Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ENDO MARK

Facility

$155.56

Hospital Charge Code	270667919
Hospital Revenue Code	272
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$77.78
Rate for Payer: Aetna Commercial	$59.11
Rate for Payer: Aetna Medicare Advantage	$46.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.67
Rate for Payer: Cigna Commercial	$77.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.67
Rate for Payer: Oxford Commercial	$31.11
Rate for Payer: Qualcare PPO/HMO/WC	$23.33
Rate for Payer: UnitedHealthcare Commercial	$31.11
Rate for Payer: UnitedHealthcare Community & State	$3.75
Rate for Payer: Wellpoint Medicaid Managed Care	$4.12

ENDOMETAL BX WO CERVICL DILATN

Facility

$2,249.90

Service Code	HCPCS 58100
Hospital Charge Code	16000759
Hospital Revenue Code	360
Min. Negotiated Rate	$337.49
Max. Negotiated Rate	$337.49
Rate for Payer: Qualcare PPO/HMO/WC	$337.49

ENDOMETAL BX WO CERVICL DILATN

Facility

$2,249.90

Service Code	HCPCS 58100
Hospital Charge Code	16000759
Hospital Revenue Code	360
Min. Negotiated Rate	$54.22
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$653.29
Rate for Payer: Aetna Medicare Advantage	$778.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$866.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$866.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$240.18
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	$866.98
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: Cigna Medicare Advantage	$240.18
Rate for Payer: Clover Medicare Advantage	$228.17
Rate for Payer: EmblemHealth Commercial	$720.54
Rate for Payer: Humana Medicare Advantage	$247.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$240.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$674.97
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.49
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$54.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$240.18
Rate for Payer: Wellcare Medicare Advantage	$240.18
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

ENDOMETRIAL ABLATION KIT

Facility

$18,300.00

Hospital Charge Code	270657261
Hospital Revenue Code	278
Min. Negotiated Rate	$441.03
Max. Negotiated Rate	$9,150.00
Rate for Payer: Aetna Commercial	$6,954.00
Rate for Payer: Aetna Medicare Advantage	$5,490.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,666.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,666.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,666.50
Rate for Payer: Cigna Commercial	$9,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,428.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,026.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,745.00
Rate for Payer: UnitedHealthcare Community & State	$441.03
Rate for Payer: Wellpoint Medicaid Managed Care	$484.95

ENDOMETRIAL ABLATION KIT

Facility

$18,300.00

Hospital Charge Code	270657261
Hospital Revenue Code	278
Min. Negotiated Rate	$2,745.00
Max. Negotiated Rate	$4,428.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,428.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,026.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,745.00

ENDOMETRIAL CRYOABLATION

Facility

$29,715.20

Service Code	HCPCS 58356
Hospital Charge Code	1600000874
Hospital Revenue Code	360
Min. Negotiated Rate	$716.14
Max. Negotiated Rate	$21,452.59
Rate for Payer: Aetna Commercial	$16,165.07
Rate for Payer: Aetna Medicare Advantage	$19,255.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,452.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,452.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5,943.04
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	$21,452.59
Rate for Payer: Cigna Commercial	$11,912.81
Rate for Payer: Cigna Medicare Advantage	$5,943.04
Rate for Payer: Clover Medicare Advantage	$5,645.89
Rate for Payer: EmblemHealth Commercial	$17,829.12
Rate for Payer: Humana Medicare Advantage	$6,121.33
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5,943.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,914.56
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,457.28
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$716.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$5,943.04
Rate for Payer: Wellcare Medicare Advantage	$5,943.04
Rate for Payer: Wellpoint Medicaid Managed Care	$787.45

ENDOMETRIAL CRYOABLATION

Facility

$29,715.20

Service Code	HCPCS 58356
Hospital Charge Code	1600000874
Hospital Revenue Code	360
Min. Negotiated Rate	$4,457.28
Max. Negotiated Rate	$4,457.28
Rate for Payer: Qualcare PPO/HMO/WC	$4,457.28

ENDOMETRIAL SAMPLING BX

Facility

$786.65

Service Code	HCPCS 58110
Hospital Charge Code	412358110
Hospital Revenue Code	761
Min. Negotiated Rate	$118.00
Max. Negotiated Rate	$118.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.00

ENDOMETRIAL SAMPLING BX

Facility

$786.65

Service Code	HCPCS 58110
Hospital Charge Code	412358110
Hospital Revenue Code	761
Min. Negotiated Rate	$18.96
Max. Negotiated Rate	$393.32
Rate for Payer: Aetna Commercial	$298.93
Rate for Payer: Aetna Medicare Advantage	$236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.60
Rate for Payer: Cigna Commercial	$393.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.00
Rate for Payer: Oxford Commercial	$157.33
Rate for Payer: Qualcare PPO/HMO/WC	$118.00
Rate for Payer: UnitedHealthcare Commercial	$157.33
Rate for Payer: UnitedHealthcare Community & State	$18.96
Rate for Payer: Wellpoint Medicaid Managed Care	$20.85

ENDO MINI SHEARS 5MM SINGLE

Facility

$412.75

Hospital Charge Code	270697813
Hospital Revenue Code	272
Min. Negotiated Rate	$61.91
Max. Negotiated Rate	$61.91
Rate for Payer: Qualcare PPO/HMO/WC	$61.91

ENDO MINI SHEARS 5MM SINGLE

Facility

$412.75

Hospital Charge Code	270697813
Hospital Revenue Code	272
Min. Negotiated Rate	$9.95
Max. Negotiated Rate	$206.38
Rate for Payer: Aetna Commercial	$156.84
Rate for Payer: Aetna Medicare Advantage	$123.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.25
Rate for Payer: Cigna Commercial	$206.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.83
Rate for Payer: Oxford Commercial	$82.55
Rate for Payer: Qualcare PPO/HMO/WC	$61.91
Rate for Payer: UnitedHealthcare Commercial	$82.55
Rate for Payer: UnitedHealthcare Community & State	$9.95
Rate for Payer: Wellpoint Medicaid Managed Care	$10.94

ENDO MULTIFIRE HERNIA 4MM*****

Facility

$245.00

Hospital Charge Code	1605948
Hospital Revenue Code	272
Min. Negotiated Rate	$5.90
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.50
Rate for Payer: Oxford Commercial	$49.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Commercial	$49.00
Rate for Payer: UnitedHealthcare Community & State	$5.90
Rate for Payer: Wellpoint Medicaid Managed Care	$6.49

ENDO MULTIFIRE HERNIA 4MM*****

Facility

$245.00

Hospital Charge Code	1605948
Hospital Revenue Code	272
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$36.75
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

ENDOMYOCARDIAL BX*****

Facility

$1,031.00

Service Code	HCPCS 93505
Hospital Charge Code	5100060
Hospital Revenue Code	481
Min. Negotiated Rate	$154.65
Max. Negotiated Rate	$154.65
Rate for Payer: Qualcare PPO/HMO/WC	$154.65

ENDOMYOCARDIAL BX*****

Facility

$1,031.00

Service Code	HCPCS 93505
Hospital Charge Code	5100060
Hospital Revenue Code	481
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$309.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$154.65
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$24.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$27.32

ENDOMYSIAL AB

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900365
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ENDOMYSIAL AB

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900365
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ENDOMYSIAL AB (IGA) SCREEN

Facility

$187.25

Service Code	HCPCS 83516
Hospital Charge Code	3006623
Hospital Revenue Code	302
Min. Negotiated Rate	$28.09
Max. Negotiated Rate	$28.09
Rate for Payer: Qualcare PPO/HMO/WC	$28.09

ENDOMYSIAL AB (IGA) SCREEN

Facility

$187.25

Service Code	HCPCS 83516
Hospital Charge Code	3006623
Hospital Revenue Code	302
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$31.36
Rate for Payer: Aetna Medicare Advantage	$37.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.62
Rate for Payer: Cigna Commercial	$93.62
Rate for Payer: Cigna Medicare Advantage	$11.53
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.09
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Medicare Advantage	$11.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.96

ENDOMYSIAL ANTIBODY

Facility

$333.00

Service Code	HCPCS 86255
Hospital Charge Code	38476261
Hospital Revenue Code	302
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$166.50
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$166.50
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.95
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$8.82

ENDOMYSIAL ANTIBODY

Facility

$333.00

Service Code	HCPCS 86255
Hospital Charge Code	38476261
Hospital Revenue Code	302
Min. Negotiated Rate	$49.95
Max. Negotiated Rate	$49.95
Rate for Payer: Qualcare PPO/HMO/WC	$49.95

ENDOMYSIAL(IGG)ANTIBDYSCR&TITR

Facility

$120.00

Service Code	HCPCS 86231
Hospital Charge Code	401191985
Hospital Revenue Code	302
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

ENDOMYSIAL(IGG)ANTIBDYSCR&TITR

Facility

$120.00

Service Code	HCPCS 86231
Hospital Charge Code	401191985
Hospital Revenue Code	302
Min. Negotiated Rate	$3.18
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.88
Rate for Payer: Aetna Medicare Advantage	$39.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.64
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: Cigna Medicare Advantage	$12.09
Rate for Payer: Clover Medicare Advantage	$11.49
Rate for Payer: EmblemHealth Commercial	$36.27
Rate for Payer: Humana Medicare Advantage	$12.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.09
Rate for Payer: Wellcare Medicare Advantage	$12.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3.18

ENDOPATH TROCAR 10/11MM

Facility

$612.00

Hospital Charge Code	270334711
Hospital Revenue Code	272
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ENDOPATH TROCAR 10/11MM

Facility

$612.00

Hospital Charge Code	270334711
Hospital Revenue Code	272
Min. Negotiated Rate	$14.75
Max. Negotiated Rate	$306.00
Rate for Payer: Aetna Commercial	$232.56
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.60
Rate for Payer: Oxford Commercial	$122.40
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$122.40
Rate for Payer: UnitedHealthcare Community & State	$14.75
Rate for Payer: Wellpoint Medicaid Managed Care	$16.22

Know your out-of-pocket cost for care.

All Charges