Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HEARING SCREEN

Facility

$446.94

Service Code	HCPCS 92511
Hospital Charge Code	83090010
Hospital Revenue Code	471
Min. Negotiated Rate	$10.77
Max. Negotiated Rate	$1,823.00
Rate for Payer: Aetna Commercial	$645.02
Rate for Payer: Aetna Medicare Advantage	$768.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$237.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$856.00
Rate for Payer: Cigna Commercial	$475.34
Rate for Payer: Cigna Medicare Advantage	$237.14
Rate for Payer: Clover Medicare Advantage	$225.28
Rate for Payer: EmblemHealth Commercial	$711.42
Rate for Payer: Humana Medicare Advantage	$244.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$237.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.08
Rate for Payer: Oxford Commercial	$1,040.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.04
Rate for Payer: UnitedHealthcare Commercial	$1,823.00
Rate for Payer: UnitedHealthcare Community & State	$10.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$237.14
Rate for Payer: Wellcare Medicare Advantage	$237.14
Rate for Payer: Wellpoint Medicaid Managed Care	$11.84

HEARING SCREEN

Facility

$27.00

Service Code	HCPCS 92551
Hospital Charge Code	83080035
Hospital Revenue Code	471
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$1,823.00
Rate for Payer: Aetna Commercial	$10.26
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.10
Rate for Payer: Oxford Commercial	$1,040.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$1,823.00
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.72

HEARING SCREEN

Facility

$27.00

Service Code	HCPCS 92551
Hospital Charge Code	83080035
Hospital Revenue Code	471
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

HEARING SCREEN

Facility

$446.94

Service Code	HCPCS 92511
Hospital Charge Code	83090010
Hospital Revenue Code	471
Min. Negotiated Rate	$67.04
Max. Negotiated Rate	$67.04
Rate for Payer: Qualcare PPO/HMO/WC	$67.04

HEARING SCREEN

Facility

$446.94

Service Code	HCPCS 92511
Hospital Charge Code	83092020
Hospital Revenue Code	471
Min. Negotiated Rate	$67.04
Max. Negotiated Rate	$67.04
Rate for Payer: Qualcare PPO/HMO/WC	$67.04

HEARING SCREEN

Facility

$446.94

Service Code	HCPCS 92511
Hospital Charge Code	83092020
Hospital Revenue Code	471
Min. Negotiated Rate	$10.77
Max. Negotiated Rate	$1,823.00
Rate for Payer: Aetna Commercial	$645.02
Rate for Payer: Aetna Medicare Advantage	$768.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$237.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$856.00
Rate for Payer: Cigna Commercial	$475.34
Rate for Payer: Cigna Medicare Advantage	$237.14
Rate for Payer: Clover Medicare Advantage	$225.28
Rate for Payer: EmblemHealth Commercial	$711.42
Rate for Payer: Humana Medicare Advantage	$244.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$237.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.08
Rate for Payer: Oxford Commercial	$1,040.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.04
Rate for Payer: UnitedHealthcare Commercial	$1,823.00
Rate for Payer: UnitedHealthcare Community & State	$10.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$237.14
Rate for Payer: Wellcare Medicare Advantage	$237.14
Rate for Payer: Wellpoint Medicaid Managed Care	$11.84

HEART AND/OR LUNG TRANSPLANT

Facility

$186,938.32

Service Code	APR-DRG 0023
Min. Negotiated Rate	$183,272.86
Max. Negotiated Rate	$186,938.32
Rate for Payer: UnitedHealthcare Community & State	$183,272.86
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$186,938.32
Rate for Payer: Wellpoint Medicaid Managed Care	$183,272.86

HEART AND/OR LUNG TRANSPLANT

Facility

$110,609.01

Service Code	APR-DRG 0021
Min. Negotiated Rate	$108,440.21
Max. Negotiated Rate	$110,609.01
Rate for Payer: UnitedHealthcare Community & State	$108,440.21
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$110,609.01
Rate for Payer: Wellpoint Medicaid Managed Care	$108,440.21

HEART AND/OR LUNG TRANSPLANT

Facility

$134,544.73

Service Code	APR-DRG 0022
Min. Negotiated Rate	$131,906.60
Max. Negotiated Rate	$134,544.73
Rate for Payer: UnitedHealthcare Community & State	$131,906.60
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$134,544.73
Rate for Payer: Wellpoint Medicaid Managed Care	$131,906.60

HEART AND/OR LUNG TRANSPLANT

Facility

$295,365.44

Service Code	APR-DRG 0024
Min. Negotiated Rate	$289,573.96
Max. Negotiated Rate	$295,365.44
Rate for Payer: UnitedHealthcare Community & State	$289,573.96
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$295,365.44
Rate for Payer: Wellpoint Medicaid Managed Care	$289,573.96

HEART FAILURE

Facility

$8,336.93

Service Code	APR-DRG 1942
Min. Negotiated Rate	$8,173.46
Max. Negotiated Rate	$8,336.93
Rate for Payer: UnitedHealthcare Community & State	$8,173.46
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,336.93
Rate for Payer: Wellpoint Medicaid Managed Care	$8,173.46

HEART FAILURE

Facility

$20,958.43

Service Code	APR-DRG 1944
Min. Negotiated Rate	$20,547.48
Max. Negotiated Rate	$20,958.43
Rate for Payer: UnitedHealthcare Community & State	$20,547.48
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,958.43
Rate for Payer: Wellpoint Medicaid Managed Care	$20,547.48

HEART FAILURE

Facility

$11,856.82

Service Code	APR-DRG 1943
Min. Negotiated Rate	$11,624.33
Max. Negotiated Rate	$11,856.82
Rate for Payer: UnitedHealthcare Community & State	$11,624.33
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,856.82
Rate for Payer: Wellpoint Medicaid Managed Care	$11,624.33

HEART FAILURE

Facility

$6,377.19

Service Code	APR-DRG 1941
Min. Negotiated Rate	$6,252.15
Max. Negotiated Rate	$6,377.19
Rate for Payer: UnitedHealthcare Community & State	$6,252.15
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,377.19
Rate for Payer: Wellpoint Medicaid Managed Care	$6,252.15

HEART FAILURE AND SHOCK WITH CC

Facility

$29,575.17

Service Code	MSDRG 292
Min. Negotiated Rate	$9,005.26
Max. Negotiated Rate	$29,575.17
Rate for Payer: Aetna Commercial	$20,578.85
Rate for Payer: Aetna Medicare Advantage	$29,575.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,004.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,004.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,479.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20,004.46
Rate for Payer: Cigna Commercial	$15,888.19
Rate for Payer: Cigna Medicare Advantage	$9,479.22
Rate for Payer: Clover Medicare Advantage	$9,005.26
Rate for Payer: EmblemHealth Commercial	$28,437.66
Rate for Payer: Humana Medicare Advantage	$9,763.60
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,479.22
Rate for Payer: Oxford Commercial	$11,419.05
Rate for Payer: UnitedHealthcare Commercial	$20,023.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,479.22
Rate for Payer: Wellcare Medicare Advantage	$9,479.22

HEART FAILURE AND SHOCK WITH MCC

Facility

$43,628.61

Service Code	MSDRG 291
Min. Negotiated Rate	$13,284.35
Max. Negotiated Rate	$43,628.61
Rate for Payer: Aetna Commercial	$30,235.16
Rate for Payer: Aetna Medicare Advantage	$43,628.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29,774.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29,774.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,983.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29,774.08
Rate for Payer: Cigna Commercial	$24,025.03
Rate for Payer: Cigna Medicare Advantage	$13,983.53
Rate for Payer: Clover Medicare Advantage	$13,284.35
Rate for Payer: EmblemHealth Commercial	$41,950.59
Rate for Payer: Humana Medicare Advantage	$14,403.04
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,983.53
Rate for Payer: Oxford Commercial	$17,267.11
Rate for Payer: UnitedHealthcare Commercial	$30,278.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,983.53
Rate for Payer: Wellcare Medicare Advantage	$13,983.53

HEART FAILURE AND SHOCK WITHOUT CC/MCC

Facility

$20,428.14

Service Code	MSDRG 293
Min. Negotiated Rate	$6,220.11
Max. Negotiated Rate	$20,428.14
Rate for Payer: Aetna Commercial	$14,293.79
Rate for Payer: Aetna Medicare Advantage	$20,428.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,026.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,026.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,547.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,026.16
Rate for Payer: Cigna Commercial	$10,592.12
Rate for Payer: Cigna Medicare Advantage	$6,547.48
Rate for Payer: Clover Medicare Advantage	$6,220.11
Rate for Payer: EmblemHealth Commercial	$19,642.44
Rate for Payer: Humana Medicare Advantage	$6,743.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,547.48
Rate for Payer: Oxford Commercial	$7,612.70
Rate for Payer: UnitedHealthcare Commercial	$13,349.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,547.48
Rate for Payer: Wellcare Medicare Advantage	$6,547.48

HEART FLOW RESERVE ADDITI VESS

Facility

$400.00

Service Code	HCPCS 93572
Hospital Charge Code	5100817
Hospital Revenue Code	481
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

HEART FLOW RESERVE ADDITI VESS

Facility

$400.00

Service Code	HCPCS 93572
Hospital Charge Code	5100817
Hospital Revenue Code	481
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

HEART FLOW RESERVE INITI VESS

Facility

$500.00

Service Code	HCPCS 93571
Hospital Charge Code	5100816
Hospital Revenue Code	481
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

HEART FLOW RESERVE INITI VESS

Facility

$500.00

Service Code	HCPCS 93571
Hospital Charge Code	5100816
Hospital Revenue Code	481
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

HEART FLOW RESERVE MEASURE

Facility

$500.00

Service Code	HCPCS 93571
Hospital Charge Code	411093571
Hospital Revenue Code	481
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

HEART FLOW RESERVE MEASURE

Facility

$500.00

Service Code	HCPCS 93571
Hospital Charge Code	411093571
Hospital Revenue Code	481
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

HEART FLOW RESERVE MEASURE

Facility

$400.00

Service Code	HCPCS 93572
Hospital Charge Code	411093572
Hospital Revenue Code	481
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

HEART FLOW RESERVE MEASURE

Facility

$400.00

Service Code	HCPCS 93572
Hospital Charge Code	411093572
Hospital Revenue Code	481
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

Know your out-of-pocket cost for care.

All Charges