Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ELECTODE 22FR ANGLED CUTTING

Facility

$560.00

Hospital Charge Code	270678697
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.00
Rate for Payer: Oxford Commercial	$112.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Commercial	$112.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

ELECTODE 22FR MONO ROLLER

Facility

$560.00

Hospital Charge Code	270678696
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.00
Rate for Payer: Oxford Commercial	$112.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Commercial	$112.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

ELECTODE 22FR MONO ROLLER

Facility

$560.00

Hospital Charge Code	270678696
Hospital Revenue Code	272
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$84.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

ELECTODE LEEP FISHER

Facility

$585.00

Hospital Charge Code	270690458
Hospital Revenue Code	272
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.50
Rate for Payer: Oxford Commercial	$117.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Commercial	$117.00
Rate for Payer: UnitedHealthcare Community & State	$14.10
Rate for Payer: Wellpoint Medicaid Managed Care	$15.50

ELECTODE LEEP FISHER

Facility

$585.00

Hospital Charge Code	270690458
Hospital Revenue Code	272
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$87.75
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

ELECTRDE WRE JTIP 28CM E277228

Facility

$205.05

Hospital Charge Code	270641087
Hospital Revenue Code	272
Min. Negotiated Rate	$30.76
Max. Negotiated Rate	$30.76
Rate for Payer: Qualcare PPO/HMO/WC	$30.76

ELECTRDE WRE JTIP 28CM E277228

Facility

$205.05

Hospital Charge Code	270641087
Hospital Revenue Code	272
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$102.53
Rate for Payer: Aetna Commercial	$77.92
Rate for Payer: Aetna Medicare Advantage	$61.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.29
Rate for Payer: Cigna Commercial	$102.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.52
Rate for Payer: Oxford Commercial	$41.01
Rate for Payer: Qualcare PPO/HMO/WC	$30.76
Rate for Payer: UnitedHealthcare Commercial	$41.01
Rate for Payer: UnitedHealthcare Community & State	$4.94
Rate for Payer: Wellpoint Medicaid Managed Care	$5.43

ELECTRICAL BONE STIMULATION

Facility

$617.50

Service Code	HCPCS 20974
Hospital Charge Code	1600000868
Hospital Revenue Code	360
Min. Negotiated Rate	$14.88
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$234.65
Rate for Payer: Aetna Medicare Advantage	$185.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.46
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	$157.46
Rate for Payer: Cigna Commercial	$308.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.25
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.62
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$14.88
Rate for Payer: Wellpoint Medicaid Managed Care	$16.36

ELECTRICAL BONE STIMULATION

Facility

$617.50

Service Code	HCPCS 20974
Hospital Charge Code	1600000868
Hospital Revenue Code	360
Min. Negotiated Rate	$92.62
Max. Negotiated Rate	$92.62
Rate for Payer: Qualcare PPO/HMO/WC	$92.62

ELECTRICAL STIM-UNATTENDED NT

Facility

$206.00

Service Code	HCPCS 97014GP
Hospital Charge Code	9108060
Hospital Revenue Code	420
Min. Negotiated Rate	$30.90
Max. Negotiated Rate	$30.90
Rate for Payer: Qualcare PPO/HMO/WC	$30.90

ELECTRICAL STIM-UNATTENDED NT

Facility

$206.00

Service Code	HCPCS 97014GP
Hospital Charge Code	9108060
Hospital Revenue Code	420
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$78.28
Rate for Payer: Aetna Medicare Advantage	$61.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.53
Rate for Payer: Cigna Commercial	$103.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.80
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$4.96
Rate for Payer: Wellpoint Medicaid Managed Care	$5.46

ELECTRICAL STIM-UNATTENDED NT

Facility

$206.00

Service Code	HCPCS 97014GP
Hospital Charge Code	1008140
Hospital Revenue Code	420
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$78.28
Rate for Payer: Aetna Medicare Advantage	$61.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.53
Rate for Payer: Cigna Commercial	$103.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.80
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$4.96
Rate for Payer: Wellpoint Medicaid Managed Care	$5.46

ELECTRICAL STIM-UNATTENDED NT

Facility

$206.00

Service Code	HCPCS 97014GP
Hospital Charge Code	1008140
Hospital Revenue Code	420
Min. Negotiated Rate	$30.90
Max. Negotiated Rate	$30.90
Rate for Payer: Qualcare PPO/HMO/WC	$30.90

ELECTRICAL STIM UNATTENDED/WC

Facility

$91.00

Service Code	HCPCS G0281GP
Hospital Charge Code	1008380
Hospital Revenue Code	420
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

ELECTRICAL STIM UNATTENDED/WC

Facility

$91.00

Service Code	HCPCS G0281GP
Hospital Charge Code	1008380
Hospital Revenue Code	420
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$34.58
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.20
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.19
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

ELECTRICAL STIM UNATTENDED/WC

Facility

$91.00

Service Code	HCPCS G0282GO
Hospital Charge Code	74203083
Hospital Revenue Code	430
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

ELECTRICAL STIM UNATTENDED/WC

Facility

$91.00

Service Code	HCPCS G0282GP
Hospital Charge Code	9108075
Hospital Revenue Code	420
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$34.58
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.20
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.19
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

ELECTRICAL STIM UNATTENDED/WC

Facility

$91.00

Hospital Charge Code	1008375
Hospital Revenue Code	430
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$34.58
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.20
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.19
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

ELECTRICAL STIM UNATTENDED/WC

Facility

$91.00

Hospital Charge Code	1008375
Hospital Revenue Code	430
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

ELECTRICAL STIM UNATTENDED/WC

Facility

$91.00

Service Code	HCPCS G0282GO
Hospital Charge Code	74203083
Hospital Revenue Code	430
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$34.58
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.20
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.19
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

ELECTRICAL STIM UNATTENDED/WC

Facility

$91.00

Service Code	HCPCS G0282GP
Hospital Charge Code	9108075
Hospital Revenue Code	420
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

ELECTRIC STIMULATION THERAPY 1

Facility

$352.64

Service Code	HCPCS 97014
Hospital Charge Code	409297014
Hospital Revenue Code	420
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$134.00
Rate for Payer: Aetna Medicare Advantage	$105.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.92
Rate for Payer: Cigna Commercial	$176.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.79
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$8.50
Rate for Payer: Wellpoint Medicaid Managed Care	$9.34

ELECTRIC STIMULATION THERAPY 1

Facility

$352.64

Service Code	HCPCS 97014
Hospital Charge Code	409297014
Hospital Revenue Code	420
Min. Negotiated Rate	$52.90
Max. Negotiated Rate	$52.90
Rate for Payer: Qualcare PPO/HMO/WC	$52.90

ELECTROCARDIOGRAM

Facility

$2,050.00

Service Code	HCPCS 93005
Hospital Charge Code	94053025
Hospital Revenue Code	730
Min. Negotiated Rate	$307.50
Max. Negotiated Rate	$307.50
Rate for Payer: Qualcare PPO/HMO/WC	$307.50

ELECTROCARDIOGRAM

Facility

$2,050.00

Service Code	HCPCS 93005
Hospital Charge Code	5300017
Hospital Revenue Code	730
Min. Negotiated Rate	$49.41
Max. Negotiated Rate	$697.00
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.97
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$615.00
Rate for Payer: Oxford Commercial	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$307.50
Rate for Payer: UnitedHealthcare Commercial	$697.00
Rate for Payer: UnitedHealthcare Community & State	$49.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$54.33

Know your out-of-pocket cost for care.

All Charges