Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

EKG RHYTHM STRIP W/O INTERPR**

Facility

$10.80

Service Code	HCPCS 93041
Hospital Charge Code	5300018
Hospital Revenue Code	730
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$1.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.62

ELASE/10GM

Facility

$84.00

Hospital Charge Code	60632928
Hospital Revenue Code	250
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

ELASE/10GM

Facility

$84.00

Hospital Charge Code	60632928
Hospital Revenue Code	250
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$31.92
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.20
Rate for Payer: Oxford Commercial	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$16.80
Rate for Payer: UnitedHealthcare Community & State	$2.02
Rate for Payer: Wellpoint Medicaid Managed Care	$2.23

ELASE-CHLOROMYCETIN/10GM

Facility

$89.00

Hospital Charge Code	60632929
Hospital Revenue Code	250
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$13.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.35

ELASE-CHLOROMYCETIN/10GM

Facility

$89.00

Hospital Charge Code	60632929
Hospital Revenue Code	250
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$44.50
Rate for Payer: Aetna Commercial	$33.82
Rate for Payer: Aetna Medicare Advantage	$26.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.70
Rate for Payer: Cigna Commercial	$44.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.70
Rate for Payer: Oxford Commercial	$17.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.35
Rate for Payer: UnitedHealthcare Commercial	$17.80
Rate for Payer: UnitedHealthcare Community & State	$2.14
Rate for Payer: Wellpoint Medicaid Managed Care	$2.36

ELASTIC BANDAGE

Facility

$40.00

Hospital Charge Code	84202110
Hospital Revenue Code	270
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.00
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

ELASTIC BANDAGE

Facility

$40.00

Hospital Charge Code	84202110
Hospital Revenue Code	270
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

ELASTIKON 4X 5YD

Facility

$55.00

Hospital Charge Code	270331857
Hospital Revenue Code	272
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

ELASTIKON 4X 5YD

Facility

$55.00

Hospital Charge Code	270331857
Hospital Revenue Code	272
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$20.90
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.50
Rate for Payer: Oxford Commercial	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$11.00
Rate for Payer: UnitedHealthcare Community & State	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$1.46

ELASTOGRAPHY 1ST TAR LESION

Facility

$1,836.40

Service Code	HCPCS 76982
Hospital Charge Code	404276982
Hospital Revenue Code	402
Min. Negotiated Rate	$44.26
Max. Negotiated Rate	$2,517.00
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	$83.36
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	$124.20
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	$550.92
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$275.46
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$44.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$48.66

ELASTOGRAPHY 1ST TAR LESION

Facility

$1,836.40

Service Code	HCPCS 76982
Hospital Charge Code	404276982
Hospital Revenue Code	402
Min. Negotiated Rate	$275.46
Max. Negotiated Rate	$275.46
Rate for Payer: Qualcare PPO/HMO/WC	$275.46

ELASTOGRAPHY EA ADDL TARGET

Facility

$1,836.40

Service Code	HCPCS 76983
Hospital Charge Code	404276983
Hospital Revenue Code	402
Min. Negotiated Rate	$44.26
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$697.83
Rate for Payer: Aetna Medicare Advantage	$550.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$468.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$468.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$468.28
Rate for Payer: Cigna Commercial	$918.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.92
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$275.46
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$44.26
Rate for Payer: Wellpoint Medicaid Managed Care	$48.66

ELASTOGRAPHY EA ADDL TARGET

Facility

$1,836.40

Service Code	HCPCS 76983
Hospital Charge Code	404276983
Hospital Revenue Code	402
Min. Negotiated Rate	$275.46
Max. Negotiated Rate	$275.46
Rate for Payer: Qualcare PPO/HMO/WC	$275.46

ELASTOGRAPHY PARENCHYMA ORGAN

Facility

$1,836.40

Service Code	HCPCS 76981
Hospital Charge Code	404276981
Hospital Revenue Code	402
Min. Negotiated Rate	$44.26
Max. Negotiated Rate	$2,517.00
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	$93.39
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	$124.20
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	$550.92
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$275.46
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$44.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$48.66

ELASTOGRAPHY PARENCHYMA ORGAN

Facility

$1,836.40

Service Code	HCPCS 76981
Hospital Charge Code	404276981
Hospital Revenue Code	402
Min. Negotiated Rate	$275.46
Max. Negotiated Rate	$275.46
Rate for Payer: Qualcare PPO/HMO/WC	$275.46

ELBOW ********

Facility

$225.00

Hospital Charge Code	8002016
Hospital Revenue Code	279
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.50
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$45.00
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

ELBOW ********

Facility

$225.00

Hospital Charge Code	8002016
Hospital Revenue Code	279
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

ELBOW 3 VIEWS-BILAT

Facility

$6,601.19

Service Code	HCPCS 7308050
Hospital Charge Code	94061221
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

ELBOW 3 VIEWS-BILAT

Facility

$6,601.19

Service Code	HCPCS 7308050
Hospital Charge Code	94061221
Hospital Revenue Code	320
Min. Negotiated Rate	$159.09
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.36
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$159.09
Rate for Payer: Wellpoint Medicaid Managed Care	$174.93

ELBOW 3 VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73080LT
Hospital Charge Code	94061301
Hospital Revenue Code	320
Min. Negotiated Rate	$159.09
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.36
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$159.09
Rate for Payer: Wellpoint Medicaid Managed Care	$174.93

ELBOW 3 VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73080LT
Hospital Charge Code	94061301
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

ELBOW 3 VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73080RT
Hospital Charge Code	94061303
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

ELBOW 3 VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73080RT
Hospital Charge Code	94061303
Hospital Revenue Code	320
Min. Negotiated Rate	$159.09
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.36
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$159.09
Rate for Payer: Wellpoint Medicaid Managed Care	$174.93

ELBOW COMP RG 32-8106-000-13

Facility

$2,718.45

Hospital Charge Code	270609045
Hospital Revenue Code	278
Min. Negotiated Rate	$407.77
Max. Negotiated Rate	$657.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$543.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$657.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$598.06
Rate for Payer: Qualcare PPO/HMO/WC	$407.77

ELBOW COMP RG 32-8106-000-13

Facility

$2,718.45

Hospital Charge Code	270609045
Hospital Revenue Code	278
Min. Negotiated Rate	$65.51
Max. Negotiated Rate	$1,359.22
Rate for Payer: Aetna Commercial	$1,033.01
Rate for Payer: Aetna Medicare Advantage	$815.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$693.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$693.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$543.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$693.20
Rate for Payer: Cigna Commercial	$1,359.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$657.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$598.06
Rate for Payer: Qualcare PPO/HMO/WC	$407.77
Rate for Payer: UnitedHealthcare Community & State	$65.51
Rate for Payer: Wellpoint Medicaid Managed Care	$72.04

Know your out-of-pocket cost for care.

All Charges