Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DEFIBRILLATION CRT-DEFIB

Facility

$126,820.00

Service Code	HCPCS C1882
Hospital Charge Code	270674919
Hospital Revenue Code	275
Min. Negotiated Rate	$3,056.36
Max. Negotiated Rate	$63,410.00
Rate for Payer: Aetna Commercial	$48,191.60
Rate for Payer: Aetna Medicare Advantage	$38,046.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32,339.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32,339.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25,364.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32,339.10
Rate for Payer: Cigna Commercial	$63,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30,690.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27,900.40
Rate for Payer: Qualcare PPO/HMO/WC	$19,023.00
Rate for Payer: UnitedHealthcare Community & State	$3,056.36
Rate for Payer: Wellpoint Medicaid Managed Care	$3,360.73

DEFIBRILLATION CRT-DEFIB

Facility

$126,820.00

Service Code	HCPCS C1882
Hospital Charge Code	270674919
Hospital Revenue Code	275
Min. Negotiated Rate	$19,023.00
Max. Negotiated Rate	$30,690.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25,364.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30,690.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27,900.40
Rate for Payer: Qualcare PPO/HMO/WC	$19,023.00

DEFIBRILLATOR ANALYSIS

Facility

$128.00

Service Code	HCPCS 93741
Hospital Charge Code	5300136
Hospital Revenue Code	921
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$6,760.00
Rate for Payer: Aetna Commercial	$48.64
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

DEFIBRILLATOR ANALYSIS

Facility

$128.00

Service Code	HCPCS 93741
Hospital Charge Code	5300136
Hospital Revenue Code	921
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

DEFIBRILLATOR CLARIA QUAD DF4

Facility

$130,740.00

Service Code	HCPCS C1882
Hospital Charge Code	270700885
Hospital Revenue Code	275
Min. Negotiated Rate	$3,150.83
Max. Negotiated Rate	$65,370.00
Rate for Payer: Aetna Commercial	$49,681.20
Rate for Payer: Aetna Medicare Advantage	$39,222.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,338.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,338.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26,148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33,338.70
Rate for Payer: Cigna Commercial	$65,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31,639.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$28,762.80
Rate for Payer: Qualcare PPO/HMO/WC	$19,611.00
Rate for Payer: UnitedHealthcare Community & State	$3,150.83
Rate for Payer: Wellpoint Medicaid Managed Care	$3,464.61

DEFIBRILLATOR CLARIA QUAD DF4

Facility

$130,740.00

Service Code	HCPCS C1882
Hospital Charge Code	270700885
Hospital Revenue Code	275
Min. Negotiated Rate	$19,611.00
Max. Negotiated Rate	$31,639.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26,148.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31,639.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$28,762.80
Rate for Payer: Qualcare PPO/HMO/WC	$19,611.00

DEFIBRILLATOR EVERA XT

Facility

$94,205.00

Hospital Charge Code	270670818
Hospital Revenue Code	275
Min. Negotiated Rate	$14,130.75
Max. Negotiated Rate	$22,797.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18,841.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,797.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20,725.10
Rate for Payer: Qualcare PPO/HMO/WC	$14,130.75

DEFIBRILLATOR EVERA XT

Facility

$94,205.00

Hospital Charge Code	270670818
Hospital Revenue Code	275
Min. Negotiated Rate	$2,270.34
Max. Negotiated Rate	$47,102.50
Rate for Payer: Aetna Commercial	$35,797.90
Rate for Payer: Aetna Medicare Advantage	$28,261.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,022.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,022.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18,841.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,022.28
Rate for Payer: Cigna Commercial	$47,102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,797.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$20,725.10
Rate for Payer: Qualcare PPO/HMO/WC	$14,130.75
Rate for Payer: UnitedHealthcare Community & State	$2,270.34
Rate for Payer: Wellpoint Medicaid Managed Care	$2,496.43

DEFIBRILLATOR IMPLANTS

Facility

$42,089.25

Service Code	APR-DRG 1791
Min. Negotiated Rate	$41,263.97
Max. Negotiated Rate	$42,089.25
Rate for Payer: UnitedHealthcare Community & State	$41,263.97
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$42,089.25
Rate for Payer: Wellpoint Medicaid Managed Care	$41,263.97

DEFIBRILLATOR IMPLANTS

Facility

$47,567.62

Service Code	APR-DRG 1792
Min. Negotiated Rate	$46,634.92
Max. Negotiated Rate	$47,567.62
Rate for Payer: UnitedHealthcare Community & State	$46,634.92
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$47,567.62
Rate for Payer: Wellpoint Medicaid Managed Care	$46,634.92

DEFIBRILLATOR IMPLANTS

Facility

$82,798.43

Service Code	APR-DRG 1794
Min. Negotiated Rate	$81,174.93
Max. Negotiated Rate	$82,798.43
Rate for Payer: UnitedHealthcare Community & State	$81,174.93
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$82,798.43
Rate for Payer: Wellpoint Medicaid Managed Care	$81,174.93

DEFIBRILLATOR IMPLANTS

Facility

$57,788.97

Service Code	APR-DRG 1793
Min. Negotiated Rate	$56,655.85
Max. Negotiated Rate	$57,788.97
Rate for Payer: UnitedHealthcare Community & State	$56,655.85
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$57,788.97
Rate for Payer: Wellpoint Medicaid Managed Care	$56,655.85

DEFIBRILLATOR REPROGRAM

Facility

$128.00

Service Code	HCPCS 93742
Hospital Charge Code	5300137
Hospital Revenue Code	480
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

DEFIBRILLATOR REPROGRAM

Facility

$128.00

Service Code	HCPCS 93742
Hospital Charge Code	5300137
Hospital Revenue Code	480
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$48.64
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

DEFINITIVE ID, AEROBIC

Facility

$154.00

Service Code	HCPCS 87077
Hospital Charge Code	38475116
Hospital Revenue Code	309
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

DEFINITIVE ID, AEROBIC

Facility

$154.00

Service Code	HCPCS 87077
Hospital Charge Code	38475116
Hospital Revenue Code	309
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$21.98
Rate for Payer: Aetna Medicare Advantage	$26.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.17
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: Cigna Medicare Advantage	$8.08
Rate for Payer: Clover Medicare Advantage	$7.68
Rate for Payer: EmblemHealth Commercial	$24.24
Rate for Payer: Humana Medicare Advantage	$8.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.08
Rate for Payer: Wellcare Medicare Advantage	$8.08
Rate for Payer: Wellpoint Medicaid Managed Care	$4.08

DEFINITIVE ID, ANAEROBIC

Facility

$390.00

Service Code	HCPCS 87076
Hospital Charge Code	38475115
Hospital Revenue Code	309
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$21.98
Rate for Payer: Aetna Medicare Advantage	$26.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.17
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$8.08
Rate for Payer: Clover Medicare Advantage	$7.68
Rate for Payer: EmblemHealth Commercial	$24.24
Rate for Payer: Humana Medicare Advantage	$8.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.08
Rate for Payer: Wellcare Medicare Advantage	$8.08
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

DEFINITIVE ID, ANAEROBIC

Facility

$390.00

Service Code	HCPCS 87076
Hospital Charge Code	38475115
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

DEFOGGER

Facility

$7.60

Hospital Charge Code	270666796
Hospital Revenue Code	270
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$1.14
Rate for Payer: Qualcare PPO/HMO/WC	$1.14

DEFOGGER

Facility

$7.60

Hospital Charge Code	270666796
Hospital Revenue Code	270
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.80
Rate for Payer: Aetna Commercial	$2.89
Rate for Payer: Aetna Medicare Advantage	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.94
Rate for Payer: Cigna Commercial	$3.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.28
Rate for Payer: Oxford Commercial	$1.52
Rate for Payer: Qualcare PPO/HMO/WC	$1.14
Rate for Payer: UnitedHealthcare Commercial	$1.52
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

DEFRIBILATOR BURDICK COR-GEL

Facility

$19.10

Hospital Charge Code	270649682
Hospital Revenue Code	270
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.55
Rate for Payer: Aetna Commercial	$7.26
Rate for Payer: Aetna Medicare Advantage	$5.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.87
Rate for Payer: Cigna Commercial	$9.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.73
Rate for Payer: Oxford Commercial	$3.82
Rate for Payer: Qualcare PPO/HMO/WC	$2.87
Rate for Payer: UnitedHealthcare Commercial	$3.82
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

DEFRIBILATOR BURDICK COR-GEL

Facility

$19.10

Hospital Charge Code	270649682
Hospital Revenue Code	270
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$2.87
Rate for Payer: Qualcare PPO/HMO/WC	$2.87

DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS

Facility

$10,452.45

Service Code	APR-DRG 0422
Min. Negotiated Rate	$10,247.50
Max. Negotiated Rate	$10,452.45
Rate for Payer: UnitedHealthcare Community & State	$10,247.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,452.45
Rate for Payer: Wellpoint Medicaid Managed Care	$10,247.50

DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS

Facility

$14,223.81

Service Code	APR-DRG 0423
Min. Negotiated Rate	$13,944.91
Max. Negotiated Rate	$14,223.81
Rate for Payer: UnitedHealthcare Community & State	$13,944.91
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,223.81
Rate for Payer: Wellpoint Medicaid Managed Care	$13,944.91

DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS

Facility

$8,206.69

Service Code	APR-DRG 0421
Min. Negotiated Rate	$8,045.77
Max. Negotiated Rate	$8,206.69
Rate for Payer: UnitedHealthcare Community & State	$8,045.77
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,206.69
Rate for Payer: Wellpoint Medicaid Managed Care	$8,045.77

Know your out-of-pocket cost for care.

All Charges