Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ENDOVENOUS RF 1ST VEIN

Facility

$25,406.80

Service Code	HCPCS 36475
Hospital Charge Code	1600000571
Hospital Revenue Code	360
Min. Negotiated Rate	$612.30
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	$1,626.00
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	$7,622.04
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,811.02
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$612.30
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	$673.28

ENDOVENOUS RF 1ST VEIN

Facility

$17,623.95

Service Code	HCPCS 36475
Hospital Charge Code	421036475
Hospital Revenue Code	761
Min. Negotiated Rate	$2,643.59
Max. Negotiated Rate	$2,643.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,643.59

ENDOVENOUS RF 1ST VEIN

Facility

$25,406.80

Service Code	HCPCS 36475
Hospital Charge Code	5600119
Hospital Revenue Code	361
Min. Negotiated Rate	$3,811.02
Max. Negotiated Rate	$3,811.02
Rate for Payer: Qualcare PPO/HMO/WC	$3,811.02

ENDOVENOUS RF 1ST VEIN

Facility

$25,406.80

Service Code	HCPCS 36475
Hospital Charge Code	5600119
Hospital Revenue Code	361
Min. Negotiated Rate	$612.30
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	$1,626.00
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	$7,622.04
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,811.02
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$612.30
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	$673.28

ENDOVENOUS RF 1ST VEIN

Facility

$17,623.95

Service Code	HCPCS 36475
Hospital Charge Code	421036475
Hospital Revenue Code	761
Min. Negotiated Rate	$424.74
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	$2,370.63
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	$5,287.19
Rate for Payer: Oxford Commercial	$3,524.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,643.59
Rate for Payer: UnitedHealthcare Commercial	$3,524.79
Rate for Payer: UnitedHealthcare Community & State	$424.74
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	$467.03

ENDOVENOUS RF VEIN ADD ON

Facility

$9,970.96

Service Code	HCPCS 36476
Hospital Charge Code	5600120
Hospital Revenue Code	361
Min. Negotiated Rate	$240.30
Max. Negotiated Rate	$4,985.48
Rate for Payer: Aetna Commercial	$3,788.96
Rate for Payer: Aetna Medicare Advantage	$2,991.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,542.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,542.59
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	$2,542.59
Rate for Payer: Cigna Commercial	$4,985.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,991.29
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.64
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$240.30
Rate for Payer: Wellpoint Medicaid Managed Care	$264.23

ENDOVENOUS RF VEIN ADD ON

Facility

$9,970.96

Service Code	HCPCS 36476
Hospital Charge Code	5600120
Hospital Revenue Code	361
Min. Negotiated Rate	$1,495.64
Max. Negotiated Rate	$1,495.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.64

ENDOVENOUS RF VEIN ADD ON

Facility

$9,970.96

Service Code	HCPCS 36476
Hospital Charge Code	1600000573
Hospital Revenue Code	360
Min. Negotiated Rate	$1,495.64
Max. Negotiated Rate	$1,495.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.64

ENDOVENOUS RF VEIN ADD ON

Facility

$9,970.96

Service Code	HCPCS 36476
Hospital Charge Code	1600000573
Hospital Revenue Code	360
Min. Negotiated Rate	$240.30
Max. Negotiated Rate	$4,985.48
Rate for Payer: Aetna Commercial	$3,788.96
Rate for Payer: Aetna Medicare Advantage	$2,991.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,542.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,542.59
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	$2,542.59
Rate for Payer: Cigna Commercial	$4,985.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,991.29
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.64
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$240.30
Rate for Payer: Wellpoint Medicaid Managed Care	$264.23

ENDOVENOUS RF VEIN ADD-ON

Facility

$17,623.95

Service Code	HCPCS 36476
Hospital Charge Code	421036476
Hospital Revenue Code	761
Min. Negotiated Rate	$424.74
Max. Negotiated Rate	$8,811.98
Rate for Payer: Aetna Commercial	$6,697.10
Rate for Payer: Aetna Medicare Advantage	$5,287.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,494.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,494.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,494.11
Rate for Payer: Cigna Commercial	$8,811.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,287.19
Rate for Payer: Oxford Commercial	$3,524.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,643.59
Rate for Payer: UnitedHealthcare Commercial	$3,524.79
Rate for Payer: UnitedHealthcare Community & State	$424.74
Rate for Payer: Wellpoint Medicaid Managed Care	$467.03

ENDOVENOUS RF VEIN ADD-ON

Facility

$17,623.95

Service Code	HCPCS 36476
Hospital Charge Code	421036476
Hospital Revenue Code	761
Min. Negotiated Rate	$2,643.59
Max. Negotiated Rate	$2,643.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,643.59

ENDOVEN THER CHEM ADHES 1ST

Facility

$29,358.35

Service Code	HCPCS 36482
Hospital Charge Code	421036482
Hospital Revenue Code	761
Min. Negotiated Rate	$707.54
Max. Negotiated Rate	$23,862.86
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,156.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,862.86
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$6,610.76
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,807.50
Rate for Payer: Oxford Commercial	$5,871.67
Rate for Payer: Qualcare PPO/HMO/WC	$4,403.75
Rate for Payer: UnitedHealthcare Commercial	$5,871.67
Rate for Payer: UnitedHealthcare Community & State	$707.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$778.00

ENDOVEN THER CHEM ADHES 1ST

Facility

$29,358.35

Service Code	HCPCS 36482
Hospital Charge Code	421036482
Hospital Revenue Code	761
Min. Negotiated Rate	$4,403.75
Max. Negotiated Rate	$4,403.75
Rate for Payer: Qualcare PPO/HMO/WC	$4,403.75

ENDOVEN THER CHEM ADHES SBSQ

Facility

$29,358.35

Service Code	HCPCS 36483
Hospital Charge Code	421036483
Hospital Revenue Code	761
Min. Negotiated Rate	$4,403.75
Max. Negotiated Rate	$4,403.75
Rate for Payer: Qualcare PPO/HMO/WC	$4,403.75

ENDOVEN THER CHEM ADHES SBSQ

Facility

$29,358.35

Service Code	HCPCS 36483
Hospital Charge Code	421036483
Hospital Revenue Code	761
Min. Negotiated Rate	$146.52
Max. Negotiated Rate	$14,679.17
Rate for Payer: Aetna Commercial	$11,156.17
Rate for Payer: Aetna Medicare Advantage	$8,807.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,486.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,486.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,486.38
Rate for Payer: Cigna Commercial	$14,679.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,807.50
Rate for Payer: Oxford Commercial	$5,871.67
Rate for Payer: Qualcare PPO/HMO/WC	$4,403.75
Rate for Payer: UnitedHealthcare Commercial	$5,871.67
Rate for Payer: UnitedHealthcare Community & State	$707.54
Rate for Payer: Wellpoint Medicaid Managed Care	$778.00

ENDOVIVE REPLACEMENT KIT 24FR

Facility

$136.50

Hospital Charge Code	270660084
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$20.48
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

ENDOVIVE REPLACEMENT KIT 24FR

Facility

$136.50

Hospital Charge Code	270660084
Hospital Revenue Code	272
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$51.87
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.95
Rate for Payer: Oxford Commercial	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$20.48
Rate for Payer: UnitedHealthcare Commercial	$27.30
Rate for Payer: UnitedHealthcare Community & State	$3.29
Rate for Payer: Wellpoint Medicaid Managed Care	$3.62

ENDOVIVE STD REPL KIT 18 FR

Facility

$136.50

Hospital Charge Code	270660083
Hospital Revenue Code	272
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$51.87
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.95
Rate for Payer: Oxford Commercial	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$20.48
Rate for Payer: UnitedHealthcare Commercial	$27.30
Rate for Payer: UnitedHealthcare Community & State	$3.29
Rate for Payer: Wellpoint Medicaid Managed Care	$3.62

ENDOVIVE STD REPL KIT 18 FR

Facility

$136.50

Hospital Charge Code	270660083
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$20.48
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

ENDOVIVE STD REPL KIT 20FR

Facility

$136.50

Hospital Charge Code	270646740
Hospital Revenue Code	272
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$51.87
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.95
Rate for Payer: Oxford Commercial	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$20.48
Rate for Payer: UnitedHealthcare Commercial	$27.30
Rate for Payer: UnitedHealthcare Community & State	$3.29
Rate for Payer: Wellpoint Medicaid Managed Care	$3.62

ENDOVIVE STD REPL KIT 20FR

Facility

$136.50

Hospital Charge Code	270646740
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$20.48
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

ENDOWRISTONE SUCTION IRRIGATOR

Facility

$6,600.00

Hospital Charge Code	270664010
Hospital Revenue Code	270
Min. Negotiated Rate	$990.00
Max. Negotiated Rate	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.00

ENDOWRISTONE SUCTION IRRIGATOR

Facility

$6,600.00

Hospital Charge Code	270664010
Hospital Revenue Code	270
Min. Negotiated Rate	$159.06
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$2,508.00
Rate for Payer: Aetna Medicare Advantage	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.00
Rate for Payer: Cigna Commercial	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.00
Rate for Payer: Oxford Commercial	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.00
Rate for Payer: UnitedHealthcare Commercial	$1,320.00
Rate for Payer: UnitedHealthcare Community & State	$159.06
Rate for Payer: Wellpoint Medicaid Managed Care	$174.90

ENDOWRIST STAPLER 45 W

Facility

$908.30

Hospital Charge Code	270677734
Hospital Revenue Code	272
Min. Negotiated Rate	$21.89
Max. Negotiated Rate	$454.15
Rate for Payer: Aetna Commercial	$345.15
Rate for Payer: Aetna Medicare Advantage	$272.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.62
Rate for Payer: Cigna Commercial	$454.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.49
Rate for Payer: Oxford Commercial	$181.66
Rate for Payer: Qualcare PPO/HMO/WC	$136.25
Rate for Payer: UnitedHealthcare Commercial	$181.66
Rate for Payer: UnitedHealthcare Community & State	$21.89
Rate for Payer: Wellpoint Medicaid Managed Care	$24.07

ENDOWRIST STAPLER 45 W

Facility

$908.30

Hospital Charge Code	270677734
Hospital Revenue Code	272
Min. Negotiated Rate	$136.25
Max. Negotiated Rate	$136.25
Rate for Payer: Qualcare PPO/HMO/WC	$136.25

Know your out-of-pocket cost for care.

All Charges