Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ER-DISLOC KNEE NO ANES-BI

Facility

$453.00

Hospital Charge Code	5790570
Hospital Revenue Code	450
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$172.14
Rate for Payer: Aetna Medicare Advantage	$135.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.52
Rate for Payer: Cigna Commercial	$226.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.95
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$12.00

ER-DISLOC KNEE NO ANES-BI

Facility

$453.00

Hospital Charge Code	5790570
Hospital Revenue Code	450
Min. Negotiated Rate	$67.95
Max. Negotiated Rate	$67.95
Rate for Payer: Qualcare PPO/HMO/WC	$67.95

ER-DISLOC P HIP ARTHRO-BI

Facility

$4,536.00

Hospital Charge Code	5790555
Hospital Revenue Code	450
Min. Negotiated Rate	$680.40
Max. Negotiated Rate	$680.40
Rate for Payer: Qualcare PPO/HMO/WC	$680.40

ER-DISLOC P HIP ARTHRO-BI

Facility

$4,536.00

Hospital Charge Code	5790555
Hospital Revenue Code	450
Min. Negotiated Rate	$120.20
Max. Negotiated Rate	$2,268.00
Rate for Payer: Aetna Commercial	$1,723.68
Rate for Payer: Aetna Medicare Advantage	$1,360.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,156.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,156.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,156.68
Rate for Payer: Cigna Commercial	$2,268.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,360.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$680.40
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$120.20

ER-DISTAL FIB FX W/MAN-BI

Facility

$453.00

Hospital Charge Code	5790600
Hospital Revenue Code	450
Min. Negotiated Rate	$67.95
Max. Negotiated Rate	$67.95
Rate for Payer: Qualcare PPO/HMO/WC	$67.95

ER-DISTAL FIB FX W/MAN-BI

Facility

$453.00

Hospital Charge Code	5790600
Hospital Revenue Code	450
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$172.14
Rate for Payer: Aetna Medicare Advantage	$135.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.52
Rate for Payer: Cigna Commercial	$226.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.95
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$12.00

ER-DRAIN ABSCES BREAST-BI

Facility

$5,146.00

Hospital Charge Code	5790285
Hospital Revenue Code	450
Min. Negotiated Rate	$771.90
Max. Negotiated Rate	$771.90
Rate for Payer: Qualcare PPO/HMO/WC	$771.90

ER-DRAIN ABSCES BREAST-BI

Facility

$5,146.00

Hospital Charge Code	5790285
Hospital Revenue Code	450
Min. Negotiated Rate	$136.37
Max. Negotiated Rate	$2,573.00
Rate for Payer: Aetna Commercial	$1,955.48
Rate for Payer: Aetna Medicare Advantage	$1,543.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,312.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,312.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,312.23
Rate for Payer: Cigna Commercial	$2,573.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,543.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$771.90
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$136.37

ER-DRAINAGE NOSE LESION

Facility

$1,019.00

Service Code	HCPCS 30000
Hospital Charge Code	5790070
Hospital Revenue Code	450
Min. Negotiated Rate	$152.85
Max. Negotiated Rate	$152.85
Rate for Payer: Qualcare PPO/HMO/WC	$152.85

ER-DRAINAGE NOSE LESION

Facility

$1,019.00

Service Code	HCPCS 30000
Hospital Charge Code	5790070
Hospital Revenue Code	450
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$1,015.70
Rate for Payer: Aetna Commercial	$765.35
Rate for Payer: Aetna Medicare Advantage	$911.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,015.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,015.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$281.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,015.70
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: Cigna Medicare Advantage	$281.38
Rate for Payer: Clover Medicare Advantage	$267.31
Rate for Payer: EmblemHealth Commercial	$844.14
Rate for Payer: Humana Medicare Advantage	$289.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$281.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$305.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$152.85
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$281.38
Rate for Payer: Wellcare Medicare Advantage	$281.38
Rate for Payer: Wellpoint Medicaid Managed Care	$27.00

ER DRAINAGE SKIN ABCESS

Facility

$980.02

Service Code	HCPCS 10060
Hospital Charge Code	5700345
Hospital Revenue Code	450
Min. Negotiated Rate	$25.97
Max. Negotiated Rate	$962.01
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	$49.39
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	$294.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.00
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: Wellcare New Jersey Medicaid/Family Care	$962.01
Rate for Payer: Wellpoint Medicaid Managed Care	$25.97

ER DRAINAGE SKIN ABCESS

Facility

$980.02

Service Code	HCPCS 10060
Hospital Charge Code	5700345
Hospital Revenue Code	450
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$147.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.00

ER-DRAIN FNGR ABSC SIM-BI

Facility

$397.00

Hospital Charge Code	5790470
Hospital Revenue Code	450
Min. Negotiated Rate	$10.52
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$150.86
Rate for Payer: Aetna Medicare Advantage	$119.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.23
Rate for Payer: Cigna Commercial	$198.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.55
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$10.52

ER-DRAIN FNGR ABSC SIM-BI

Facility

$397.00

Hospital Charge Code	5790470
Hospital Revenue Code	450
Min. Negotiated Rate	$59.55
Max. Negotiated Rate	$59.55
Rate for Payer: Qualcare PPO/HMO/WC	$59.55

ER DRAIN SCROTAL WALL ABSCESS

Facility

$8,041.95

Service Code	HCPCS 55100
Hospital Charge Code	5700799
Hospital Revenue Code	450
Min. Negotiated Rate	$1,206.29
Max. Negotiated Rate	$1,206.29
Rate for Payer: Qualcare PPO/HMO/WC	$1,206.29

ER DRAIN SCROTAL WALL ABSCESS

Facility

$8,041.95

Service Code	HCPCS 55100
Hospital Charge Code	5700799
Hospital Revenue Code	450
Min. Negotiated Rate	$81.31
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,412.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,206.29
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$213.11

ER EKG

Facility

$2,050.00

Service Code	HCPCS 93005
Hospital Charge Code	5780290
Hospital Revenue Code	730
Min. Negotiated Rate	$49.41
Max. Negotiated Rate	$697.00
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.97
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$615.00
Rate for Payer: Oxford Commercial	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$307.50
Rate for Payer: UnitedHealthcare Commercial	$697.00
Rate for Payer: UnitedHealthcare Community & State	$49.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$54.33

ER EKG

Facility

$2,050.00

Service Code	HCPCS 93005
Hospital Charge Code	5780290
Hospital Revenue Code	730
Min. Negotiated Rate	$307.50
Max. Negotiated Rate	$307.50
Rate for Payer: Qualcare PPO/HMO/WC	$307.50

ER EMERGENT CRICOTHYROTOMY

Facility

$4,167.70

Service Code	HCPCS 31605
Hospital Charge Code	5700776
Hospital Revenue Code	450
Min. Negotiated Rate	$625.15
Max. Negotiated Rate	$625.15
Rate for Payer: Qualcare PPO/HMO/WC	$625.15

ER EMERGENT CRICOTHYROTOMY

Facility

$4,167.70

Service Code	HCPCS 31605
Hospital Charge Code	5700776
Hospital Revenue Code	450
Min. Negotiated Rate	$110.44
Max. Negotiated Rate	$1,601.46
Rate for Payer: Aetna Commercial	$765.35
Rate for Payer: Aetna Medicare Advantage	$911.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,015.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,015.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$281.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,015.70
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: Cigna Medicare Advantage	$281.38
Rate for Payer: Clover Medicare Advantage	$267.31
Rate for Payer: EmblemHealth Commercial	$844.14
Rate for Payer: Humana Medicare Advantage	$289.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$281.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,250.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$625.15
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$281.38
Rate for Payer: Wellcare Medicare Advantage	$281.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,601.46
Rate for Payer: Wellpoint Medicaid Managed Care	$110.44

E.R. EQUIPMENT RE-LOCATION

Facility

$3,076.25

Hospital Charge Code	270659142
Hospital Revenue Code	278
Min. Negotiated Rate	$461.44
Max. Negotiated Rate	$744.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$615.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$676.77
Rate for Payer: Qualcare PPO/HMO/WC	$461.44

E.R. EQUIPMENT RE-LOCATION

Facility

$3,076.25

Hospital Charge Code	270659142
Hospital Revenue Code	278
Min. Negotiated Rate	$74.14
Max. Negotiated Rate	$1,538.12
Rate for Payer: Aetna Commercial	$1,168.97
Rate for Payer: Aetna Medicare Advantage	$922.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$784.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$784.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$615.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$784.44
Rate for Payer: Cigna Commercial	$1,538.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$676.77
Rate for Payer: Qualcare PPO/HMO/WC	$461.44
Rate for Payer: UnitedHealthcare Community & State	$74.14
Rate for Payer: Wellpoint Medicaid Managed Care	$81.52

ER ESCHAROTOMY INITIAL

Facility

$843.05

Service Code	HCPCS 16035
Hospital Charge Code	5700721
Hospital Revenue Code	450
Min. Negotiated Rate	$126.46
Max. Negotiated Rate	$126.46
Rate for Payer: Qualcare PPO/HMO/WC	$126.46

ER ESCHAROTOMY INITIAL

Facility

$843.05

Service Code	HCPCS 16035
Hospital Charge Code	5700721
Hospital Revenue Code	450
Min. Negotiated Rate	$22.34
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.46
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$22.34

ER-EVAC SUBUNG HEMATO-BIL

Facility

$214.00

Hospital Charge Code	5790270
Hospital Revenue Code	450
Min. Negotiated Rate	$32.10
Max. Negotiated Rate	$32.10
Rate for Payer: Qualcare PPO/HMO/WC	$32.10

Know your out-of-pocket cost for care.

All Charges