Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DEL HYSTERECTOMY

Facility

$9,448.60

Service Code	HCPCS 59525
Hospital Charge Code	73190045
Hospital Revenue Code	361
Min. Negotiated Rate	$1,417.29
Max. Negotiated Rate	$1,417.29
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.29

DEL HYSTERECTOMY

Facility

$9,448.60

Service Code	HCPCS 59525
Hospital Charge Code	73190045
Hospital Revenue Code	361
Min. Negotiated Rate	$227.71
Max. Negotiated Rate	$4,724.30
Rate for Payer: Aetna Commercial	$3,590.47
Rate for Payer: Aetna Medicare Advantage	$2,834.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,409.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,409.39
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	$2,409.39
Rate for Payer: Cigna Commercial	$4,724.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,834.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.29
Rate for Payer: UnitedHealthcare Community & State	$227.71
Rate for Payer: Wellpoint Medicaid Managed Care	$250.39

DELIVERY CANNULA&TAMP 8G 10CM

Facility

$267.30

Hospital Charge Code	270645740
Hospital Revenue Code	272
Min. Negotiated Rate	$40.09
Max. Negotiated Rate	$40.09
Rate for Payer: Qualcare PPO/HMO/WC	$40.09

DELIVERY CANNULA&TAMP 8G 10CM

Facility

$267.30

Hospital Charge Code	270645740
Hospital Revenue Code	272
Min. Negotiated Rate	$6.44
Max. Negotiated Rate	$133.65
Rate for Payer: Aetna Commercial	$101.57
Rate for Payer: Aetna Medicare Advantage	$80.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.16
Rate for Payer: Cigna Commercial	$133.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.19
Rate for Payer: Oxford Commercial	$53.46
Rate for Payer: Qualcare PPO/HMO/WC	$40.09
Rate for Payer: UnitedHealthcare Commercial	$53.46
Rate for Payer: UnitedHealthcare Community & State	$6.44
Rate for Payer: Wellpoint Medicaid Managed Care	$7.08

DELIVERY FEE

Facility

$245.00

Hospital Charge Code	270657510
Hospital Revenue Code	270
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$36.75
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

DELIVERY FEE

Facility

$245.00

Hospital Charge Code	270657510
Hospital Revenue Code	270
Min. Negotiated Rate	$5.90
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.50
Rate for Payer: Oxford Commercial	$49.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Commercial	$49.00
Rate for Payer: UnitedHealthcare Community & State	$5.90
Rate for Payer: Wellpoint Medicaid Managed Care	$6.49

DELIVERY NEEDLES, STERILE

Facility

$235.50

Hospital Charge Code	270659780
Hospital Revenue Code	272
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$117.75
Rate for Payer: Aetna Commercial	$89.49
Rate for Payer: Aetna Medicare Advantage	$70.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.05
Rate for Payer: Cigna Commercial	$117.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.65
Rate for Payer: Oxford Commercial	$47.10
Rate for Payer: Qualcare PPO/HMO/WC	$35.33
Rate for Payer: UnitedHealthcare Commercial	$47.10
Rate for Payer: UnitedHealthcare Community & State	$5.68
Rate for Payer: Wellpoint Medicaid Managed Care	$6.24

DELIVERY NEEDLES, STERILE

Facility

$235.50

Hospital Charge Code	270659780
Hospital Revenue Code	272
Min. Negotiated Rate	$35.33
Max. Negotiated Rate	$35.33
Rate for Payer: Qualcare PPO/HMO/WC	$35.33

DELIVERY ROOM

Facility

$3,775.00

Hospital Charge Code	1800010
Hospital Revenue Code	722
Min. Negotiated Rate	$90.98
Max. Negotiated Rate	$4,601.00
Rate for Payer: Aetna Commercial	$1,434.50
Rate for Payer: Aetna Medicare Advantage	$1,132.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$962.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$962.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$962.62
Rate for Payer: Cigna Commercial	$1,887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,132.50
Rate for Payer: Oxford Commercial	$2,624.00
Rate for Payer: Qualcare PPO/HMO/WC	$566.25
Rate for Payer: UnitedHealthcare Commercial	$4,601.00
Rate for Payer: UnitedHealthcare Community & State	$90.98
Rate for Payer: Wellpoint Medicaid Managed Care	$100.04

DELIVERY ROOM

Facility

$3,775.00

Hospital Charge Code	1800010
Hospital Revenue Code	722
Min. Negotiated Rate	$566.25
Max. Negotiated Rate	$566.25
Rate for Payer: Qualcare PPO/HMO/WC	$566.25

DELIVERY SYSTEM FMT LOWER

Facility

$2,425.00

Hospital Charge Code	270683731
Hospital Revenue Code	272
Min. Negotiated Rate	$58.44
Max. Negotiated Rate	$1,212.50
Rate for Payer: Aetna Commercial	$921.50
Rate for Payer: Aetna Medicare Advantage	$727.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.38
Rate for Payer: Cigna Commercial	$1,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$727.50
Rate for Payer: Oxford Commercial	$485.00
Rate for Payer: Qualcare PPO/HMO/WC	$363.75
Rate for Payer: UnitedHealthcare Commercial	$485.00
Rate for Payer: UnitedHealthcare Community & State	$58.44
Rate for Payer: Wellpoint Medicaid Managed Care	$64.26

DELIVERY SYSTEM FMT LOWER

Facility

$2,425.00

Hospital Charge Code	270683731
Hospital Revenue Code	272
Min. Negotiated Rate	$363.75
Max. Negotiated Rate	$363.75
Rate for Payer: Qualcare PPO/HMO/WC	$363.75

DELIVERY SYSTEM FMT UPPER

Facility

$2,425.00

Hospital Charge Code	270683732
Hospital Revenue Code	272
Min. Negotiated Rate	$58.44
Max. Negotiated Rate	$1,212.50
Rate for Payer: Aetna Commercial	$921.50
Rate for Payer: Aetna Medicare Advantage	$727.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.38
Rate for Payer: Cigna Commercial	$1,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$727.50
Rate for Payer: Oxford Commercial	$485.00
Rate for Payer: Qualcare PPO/HMO/WC	$363.75
Rate for Payer: UnitedHealthcare Commercial	$485.00
Rate for Payer: UnitedHealthcare Community & State	$58.44
Rate for Payer: Wellpoint Medicaid Managed Care	$64.26

DELIVERY SYSTEM FMT UPPER

Facility

$2,425.00

Hospital Charge Code	270683732
Hospital Revenue Code	272
Min. Negotiated Rate	$363.75
Max. Negotiated Rate	$363.75
Rate for Payer: Qualcare PPO/HMO/WC	$363.75

DELIVERY SYST RX BILIARY

Facility

$399.25

Hospital Charge Code	270677724
Hospital Revenue Code	272
Min. Negotiated Rate	$9.62
Max. Negotiated Rate	$199.62
Rate for Payer: Aetna Commercial	$151.72
Rate for Payer: Aetna Medicare Advantage	$119.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.81
Rate for Payer: Cigna Commercial	$199.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.78
Rate for Payer: Oxford Commercial	$79.85
Rate for Payer: Qualcare PPO/HMO/WC	$59.89
Rate for Payer: UnitedHealthcare Commercial	$79.85
Rate for Payer: UnitedHealthcare Community & State	$9.62
Rate for Payer: Wellpoint Medicaid Managed Care	$10.58

DELIVERY SYST RX BILIARY

Facility

$399.25

Hospital Charge Code	270677724
Hospital Revenue Code	272
Min. Negotiated Rate	$59.89
Max. Negotiated Rate	$59.89
Rate for Payer: Qualcare PPO/HMO/WC	$59.89

DEL IV HYDRA 31-90 INITL AVS

Facility

$1,326.52

Service Code	HCPCS 9636059
Hospital Charge Code	73190087
Hospital Revenue Code	260
Min. Negotiated Rate	$31.97
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$504.08
Rate for Payer: Aetna Medicare Advantage	$397.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$338.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$338.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$338.26
Rate for Payer: Cigna Commercial	$663.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$397.96
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$198.98
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$31.97
Rate for Payer: Wellpoint Medicaid Managed Care	$35.15

DEL IV HYDRA 31-90 INITL AVS

Facility

$1,326.52

Service Code	HCPCS 9636059
Hospital Charge Code	73190087
Hospital Revenue Code	260
Min. Negotiated Rate	$198.98
Max. Negotiated Rate	$198.98
Rate for Payer: Qualcare PPO/HMO/WC	$198.98

DEL IV HYDRA 31-90 NOT INITL

Facility

$320.48

Service Code	HCPCS 96361
Hospital Charge Code	73190089
Hospital Revenue Code	260
Min. Negotiated Rate	$7.72
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.81
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.14
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.07
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$7.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$8.49

DEL IV HYDRA 31-90 NOT INITL

Facility

$320.48

Service Code	HCPCS 96361
Hospital Charge Code	73190089
Hospital Revenue Code	260
Min. Negotiated Rate	$48.07
Max. Negotiated Rate	$48.07
Rate for Payer: Qualcare PPO/HMO/WC	$48.07

DEL IV INF 1STMED16-90 INIAVS

Facility

$1,405.77

Service Code	HCPCS 9636559
Hospital Charge Code	73190095
Hospital Revenue Code	260
Min. Negotiated Rate	$210.87
Max. Negotiated Rate	$210.87
Rate for Payer: Qualcare PPO/HMO/WC	$210.87

DEL IV INF 1STMED16-90 INIAVS

Facility

$1,405.77

Service Code	HCPCS 9636559
Hospital Charge Code	73190095
Hospital Revenue Code	260
Min. Negotiated Rate	$33.88
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$534.19
Rate for Payer: Aetna Medicare Advantage	$421.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.47
Rate for Payer: Cigna Commercial	$702.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.73
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.87
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$33.88
Rate for Payer: Wellpoint Medicaid Managed Care	$37.25

DEL IV PUSH-1ST MED INITL AVS

Facility

$394.88

Service Code	HCPCS 9637459
Hospital Charge Code	73190109
Hospital Revenue Code	260
Min. Negotiated Rate	$59.23
Max. Negotiated Rate	$59.23
Rate for Payer: Qualcare PPO/HMO/WC	$59.23

DEL IV PUSH-1ST MED INITL AVS

Facility

$394.88

Service Code	HCPCS 9637459
Hospital Charge Code	73190109
Hospital Revenue Code	260
Min. Negotiated Rate	$9.52
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$150.05
Rate for Payer: Aetna Medicare Advantage	$118.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.69
Rate for Payer: Cigna Commercial	$197.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.46
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.23
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$9.52
Rate for Payer: Wellpoint Medicaid Managed Care	$10.46

DEL L & D NURSE LOC W/NO PROC

Facility

$10,100.00

Service Code	HCPCS 99211
Hospital Charge Code	73190115
Hospital Revenue Code	720
Min. Negotiated Rate	$243.41
Max. Negotiated Rate	$5,050.00
Rate for Payer: Aetna Commercial	$3,838.00
Rate for Payer: Aetna Medicare Advantage	$3,030.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,575.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,575.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,575.50
Rate for Payer: Cigna Commercial	$5,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,030.00
Rate for Payer: Oxford Commercial	$2,624.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,515.00
Rate for Payer: UnitedHealthcare Commercial	$4,601.00
Rate for Payer: UnitedHealthcare Community & State	$243.41
Rate for Payer: Wellpoint Medicaid Managed Care	$267.65

Know your out-of-pocket cost for care.

All Charges