Commercial	$625.14
Rate for Payer: Humana Medicare Advantage	$214.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$208.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,586.55
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$793.27
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$127.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$958.88
Rate for Payer: Wellpoint Medicaid Managed Care	$140.15

CT COLON SCREENING

Facility

$1,060.85

Service Code	HCPCS 74150
Hospital Charge Code	2205190
Hospital Revenue Code	352
Min. Negotiated Rate	$25.57
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.25
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$159.13
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$25.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$28.11

CT COLON SCREENING

Facility

$1,060.85

Service Code	HCPCS 74150
Hospital Charge Code	2205190
Hospital Revenue Code	352
Min. Negotiated Rate	$159.13
Max. Negotiated Rate	$159.13
Rate for Payer: Qualcare PPO/HMO/WC	$159.13

CT CYST ASPIRATION

Facility

$9,500.00

Service Code	HCPCS 77012
Hospital Charge Code	2200400
Hospital Revenue Code	350
Min. Negotiated Rate	$222.89
Max. Negotiated Rate	$4,750.00
Rate for Payer: Aetna Commercial	$3,610.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
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	$2,422.50
Rate for Payer: Cigna Commercial	$4,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,850.00
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$228.95
Rate for Payer: Wellpoint Medicaid Managed Care	$251.75

CT CYST ASPIRATION

Facility

$9,500.00

Service Code	HCPCS 77012
Hospital Charge Code	2200400
Hospital Revenue Code	350
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CT DENTASCAN RECONTST

Facility

$1,194.45

Service Code	HCPCS 76376
Hospital Charge Code	2200442
Hospital Revenue Code	359
Min. Negotiated Rate	$28.79
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$453.89
Rate for Payer: Aetna Medicare Advantage	$358.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$304.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$304.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$304.58
Rate for Payer: Cigna Commercial	$597.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.33
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$179.17
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$28.79
Rate for Payer: Wellpoint Medicaid Managed Care	$31.65

CT DENTASCAN RECONTST

Facility

$1,194.45

Service Code	HCPCS 76376
Hospital Charge Code	2200442
Hospital Revenue Code	359
Min. Negotiated Rate	$179.17
Max. Negotiated Rate	$179.17
Rate for Payer: Qualcare PPO/HMO/WC	$179.17

CT DRAINAGE TRAY

Facility

$720.00

Hospital Charge Code	270669755
Hospital Revenue Code	272
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$108.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

CT DRAINAGE TRAY

Facility

$720.00

Hospital Charge Code	270669755
Hospital Revenue Code	272
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.00
Rate for Payer: Oxford Commercial	$144.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Commercial	$144.00
Rate for Payer: UnitedHealthcare Community & State	$17.35
Rate for Payer: Wellpoint Medicaid Managed Care	$19.08

Know your out-of-pocket cost for care.

All Charges