Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ERROR

Facility

$8,625.00

Hospital Charge Code	270632237C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,897.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

ERROR

Facility

$485.90

Hospital Charge Code	27065737
Hospital Revenue Code	271
Min. Negotiated Rate	$11.71
Max. Negotiated Rate	$242.95
Rate for Payer: Aetna Commercial	$184.64
Rate for Payer: Aetna Medicare Advantage	$145.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.90
Rate for Payer: Cigna Commercial	$242.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.77
Rate for Payer: Oxford Commercial	$97.18
Rate for Payer: Qualcare PPO/HMO/WC	$72.89
Rate for Payer: UnitedHealthcare Commercial	$97.18
Rate for Payer: UnitedHealthcare Community & State	$11.71
Rate for Payer: Wellpoint Medicaid Managed Care	$12.88

ERROR

Facility

$485.90

Hospital Charge Code	27065737
Hospital Revenue Code	271
Min. Negotiated Rate	$72.89
Max. Negotiated Rate	$72.89
Rate for Payer: Qualcare PPO/HMO/WC	$72.89

ERROR CAN USE

Facility

$6,864.00

Hospital Charge Code	270647450
Hospital Revenue Code	278
Min. Negotiated Rate	$165.42
Max. Negotiated Rate	$3,432.00
Rate for Payer: Aetna Commercial	$2,608.32
Rate for Payer: Aetna Medicare Advantage	$2,059.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,750.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,750.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,372.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,750.32
Rate for Payer: Cigna Commercial	$3,432.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,661.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,510.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.60
Rate for Payer: UnitedHealthcare Community & State	$165.42
Rate for Payer: Wellpoint Medicaid Managed Care	$181.90

ERROR CAN USE

Facility

$6,864.00

Hospital Charge Code	270647450
Hospital Revenue Code	278
Min. Negotiated Rate	$1,029.60
Max. Negotiated Rate	$1,661.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,372.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,661.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,510.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.60

ERROR MAY USE

Facility

$255.00

Hospital Charge Code	270643964
Hospital Revenue Code	272
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$96.90
Rate for Payer: Aetna Medicare Advantage	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.03
Rate for Payer: Cigna Commercial	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.50
Rate for Payer: Oxford Commercial	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.25
Rate for Payer: UnitedHealthcare Commercial	$51.00
Rate for Payer: UnitedHealthcare Community & State	$6.15
Rate for Payer: Wellpoint Medicaid Managed Care	$6.76

ERROR MAY USE

Facility

$255.00

Hospital Charge Code	270643964
Hospital Revenue Code	272
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$38.25
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

ER-RPR BLD VSL LOW EXT-BI

Facility

$2,433.00

Hospital Charge Code	5790825
Hospital Revenue Code	450
Min. Negotiated Rate	$64.47
Max. Negotiated Rate	$1,216.50
Rate for Payer: Aetna Commercial	$924.54
Rate for Payer: Aetna Medicare Advantage	$729.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$620.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$620.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$620.41
Rate for Payer: Cigna Commercial	$1,216.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$729.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$364.95
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$64.47

ER-RPR BLD VSL LOW EXT-BI

Facility

$2,433.00

Hospital Charge Code	5790825
Hospital Revenue Code	450
Min. Negotiated Rate	$364.95
Max. Negotiated Rate	$364.95
Rate for Payer: Qualcare PPO/HMO/WC	$364.95

ER SALEM SUMP INSERTION****

Facility

$151.00

Hospital Charge Code	8004038
Hospital Revenue Code	272
Min. Negotiated Rate	$22.65
Max. Negotiated Rate	$22.65
Rate for Payer: Qualcare PPO/HMO/WC	$22.65

ER SALEM SUMP INSERTION****

Facility

$151.00

Hospital Charge Code	8004038
Hospital Revenue Code	272
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$75.50
Rate for Payer: Aetna Commercial	$57.38
Rate for Payer: Aetna Medicare Advantage	$45.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.51
Rate for Payer: Cigna Commercial	$75.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.30
Rate for Payer: Oxford Commercial	$30.20
Rate for Payer: Qualcare PPO/HMO/WC	$22.65
Rate for Payer: UnitedHealthcare Commercial	$30.20
Rate for Payer: UnitedHealthcare Community & State	$3.64
Rate for Payer: Wellpoint Medicaid Managed Care	$4.00

ER-SCAPULA FRACTURE-BILAT

Facility

$612.00

Hospital Charge Code	5790340
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-SCAPULA FRACTURE-BILAT

Facility

$612.00

Hospital Charge Code	5790340
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 SEDATION 1 MD <5 YR - 30MIN

Facility

$448.75

Service Code	HCPCS 99143
Hospital Charge Code	5700813
Hospital Revenue Code	370
Min. Negotiated Rate	$67.31
Max. Negotiated Rate	$67.31
Rate for Payer: Qualcare PPO/HMO/WC	$67.31

ER SEDATION 1 MD <5 YR - 30MIN

Facility

$448.75

Service Code	HCPCS 99143
Hospital Charge Code	5700813
Hospital Revenue Code	370
Min. Negotiated Rate	$10.81
Max. Negotiated Rate	$224.38
Rate for Payer: Aetna Commercial	$170.53
Rate for Payer: Aetna Medicare Advantage	$134.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.43
Rate for Payer: Cigna Commercial	$224.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.62
Rate for Payer: Oxford Commercial	$89.75
Rate for Payer: Qualcare PPO/HMO/WC	$67.31
Rate for Payer: UnitedHealthcare Commercial	$89.75
Rate for Payer: UnitedHealthcare Community & State	$10.81
Rate for Payer: Wellpoint Medicaid Managed Care	$11.89

ER SEDATION 1 MD >5YRS - 30MIN

Facility

$432.95

Service Code	HCPCS 99144
Hospital Charge Code	5700814
Hospital Revenue Code	370
Min. Negotiated Rate	$10.43
Max. Negotiated Rate	$216.47
Rate for Payer: Aetna Commercial	$164.52
Rate for Payer: Aetna Medicare Advantage	$129.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.40
Rate for Payer: Cigna Commercial	$216.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.88
Rate for Payer: Oxford Commercial	$86.59
Rate for Payer: Qualcare PPO/HMO/WC	$64.94
Rate for Payer: UnitedHealthcare Commercial	$86.59
Rate for Payer: UnitedHealthcare Community & State	$10.43
Rate for Payer: Wellpoint Medicaid Managed Care	$11.47

ER SEDATION 1 MD >5YRS - 30MIN

Facility

$432.95

Service Code	HCPCS 99144
Hospital Charge Code	5700814
Hospital Revenue Code	370
Min. Negotiated Rate	$64.94
Max. Negotiated Rate	$64.94
Rate for Payer: Qualcare PPO/HMO/WC	$64.94

ER SEDATION 1 MD EACH ADD 15M

Facility

$184.30

Service Code	HCPCS 99145
Hospital Charge Code	5700815
Hospital Revenue Code	370
Min. Negotiated Rate	$27.64
Max. Negotiated Rate	$27.64
Rate for Payer: Qualcare PPO/HMO/WC	$27.64

ER SEDATION 1 MD EACH ADD 15M

Facility

$184.30

Service Code	HCPCS 99145
Hospital Charge Code	5700815
Hospital Revenue Code	370
Min. Negotiated Rate	$4.44
Max. Negotiated Rate	$92.15
Rate for Payer: Aetna Commercial	$70.03
Rate for Payer: Aetna Medicare Advantage	$55.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.00
Rate for Payer: Cigna Commercial	$92.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.29
Rate for Payer: Oxford Commercial	$36.86
Rate for Payer: Qualcare PPO/HMO/WC	$27.64
Rate for Payer: UnitedHealthcare Commercial	$36.86
Rate for Payer: UnitedHealthcare Community & State	$4.44
Rate for Payer: Wellpoint Medicaid Managed Care	$4.88

ER SEDATION 2 MD <5 YR - 30MIN

Facility

$371.25

Service Code	HCPCS 99148
Hospital Charge Code	5700816
Hospital Revenue Code	370
Min. Negotiated Rate	$8.95
Max. Negotiated Rate	$185.62
Rate for Payer: Aetna Commercial	$141.07
Rate for Payer: Aetna Medicare Advantage	$111.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.67
Rate for Payer: Cigna Commercial	$185.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.38
Rate for Payer: Oxford Commercial	$74.25
Rate for Payer: Qualcare PPO/HMO/WC	$55.69
Rate for Payer: UnitedHealthcare Commercial	$74.25
Rate for Payer: UnitedHealthcare Community & State	$8.95
Rate for Payer: Wellpoint Medicaid Managed Care	$9.84

ER SEDATION 2 MD <5 YR - 30MIN

Facility

$371.25

Service Code	HCPCS 99148
Hospital Charge Code	5700816
Hospital Revenue Code	370
Min. Negotiated Rate	$55.69
Max. Negotiated Rate	$55.69
Rate for Payer: Qualcare PPO/HMO/WC	$55.69

ER SEDATION 2 MD > 5YRS - 30MI

Facility

$453.75

Service Code	HCPCS 99149
Hospital Charge Code	5700817
Hospital Revenue Code	370
Min. Negotiated Rate	$68.06
Max. Negotiated Rate	$68.06
Rate for Payer: Qualcare PPO/HMO/WC	$68.06

ER SEDATION 2 MD > 5YRS - 30MI

Facility

$453.75

Service Code	HCPCS 99149
Hospital Charge Code	5700817
Hospital Revenue Code	370
Min. Negotiated Rate	$10.94
Max. Negotiated Rate	$226.88
Rate for Payer: Aetna Commercial	$172.43
Rate for Payer: Aetna Medicare Advantage	$136.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.71
Rate for Payer: Cigna Commercial	$226.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.12
Rate for Payer: Oxford Commercial	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$68.06
Rate for Payer: UnitedHealthcare Commercial	$90.75
Rate for Payer: UnitedHealthcare Community & State	$10.94
Rate for Payer: Wellpoint Medicaid Managed Care	$12.02

ER SEDATION 2 MDS ECH ADD 15M

Facility

$198.75

Service Code	HCPCS 99150
Hospital Charge Code	5700818
Hospital Revenue Code	370
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$99.38
Rate for Payer: Aetna Commercial	$75.53
Rate for Payer: Aetna Medicare Advantage	$59.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.68
Rate for Payer: Cigna Commercial	$99.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.62
Rate for Payer: Oxford Commercial	$39.75
Rate for Payer: Qualcare PPO/HMO/WC	$29.81
Rate for Payer: UnitedHealthcare Commercial	$39.75
Rate for Payer: UnitedHealthcare Community & State	$4.79
Rate for Payer: Wellpoint Medicaid Managed Care	$5.27

ER SEDATION 2 MDS ECH ADD 15M

Facility

$198.75

Service Code	HCPCS 99150
Hospital Charge Code	5700818
Hospital Revenue Code	370
Min. Negotiated Rate	$29.81
Max. Negotiated Rate	$29.81
Rate for Payer: Qualcare PPO/HMO/WC	$29.81

Know your out-of-pocket cost for care.

All Charges