Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ER BURN DSG/DEBRID MED W/O ANE

Facility

$847.50

Service Code	HCPCS 16025
Hospital Charge Code	5700542
Hospital Revenue Code	450
Min. Negotiated Rate	$127.12
Max. Negotiated Rate	$127.12
Rate for Payer: Qualcare PPO/HMO/WC	$127.12

ER CARDIOVERSION

Facility

$2,190.00

Service Code	HCPCS 92960
Hospital Charge Code	5700260
Hospital Revenue Code	450
Min. Negotiated Rate	$58.03
Max. Negotiated Rate	$2,834.41
Rate for Payer: Aetna Commercial	$2,135.80
Rate for Payer: Aetna Medicare Advantage	$2,544.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,834.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,834.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$785.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,002.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,834.41
Rate for Payer: Cigna Commercial	$1,573.96
Rate for Payer: Cigna Medicare Advantage	$785.22
Rate for Payer: Clover Medicare Advantage	$745.96
Rate for Payer: EmblemHealth Commercial	$2,355.66
Rate for Payer: Humana Medicare Advantage	$808.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$785.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$657.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$328.50
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$785.22
Rate for Payer: Wellcare Medicare Advantage	$785.22
Rate for Payer: Wellpoint Medicaid Managed Care	$58.03

ER CARDIOVERSION

Facility

$2,190.00

Service Code	HCPCS 92960
Hospital Charge Code	5700260
Hospital Revenue Code	450
Min. Negotiated Rate	$328.50
Max. Negotiated Rate	$328.50
Rate for Payer: Qualcare PPO/HMO/WC	$328.50

ER CASTING/STRAPPING LEVEL I

Facility

$218.25

Hospital Charge Code	5700026
Hospital Revenue Code	450
Min. Negotiated Rate	$32.74
Max. Negotiated Rate	$32.74
Rate for Payer: Qualcare PPO/HMO/WC	$32.74

ER CASTING/STRAPPING LEVEL I

Facility

$218.25

Hospital Charge Code	5700026
Hospital Revenue Code	450
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$82.94
Rate for Payer: Aetna Medicare Advantage	$65.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.65
Rate for Payer: Cigna Commercial	$109.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.74
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$5.78

ER CASTING/STRAPPING LEVEL II

Facility

$346.90

Hospital Charge Code	5700028
Hospital Revenue Code	450
Min. Negotiated Rate	$9.19
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$131.82
Rate for Payer: Aetna Medicare Advantage	$104.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.46
Rate for Payer: Cigna Commercial	$173.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.03
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$9.19

ER CASTING/STRAPPING LEVEL II

Facility

$346.90

Hospital Charge Code	5700028
Hospital Revenue Code	450
Min. Negotiated Rate	$52.03
Max. Negotiated Rate	$52.03
Rate for Payer: Qualcare PPO/HMO/WC	$52.03

ER-CAST/STARPP OTHER-BI

Facility

$305.00

Hospital Charge Code	5790785
Hospital Revenue Code	450
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$115.90
Rate for Payer: Aetna Medicare Advantage	$91.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.78
Rate for Payer: Cigna Commercial	$152.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.75
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$8.08

ER-CAST/STARPP OTHER-BI

Facility

$305.00

Hospital Charge Code	5790785
Hospital Revenue Code	450
Min. Negotiated Rate	$45.75
Max. Negotiated Rate	$45.75
Rate for Payer: Qualcare PPO/HMO/WC	$45.75

ER CATH ASPIRATION NASOTRACH

Facility

$128.00

Service Code	HCPCS 31720
Hospital Charge Code	5700406
Hospital Revenue Code	450
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

ER CATH ASPIRATION NASOTRACH

Facility

$128.00

Service Code	HCPCS 31720
Hospital Charge Code	5700406
Hospital Revenue Code	450
Min. Negotiated Rate	$3.39
Max. Negotiated Rate	$939.06
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	$46.00
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	$38.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

ER-CAUTERY OF CERVIX

Facility

$5,763.00

Service Code	HCPCS 57510
Hospital Charge Code	5790200
Hospital Revenue Code	450
Min. Negotiated Rate	$864.45
Max. Negotiated Rate	$864.45
Rate for Payer: Qualcare PPO/HMO/WC	$864.45

ER-CAUTERY OF CERVIX

Facility

$5,763.00

Service Code	HCPCS 57510
Hospital Charge Code	5790200
Hospital Revenue Code	450
Min. Negotiated Rate	$43.37
Max. Negotiated Rate	$13,882.15
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,882.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,882.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,882.15
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,728.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$864.45
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$152.72

ER CENTRAL LINE INSERT <5YRS

Facility

$6,107.50

Service Code	HCPCS 36555
Hospital Charge Code	5700779
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
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	$332.99
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	$1,832.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$916.12
Rate for Payer: UnitedHealthcare Community & State	$140.00
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	$161.85

ER CENTRAL LINE INSERT <5YRS

Facility

$6,107.50

Service Code	HCPCS 36555
Hospital Charge Code	5700779
Hospital Revenue Code	450
Min. Negotiated Rate	$916.12
Max. Negotiated Rate	$916.12
Rate for Payer: Qualcare PPO/HMO/WC	$916.12

ER CENTRAL LINE INSERT>5YRS

Facility

$6,107.50

Service Code	HCPCS 36556
Hospital Charge Code	5700780
Hospital Revenue Code	450
Min. Negotiated Rate	$916.12
Max. Negotiated Rate	$916.12
Rate for Payer: Qualcare PPO/HMO/WC	$916.12

ER CENTRAL LINE INSERT>5YRS

Facility

$6,107.50

Service Code	HCPCS 36556
Hospital Charge Code	5700780
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
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	$309.76
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	$1,832.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$916.12
Rate for Payer: UnitedHealthcare Community & State	$140.00
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	$161.85

ER CHANGE G TUBE

Facility

$776.45

Service Code	HCPCS 43760
Hospital Charge Code	5700293
Hospital Revenue Code	450
Min. Negotiated Rate	$20.58
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$295.05
Rate for Payer: Aetna Medicare Advantage	$232.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.99
Rate for Payer: Cigna Commercial	$388.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.47
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$781.67
Rate for Payer: Wellpoint Medicaid Managed Care	$20.58

ER CHANGE G TUBE

Facility

$776.45

Service Code	HCPCS 43760
Hospital Charge Code	5700293
Hospital Revenue Code	450
Min. Negotiated Rate	$116.47
Max. Negotiated Rate	$116.47
Rate for Payer: Qualcare PPO/HMO/WC	$116.47

ER-CHEMCAL CAUTERY TISSUE

Facility

$990.50

Service Code	HCPCS 17250
Hospital Charge Code	5790045
Hospital Revenue Code	450
Min. Negotiated Rate	$148.57
Max. Negotiated Rate	$148.57
Rate for Payer: Qualcare PPO/HMO/WC	$148.57

ER-CHEMCAL CAUTERY TISSUE

Facility

$990.50

Service Code	HCPCS 17250
Hospital Charge Code	5790045
Hospital Revenue Code	450
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$860.41
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.41
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$297.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$148.57
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$26.25

ER CHEMO IM/SQ NON HORM

Facility

$462.00

Service Code	HCPCS 96401
Hospital Charge Code	5792276
Hospital Revenue Code	331
Min. Negotiated Rate	$69.30
Max. Negotiated Rate	$69.30
Rate for Payer: Qualcare PPO/HMO/WC	$69.30

ER CHEMO IM/SQ NON HORM

Facility

$462.00

Service Code	HCPCS 96401
Hospital Charge Code	5792276
Hospital Revenue Code	331
Min. Negotiated Rate	$11.13
Max. Negotiated Rate	$2,770.00
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) PPO	$308.77
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$59.88
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	$138.60
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.30
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$11.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$12.24

ER-CHG CYSTO TUBE-SIMPLE

Facility

$576.00

Service Code	HCPCS 51705
Hospital Charge Code	5790170
Hospital Revenue Code	450
Min. Negotiated Rate	$86.40
Max. Negotiated Rate	$86.40
Rate for Payer: Qualcare PPO/HMO/WC	$86.40

ER-CHG CYSTO TUBE-SIMPLE

Facility

$576.00

Service Code	HCPCS 51705
Hospital Charge Code	5790170
Hospital Revenue Code	450
Min. Negotiated Rate	$15.26
Max. Negotiated Rate	$1,071.47
Rate for Payer: Aetna Commercial	$807.38
Rate for Payer: Aetna Medicare Advantage	$961.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,071.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,071.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$296.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,071.47
Rate for Payer: Cigna Commercial	$594.98
Rate for Payer: Cigna Medicare Advantage	$296.83
Rate for Payer: Clover Medicare Advantage	$281.99
Rate for Payer: EmblemHealth Commercial	$890.49
Rate for Payer: Humana Medicare Advantage	$305.73
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$296.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.40
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$296.83
Rate for Payer: Wellcare Medicare Advantage	$296.83
Rate for Payer: Wellpoint Medicaid Managed Care	$15.26

Know your out-of-pocket cost for care.

All Charges