Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ENDOSCOPY 3 PROCEDURES > 1 HR

Facility

$9,375.00

Hospital Charge Code	2300087
Hospital Revenue Code	750
Min. Negotiated Rate	$1,406.25
Max. Negotiated Rate	$1,406.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,406.25

ENDOSCOPY 3 PROCEDURES > 1 HR

Facility

$9,375.00

Hospital Charge Code	2300087
Hospital Revenue Code	750
Min. Negotiated Rate	$225.94
Max. Negotiated Rate	$4,687.50
Rate for Payer: Aetna Commercial	$3,562.50
Rate for Payer: Aetna Medicare Advantage	$2,812.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,390.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,390.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,390.62
Rate for Payer: Cigna Commercial	$4,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,812.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,406.25
Rate for Payer: UnitedHealthcare Community & State	$225.94
Rate for Payer: Wellpoint Medicaid Managed Care	$248.44

ENDOSCOPY 4 PROCEDURES < 1 HR

Facility

$8,750.00

Hospital Charge Code	2300090
Hospital Revenue Code	750
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$1,312.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

ENDOSCOPY 4 PROCEDURES < 1 HR

Facility

$8,750.00

Hospital Charge Code	2300090
Hospital Revenue Code	750
Min. Negotiated Rate	$210.88
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$210.88
Rate for Payer: Wellpoint Medicaid Managed Care	$231.88

ENDOSCOPY 4 PROCEDURES > 1 HR

Facility

$10,250.00

Hospital Charge Code	2300091
Hospital Revenue Code	750
Min. Negotiated Rate	$247.03
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,895.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,075.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50
Rate for Payer: UnitedHealthcare Community & State	$247.03
Rate for Payer: Wellpoint Medicaid Managed Care	$271.62

ENDOSCOPY 4 PROCEDURES > 1 HR

Facility

$10,250.00

Hospital Charge Code	2300091
Hospital Revenue Code	750
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$1,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

ENDOSERV CURETAGE W CLAMP & BL

Facility

$2,685.00

Service Code	HCPCS 57505
Hospital Charge Code	87502600
Hospital Revenue Code	761
Min. Negotiated Rate	$402.75
Max. Negotiated Rate	$402.75
Rate for Payer: Qualcare PPO/HMO/WC	$402.75

ENDOSERV CURETAGE W CLAMP & BL

Facility

$2,685.00

Service Code	HCPCS 57505
Hospital Charge Code	87502600
Hospital Revenue Code	761
Min. Negotiated Rate	$50.34
Max. Negotiated Rate	$3,949.84
Rate for Payer: Aetna Commercial	$2,976.31
Rate for Payer: Aetna Medicare Advantage	$3,545.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,949.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,949.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,094.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,949.84
Rate for Payer: Cigna Commercial	$2,193.38
Rate for Payer: Cigna Medicare Advantage	$1,094.23
Rate for Payer: Clover Medicare Advantage	$1,039.52
Rate for Payer: EmblemHealth Commercial	$3,282.69
Rate for Payer: Humana Medicare Advantage	$1,127.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,094.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$805.50
Rate for Payer: Oxford Commercial	$537.00
Rate for Payer: Qualcare PPO/HMO/WC	$402.75
Rate for Payer: UnitedHealthcare Commercial	$537.00
Rate for Payer: UnitedHealthcare Community & State	$64.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,094.23
Rate for Payer: Wellcare Medicare Advantage	$1,094.23
Rate for Payer: Wellpoint Medicaid Managed Care	$71.15

ENDO SHEARS ********

Facility

$520.00

Hospital Charge Code	1603513
Hospital Revenue Code	272
Min. Negotiated Rate	$12.53
Max. Negotiated Rate	$260.00
Rate for Payer: Aetna Commercial	$197.60
Rate for Payer: Aetna Medicare Advantage	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.60
Rate for Payer: Cigna Commercial	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.00
Rate for Payer: Oxford Commercial	$104.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.00
Rate for Payer: UnitedHealthcare Commercial	$104.00
Rate for Payer: UnitedHealthcare Community & State	$12.53
Rate for Payer: Wellpoint Medicaid Managed Care	$13.78

ENDO SHEARS ********

Facility

$520.00

Hospital Charge Code	1603513
Hospital Revenue Code	272
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$78.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.00

ENDOSHEARS 5MM LONG

Facility

$138.00

Hospital Charge Code	270335708
Hospital Revenue Code	272
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$69.00
Rate for Payer: Aetna Commercial	$52.44
Rate for Payer: Aetna Medicare Advantage	$41.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.19
Rate for Payer: Cigna Commercial	$69.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.40
Rate for Payer: Oxford Commercial	$27.60
Rate for Payer: Qualcare PPO/HMO/WC	$20.70
Rate for Payer: UnitedHealthcare Commercial	$27.60
Rate for Payer: UnitedHealthcare Community & State	$3.33
Rate for Payer: Wellpoint Medicaid Managed Care	$3.66

ENDOSHEARS 5MM LONG

Facility

$138.00

Hospital Charge Code	270335708
Hospital Revenue Code	272
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$20.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.70

ENDO SHEARS LONG ******

Facility

$520.00

Hospital Charge Code	1603539
Hospital Revenue Code	272
Min. Negotiated Rate	$12.53
Max. Negotiated Rate	$260.00
Rate for Payer: Aetna Commercial	$197.60
Rate for Payer: Aetna Medicare Advantage	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.60
Rate for Payer: Cigna Commercial	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.00
Rate for Payer: Oxford Commercial	$104.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.00
Rate for Payer: UnitedHealthcare Commercial	$104.00
Rate for Payer: UnitedHealthcare Community & State	$12.53
Rate for Payer: Wellpoint Medicaid Managed Care	$13.78

ENDO SHEARS LONG ******

Facility

$520.00

Hospital Charge Code	1603539
Hospital Revenue Code	272
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$78.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.00

ENDO SHEARS LONG W/CAUTERY 5MM

Facility

$1,040.00

Hospital Charge Code	270600117
Hospital Revenue Code	272
Min. Negotiated Rate	$156.00
Max. Negotiated Rate	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.00

ENDO SHEARS LONG W/CAUTERY 5MM

Facility

$1,040.00

Hospital Charge Code	270600117
Hospital Revenue Code	272
Min. Negotiated Rate	$25.06
Max. Negotiated Rate	$520.00
Rate for Payer: Aetna Commercial	$395.20
Rate for Payer: Aetna Medicare Advantage	$312.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$265.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$265.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$265.20
Rate for Payer: Cigna Commercial	$520.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.00
Rate for Payer: Oxford Commercial	$208.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.00
Rate for Payer: UnitedHealthcare Commercial	$208.00
Rate for Payer: UnitedHealthcare Community & State	$25.06
Rate for Payer: Wellpoint Medicaid Managed Care	$27.56

ENDO SHEARS MAXI 10MM 173017

Facility

$956.85

Hospital Charge Code	270600108
Hospital Revenue Code	272
Min. Negotiated Rate	$23.06
Max. Negotiated Rate	$478.43
Rate for Payer: Aetna Commercial	$363.60
Rate for Payer: Aetna Medicare Advantage	$287.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.00
Rate for Payer: Cigna Commercial	$478.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.06
Rate for Payer: Oxford Commercial	$191.37
Rate for Payer: Qualcare PPO/HMO/WC	$143.53
Rate for Payer: UnitedHealthcare Commercial	$191.37
Rate for Payer: UnitedHealthcare Community & State	$23.06
Rate for Payer: Wellpoint Medicaid Managed Care	$25.36

ENDO SHEARS MAXI 10MM 173017

Facility

$956.85

Hospital Charge Code	270600108
Hospital Revenue Code	272
Min. Negotiated Rate	$143.53
Max. Negotiated Rate	$143.53
Rate for Payer: Qualcare PPO/HMO/WC	$143.53

ENDO SHEARS MINI ****

Facility

$488.00

Hospital Charge Code	1603562
Hospital Revenue Code	272
Min. Negotiated Rate	$11.76
Max. Negotiated Rate	$244.00
Rate for Payer: Aetna Commercial	$185.44
Rate for Payer: Aetna Medicare Advantage	$146.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.44
Rate for Payer: Cigna Commercial	$244.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.40
Rate for Payer: Oxford Commercial	$97.60
Rate for Payer: Qualcare PPO/HMO/WC	$73.20
Rate for Payer: UnitedHealthcare Commercial	$97.60
Rate for Payer: UnitedHealthcare Community & State	$11.76
Rate for Payer: Wellpoint Medicaid Managed Care	$12.93

ENDO SHEARS MINI ****

Facility

$488.00

Hospital Charge Code	1603562
Hospital Revenue Code	272
Min. Negotiated Rate	$73.20
Max. Negotiated Rate	$73.20
Rate for Payer: Qualcare PPO/HMO/WC	$73.20

ENDO STAPLER 45MM

Facility

$395.00

Hospital Charge Code	270338731
Hospital Revenue Code	272
Min. Negotiated Rate	$59.25
Max. Negotiated Rate	$59.25
Rate for Payer: Qualcare PPO/HMO/WC	$59.25

ENDO STAPLER 45MM

Facility

$395.00

Hospital Charge Code	270338731
Hospital Revenue Code	272
Min. Negotiated Rate	$9.52
Max. Negotiated Rate	$197.50
Rate for Payer: Aetna Commercial	$150.10
Rate for Payer: Aetna Medicare Advantage	$118.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.72
Rate for Payer: Cigna Commercial	$197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.50
Rate for Payer: Oxford Commercial	$79.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.25
Rate for Payer: UnitedHealthcare Commercial	$79.00
Rate for Payer: UnitedHealthcare Community & State	$9.52
Rate for Payer: Wellpoint Medicaid Managed Care	$10.47

ENDO STITCH *******

Facility

$533.00

Hospital Charge Code	1606581
Hospital Revenue Code	278
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$266.50
Rate for Payer: Aetna Commercial	$202.54
Rate for Payer: Aetna Medicare Advantage	$159.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.91
Rate for Payer: Cigna Commercial	$266.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.26
Rate for Payer: Qualcare PPO/HMO/WC	$79.95
Rate for Payer: UnitedHealthcare Community & State	$12.85
Rate for Payer: Wellpoint Medicaid Managed Care	$14.12

ENDO STITCH *******

Facility

$533.00

Hospital Charge Code	1606581
Hospital Revenue Code	278
Min. Negotiated Rate	$79.95
Max. Negotiated Rate	$128.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.26
Rate for Payer: Qualcare PPO/HMO/WC	$79.95

ENDOSTITCH 0 BLK 18CM SOFSILK

Facility

$559.50

Hospital Charge Code	270692094
Hospital Revenue Code	272
Min. Negotiated Rate	$83.92
Max. Negotiated Rate	$83.92
Rate for Payer: Qualcare PPO/HMO/WC	$83.92

Know your out-of-pocket cost for care.

All Charges