Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ER MD VENIPUNCTR FEM/JUG <3YRS

Facility

$301.25

Service Code	HCPCS 36400
Hospital Charge Code	5700777
Hospital Revenue Code	450
Min. Negotiated Rate	$45.19
Max. Negotiated Rate	$45.19
Rate for Payer: Qualcare PPO/HMO/WC	$45.19

ER-METACARPAL FRACTUR-BIL

Facility

$612.00

Hospital Charge Code	5790480
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-METACARPAL FRACTUR-BIL

Facility

$612.00

Hospital Charge Code	5790480
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-METATARSAL FRACTUR-BIL

Facility

$612.00

Hospital Charge Code	5790635
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-METATARSAL FRACTUR-BIL

Facility

$612.00

Hospital Charge Code	5790635
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-MP FINGER DISLOCAT-BIL

Facility

$612.00

Hospital Charge Code	5790505
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-MP FINGER DISLOCAT-BIL

Facility

$612.00

Hospital Charge Code	5790505
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-MP TOE DISLOCATED-BI

Facility

$3,956.00

Hospital Charge Code	5790670
Hospital Revenue Code	450
Min. Negotiated Rate	$593.40
Max. Negotiated Rate	$593.40
Rate for Payer: Qualcare PPO/HMO/WC	$593.40

ER-MP TOE DISLOCATED-BI

Facility

$3,956.00

Hospital Charge Code	5790670
Hospital Revenue Code	450
Min. Negotiated Rate	$104.83
Max. Negotiated Rate	$1,978.00
Rate for Payer: Aetna Commercial	$1,503.28
Rate for Payer: Aetna Medicare Advantage	$1,186.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.78
Rate for Payer: Cigna Commercial	$1,978.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,186.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$593.40
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$104.83

ER-NAIL AVULSION-BILAT

Facility

$362.00

Hospital Charge Code	5790265
Hospital Revenue Code	450
Min. Negotiated Rate	$54.30
Max. Negotiated Rate	$54.30
Rate for Payer: Qualcare PPO/HMO/WC	$54.30

ER-NAIL AVULSION-BILAT

Facility

$362.00

Hospital Charge Code	5790265
Hospital Revenue Code	450
Min. Negotiated Rate	$9.59
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$137.56
Rate for Payer: Aetna Medicare Advantage	$108.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.31
Rate for Payer: Cigna Commercial	$181.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.30
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$9.59

ER NEEDLE ASPIRATION BLADDER

Facility

$1,104.55

Service Code	HCPCS 51100
Hospital Charge Code	5700796
Hospital Revenue Code	450
Min. Negotiated Rate	$165.68
Max. Negotiated Rate	$165.68
Rate for Payer: Qualcare PPO/HMO/WC	$165.68

ER NEEDLE ASPIRATION BLADDER

Facility

$1,104.55

Service Code	HCPCS 51100
Hospital Charge Code	5700796
Hospital Revenue Code	450
Min. Negotiated Rate	$29.27
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) 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	$331.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.68
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	$29.27

ER NEWBORN RESUSCITATION

Facility

$1,343.00

Service Code	HCPCS 99465
Hospital Charge Code	5700820
Hospital Revenue Code	450
Min. Negotiated Rate	$35.59
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) 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	$402.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$201.45
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	$35.59

ER NEWBORN RESUSCITATION

Facility

$1,343.00

Service Code	HCPCS 99465
Hospital Charge Code	5700820
Hospital Revenue Code	450
Min. Negotiated Rate	$201.45
Max. Negotiated Rate	$201.45
Rate for Payer: Qualcare PPO/HMO/WC	$201.45

ER-NG TUBE INSERTION

Facility

$523.78

Service Code	HCPCS 4375259
Hospital Charge Code	5770045
Hospital Revenue Code	450
Min. Negotiated Rate	$13.88
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$199.04
Rate for Payer: Aetna Medicare Advantage	$157.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.56
Rate for Payer: Cigna Commercial	$261.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.57
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$13.88

ER-NG TUBE INSERTION

Facility

$523.78

Service Code	HCPCS 4375259
Hospital Charge Code	5770045
Hospital Revenue Code	450
Min. Negotiated Rate	$78.57
Max. Negotiated Rate	$78.57
Rate for Payer: Qualcare PPO/HMO/WC	$78.57

ER OPEN DIS PHAL FINGER EACH

Facility

$15,508.45

Service Code	HCPCS 26765
Hospital Charge Code	5700672
Hospital Revenue Code	450
Min. Negotiated Rate	$2,326.27
Max. Negotiated Rate	$2,326.27
Rate for Payer: Qualcare PPO/HMO/WC	$2,326.27

ER OPEN DIS PHAL FINGER EACH

Facility

$15,508.45

Service Code	HCPCS 26765
Hospital Charge Code	5700672
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,652.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,326.27
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$410.97

ER OPEN RED OF THUMB IP SUBLX

Facility

$3,127.15

Service Code	HCPCS 26785
Hospital Charge Code	5700322
Hospital Revenue Code	450
Min. Negotiated Rate	$469.07
Max. Negotiated Rate	$469.07
Rate for Payer: Qualcare PPO/HMO/WC	$469.07

ER OPEN RED OF THUMB IP SUBLX

Facility

$3,127.15

Service Code	HCPCS 26785
Hospital Charge Code	5700322
Hospital Revenue Code	450
Min. Negotiated Rate	$82.87
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$938.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$469.07
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$82.87

ER OPEN TX FINGER EXT TENDON

Facility

$5,243.75

Service Code	HCPCS 26410
Hospital Charge Code	5700576
Hospital Revenue Code	450
Min. Negotiated Rate	$786.56
Max. Negotiated Rate	$786.56
Rate for Payer: Qualcare PPO/HMO/WC	$786.56

ER OPEN TX FINGER EXT TENDON

Facility

$5,243.75

Service Code	HCPCS 26410
Hospital Charge Code	5700576
Hospital Revenue Code	450
Min. Negotiated Rate	$138.96
Max. Negotiated Rate	$6,895.75
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$317.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$786.56
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$138.96

ER OPERATIVE UPER GI ENDOSCOPY

Facility

$3,673.00

Service Code	HCPCS 43247
Hospital Charge Code	5700830
Hospital Revenue Code	450
Min. Negotiated Rate	$550.95
Max. Negotiated Rate	$550.95
Rate for Payer: Qualcare PPO/HMO/WC	$550.95

ER OPERATIVE UPER GI ENDOSCOPY

Facility

$3,673.00

Service Code	HCPCS 43247
Hospital Charge Code	5700830
Hospital Revenue Code	450
Min. Negotiated Rate	$97.33
Max. Negotiated Rate	$3,889.52
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,889.52
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,101.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$550.95
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$97.33

Know your out-of-pocket cost for care.

All Charges