Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

ELECTROCARDIOGRAM

Facility

$2,050.00

Service Code	HCPCS 93005
Hospital Charge Code	5300017
Hospital Revenue Code	730
Min. Negotiated Rate	$307.50
Max. Negotiated Rate	$307.50
Rate for Payer: Qualcare PPO/HMO/WC	$307.50

ELECTROCAUTERY OPHTHAL WECK***

Facility

$34.00

Hospital Charge Code	1600774
Hospital Revenue Code	272
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$17.00
Rate for Payer: Aetna Commercial	$12.92
Rate for Payer: Aetna Medicare Advantage	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.67
Rate for Payer: Cigna Commercial	$17.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.20
Rate for Payer: Oxford Commercial	$6.80
Rate for Payer: Qualcare PPO/HMO/WC	$5.10
Rate for Payer: UnitedHealthcare Commercial	$6.80
Rate for Payer: UnitedHealthcare Community & State	$0.82
Rate for Payer: Wellpoint Medicaid Managed Care	$0.90

ELECTROCAUTERY OPHTHAL WECK***

Facility

$34.00

Hospital Charge Code	1600774
Hospital Revenue Code	272
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.10
Rate for Payer: Qualcare PPO/HMO/WC	$5.10

ELECTROCAUTERY VALLEY LAB ****

Facility

$131.00

Hospital Charge Code	1601202
Hospital Revenue Code	272
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$65.50
Rate for Payer: Aetna Commercial	$49.78
Rate for Payer: Aetna Medicare Advantage	$39.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.41
Rate for Payer: Cigna Commercial	$65.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.30
Rate for Payer: Oxford Commercial	$26.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.65
Rate for Payer: UnitedHealthcare Commercial	$26.20
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$3.47

ELECTROCAUTERY VALLEY LAB ****

Facility

$131.00

Hospital Charge Code	1601202
Hospital Revenue Code	272
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$19.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

ELECTRODE adlt zll fnctin mlti

Facility

$18.65

Hospital Charge Code	270649729
Hospital Revenue Code	271
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$9.32
Rate for Payer: Aetna Commercial	$7.09
Rate for Payer: Aetna Medicare Advantage	$5.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.76
Rate for Payer: Cigna Commercial	$9.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.80
Rate for Payer: UnitedHealthcare Commercial	$3.73
Rate for Payer: UnitedHealthcare Community & State	$0.45
Rate for Payer: Wellpoint Medicaid Managed Care	$0.49

ELECTRODE adlt zll fnctin mlti

Facility

$18.65

Hospital Charge Code	270649729
Hospital Revenue Code	271
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$2.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.80

ELECTRODE ADULT MASIMO

Facility

$890.40

Hospital Charge Code	270650433
Hospital Revenue Code	272
Min. Negotiated Rate	$21.46
Max. Negotiated Rate	$445.20
Rate for Payer: Aetna Commercial	$338.35
Rate for Payer: Aetna Medicare Advantage	$267.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.05
Rate for Payer: Cigna Commercial	$445.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$267.12
Rate for Payer: Oxford Commercial	$178.08
Rate for Payer: Qualcare PPO/HMO/WC	$133.56
Rate for Payer: UnitedHealthcare Commercial	$178.08
Rate for Payer: UnitedHealthcare Community & State	$21.46
Rate for Payer: Wellpoint Medicaid Managed Care	$23.60

ELECTRODE ADULT MASIMO

Facility

$890.40

Hospital Charge Code	270650433
Hospital Revenue Code	272
Min. Negotiated Rate	$133.56
Max. Negotiated Rate	$133.56
Rate for Payer: Qualcare PPO/HMO/WC	$133.56

ELECTRODE ADULT MONITORING

Facility

$19.16

Hospital Charge Code	270649192
Hospital Revenue Code	272
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$2.87
Rate for Payer: Qualcare PPO/HMO/WC	$2.87

ELECTRODE ADULT MONITORING

Facility

$19.16

Hospital Charge Code	270649192
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.58
Rate for Payer: Aetna Commercial	$7.28
Rate for Payer: Aetna Medicare Advantage	$5.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.89
Rate for Payer: Cigna Commercial	$9.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.75
Rate for Payer: Oxford Commercial	$3.83
Rate for Payer: Qualcare PPO/HMO/WC	$2.87
Rate for Payer: UnitedHealthcare Commercial	$3.83
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

ELECTRODE AXS DISP LS211

Facility

$967.09

Hospital Charge Code	270623965
Hospital Revenue Code	272
Min. Negotiated Rate	$145.06
Max. Negotiated Rate	$145.06
Rate for Payer: Qualcare PPO/HMO/WC	$145.06

ELECTRODE AXS DISP LS211

Facility

$967.09

Hospital Charge Code	270623965
Hospital Revenue Code	272
Min. Negotiated Rate	$23.31
Max. Negotiated Rate	$483.55
Rate for Payer: Aetna Commercial	$367.49
Rate for Payer: Aetna Medicare Advantage	$290.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$246.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$246.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$246.61
Rate for Payer: Cigna Commercial	$483.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.13
Rate for Payer: Oxford Commercial	$193.42
Rate for Payer: Qualcare PPO/HMO/WC	$145.06
Rate for Payer: UnitedHealthcare Commercial	$193.42
Rate for Payer: UnitedHealthcare Community & State	$23.31
Rate for Payer: Wellpoint Medicaid Managed Care	$25.63

ELECTRODE BALEND 3F 110 11770T

Facility

$153.75

Hospital Charge Code	270617947
Hospital Revenue Code	272
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$76.88
Rate for Payer: Aetna Commercial	$58.42
Rate for Payer: Aetna Medicare Advantage	$46.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.21
Rate for Payer: Cigna Commercial	$76.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.12
Rate for Payer: Oxford Commercial	$30.75
Rate for Payer: Qualcare PPO/HMO/WC	$23.06
Rate for Payer: UnitedHealthcare Commercial	$30.75
Rate for Payer: UnitedHealthcare Community & State	$3.71
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

ELECTRODE BALEND 3F 110 11770T

Facility

$153.75

Hospital Charge Code	270617947
Hospital Revenue Code	272
Min. Negotiated Rate	$23.06
Max. Negotiated Rate	$23.06
Rate for Payer: Qualcare PPO/HMO/WC	$23.06

ELECTRODE BALL TIP

Facility

$409.50

Hospital Charge Code	270658547
Hospital Revenue Code	270
Min. Negotiated Rate	$61.42
Max. Negotiated Rate	$61.42
Rate for Payer: Qualcare PPO/HMO/WC	$61.42

ELECTRODE BALL TIP

Facility

$409.50

Hospital Charge Code	270658547
Hospital Revenue Code	270
Min. Negotiated Rate	$9.87
Max. Negotiated Rate	$204.75
Rate for Payer: Aetna Commercial	$155.61
Rate for Payer: Aetna Medicare Advantage	$122.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.42
Rate for Payer: Cigna Commercial	$204.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.85
Rate for Payer: Oxford Commercial	$81.90
Rate for Payer: Qualcare PPO/HMO/WC	$61.42
Rate for Payer: UnitedHealthcare Commercial	$81.90
Rate for Payer: UnitedHealthcare Community & State	$9.87
Rate for Payer: Wellpoint Medicaid Managed Care	$10.85

ELECTRODE BALL TIP 0.5cm

Facility

$5.69

Hospital Charge Code	270651086
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

ELECTRODE BALL TIP 0.5cm

Facility

$5.69

Hospital Charge Code	270651086
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.85
Rate for Payer: Aetna Commercial	$2.16
Rate for Payer: Aetna Medicare Advantage	$1.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.45
Rate for Payer: Cigna Commercial	$2.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.71
Rate for Payer: Oxford Commercial	$1.14
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$1.14
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

ELECTRODE BALL TIP 3/16 E1550

Facility

$60.00

Hospital Charge Code	270600398
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.00
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

ELECTRODE BALL TIP 3/16 E1550

Facility

$60.00

Hospital Charge Code	270600398
Hospital Revenue Code	272
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

ELECTRODE BALL TIP FULGURATING

Facility

$525.00

Hospital Charge Code	270610288
Hospital Revenue Code	272
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.50
Rate for Payer: Oxford Commercial	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Commercial	$105.00
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

ELECTRODE BALL TIP FULGURATING

Facility

$525.00

Hospital Charge Code	270610288
Hospital Revenue Code	272
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

ELECTRODE BIPOLAR PACING 6FR

Facility

$840.42

Hospital Charge Code	270650139
Hospital Revenue Code	272
Min. Negotiated Rate	$126.06
Max. Negotiated Rate	$126.06
Rate for Payer: Qualcare PPO/HMO/WC	$126.06

Know your out-of-pocket cost for care.

All Charges