Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

EGD-OSCOPY W/BICAP CAUT***

Facility

$351.00

Hospital Charge Code	2300119
Hospital Revenue Code	759
Min. Negotiated Rate	$52.65
Max. Negotiated Rate	$52.65
Rate for Payer: Qualcare PPO/HMO/WC	$52.65

EGD-OSCOPY W/PEG***

Facility

$527.00

Hospital Charge Code	2300366
Hospital Revenue Code	759
Min. Negotiated Rate	$12.70
Max. Negotiated Rate	$263.50
Rate for Payer: Aetna Commercial	$200.26
Rate for Payer: Aetna Medicare Advantage	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$134.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$134.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$134.38
Rate for Payer: Cigna Commercial	$263.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.10
Rate for Payer: Qualcare PPO/HMO/WC	$79.05
Rate for Payer: UnitedHealthcare Community & State	$12.70
Rate for Payer: Wellpoint Medicaid Managed Care	$13.97

EGD-OSCOPY W/PEG***

Facility

$527.00

Hospital Charge Code	2300366
Hospital Revenue Code	759
Min. Negotiated Rate	$79.05
Max. Negotiated Rate	$79.05
Rate for Payer: Qualcare PPO/HMO/WC	$79.05

EGD-OSCOPY W/PEJ***

Facility

$391.00

Service Code	HCPCS 99999
Hospital Charge Code	2300283
Hospital Revenue Code	759
Min. Negotiated Rate	$9.42
Max. Negotiated Rate	$195.50
Rate for Payer: Aetna Commercial	$148.58
Rate for Payer: Aetna Medicare Advantage	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.70
Rate for Payer: Cigna Commercial	$195.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.30
Rate for Payer: Qualcare PPO/HMO/WC	$58.65
Rate for Payer: UnitedHealthcare Community & State	$9.42
Rate for Payer: Wellpoint Medicaid Managed Care	$10.36

EGD-OSCOPY W/PEJ***

Facility

$391.00

Service Code	HCPCS 99999
Hospital Charge Code	2300283
Hospital Revenue Code	759
Min. Negotiated Rate	$58.65
Max. Negotiated Rate	$58.65
Rate for Payer: Qualcare PPO/HMO/WC	$58.65

EGD-OSCOPY W/PNEUM ACHALASIA**

Facility

$283.00

Hospital Charge Code	2300135
Hospital Revenue Code	759
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$141.50
Rate for Payer: Aetna Commercial	$107.54
Rate for Payer: Aetna Medicare Advantage	$84.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.17
Rate for Payer: Cigna Commercial	$141.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.90
Rate for Payer: Qualcare PPO/HMO/WC	$42.45
Rate for Payer: UnitedHealthcare Community & State	$6.82
Rate for Payer: Wellpoint Medicaid Managed Care	$7.50

EGD-OSCOPY W/PNEUM ACHALASIA**

Facility

$283.00

Hospital Charge Code	2300135
Hospital Revenue Code	759
Min. Negotiated Rate	$42.45
Max. Negotiated Rate	$42.45
Rate for Payer: Qualcare PPO/HMO/WC	$42.45

EGD-OSCOPY W/REMOVAL PEG***

Facility

$351.00

Hospital Charge Code	2300358
Hospital Revenue Code	759
Min. Negotiated Rate	$8.46
Max. Negotiated Rate	$175.50
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: Qualcare PPO/HMO/WC	$52.65
Rate for Payer: UnitedHealthcare Community & State	$8.46
Rate for Payer: Wellpoint Medicaid Managed Care	$9.30

EGD-OSCOPY W/REMOVAL PEG***

Facility

$351.00

Hospital Charge Code	2300358
Hospital Revenue Code	759
Min. Negotiated Rate	$52.65
Max. Negotiated Rate	$52.65
Rate for Payer: Qualcare PPO/HMO/WC	$52.65

EGD-OSCOPY W/SCLEROTHERAPY***

Facility

$356.00

Hospital Charge Code	2300150
Hospital Revenue Code	759
Min. Negotiated Rate	$53.40
Max. Negotiated Rate	$53.40
Rate for Payer: Qualcare PPO/HMO/WC	$53.40

EGD-OSCOPY W/SCLEROTHERAPY***

Facility

$356.00

Hospital Charge Code	2300150
Hospital Revenue Code	759
Min. Negotiated Rate	$8.58
Max. Negotiated Rate	$178.00
Rate for Payer: Aetna Commercial	$135.28
Rate for Payer: Aetna Medicare Advantage	$106.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.78
Rate for Payer: Cigna Commercial	$178.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.80
Rate for Payer: Qualcare PPO/HMO/WC	$53.40
Rate for Payer: UnitedHealthcare Community & State	$8.58
Rate for Payer: Wellpoint Medicaid Managed Care	$9.43

EGD VARICES LIGATION

Facility

$7,999.56

Service Code	HCPCS 43244
Hospital Charge Code	16000743
Hospital Revenue Code	360
Min. Negotiated Rate	$1,199.93
Max. Negotiated Rate	$1,199.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,199.93

EGD VARICES LIGATION

Facility

$7,999.56

Service Code	HCPCS 43244
Hospital Charge Code	16000743
Hospital Revenue Code	360
Min. Negotiated Rate	$192.79
Max. Negotiated Rate	$8,229.07
Rate for Payer: Aetna Commercial	$6,200.81
Rate for Payer: Aetna Medicare Advantage	$7,386.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,229.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,229.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,279.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,229.07
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: Cigna Medicare Advantage	$2,279.71
Rate for Payer: Clover Medicare Advantage	$2,165.72
Rate for Payer: EmblemHealth Commercial	$6,839.13
Rate for Payer: Humana Medicare Advantage	$2,348.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,279.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,399.87
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,199.93
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$192.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,279.71
Rate for Payer: Wellcare Medicare Advantage	$2,279.71
Rate for Payer: Wellpoint Medicaid Managed Care	$211.99

EGFR GENE COM VARIANTS

Facility

$1,270.55

Service Code	HCPCS 81235
Hospital Charge Code	401181235
Hospital Revenue Code	310
Min. Negotiated Rate	$190.58
Max. Negotiated Rate	$190.58
Rate for Payer: Qualcare PPO/HMO/WC	$190.58

EGFR GENE COM VARIANTS

Facility

$1,270.55

Service Code	HCPCS 81235
Hospital Charge Code	401181235
Hospital Revenue Code	310
Min. Negotiated Rate	$33.67
Max. Negotiated Rate	$1,171.64
Rate for Payer: Aetna Commercial	$882.86
Rate for Payer: Aetna Medicare Advantage	$1,051.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,171.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,171.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$324.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,171.64
Rate for Payer: Cigna Commercial	$635.27
Rate for Payer: Cigna Medicare Advantage	$324.58
Rate for Payer: Clover Medicare Advantage	$308.35
Rate for Payer: EmblemHealth Commercial	$973.74
Rate for Payer: Humana Medicare Advantage	$334.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$324.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$190.58
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$259.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$324.58
Rate for Payer: Wellcare Medicare Advantage	$324.58
Rate for Payer: Wellpoint Medicaid Managed Care	$33.67

EGGCRATE PAD

Facility

$35.86

Hospital Charge Code	270665428
Hospital Revenue Code	270
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$17.93
Rate for Payer: Aetna Commercial	$13.63
Rate for Payer: Aetna Medicare Advantage	$10.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.14
Rate for Payer: Cigna Commercial	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.76
Rate for Payer: Oxford Commercial	$7.17
Rate for Payer: Qualcare PPO/HMO/WC	$5.38
Rate for Payer: UnitedHealthcare Commercial	$7.17
Rate for Payer: UnitedHealthcare Community & State	$0.86
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

EGGCRATE PAD

Facility

$35.86

Hospital Charge Code	270665428
Hospital Revenue Code	270
Min. Negotiated Rate	$5.38
Max. Negotiated Rate	$5.38
Rate for Payer: Qualcare PPO/HMO/WC	$5.38

EGGNOG

Facility

$13.00

Hospital Charge Code	60634843
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

EGGNOG

Facility

$13.00

Hospital Charge Code	60634843
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

EGIA 45 ARTICULATING VASCULAR

Facility

$594.35

Hospital Charge Code	270652090
Hospital Revenue Code	272
Min. Negotiated Rate	$14.32
Max. Negotiated Rate	$297.18
Rate for Payer: Aetna Commercial	$225.85
Rate for Payer: Aetna Medicare Advantage	$178.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.56
Rate for Payer: Cigna Commercial	$297.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.31
Rate for Payer: Oxford Commercial	$118.87
Rate for Payer: Qualcare PPO/HMO/WC	$89.15
Rate for Payer: UnitedHealthcare Commercial	$118.87
Rate for Payer: UnitedHealthcare Community & State	$14.32
Rate for Payer: Wellpoint Medicaid Managed Care	$15.75

EGIA 45 ARTICULATING VASCULAR

Facility

$594.35

Hospital Charge Code	270652090
Hospital Revenue Code	272
Min. Negotiated Rate	$89.15
Max. Negotiated Rate	$89.15
Rate for Payer: Qualcare PPO/HMO/WC	$89.15

EG-OSCOPY W/REM FOREIGN BODY**

Facility

$439.00

Hospital Charge Code	2300374
Hospital Revenue Code	759
Min. Negotiated Rate	$10.58
Max. Negotiated Rate	$219.50
Rate for Payer: Aetna Commercial	$166.82
Rate for Payer: Aetna Medicare Advantage	$131.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.94
Rate for Payer: Cigna Commercial	$219.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.70
Rate for Payer: Qualcare PPO/HMO/WC	$65.85
Rate for Payer: UnitedHealthcare Community & State	$10.58
Rate for Payer: Wellpoint Medicaid Managed Care	$11.63

EG-OSCOPY W/REM FOREIGN BODY**

Facility

$439.00

Hospital Charge Code	2300374
Hospital Revenue Code	759
Min. Negotiated Rate	$65.85
Max. Negotiated Rate	$65.85
Rate for Payer: Qualcare PPO/HMO/WC	$65.85

E HISTO AG

Facility

$125.00

Service Code	HCPCS 87449
Hospital Charge Code	3009741
Hospital Revenue Code	306
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.59
Rate for Payer: Aetna Medicare Advantage	$38.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.24
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: Cigna Medicare Advantage	$11.98
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Medicare Advantage	$11.98
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

E HISTO AG

Facility

$125.00

Service Code	HCPCS 87449
Hospital Charge Code	3009741
Hospital Revenue Code	306
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

Know your out-of-pocket cost for care.

All Charges