Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FP EXC.SKIN&SUBC HIDRADENIT

Facility

$2,052.00

Service Code	HCPCS 11450
Hospital Charge Code	83652049
Hospital Revenue Code	761
Min. Negotiated Rate	$307.80
Max. Negotiated Rate	$307.80
Rate for Payer: Qualcare PPO/HMO/WC	$307.80

FP FB REMOVAL, EAR

Facility

$299.00

Service Code	HCPCS 69200
Hospital Charge Code	87502655
Hospital Revenue Code	761
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$570.55
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.70
Rate for Payer: Oxford Commercial	$59.80
Rate for Payer: Qualcare PPO/HMO/WC	$44.85
Rate for Payer: UnitedHealthcare Commercial	$59.80
Rate for Payer: UnitedHealthcare Community & State	$7.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$7.92

FP FB REMOVAL, EAR

Facility

$299.00

Service Code	HCPCS 69200
Hospital Charge Code	87502655
Hospital Revenue Code	761
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$44.85
Rate for Payer: Qualcare PPO/HMO/WC	$44.85

FP FB REMOVAL EYE EXTERNAL

Facility

$696.50

Service Code	HCPCS 65205
Hospital Charge Code	87502545
Hospital Revenue Code	761
Min. Negotiated Rate	$104.47
Max. Negotiated Rate	$104.47
Rate for Payer: Qualcare PPO/HMO/WC	$104.47

FP FB REMOVAL EYE EXTERNAL

Facility

$696.50

Service Code	HCPCS 65205
Hospital Charge Code	87502545
Hospital Revenue Code	761
Min. Negotiated Rate	$16.79
Max. Negotiated Rate	$570.55
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.95
Rate for Payer: Oxford Commercial	$139.30
Rate for Payer: Qualcare PPO/HMO/WC	$104.47
Rate for Payer: UnitedHealthcare Commercial	$139.30
Rate for Payer: UnitedHealthcare Community & State	$16.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$18.46

FP FIRST DEGREE INITIAL TREAT

Facility

$372.00

Service Code	HCPCS 16000
Hospital Charge Code	83652075
Hospital Revenue Code	361
Min. Negotiated Rate	$8.97
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
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	$860.41
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.60
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$8.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$554.01
Rate for Payer: Wellpoint Medicaid Managed Care	$543.15

FP FIRST DEGREE INITIAL TREAT

Facility

$372.00

Service Code	HCPCS 16000
Hospital Charge Code	83652075
Hospital Revenue Code	361
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

FP FP SPINAL PUNCT,LUMBAR,DIAG

Professional

Both

$468.00

Service Code	HCPCS 62270
Hospital Charge Code	83652259
Hospital Revenue Code	975
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$125.85
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.50
Rate for Payer: UnitedHealthcare Commercial	$125.85
Rate for Payer: UnitedHealthcare Community & State	$125.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$125.85

FP FUNCT ASPIRATION ABS/HEMT

Facility

$420.44

Service Code	HCPCS 10160
Hospital Charge Code	87502440
Hospital Revenue Code	761
Min. Negotiated Rate	$10.13
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.13
Rate for Payer: Oxford Commercial	$84.09
Rate for Payer: Qualcare PPO/HMO/WC	$63.07
Rate for Payer: UnitedHealthcare Commercial	$84.09
Rate for Payer: UnitedHealthcare Community & State	$10.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$11.14

FP FUNCT ASPIRATION ABS/HEMT

Facility

$420.44

Service Code	HCPCS 10160
Hospital Charge Code	87502440
Hospital Revenue Code	761
Min. Negotiated Rate	$63.07
Max. Negotiated Rate	$63.07
Rate for Payer: Qualcare PPO/HMO/WC	$63.07

FP HEMOCULT (BLOOD OCCULT)

Facility

$390.00

Service Code	HCPCS 82270
Hospital Charge Code	87502765
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FP HEMOCULT (BLOOD OCCULT)

Facility

$390.00

Service Code	HCPCS 82270
Hospital Charge Code	87502765
Hospital Revenue Code	301
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$11.91
Rate for Payer: Aetna Medicare Advantage	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.81
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.38
Rate for Payer: Clover Medicare Advantage	$4.16
Rate for Payer: EmblemHealth Commercial	$13.14
Rate for Payer: Humana Medicare Advantage	$4.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.38
Rate for Payer: Wellcare Medicare Advantage	$4.38
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

FP HM VIS E&M ESTPT LOW COM 25

Facility

$165.00

Service Code	HCPCS 99348
Hospital Charge Code	87502355
Hospital Revenue Code	510
Min. Negotiated Rate	$24.75
Max. Negotiated Rate	$24.75
Rate for Payer: Qualcare PPO/HMO/WC	$24.75

FP HM VIS E&M ESTPT LOW COM 25

Facility

$165.00

Service Code	HCPCS 99348
Hospital Charge Code	87502355
Hospital Revenue Code	510
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$82.50
Rate for Payer: Aetna Commercial	$62.70
Rate for Payer: Aetna Medicare Advantage	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.08
Rate for Payer: Cigna Commercial	$82.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$24.75
Rate for Payer: UnitedHealthcare Community & State	$3.98
Rate for Payer: Wellpoint Medicaid Managed Care	$4.37

FP HOME VISIT E&M EST. PT L C

Professional

Both

$165.00

Service Code	HCPCS 99348
Hospital Charge Code	83652463
Hospital Revenue Code	969
Min. Negotiated Rate	$79.59
Max. Negotiated Rate	$79.59
Rate for Payer: Aetna Medicare Advantage	$79.59
Rate for Payer: Clover Medicare Advantage	$79.59

FP I&D ABCESS/CYST COMP/MULTI

Facility

$641.65

Service Code	HCPCS 10061
Hospital Charge Code	83652003
Hospital Revenue Code	761
Min. Negotiated Rate	$15.46
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.50
Rate for Payer: Oxford Commercial	$128.33
Rate for Payer: Qualcare PPO/HMO/WC	$96.25
Rate for Payer: UnitedHealthcare Commercial	$128.33
Rate for Payer: UnitedHealthcare Community & State	$15.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$17.00

FP I&D ABCESS/CYST COMP/MULTI

Facility

$641.65

Service Code	HCPCS 10061
Hospital Charge Code	83652003
Hospital Revenue Code	761
Min. Negotiated Rate	$96.25
Max. Negotiated Rate	$96.25
Rate for Payer: Qualcare PPO/HMO/WC	$96.25

FP I&D ABCESS/CYST COMP/MULTI

Facility

$2,237.95

Service Code	HCPCS 10061
Hospital Charge Code	87502420
Hospital Revenue Code	761
Min. Negotiated Rate	$53.93
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$671.38
Rate for Payer: Oxford Commercial	$447.59
Rate for Payer: Qualcare PPO/HMO/WC	$335.69
Rate for Payer: UnitedHealthcare Commercial	$447.59
Rate for Payer: UnitedHealthcare Community & State	$53.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$59.31

FP I&D ABCESS/CYST COMP/MULTI

Facility

$2,237.95

Service Code	HCPCS 10061
Hospital Charge Code	87502420
Hospital Revenue Code	761
Min. Negotiated Rate	$335.69
Max. Negotiated Rate	$335.69
Rate for Payer: Qualcare PPO/HMO/WC	$335.69

FP I&D HEMATOMA FLUID COLLECT

Facility

$8,995.35

Service Code	HCPCS 10140
Hospital Charge Code	87502435
Hospital Revenue Code	761
Min. Negotiated Rate	$1,349.30
Max. Negotiated Rate	$1,349.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,349.30

FP I&D HEMATOMA FLUID COLLECT

Facility

$8,995.35

Service Code	HCPCS 10140
Hospital Charge Code	87502435
Hospital Revenue Code	761
Min. Negotiated Rate	$73.18
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,698.61
Rate for Payer: Oxford Commercial	$1,799.07
Rate for Payer: Qualcare PPO/HMO/WC	$1,349.30
Rate for Payer: UnitedHealthcare Commercial	$1,799.07
Rate for Payer: UnitedHealthcare Community & State	$216.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$238.38

FP I&D HEMATOMA, FLUID COLLECT

Facility

$882.00

Service Code	HCPCS 10140
Hospital Charge Code	83652009
Hospital Revenue Code	761
Min. Negotiated Rate	$132.30
Max. Negotiated Rate	$132.30
Rate for Payer: Qualcare PPO/HMO/WC	$132.30

FP I&D HEMATOMA, FLUID COLLECT

Facility

$882.00

Service Code	HCPCS 10140
Hospital Charge Code	83652009
Hospital Revenue Code	761
Min. Negotiated Rate	$21.26
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$264.60
Rate for Payer: Oxford Commercial	$176.40
Rate for Payer: Qualcare PPO/HMO/WC	$132.30
Rate for Payer: UnitedHealthcare Commercial	$176.40
Rate for Payer: UnitedHealthcare Community & State	$21.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$23.37

FP IMM.ADM@ADDTN'L INTNAS/ORL

Facility

$156.00

Service Code	HCPCS 90474
Hospital Charge Code	83652301
Hospital Revenue Code	771
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$23.40
Rate for Payer: Qualcare PPO/HMO/WC	$23.40

FP IMM.ADM@ADDTN'L INTNAS/ORL

Facility

$156.00

Service Code	HCPCS 90474
Hospital Charge Code	83652301
Hospital Revenue Code	771
Min. Negotiated Rate	$3.76
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$59.28
Rate for Payer: Aetna Medicare Advantage	$46.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.78
Rate for Payer: Cigna Commercial	$78.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.80
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.40
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$3.76
Rate for Payer: Wellpoint Medicaid Managed Care	$4.13

Know your out-of-pocket cost for care.

All Charges