Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ER INSERTION BLADDER CATH-TEMP

Facility

$226.23

Service Code	HCPCS 51702
Hospital Charge Code	5700290
Hospital Revenue Code	450
Min. Negotiated Rate	$33.93
Max. Negotiated Rate	$33.93
Rate for Payer: Qualcare PPO/HMO/WC	$33.93

ER INSERTION BLADDER CATH-TEMP

Facility

$226.23

Service Code	HCPCS 51702
Hospital Charge Code	5700290
Hospital Revenue Code	450
Min. Negotiated Rate	$6.00
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	$77.67
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	$67.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.93
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	$6.00

ER INSERTION STRAIGHT CATH

Facility

$345.75

Service Code	HCPCS 51701
Hospital Charge Code	5700289
Hospital Revenue Code	450
Min. Negotiated Rate	$51.86
Max. Negotiated Rate	$51.86
Rate for Payer: Qualcare PPO/HMO/WC	$51.86

ER INSERTION STRAIGHT CATH

Facility

$345.75

Service Code	HCPCS 51701
Hospital Charge Code	5700289
Hospital Revenue Code	450
Min. Negotiated Rate	$9.16
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	$60.71
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	$103.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.86
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	$9.16

ER INSERTION SUPRAPUBIC CATHET

Facility

$10,952.70

Service Code	HCPCS 51102
Hospital Charge Code	5700798
Hospital Revenue Code	450
Min. Negotiated Rate	$1,642.90
Max. Negotiated Rate	$1,642.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,642.90

ER INSERTION SUPRAPUBIC CATHET

Facility

$10,952.70

Service Code	HCPCS 51102
Hospital Charge Code	5700798
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$8,964.44
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,964.44
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,285.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,642.90
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$290.25

ER-INSERT PIN SKL TRCT-BI

Facility

$5,352.00

Hospital Charge Code	5790310
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$2,676.00
Rate for Payer: Aetna Commercial	$2,033.76
Rate for Payer: Aetna Medicare Advantage	$1,605.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,364.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,364.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,364.76
Rate for Payer: Cigna Commercial	$2,676.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,605.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$802.80
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$141.83

ER-INSERT PIN SKL TRCT-BI

Facility

$5,352.00

Hospital Charge Code	5790310
Hospital Revenue Code	450
Min. Negotiated Rate	$802.80
Max. Negotiated Rate	$802.80
Rate for Payer: Qualcare PPO/HMO/WC	$802.80

ER INSERT PLEURAL CATH

Facility

$13,564.25

Service Code	HCPCS 32550
Hospital Charge Code	5700627
Hospital Revenue Code	450
Min. Negotiated Rate	$2,034.64
Max. Negotiated Rate	$2,034.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,034.64

ER INSERT PLEURAL CATH

Facility

$13,564.25

Service Code	HCPCS 32550
Hospital Charge Code	5700627
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,069.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,034.64
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$359.45

ER-INS TEMP PACEMAKR DUAL

Facility

$14,681.00

Service Code	HCPCS 33211
Hospital Charge Code	5790085
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$35,488.33
Rate for Payer: Aetna Commercial	$26,741.35
Rate for Payer: Aetna Medicare Advantage	$31,853.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,831.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$331.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,488.33
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: Cigna Medicare Advantage	$9,831.38
Rate for Payer: Clover Medicare Advantage	$9,339.81
Rate for Payer: EmblemHealth Commercial	$29,494.14
Rate for Payer: Humana Medicare Advantage	$10,126.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,831.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,404.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,202.15
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,831.38
Rate for Payer: Wellcare Medicare Advantage	$9,831.38
Rate for Payer: Wellpoint Medicaid Managed Care	$389.05

ER-INS TEMP PACEMAKR DUAL

Facility

$14,681.00

Service Code	HCPCS 33211
Hospital Charge Code	5790085
Hospital Revenue Code	450
Min. Negotiated Rate	$2,202.15
Max. Negotiated Rate	$2,202.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,202.15

ER INS THROMB HEMORRHOID EXT

Facility

$1,638.25

Service Code	HCPCS 46083
Hospital Charge Code	5700650
Hospital Revenue Code	450
Min. Negotiated Rate	$43.37
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	$43.37
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	$491.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$245.74
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	$43.41

ER INS THROMB HEMORRHOID EXT

Facility

$1,638.25

Service Code	HCPCS 46083
Hospital Charge Code	5700650
Hospital Revenue Code	450
Min. Negotiated Rate	$245.74
Max. Negotiated Rate	$245.74
Rate for Payer: Qualcare PPO/HMO/WC	$245.74

ER INTERMEDIATE - III

Facility

$13,269.54

Service Code	HCPCS 99283
Hospital Charge Code	5700083
Hospital Revenue Code	450
Min. Negotiated Rate	$1,990.43
Max. Negotiated Rate	$1,990.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,990.43

ER INTERMEDIATE - III

Facility

$13,269.54

Service Code	HCPCS 99283
Hospital Charge Code	5700083
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$2,627.00
Rate for Payer: Aetna Commercial	$882.10
Rate for Payer: Aetna Medicare Advantage	$1,050.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,170.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,170.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$324.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$283.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,170.63
Rate for Payer: Cigna Commercial	$650.06
Rate for Payer: Cigna Medicare Advantage	$324.30
Rate for Payer: Clover Medicare Advantage	$308.08
Rate for Payer: EmblemHealth Commercial	$972.90
Rate for Payer: Humana Medicare Advantage	$334.03
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$324.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$869.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Oxford Commercial	$1,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,990.43
Rate for Payer: UnitedHealthcare Commercial	$2,627.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$324.30
Rate for Payer: Wellcare Medicare Advantage	$324.30
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

ER INTERMEDIATE - III W/O MF

Facility

$8,252.70

Service Code	HCPCS 99283
Hospital Charge Code	5700082
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$2,627.00
Rate for Payer: Aetna Commercial	$882.10
Rate for Payer: Aetna Medicare Advantage	$1,050.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,170.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,170.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$324.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$283.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,170.63
Rate for Payer: Cigna Commercial	$650.06
Rate for Payer: Cigna Medicare Advantage	$324.30
Rate for Payer: Clover Medicare Advantage	$308.08
Rate for Payer: EmblemHealth Commercial	$972.90
Rate for Payer: Humana Medicare Advantage	$334.03
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$324.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$869.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Oxford Commercial	$1,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.90
Rate for Payer: UnitedHealthcare Commercial	$2,627.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$324.30
Rate for Payer: Wellcare Medicare Advantage	$324.30
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

ER INTERMEDIATE - III W/O MF

Facility

$8,252.70

Service Code	HCPCS 99283
Hospital Charge Code	5700082
Hospital Revenue Code	450
Min. Negotiated Rate	$1,237.90
Max. Negotiated Rate	$1,237.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.90

ER-INTERMEDIATE JOINT-BIL

Facility

$697.00

Hospital Charge Code	5790300
Hospital Revenue Code	450
Min. Negotiated Rate	$104.55
Max. Negotiated Rate	$104.55
Rate for Payer: Qualcare PPO/HMO/WC	$104.55

ER-INTERMEDIATE JOINT-BIL

Facility

$697.00

Hospital Charge Code	5790300
Hospital Revenue Code	450
Min. Negotiated Rate	$18.47
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$264.86
Rate for Payer: Aetna Medicare Advantage	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.74
Rate for Payer: Cigna Commercial	$348.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.55
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$18.47

ER INTERMEDIATE - PP III

Facility

$1,252.70

Service Code	HCPCS 9928325
Hospital Charge Code	5700224
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$476.03
Rate for Payer: Aetna Medicare Advantage	$375.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$319.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$319.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$319.44
Rate for Payer: Cigna Commercial	$626.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.91
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

ER INTERMEDIATE - PP III

Facility

$1,252.70

Service Code	HCPCS 9928325
Hospital Charge Code	5700224
Hospital Revenue Code	450
Min. Negotiated Rate	$187.91
Max. Negotiated Rate	$187.91
Rate for Payer: Qualcare PPO/HMO/WC	$187.91

ER INTERMEDIATE- PP III W/O MF

Facility

$1,252.70

Service Code	HCPCS 99283
Hospital Charge Code	5700223
Hospital Revenue Code	450
Min. Negotiated Rate	$187.91
Max. Negotiated Rate	$187.91
Rate for Payer: Qualcare PPO/HMO/WC	$187.91

ER INTERMEDIATE- PP III W/O MF

Facility

$1,252.70

Service Code	HCPCS 99283
Hospital Charge Code	5700223
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$2,627.00
Rate for Payer: Aetna Commercial	$882.10
Rate for Payer: Aetna Medicare Advantage	$1,050.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,170.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,170.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$324.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$283.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,170.63
Rate for Payer: Cigna Commercial	$650.06
Rate for Payer: Cigna Medicare Advantage	$324.30
Rate for Payer: Clover Medicare Advantage	$308.08
Rate for Payer: EmblemHealth Commercial	$972.90
Rate for Payer: Humana Medicare Advantage	$334.03
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$324.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$869.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Oxford Commercial	$1,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.91
Rate for Payer: UnitedHealthcare Commercial	$2,627.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$324.30
Rate for Payer: Wellcare Medicare Advantage	$324.30
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

ER-INTRA-AORTIC BALLOON CATH

Facility

$22,823.38

Service Code	HCPCS 33967
Hospital Charge Code	5780180
Hospital Revenue Code	361
Min. Negotiated Rate	$3,423.51
Max. Negotiated Rate	$3,423.51
Rate for Payer: Qualcare PPO/HMO/WC	$3,423.51

Know your out-of-pocket cost for care.

All Charges