Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ECHO COMP W/ M MODE/C FLOW/DOP

Facility

$7,938.54

Service Code	HCPCS 93306
Hospital Charge Code	5300080
Hospital Revenue Code	483
Min. Negotiated Rate	$191.32
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,146.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$649.16
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,381.56
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,190.78
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$191.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$210.37

ECHO COMP W/ M MODE/C FLOW/DOP

Facility

$7,938.54

Service Code	HCPCS 93306
Hospital Charge Code	74116025
Hospital Revenue Code	483
Min. Negotiated Rate	$1,190.78
Max. Negotiated Rate	$1,190.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,190.78

ECHO COMP W/ M MODE/C FLOW/DOP

Facility

$7,938.54

Service Code	HCPCS 93306
Hospital Charge Code	74116025
Hospital Revenue Code	483
Min. Negotiated Rate	$191.32
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,146.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$649.16
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,381.56
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,190.78
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$191.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$210.37

ECHO COMP W/ M MODE/C FLOW/DOP

Facility

$7,938.54

Service Code	HCPCS 93306
Hospital Charge Code	74117025
Hospital Revenue Code	483
Min. Negotiated Rate	$191.32
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,146.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$649.16
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,381.56
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,190.78
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$191.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$210.37

ECHO DOPPLER COLOR FLOW

Facility

$1,509.35

Service Code	HCPCS 93325
Hospital Charge Code	94053135
Hospital Revenue Code	483
Min. Negotiated Rate	$36.38
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$573.55
Rate for Payer: Aetna Medicare Advantage	$452.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$384.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$384.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$384.88
Rate for Payer: Cigna Commercial	$754.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$452.81
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$226.40
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$36.38
Rate for Payer: Wellpoint Medicaid Managed Care	$40.00

ECHO DOPPLER COLOR FLOW

Facility

$1,509.35

Service Code	HCPCS 93325
Hospital Charge Code	5300132
Hospital Revenue Code	483
Min. Negotiated Rate	$226.40
Max. Negotiated Rate	$226.40
Rate for Payer: Qualcare PPO/HMO/WC	$226.40

ECHO DOPPLER COLOR FLOW

Facility

$1,509.35

Service Code	HCPCS 93325
Hospital Charge Code	94053135
Hospital Revenue Code	483
Min. Negotiated Rate	$226.40
Max. Negotiated Rate	$226.40
Rate for Payer: Qualcare PPO/HMO/WC	$226.40

ECHO DOPPLER COLOR FLOW

Facility

$1,509.35

Service Code	HCPCS 93325
Hospital Charge Code	5300132
Hospital Revenue Code	483
Min. Negotiated Rate	$36.38
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$573.55
Rate for Payer: Aetna Medicare Advantage	$452.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$384.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$384.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$384.88
Rate for Payer: Cigna Commercial	$754.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$452.81
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$226.40
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$36.38
Rate for Payer: Wellpoint Medicaid Managed Care	$40.00

ECHO DOPPLER COMPLETE

Facility

$1,392.95

Service Code	HCPCS 93320
Hospital Charge Code	5300108
Hospital Revenue Code	483
Min. Negotiated Rate	$33.57
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$529.32
Rate for Payer: Aetna Medicare Advantage	$417.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$468.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.20
Rate for Payer: Cigna Commercial	$696.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.88
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$208.94
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$33.57
Rate for Payer: Wellpoint Medicaid Managed Care	$36.91

ECHO DOPPLER COMPLETE

Facility

$1,392.95

Service Code	HCPCS 93320
Hospital Charge Code	5300108
Hospital Revenue Code	483
Min. Negotiated Rate	$208.94
Max. Negotiated Rate	$208.94
Rate for Payer: Qualcare PPO/HMO/WC	$208.94

ECHO DOPPLER COMPLETE

Facility

$1,392.95

Service Code	HCPCS 93320
Hospital Charge Code	94053125
Hospital Revenue Code	483
Min. Negotiated Rate	$208.94
Max. Negotiated Rate	$208.94
Rate for Payer: Qualcare PPO/HMO/WC	$208.94

ECHO DOPPLER COMPLETE

Facility

$1,392.95

Service Code	HCPCS 93320
Hospital Charge Code	94053125
Hospital Revenue Code	483
Min. Negotiated Rate	$33.57
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$529.32
Rate for Payer: Aetna Medicare Advantage	$417.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$468.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.20
Rate for Payer: Cigna Commercial	$696.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.88
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$208.94
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$33.57
Rate for Payer: Wellpoint Medicaid Managed Care	$36.91

ECHO DOPPLER LIMITED/FOLLOW UP

Facility

$5,900.00

Service Code	HCPCS 93321
Hospital Charge Code	5300086
Hospital Revenue Code	483
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$2,950.00
Rate for Payer: Aetna Commercial	$2,242.00
Rate for Payer: Aetna Medicare Advantage	$1,770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$197.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,504.50
Rate for Payer: Cigna Commercial	$2,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.00
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$142.19
Rate for Payer: Wellpoint Medicaid Managed Care	$156.35

ECHO DOPPLER LIMITED/FOLLOW UP

Facility

$1,174.45

Service Code	HCPCS 93321
Hospital Charge Code	94053130
Hospital Revenue Code	483
Min. Negotiated Rate	$176.17
Max. Negotiated Rate	$176.17
Rate for Payer: Qualcare PPO/HMO/WC	$176.17

ECHO DOPPLER LIMITED/FOLLOW UP

Facility

$1,174.45

Service Code	HCPCS 93321
Hospital Charge Code	94053130
Hospital Revenue Code	483
Min. Negotiated Rate	$28.30
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$446.29
Rate for Payer: Aetna Medicare Advantage	$352.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$197.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.48
Rate for Payer: Cigna Commercial	$587.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.33
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$176.17
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$28.30
Rate for Payer: Wellpoint Medicaid Managed Care	$31.12

ECHO DOPPLER LIMITED/FOLLOW UP

Facility

$5,900.00

Service Code	HCPCS 93321
Hospital Charge Code	5300086
Hospital Revenue Code	483
Min. Negotiated Rate	$885.00
Max. Negotiated Rate	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00

ECHO GUIDE FOR BIOPSY

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	421076942
Hospital Revenue Code	402
Min. Negotiated Rate	$71.63
Max. Negotiated Rate	$3,350.00
Rate for Payer: Aetna Commercial	$2,546.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$161.47
Rate for Payer: Wellpoint Medicaid Managed Care	$177.55

ECHO GUIDE FOR BIOPSY

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	421076942
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

ECHO POR FMRL FPP NC 13X145MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270694003
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,970.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

ECHO POR FMRL FPP NC 13X145MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270694003
Hospital Revenue Code	278
Min. Negotiated Rate	$325.35
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$5,130.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,970.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: UnitedHealthcare Community & State	$325.35
Rate for Payer: Wellpoint Medicaid Managed Care	$357.75

ECHO POR FMRL FPP NC 14 X 150

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690626
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

ECHO POR FMRL FPP NC 14 X 150

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690626
Hospital Revenue Code	278
Min. Negotiated Rate	$253.05
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$253.05
Rate for Payer: Wellpoint Medicaid Managed Care	$278.25

ECHOPOR FMRLLAT FPP NC 16X160M

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697933
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

ECHOPOR FMRLLAT FPP NC 16X160M

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697933
Hospital Revenue Code	278
Min. Negotiated Rate	$253.05
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$253.05
Rate for Payer: Wellpoint Medicaid Managed Care	$278.25

ECHO POR FMRL RPP NC 12 X 140

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270691571
Hospital Revenue Code	278
Min. Negotiated Rate	$253.05
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$253.05
Rate for Payer: Wellpoint Medicaid Managed Care	$278.25

Know your out-of-pocket cost for care.

All Charges