Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

EVASC RPR A-AO NDGFT RPT

Facility

$13,570.00

Service Code	HCPCS 34702
Hospital Charge Code	2004952
Hospital Revenue Code	361
Min. Negotiated Rate	$327.04
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,156.60
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,460.35
Rate for Payer: Cigna Commercial	$6,785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,071.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$327.04
Rate for Payer: Wellpoint Medicaid Managed Care	$359.61

EVASC RPR A-AO NDGFT RPT

Facility

$13,570.00

Service Code	HCPCS 34702
Hospital Charge Code	2004952
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR A-AO NDGFT RPT

Facility

$13,570.00

Service Code	HCPCS 34702
Hospital Charge Code	321034702
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR A-AO NDGFT RPT

Facility

$13,570.00

Service Code	HCPCS 34702
Hospital Charge Code	321034702
Hospital Revenue Code	361
Min. Negotiated Rate	$327.04
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,156.60
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,460.35
Rate for Payer: Cigna Commercial	$6,785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,071.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$327.04
Rate for Payer: Wellpoint Medicaid Managed Care	$359.61

EVASC RPR A-BIILIAC RPT

Facility

$13,570.00

Service Code	HCPCS 34706
Hospital Charge Code	2004956
Hospital Revenue Code	361
Min. Negotiated Rate	$327.04
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,156.60
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,460.35
Rate for Payer: Cigna Commercial	$6,785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,071.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$327.04
Rate for Payer: Wellpoint Medicaid Managed Care	$359.61

EVASC RPR A-BIILIAC RPT

Facility

$13,570.00

Service Code	HCPCS 34706
Hospital Charge Code	2004956
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR A-BIILIAC RPT

Facility

$13,570.00

Service Code	HCPCS 34706
Hospital Charge Code	321034706
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR A-BIILIAC RPT

Facility

$13,570.00

Service Code	HCPCS 34706
Hospital Charge Code	321034706
Hospital Revenue Code	361
Min. Negotiated Rate	$327.04
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,156.60
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,460.35
Rate for Payer: Cigna Commercial	$6,785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,071.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$327.04
Rate for Payer: Wellpoint Medicaid Managed Care	$359.61

EVASC RPR A-UNILAC NDGFT

Facility

$13,570.00

Service Code	HCPCS 34703
Hospital Charge Code	2004953
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR A-UNILAC NDGFT

Facility

$13,570.00

Service Code	HCPCS 34703
Hospital Charge Code	321034703
Hospital Revenue Code	361
Min. Negotiated Rate	$327.04
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,156.60
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,460.35
Rate for Payer: Cigna Commercial	$6,785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,071.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$327.04
Rate for Payer: Wellpoint Medicaid Managed Care	$359.61

EVASC RPR A-UNILAC NDGFT

Facility

$13,570.00

Service Code	HCPCS 34703
Hospital Charge Code	2004953
Hospital Revenue Code	361
Min. Negotiated Rate	$327.04
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,156.60
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,460.35
Rate for Payer: Cigna Commercial	$6,785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,071.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$327.04
Rate for Payer: Wellpoint Medicaid Managed Care	$359.61

EVASC RPR A-UNILAC NDGFT

Facility

$13,570.00

Service Code	HCPCS 34703
Hospital Charge Code	321034703
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR A-UNILAC NDGFT RPT

Facility

$13,570.00

Service Code	HCPCS 34704
Hospital Charge Code	321034704
Hospital Revenue Code	361
Min. Negotiated Rate	$327.04
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,156.60
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,460.35
Rate for Payer: Cigna Commercial	$6,785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,071.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$327.04
Rate for Payer: Wellpoint Medicaid Managed Care	$359.61

EVASC RPR A-UNILAC NDGFT RPT

Facility

$13,570.00

Service Code	HCPCS 34704
Hospital Charge Code	2004954
Hospital Revenue Code	361
Min. Negotiated Rate	$327.04
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,156.60
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,460.35
Rate for Payer: Cigna Commercial	$6,785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,071.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$327.04
Rate for Payer: Wellpoint Medicaid Managed Care	$359.61

EVASC RPR A-UNILAC NDGFT RPT

Facility

$13,570.00

Service Code	HCPCS 34704
Hospital Charge Code	321034704
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR A-UNILAC NDGFT RPT

Facility

$13,570.00

Service Code	HCPCS 34704
Hospital Charge Code	2004954
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR ILIO-ILIAC NDGFT

Facility

$13,570.00

Service Code	HCPCS 34707
Hospital Charge Code	321034707
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR ILIO-ILIAC NDGFT

Facility

$13,570.00

Service Code	HCPCS 34707
Hospital Charge Code	2004957
Hospital Revenue Code	361
Min. Negotiated Rate	$327.04
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,156.60
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,460.35
Rate for Payer: Cigna Commercial	$6,785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,071.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$327.04
Rate for Payer: Wellpoint Medicaid Managed Care	$359.61

EVASC RPR ILIO-ILIAC NDGFT

Facility

$13,570.00

Service Code	HCPCS 34707
Hospital Charge Code	321034707
Hospital Revenue Code	361
Min. Negotiated Rate	$327.04
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,156.60
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,460.35
Rate for Payer: Cigna Commercial	$6,785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,071.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$327.04
Rate for Payer: Wellpoint Medicaid Managed Care	$359.61

EVASC RPR ILIO-ILIAC NDGFT

Facility

$13,570.00

Service Code	HCPCS 34707
Hospital Charge Code	2004957
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR ILIO-ILIAC RPT

Facility

$13,570.00

Service Code	HCPCS 34708
Hospital Charge Code	2004958
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR ILIO-ILIAC RPT

Facility

$13,570.00

Service Code	HCPCS 34708
Hospital Charge Code	321034708
Hospital Revenue Code	361
Min. Negotiated Rate	$2,035.50
Max. Negotiated Rate	$2,035.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50

EVASC RPR ILIO-ILIAC RPT

Facility

$13,570.00

Service Code	HCPCS 34708
Hospital Charge Code	321034708
Hospital Revenue Code	361
Min. Negotiated Rate	$327.04
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,156.60
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,460.35
Rate for Payer: Cigna Commercial	$6,785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,071.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$327.04
Rate for Payer: Wellpoint Medicaid Managed Care	$359.61

EVASC RPR ILIO-ILIAC RPT

Facility

$13,570.00

Service Code	HCPCS 34708
Hospital Charge Code	2004958
Hospital Revenue Code	361
Min. Negotiated Rate	$327.04
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,156.60
Rate for Payer: Aetna Medicare Advantage	$4,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,460.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,460.35
Rate for Payer: Cigna Commercial	$6,785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,071.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$327.04
Rate for Payer: Wellpoint Medicaid Managed Care	$359.61

EVASC VEN ARTLZ TIBL/PRNL VN

Facility

$98,874.75

Service Code	HCPCS 0620T
Hospital Charge Code	41100620T
Hospital Revenue Code	360
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$188,889.75
Rate for Payer: Aetna Commercial	$142,333.19
Rate for Payer: Aetna Medicare Advantage	$169,543.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188,889.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188,889.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$52,328.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188,889.75
Rate for Payer: Cigna Medicare Advantage	$52,328.38
Rate for Payer: Clover Medicare Advantage	$49,711.96
Rate for Payer: EmblemHealth Commercial	$156,985.14
Rate for Payer: Humana Medicare Advantage	$53,898.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$52,328.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29,662.42
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$14,831.21
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$2,382.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$52,328.38
Rate for Payer: Wellcare Medicare Advantage	$52,328.38
Rate for Payer: Wellpoint Medicaid Managed Care	$2,620.18

Know your out-of-pocket cost for care.

All Charges