Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ER-IP FINGER DISLOCAT-BIL

Facility

$612.00

Hospital Charge Code	5790540
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-IRRIGATION,BLADDER COMPLIC

Facility

$511.00

Service Code	HCPCS 51703
Hospital Charge Code	5770030
Hospital Revenue Code	450
Min. Negotiated Rate	$76.65
Max. Negotiated Rate	$76.65
Rate for Payer: Qualcare PPO/HMO/WC	$76.65

ER-IRRIGATION,BLADDER COMPLIC

Facility

$511.00

Service Code	HCPCS 51703
Hospital Charge Code	5770030
Hospital Revenue Code	450
Min. Negotiated Rate	$13.54
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$415.81
Rate for Payer: Aetna Medicare Advantage	$495.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$551.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$551.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$152.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$551.81
Rate for Payer: Cigna Commercial	$306.43
Rate for Payer: Cigna Medicare Advantage	$152.87
Rate for Payer: Clover Medicare Advantage	$145.23
Rate for Payer: EmblemHealth Commercial	$458.61
Rate for Payer: Humana Medicare Advantage	$157.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$152.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$76.65
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$152.87
Rate for Payer: Wellcare Medicare Advantage	$152.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$459.87
Rate for Payer: Wellpoint Medicaid Managed Care	$13.54

ER IV NEEDLE PLACE INTRACATH

Facility

$621.65

Service Code	HCPCS 36000
Hospital Charge Code	5700630
Hospital Revenue Code	450
Min. Negotiated Rate	$93.25
Max. Negotiated Rate	$93.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.25

ER IV NEEDLE PLACE INTRACATH

Facility

$621.65

Service Code	HCPCS 36000
Hospital Charge Code	5700630
Hospital Revenue Code	450
Min. Negotiated Rate	$16.47
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$236.23
Rate for Payer: Aetna Medicare Advantage	$186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.52
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	$158.52
Rate for Payer: Cigna Commercial	$310.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.25
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$16.47

ER IVPB PUMP SETUP PROCEDURE**

Facility

$59.00

Hospital Charge Code	8004103
Hospital Revenue Code	272
Min. Negotiated Rate	$8.85
Max. Negotiated Rate	$8.85
Rate for Payer: Qualcare PPO/HMO/WC	$8.85

ER IVPB PUMP SETUP PROCEDURE**

Facility

$59.00

Hospital Charge Code	8004103
Hospital Revenue Code	272
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$29.50
Rate for Payer: Aetna Commercial	$22.42
Rate for Payer: Aetna Medicare Advantage	$17.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.04
Rate for Payer: Cigna Commercial	$29.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.70
Rate for Payer: Oxford Commercial	$11.80
Rate for Payer: Qualcare PPO/HMO/WC	$8.85
Rate for Payer: UnitedHealthcare Commercial	$11.80
Rate for Payer: UnitedHealthcare Community & State	$1.42
Rate for Payer: Wellpoint Medicaid Managed Care	$1.56

ER IVPB SETUP PROCEDURE

Facility

$52.00

Hospital Charge Code	8004095
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

ER IVPB SETUP PROCEDURE

Facility

$52.00

Hospital Charge Code	8004095
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

ER IV REG SETUP PROCEDURE***

Facility

$57.00

Hospital Charge Code	8004087
Hospital Revenue Code	272
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$8.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.55

ER IV REG SETUP PROCEDURE***

Facility

$57.00

Hospital Charge Code	8004087
Hospital Revenue Code	272
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$28.50
Rate for Payer: Aetna Commercial	$21.66
Rate for Payer: Aetna Medicare Advantage	$17.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.54
Rate for Payer: Cigna Commercial	$28.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.10
Rate for Payer: Oxford Commercial	$11.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.55
Rate for Payer: UnitedHealthcare Commercial	$11.40
Rate for Payer: UnitedHealthcare Community & State	$1.37
Rate for Payer: Wellpoint Medicaid Managed Care	$1.51

ER JAW RESET DISLOCATION

Facility

$744.46

Service Code	HCPCS 21480
Hospital Charge Code	5700452
Hospital Revenue Code	450
Min. Negotiated Rate	$111.67
Max. Negotiated Rate	$111.67
Rate for Payer: Qualcare PPO/HMO/WC	$111.67

ER JAW RESET DISLOCATION

Facility

$744.46

Service Code	HCPCS 21480
Hospital Charge Code	5700452
Hospital Revenue Code	450
Min. Negotiated Rate	$19.73
Max. Negotiated Rate	$1,057.82
Rate for Payer: Aetna Commercial	$797.10
Rate for Payer: Aetna Medicare Advantage	$949.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,057.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,057.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$293.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,057.82
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: Cigna Medicare Advantage	$293.05
Rate for Payer: Clover Medicare Advantage	$278.40
Rate for Payer: EmblemHealth Commercial	$879.15
Rate for Payer: Humana Medicare Advantage	$301.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$293.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.67
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$19.73

ER-KNEECAP DISL W/ANES-BI

Facility

$3,955.00

Hospital Charge Code	5790580
Hospital Revenue Code	450
Min. Negotiated Rate	$593.25
Max. Negotiated Rate	$593.25
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

ER-KNEECAP DISL W/ANES-BI

Facility

$3,955.00

Hospital Charge Code	5790580
Hospital Revenue Code	450
Min. Negotiated Rate	$104.81
Max. Negotiated Rate	$1,977.50
Rate for Payer: Aetna Commercial	$1,502.90
Rate for Payer: Aetna Medicare Advantage	$1,186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.52
Rate for Payer: Cigna Commercial	$1,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,186.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$593.25
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$104.81

ER-KNEECAP DISL W/ANES-RT

Facility

$3,955.00

Hospital Charge Code	5791595
Hospital Revenue Code	450
Min. Negotiated Rate	$104.81
Max. Negotiated Rate	$1,977.50
Rate for Payer: Aetna Commercial	$1,502.90
Rate for Payer: Aetna Medicare Advantage	$1,186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.52
Rate for Payer: Cigna Commercial	$1,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,186.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$593.25
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$104.81

ER-KNEECAP DISL W/ANES-RT

Facility

$3,955.00

Hospital Charge Code	5791595
Hospital Revenue Code	450
Min. Negotiated Rate	$593.25
Max. Negotiated Rate	$593.25
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

ER-LACER RPR MOUTH<=2.5CM

Facility

$546.00

Service Code	HCPCS 40830
Hospital Charge Code	5790125
Hospital Revenue Code	450
Min. Negotiated Rate	$81.90
Max. Negotiated Rate	$81.90
Rate for Payer: Qualcare PPO/HMO/WC	$81.90

ER-LACER RPR MOUTH<=2.5CM

Facility

$546.00

Service Code	HCPCS 40830
Hospital Charge Code	5790125
Hospital Revenue Code	450
Min. Negotiated Rate	$14.47
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	$48.79
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	$163.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.90
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	$14.47

ER LARYNGO DIRECT FOR ASPIRATI

Facility

$5,418.75

Service Code	HCPCS 31515
Hospital Charge Code	5700622
Hospital Revenue Code	450
Min. Negotiated Rate	$812.81
Max. Negotiated Rate	$812.81
Rate for Payer: Qualcare PPO/HMO/WC	$812.81

ER LARYNGO DIRECT FOR ASPIRATI

Facility

$5,418.75

Service Code	HCPCS 31515
Hospital Charge Code	5700622
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$1,677.28
Rate for Payer: Aetna Commercial	$1,263.88
Rate for Payer: Aetna Medicare Advantage	$1,505.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,677.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,677.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$464.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,677.28
Rate for Payer: Cigna Commercial	$931.42
Rate for Payer: Cigna Medicare Advantage	$464.66
Rate for Payer: Clover Medicare Advantage	$441.43
Rate for Payer: EmblemHealth Commercial	$1,393.98
Rate for Payer: Humana Medicare Advantage	$478.60
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$464.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,625.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$812.81
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$464.66
Rate for Payer: Wellcare Medicare Advantage	$464.66
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,309.48
Rate for Payer: Wellpoint Medicaid Managed Care	$143.60

ER LARYNGO INDIRECT REMOVAL FB

Facility

$513.75

Service Code	HCPCS 31511
Hospital Charge Code	5700621
Hospital Revenue Code	450
Min. Negotiated Rate	$77.06
Max. Negotiated Rate	$77.06
Rate for Payer: Qualcare PPO/HMO/WC	$77.06

ER LARYNGO INDIRECT REMOVAL FB

Facility

$513.75

Service Code	HCPCS 31511
Hospital Charge Code	5700621
Hospital Revenue Code	450
Min. Negotiated Rate	$13.61
Max. Negotiated Rate	$856.00
Rate for Payer: Aetna Commercial	$645.02
Rate for Payer: Aetna Medicare Advantage	$768.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$237.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$856.00
Rate for Payer: Cigna Commercial	$475.34
Rate for Payer: Cigna Medicare Advantage	$237.14
Rate for Payer: Clover Medicare Advantage	$225.28
Rate for Payer: EmblemHealth Commercial	$711.42
Rate for Payer: Humana Medicare Advantage	$244.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$237.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$77.06
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$237.14
Rate for Payer: Wellcare Medicare Advantage	$237.14
Rate for Payer: Wellpoint Medicaid Managed Care	$13.61

ER LARYNGOSCOPY DIAGNOSTC FLEX

Facility

$769.35

Service Code	HCPCS 31575
Hospital Charge Code	5700825
Hospital Revenue Code	450
Min. Negotiated Rate	$20.39
Max. Negotiated Rate	$856.00
Rate for Payer: Aetna Commercial	$645.02
Rate for Payer: Aetna Medicare Advantage	$768.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$237.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$856.00
Rate for Payer: Cigna Commercial	$475.34
Rate for Payer: Cigna Medicare Advantage	$237.14
Rate for Payer: Clover Medicare Advantage	$225.28
Rate for Payer: EmblemHealth Commercial	$711.42
Rate for Payer: Humana Medicare Advantage	$244.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$237.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$115.40
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$237.14
Rate for Payer: Wellcare Medicare Advantage	$237.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$528.97
Rate for Payer: Wellpoint Medicaid Managed Care	$20.39

ER LARYNGOSCOPY DIAGNOSTC FLEX

Facility

$769.35

Service Code	HCPCS 31575
Hospital Charge Code	5700825
Hospital Revenue Code	450
Min. Negotiated Rate	$115.40
Max. Negotiated Rate	$115.40
Rate for Payer: Qualcare PPO/HMO/WC	$115.40

Know your out-of-pocket cost for care.

All Charges