Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

EMCYT/140MG/CAP

Facility

$18.00

Hospital Charge Code	60632935
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

EMERGENCY CARE - CODE

Professional

Both

$218.25

Service Code	HCPCS 92950
Hospital Charge Code	2500064
Hospital Revenue Code	981
Min. Negotiated Rate	$176.07
Max. Negotiated Rate	$936.89
Rate for Payer: Aetna Commercial	$179.45
Rate for Payer: Aetna Medicare Advantage	$179.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$936.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$936.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$936.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$936.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$936.89
Rate for Payer: Clover Medicare Advantage	$185.00
Rate for Payer: Fidelis All Plans	$183.47
Rate for Payer: Humana Medicare Advantage	$186.27
Rate for Payer: UnitedHealthcare Commercial	$176.07
Rate for Payer: UnitedHealthcare Community & State	$176.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$176.07
Rate for Payer: Wellpoint Medicaid Managed Care	$187.03

EMERGENCY CARE - NON-CODE****

Professional

Both

$53.00

Service Code	HCPCS 99291
Hospital Charge Code	2500056
Hospital Revenue Code	981
Min. Negotiated Rate	$84.68
Max. Negotiated Rate	$475.68
Rate for Payer: Aetna Commercial	$216.34
Rate for Payer: Aetna Medicare Advantage	$210.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$84.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.68
Rate for Payer: Cigna Commercial	$475.68
Rate for Payer: Cigna Medicare Advantage	$475.68
Rate for Payer: Clover Medicare Advantage	$217.79
Rate for Payer: EmblemHealth Commercial	$128.44
Rate for Payer: Fidelis All Plans	$146.02
Rate for Payer: Healthfirst NY All Plans	$84.68
Rate for Payer: Humana Medicare Advantage	$225.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.33
Rate for Payer: Marpai Administrators LLC Commercial	$185.46
Rate for Payer: MetroPlus Health All Plans	$84.68
Rate for Payer: Oscar Health Commercial	$475.68
Rate for Payer: UnitedHealthcare Commercial	$210.63
Rate for Payer: UnitedHealthcare Community & State	$210.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.63
Rate for Payer: Wellpoint Medicaid Managed Care	$219.49

EMERGENCY PROCEDURE MINOR

Facility

$3,598.75

Service Code	HCPCS 99281
Hospital Charge Code	5700024
Hospital Revenue Code	450
Min. Negotiated Rate	$95.17
Max. Negotiated Rate	$1,149.00
Rate for Payer: Aetna Commercial	$272.49
Rate for Payer: Aetna Medicare Advantage	$324.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$361.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$361.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$100.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$361.62
Rate for Payer: Cigna Commercial	$200.81
Rate for Payer: Cigna Medicare Advantage	$100.18
Rate for Payer: Clover Medicare Advantage	$95.17
Rate for Payer: EmblemHealth Commercial	$300.54
Rate for Payer: Humana Medicare Advantage	$103.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$100.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$321.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Oxford Commercial	$673.00
Rate for Payer: Qualcare PPO/HMO/WC	$539.81
Rate for Payer: UnitedHealthcare Commercial	$1,149.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$100.18
Rate for Payer: Wellcare Medicare Advantage	$100.18
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

EMERGENCY PROCEDURE MINOR

Facility

$3,598.75

Service Code	HCPCS 99281
Hospital Charge Code	5700024
Hospital Revenue Code	450
Min. Negotiated Rate	$539.81
Max. Negotiated Rate	$539.81
Rate for Payer: Qualcare PPO/HMO/WC	$539.81

Emergency Procedure Minor I

Facility

$510.75

Hospital Charge Code	5700020
Hospital Revenue Code	450
Min. Negotiated Rate	$13.53
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$194.09
Rate for Payer: Aetna Medicare Advantage	$153.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.24
Rate for Payer: Cigna Commercial	$255.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$76.61
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$13.53

Emergency Procedure Minor I

Facility

$510.75

Hospital Charge Code	5700020
Hospital Revenue Code	450
Min. Negotiated Rate	$76.61
Max. Negotiated Rate	$76.61
Rate for Payer: Qualcare PPO/HMO/WC	$76.61

EMERGENCY PROCEDURE MINOR II

Facility

$715.55

Hospital Charge Code	5700022
Hospital Revenue Code	450
Min. Negotiated Rate	$18.96
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$271.91
Rate for Payer: Aetna Medicare Advantage	$214.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.47
Rate for Payer: Cigna Commercial	$357.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$107.33
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

EMERGENCY PROCEDURE MINOR II

Facility

$715.55

Hospital Charge Code	5700022
Hospital Revenue Code	450
Min. Negotiated Rate	$107.33
Max. Negotiated Rate	$107.33
Rate for Payer: Qualcare PPO/HMO/WC	$107.33

EMERSON 2 BT *******

Facility

$55.00

Hospital Charge Code	8000598
Hospital Revenue Code	279
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

EMERSON 2 BT *******

Facility

$55.00

Hospital Charge Code	8000598
Hospital Revenue Code	279
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

EMG 1 EXTREMITY

Facility

$616.00

Service Code	HCPCS 95860
Hospital Charge Code	5500012
Hospital Revenue Code	922
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$92.40

EMG 1 EXTREMITY

Facility

$616.00

Service Code	HCPCS 95860
Hospital Charge Code	5500012
Hospital Revenue Code	922
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$2,584.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$358.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.80
Rate for Payer: Oxford Commercial	$1,474.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.40
Rate for Payer: UnitedHealthcare Commercial	$2,584.00
Rate for Payer: UnitedHealthcare Community & State	$14.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.32

EMG-1 EXTREMITY

Facility

$5,700.00

Hospital Charge Code	9109105
Hospital Revenue Code	922
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

EMG-1 EXTREMITY

Facility

$5,700.00

Hospital Charge Code	9109105
Hospital Revenue Code	922
Min. Negotiated Rate	$137.37
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$2,166.00
Rate for Payer: Aetna Medicare Advantage	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.50
Rate for Payer: Cigna Commercial	$2,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,710.00
Rate for Payer: Oxford Commercial	$1,474.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00
Rate for Payer: UnitedHealthcare Commercial	$2,584.00
Rate for Payer: UnitedHealthcare Community & State	$137.37
Rate for Payer: Wellpoint Medicaid Managed Care	$151.05

EMG 2 EXTREMITIES

Facility

$664.85

Service Code	HCPCS 95861
Hospital Charge Code	5500014
Hospital Revenue Code	922
Min. Negotiated Rate	$99.73
Max. Negotiated Rate	$99.73
Rate for Payer: Qualcare PPO/HMO/WC	$99.73

EMG 2 EXTREMITIES

Facility

$664.85

Service Code	HCPCS 95861
Hospital Charge Code	5500014
Hospital Revenue Code	922
Min. Negotiated Rate	$16.02
Max. Negotiated Rate	$2,584.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$396.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.46
Rate for Payer: Oxford Commercial	$1,474.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.73
Rate for Payer: UnitedHealthcare Commercial	$2,584.00
Rate for Payer: UnitedHealthcare Community & State	$16.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

EMG-2 EXTREMITIES

Facility

$5,700.00

Hospital Charge Code	9109085
Hospital Revenue Code	922
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

EMG-2 EXTREMITIES

Facility

$5,700.00

Hospital Charge Code	9109085
Hospital Revenue Code	922
Min. Negotiated Rate	$137.37
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$2,166.00
Rate for Payer: Aetna Medicare Advantage	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.50
Rate for Payer: Cigna Commercial	$2,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,710.00
Rate for Payer: Oxford Commercial	$1,474.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00
Rate for Payer: UnitedHealthcare Commercial	$2,584.00
Rate for Payer: UnitedHealthcare Community & State	$137.37
Rate for Payer: Wellpoint Medicaid Managed Care	$151.05

EMG 3 EXTREMITIES

Facility

$777.65

Service Code	HCPCS 95863
Hospital Charge Code	5500016
Hospital Revenue Code	922
Min. Negotiated Rate	$116.65
Max. Negotiated Rate	$116.65
Rate for Payer: Qualcare PPO/HMO/WC	$116.65

EMG 3 EXTREMITIES

Facility

$777.65

Service Code	HCPCS 95863
Hospital Charge Code	5500016
Hospital Revenue Code	922
Min. Negotiated Rate	$18.74
Max. Negotiated Rate	$2,584.00
Rate for Payer: Aetna Commercial	$415.81
Rate for Payer: Aetna Medicare Advantage	$495.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$551.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$551.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$152.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$253.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$551.81
Rate for Payer: Cigna Commercial	$306.43
Rate for Payer: Cigna Medicare Advantage	$152.87
Rate for Payer: Clover Medicare Advantage	$145.23
Rate for Payer: EmblemHealth Commercial	$458.61
Rate for Payer: Humana Medicare Advantage	$157.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$152.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.29
Rate for Payer: Oxford Commercial	$1,474.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.65
Rate for Payer: UnitedHealthcare Commercial	$2,584.00
Rate for Payer: UnitedHealthcare Community & State	$18.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$152.87
Rate for Payer: Wellcare Medicare Advantage	$152.87
Rate for Payer: Wellpoint Medicaid Managed Care	$20.61

EMG-3 EXTREMITIES

Facility

$5,700.00

Hospital Charge Code	9109055
Hospital Revenue Code	922
Min. Negotiated Rate	$137.37
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$2,166.00
Rate for Payer: Aetna Medicare Advantage	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.50
Rate for Payer: Cigna Commercial	$2,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,710.00
Rate for Payer: Oxford Commercial	$1,474.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00
Rate for Payer: UnitedHealthcare Commercial	$2,584.00
Rate for Payer: UnitedHealthcare Community & State	$137.37
Rate for Payer: Wellpoint Medicaid Managed Care	$151.05

EMG-3 EXTREMITIES

Facility

$5,700.00

Hospital Charge Code	9109055
Hospital Revenue Code	922
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

EMG 4 EXTREMITIES

Facility

$1,035.25

Service Code	HCPCS 95864
Hospital Charge Code	5500018
Hospital Revenue Code	922
Min. Negotiated Rate	$24.95
Max. Negotiated Rate	$2,584.00
Rate for Payer: Aetna Commercial	$415.81
Rate for Payer: Aetna Medicare Advantage	$495.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$551.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$551.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$152.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$406.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$551.81
Rate for Payer: Cigna Commercial	$306.43
Rate for Payer: Cigna Medicare Advantage	$152.87
Rate for Payer: Clover Medicare Advantage	$145.23
Rate for Payer: EmblemHealth Commercial	$458.61
Rate for Payer: Humana Medicare Advantage	$157.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$152.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.57
Rate for Payer: Oxford Commercial	$1,474.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.29
Rate for Payer: UnitedHealthcare Commercial	$2,584.00
Rate for Payer: UnitedHealthcare Community & State	$24.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$152.87
Rate for Payer: Wellcare Medicare Advantage	$152.87
Rate for Payer: Wellpoint Medicaid Managed Care	$27.43

EMG 4 EXTREMITIES

Facility

$1,035.25

Service Code	HCPCS 95864
Hospital Charge Code	5500018
Hospital Revenue Code	922
Min. Negotiated Rate	$155.29
Max. Negotiated Rate	$155.29
Rate for Payer: Qualcare PPO/HMO/WC	$155.29

Know your out-of-pocket cost for care.

All Charges