Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

EXTRACTRSTRIPSCREW4MMSINGLEUSE

Facility

$1,700.00

Hospital Charge Code	270695332
Hospital Revenue Code	272
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$255.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00

EXTRAOCULAR PROCEDURES EXCEPT ORBIT

Facility

$51,744.61

Service Code	MSDRG 115
Min. Negotiated Rate	$15,755.57
Max. Negotiated Rate	$51,744.61
Rate for Payer: Aetna Commercial	$35,811.77
Rate for Payer: Aetna Medicare Advantage	$51,744.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36,287.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36,287.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,584.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36,287.16
Rate for Payer: Cigna Commercial	$28,724.12
Rate for Payer: Cigna Medicare Advantage	$16,584.81
Rate for Payer: Clover Medicare Advantage	$15,755.57
Rate for Payer: EmblemHealth Commercial	$49,754.43
Rate for Payer: Humana Medicare Advantage	$17,082.35
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,584.81
Rate for Payer: Oxford Commercial	$20,644.40
Rate for Payer: UnitedHealthcare Commercial	$36,200.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,584.81
Rate for Payer: Wellcare Medicare Advantage	$16,584.81

EXTRCTR PRO RPD 15-18M00547020

Facility

$742.00

Hospital Charge Code	270646921
Hospital Revenue Code	272
Min. Negotiated Rate	$111.30
Max. Negotiated Rate	$111.30
Rate for Payer: Qualcare PPO/HMO/WC	$111.30

EXTRCTR PRO RPD 15-18M00547020

Facility

$742.00

Hospital Charge Code	270646921
Hospital Revenue Code	272
Min. Negotiated Rate	$17.88
Max. Negotiated Rate	$371.00
Rate for Payer: Aetna Commercial	$281.96
Rate for Payer: Aetna Medicare Advantage	$222.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.21
Rate for Payer: Cigna Commercial	$371.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.60
Rate for Payer: Oxford Commercial	$148.40
Rate for Payer: Qualcare PPO/HMO/WC	$111.30
Rate for Payer: UnitedHealthcare Commercial	$148.40
Rate for Payer: UnitedHealthcare Community & State	$17.88
Rate for Payer: Wellpoint Medicaid Managed Care	$19.66

EXTREM ANGIO-BILAT

Facility

$21,359.77

Hospital Charge Code	2009065
Hospital Revenue Code	323
Min. Negotiated Rate	$514.77
Max. Negotiated Rate	$10,679.89
Rate for Payer: Aetna Commercial	$8,116.71
Rate for Payer: Aetna Medicare Advantage	$6,407.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,446.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,446.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,446.74
Rate for Payer: Cigna Commercial	$10,679.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,407.93
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$514.77
Rate for Payer: Wellpoint Medicaid Managed Care	$566.03

EXTREM ANGIO-BILAT

Facility

$21,359.77

Hospital Charge Code	2009065
Hospital Revenue Code	323
Min. Negotiated Rate	$3,203.97
Max. Negotiated Rate	$3,203.97
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97

EXTREM ARTERIO-UNILAT

Facility

$6,122.00

Hospital Charge Code	2009055
Hospital Revenue Code	323
Min. Negotiated Rate	$918.30
Max. Negotiated Rate	$918.30
Rate for Payer: Qualcare PPO/HMO/WC	$918.30

EXTREM ARTERIO-UNILAT

Facility

$6,122.00

Hospital Charge Code	2009055
Hospital Revenue Code	323
Min. Negotiated Rate	$147.54
Max. Negotiated Rate	$3,061.00
Rate for Payer: Aetna Commercial	$2,326.36
Rate for Payer: Aetna Medicare Advantage	$1,836.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,561.11
Rate for Payer: Cigna Commercial	$3,061.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.60
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$918.30
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$147.54
Rate for Payer: Wellpoint Medicaid Managed Care	$162.23

EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE

Facility

$194,237.82

Service Code	MSDRG 790
Min. Negotiated Rate	$4,037.00
Max. Negotiated Rate	$194,237.82
Rate for Payer: Aetna Commercial	$133,720.85
Rate for Payer: Aetna Medicare Advantage	$194,237.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139,566.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139,566.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$62,255.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139,566.00
Rate for Payer: Cigna Commercial	$111,226.66
Rate for Payer: Cigna Medicare Advantage	$62,255.71
Rate for Payer: Clover Medicare Advantage	$59,142.92
Rate for Payer: EmblemHealth Commercial	$186,767.13
Rate for Payer: Humana Medicare Advantage	$64,123.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$62,255.71
Rate for Payer: Oxford Commercial	$4,037.00
Rate for Payer: UnitedHealthcare Commercial	$7,078.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$62,255.71
Rate for Payer: Wellcare Medicare Advantage	$62,255.71

EXTREMITY ANGIOGRAM-BILAT

Facility

$21,359.77

Service Code	HCPCS 75716
Hospital Charge Code	7411149
Hospital Revenue Code	323
Min. Negotiated Rate	$243.94
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$2,625.82
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,407.93
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$514.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$566.03

EXTREMITY ANGIOGRAM-BILAT

Facility

$21,359.77

Service Code	HCPCS 75716
Hospital Charge Code	7411149
Hospital Revenue Code	323
Min. Negotiated Rate	$3,203.97
Max. Negotiated Rate	$3,203.97
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97

EXTREMITY ANGIO-LT

Facility

$6,122.00

Service Code	HCPCS 75710LT
Hospital Charge Code	7412002
Hospital Revenue Code	323
Min. Negotiated Rate	$918.30
Max. Negotiated Rate	$918.30
Rate for Payer: Qualcare PPO/HMO/WC	$918.30

EXTREMITY ANGIO-LT

Facility

$15,468.50

Service Code	HCPCS 75710LT
Hospital Charge Code	2691865
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

EXTREMITY ANGIO-LT

Facility

$15,468.50

Service Code	HCPCS 75710LT
Hospital Charge Code	2691865
Hospital Revenue Code	323
Min. Negotiated Rate	$372.79
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$5,878.03
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.55
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$372.79
Rate for Payer: Wellpoint Medicaid Managed Care	$409.92

EXTREMITY ANGIO-LT

Facility

$6,122.00

Service Code	HCPCS 75710LT
Hospital Charge Code	7412002
Hospital Revenue Code	323
Min. Negotiated Rate	$147.54
Max. Negotiated Rate	$3,061.00
Rate for Payer: Aetna Commercial	$2,326.36
Rate for Payer: Aetna Medicare Advantage	$1,836.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,561.11
Rate for Payer: Cigna Commercial	$3,061.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.60
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$918.30
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$147.54
Rate for Payer: Wellpoint Medicaid Managed Care	$162.23

EXTREMITY ANGIO-LT

Facility

$15,468.50

Service Code	HCPCS 75710LT
Hospital Charge Code	321075710L
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

EXTREMITY ANGIO-LT

Facility

$15,468.50

Service Code	HCPCS 75710LT
Hospital Charge Code	321075710L
Hospital Revenue Code	323
Min. Negotiated Rate	$372.79
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$5,878.03
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.55
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$372.79
Rate for Payer: Wellpoint Medicaid Managed Care	$409.92

EXTREMITY ANGIO-LT

Facility

$15,468.50

Service Code	HCPCS 75710LT
Hospital Charge Code	366875710L
Hospital Revenue Code	323
Min. Negotiated Rate	$372.79
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$5,878.03
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.55
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$372.79
Rate for Payer: Wellpoint Medicaid Managed Care	$409.92

EXTREMITY ANGIO-LT

Facility

$15,468.50

Service Code	HCPCS 75710LT
Hospital Charge Code	366875710L
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

EXTREMITY ANGIO-LT

Facility

$15,468.50

Service Code	HCPCS 75710LT
Hospital Charge Code	411075710L
Hospital Revenue Code	323
Min. Negotiated Rate	$372.79
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$5,878.03
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.55
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$372.79
Rate for Payer: Wellpoint Medicaid Managed Care	$409.92

EXTREMITY ANGIO-LT

Facility

$15,468.50

Service Code	HCPCS 75710LT
Hospital Charge Code	411075710L
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

EXTREMITY ANGIO-RT

Facility

$15,468.50

Service Code	HCPCS 75710RT
Hospital Charge Code	321075710R
Hospital Revenue Code	323
Min. Negotiated Rate	$372.79
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$5,878.03
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.55
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$372.79
Rate for Payer: Wellpoint Medicaid Managed Care	$409.92

EXTREMITY ANGIO-RT

Facility

$15,468.50

Service Code	HCPCS 75710RT
Hospital Charge Code	321075710R
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

EXTREMITY ANGIO-RT

Facility

$15,468.50

Service Code	HCPCS 75710RT
Hospital Charge Code	366875710R
Hospital Revenue Code	323
Min. Negotiated Rate	$372.79
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$5,878.03
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.55
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$372.79
Rate for Payer: Wellpoint Medicaid Managed Care	$409.92

EXTREMITY ANGIO-RT

Facility

$15,468.50

Service Code	HCPCS 75710RT
Hospital Charge Code	2691870
Hospital Revenue Code	323
Min. Negotiated Rate	$372.79
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$5,878.03
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.55
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$372.79
Rate for Payer: Wellpoint Medicaid Managed Care	$409.92

Know your out-of-pocket cost for care.

All Charges