Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ER ADMIN BLOOD TRANSFUSION

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	5700032
Hospital Revenue Code	391
Min. Negotiated Rate	$33.83
Max. Negotiated Rate	$1,891.95
Rate for Payer: Aetna Commercial	$1,425.63
Rate for Payer: Aetna Medicare Advantage	$1,698.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,891.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,891.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$524.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,891.95
Rate for Payer: Cigna Commercial	$1,050.61
Rate for Payer: Cigna Medicare Advantage	$524.13
Rate for Payer: Clover Medicare Advantage	$497.92
Rate for Payer: EmblemHealth Commercial	$1,572.39
Rate for Payer: Humana Medicare Advantage	$539.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$524.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.12
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.56
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$33.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$524.13
Rate for Payer: Wellcare Medicare Advantage	$524.13
Rate for Payer: Wellpoint Medicaid Managed Care	$37.20

ER ADMIN BLOOD TRANSFUSION

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	5700032
Hospital Revenue Code	391
Min. Negotiated Rate	$210.56
Max. Negotiated Rate	$210.56
Rate for Payer: Qualcare PPO/HMO/WC	$210.56

ER ADMINISTRATION IMMUNIZATION

Facility

$72.75

Service Code	HCPCS 90471
Hospital Charge Code	5700275
Hospital Revenue Code	771
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$308.77
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.77
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.82
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.91
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1.93

ER ADMINISTRATION IMMUNIZATION

Facility

$72.75

Service Code	HCPCS 90471
Hospital Charge Code	5700275
Hospital Revenue Code	771
Min. Negotiated Rate	$10.91
Max. Negotiated Rate	$10.91
Rate for Payer: Qualcare PPO/HMO/WC	$10.91

ER AIRWAY INHALATION TREATMENT

Facility

$467.85

Service Code	HCPCS 94640
Hospital Charge Code	5700655
Hospital Revenue Code	410
Min. Negotiated Rate	$11.28
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$707.61
Rate for Payer: Aetna Medicare Advantage	$842.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$939.06
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: Cigna Medicare Advantage	$260.15
Rate for Payer: Clover Medicare Advantage	$247.14
Rate for Payer: EmblemHealth Commercial	$780.45
Rate for Payer: Humana Medicare Advantage	$267.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$260.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.35
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.18
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$11.28
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$12.40

ER AIRWAY INHALATION TREATMENT

Facility

$467.85

Service Code	HCPCS 94640
Hospital Charge Code	5700655
Hospital Revenue Code	410
Min. Negotiated Rate	$70.18
Max. Negotiated Rate	$70.18
Rate for Payer: Qualcare PPO/HMO/WC	$70.18

ER AIRWAY INHALATION TX SUBSEQ

Facility

$467.85

Service Code	HCPCS 9464076
Hospital Charge Code	5701016
Hospital Revenue Code	410
Min. Negotiated Rate	$11.28
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$177.78
Rate for Payer: Aetna Medicare Advantage	$140.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.30
Rate for Payer: Cigna Commercial	$233.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.35
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.18
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$11.28
Rate for Payer: Wellpoint Medicaid Managed Care	$12.40

ER AIRWAY INHALATION TX SUBSEQ

Facility

$467.85

Service Code	HCPCS 9464076
Hospital Charge Code	5701016
Hospital Revenue Code	410
Min. Negotiated Rate	$70.18
Max. Negotiated Rate	$70.18
Rate for Payer: Qualcare PPO/HMO/WC	$70.18

ER ANESTHESIA IV CONSCIOUS SED

Facility

$336.00

Hospital Charge Code	5700010
Hospital Revenue Code	370
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$50.40
Rate for Payer: Qualcare PPO/HMO/WC	$50.40

ER ANESTHESIA IV CONSCIOUS SED

Facility

$336.00

Hospital Charge Code	5700010
Hospital Revenue Code	370
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$168.00
Rate for Payer: Aetna Commercial	$127.68
Rate for Payer: Aetna Medicare Advantage	$100.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.68
Rate for Payer: Cigna Commercial	$168.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.80
Rate for Payer: Oxford Commercial	$67.20
Rate for Payer: Qualcare PPO/HMO/WC	$50.40
Rate for Payer: UnitedHealthcare Commercial	$67.20
Rate for Payer: UnitedHealthcare Community & State	$8.10
Rate for Payer: Wellpoint Medicaid Managed Care	$8.90

ER-ANKLE DISLOCATED-BILAT

Facility

$612.00

Hospital Charge Code	5790620
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-ANKLE DISLOCATED-BILAT

Facility

$612.00

Hospital Charge Code	5790620
Hospital Revenue Code	450
Min. Negotiated Rate	$16.22
Max. Negotiated Rate	$850.00
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: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$16.22

ER-ANTERIOR SEG EYE OTHER

Facility

$1,817.00

Service Code	HCPCS 66999
Hospital Charge Code	5790215
Hospital Revenue Code	450
Min. Negotiated Rate	$48.15
Max. Negotiated Rate	$9,896.93
Rate for Payer: Aetna Commercial	$7,457.59
Rate for Payer: Aetna Medicare Advantage	$8,883.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,896.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,896.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,741.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,896.93
Rate for Payer: Cigna Commercial	$5,495.84
Rate for Payer: Cigna Medicare Advantage	$2,741.76
Rate for Payer: Clover Medicare Advantage	$2,604.67
Rate for Payer: EmblemHealth Commercial	$8,225.28
Rate for Payer: Humana Medicare Advantage	$2,824.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,741.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$272.55
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,741.76
Rate for Payer: Wellcare Medicare Advantage	$2,741.76
Rate for Payer: Wellpoint Medicaid Managed Care	$48.15

ER-ANTERIOR SEG EYE OTHER

Facility

$1,817.00

Service Code	HCPCS 66999
Hospital Charge Code	5790215
Hospital Revenue Code	450
Min. Negotiated Rate	$272.55
Max. Negotiated Rate	$272.55
Rate for Payer: Qualcare PPO/HMO/WC	$272.55

ER APPLICATION FINGER SPLINT

Facility

$322.82

Service Code	HCPCS 29130
Hospital Charge Code	5700310
Hospital Revenue Code	450
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$850.00
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	$34.85
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	$96.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.42
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$8.55

ER APPLICATION FINGER SPLINT

Facility

$322.82

Service Code	HCPCS 29130
Hospital Charge Code	5700310
Hospital Revenue Code	450
Min. Negotiated Rate	$48.42
Max. Negotiated Rate	$48.42
Rate for Payer: Qualcare PPO/HMO/WC	$48.42

ER APPLICATION FOREARM SPLINT

Facility

$988.72

Service Code	HCPCS 29125
Hospital Charge Code	5700305
Hospital Revenue Code	450
Min. Negotiated Rate	$148.31
Max. Negotiated Rate	$148.31
Rate for Payer: Qualcare PPO/HMO/WC	$148.31

ER APPLICATION FOREARM SPLINT

Facility

$988.72

Service Code	HCPCS 29125
Hospital Charge Code	5700305
Hospital Revenue Code	450
Min. Negotiated Rate	$26.20
Max. Negotiated Rate	$850.00
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	$56.14
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	$296.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$148.31
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$26.20

ER APPLICATION HAND/WRIST CAST

Facility

$244.50

Service Code	HCPCS 29085
Hospital Charge Code	5700365
Hospital Revenue Code	450
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$525.10
Rate for Payer: Aetna Medicare Advantage	$625.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$193.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.85
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: Cigna Medicare Advantage	$193.05
Rate for Payer: Clover Medicare Advantage	$183.40
Rate for Payer: EmblemHealth Commercial	$579.15
Rate for Payer: Humana Medicare Advantage	$198.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$193.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.67
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$193.05
Rate for Payer: Wellcare Medicare Advantage	$193.05
Rate for Payer: Wellpoint Medicaid Managed Care	$6.48

ER APPLICATION HAND/WRIST CAST

Facility

$244.50

Service Code	HCPCS 29085
Hospital Charge Code	5700365
Hospital Revenue Code	450
Min. Negotiated Rate	$36.67
Max. Negotiated Rate	$36.67
Rate for Payer: Qualcare PPO/HMO/WC	$36.67

ER APPLICATION LONG ARM CAST

Facility

$1,360.45

Service Code	HCPCS 29065
Hospital Charge Code	5700372
Hospital Revenue Code	450
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

ER APPLICATION LONG ARM CAST

Facility

$1,360.45

Service Code	HCPCS 29065
Hospital Charge Code	5700372
Hospital Revenue Code	450
Min. Negotiated Rate	$36.05
Max. Negotiated Rate	$1,199.43
Rate for Payer: Aetna Commercial	$903.80
Rate for Payer: Aetna Medicare Advantage	$1,076.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,199.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,199.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$332.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,199.43
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: Cigna Medicare Advantage	$332.28
Rate for Payer: Clover Medicare Advantage	$315.67
Rate for Payer: EmblemHealth Commercial	$996.84
Rate for Payer: Humana Medicare Advantage	$342.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$332.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$408.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$204.07
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.28
Rate for Payer: Wellcare Medicare Advantage	$332.28
Rate for Payer: Wellpoint Medicaid Managed Care	$36.05

ER APPLICATION LONG ARM SPLINT

Facility

$777.42

Service Code	HCPCS 29105
Hospital Charge Code	5700330
Hospital Revenue Code	450
Min. Negotiated Rate	$116.61
Max. Negotiated Rate	$116.61
Rate for Payer: Qualcare PPO/HMO/WC	$116.61

ER APPLICATION LONG ARM SPLINT

Facility

$777.42

Service Code	HCPCS 29105
Hospital Charge Code	5700330
Hospital Revenue Code	450
Min. Negotiated Rate	$20.60
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$525.10
Rate for Payer: Aetna Medicare Advantage	$625.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$193.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.85
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: Cigna Medicare Advantage	$193.05
Rate for Payer: Clover Medicare Advantage	$183.40
Rate for Payer: EmblemHealth Commercial	$579.15
Rate for Payer: Humana Medicare Advantage	$198.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$193.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.61
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$193.05
Rate for Payer: Wellcare Medicare Advantage	$193.05
Rate for Payer: Wellpoint Medicaid Managed Care	$20.60

ER APPLICATION LONG LEG CAST

Facility

$1,360.45

Service Code	HCPCS 29345
Hospital Charge Code	5700355
Hospital Revenue Code	450
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

Know your out-of-pocket cost for care.

All Charges