Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HELICAL BLADE

Facility

$3,290.85

Hospital Charge Code	270679032
Hospital Revenue Code	272
Min. Negotiated Rate	$79.31
Max. Negotiated Rate	$1,645.42
Rate for Payer: Aetna Commercial	$1,250.52
Rate for Payer: Aetna Medicare Advantage	$987.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$839.17
Rate for Payer: Cigna Commercial	$1,645.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$987.25
Rate for Payer: Oxford Commercial	$658.17
Rate for Payer: Qualcare PPO/HMO/WC	$493.63
Rate for Payer: UnitedHealthcare Commercial	$658.17
Rate for Payer: UnitedHealthcare Community & State	$79.31
Rate for Payer: Wellpoint Medicaid Managed Care	$87.21

HELICAL BLADE

Facility

$3,290.85

Hospital Charge Code	270679032
Hospital Revenue Code	272
Min. Negotiated Rate	$493.63
Max. Negotiated Rate	$493.63
Rate for Payer: Qualcare PPO/HMO/WC	$493.63

HELICAL BLADE 11/X85

Facility

$12,225.00

Hospital Charge Code	270681680
Hospital Revenue Code	272
Min. Negotiated Rate	$294.62
Max. Negotiated Rate	$6,112.50
Rate for Payer: Aetna Commercial	$4,645.50
Rate for Payer: Aetna Medicare Advantage	$3,667.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,117.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,117.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,117.38
Rate for Payer: Cigna Commercial	$6,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,667.50
Rate for Payer: Oxford Commercial	$2,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,833.75
Rate for Payer: UnitedHealthcare Commercial	$2,445.00
Rate for Payer: UnitedHealthcare Community & State	$294.62
Rate for Payer: Wellpoint Medicaid Managed Care	$323.96

HELICAL BLADE 11/X85

Facility

$12,225.00

Hospital Charge Code	270681680
Hospital Revenue Code	272
Min. Negotiated Rate	$1,833.75
Max. Negotiated Rate	$1,833.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,833.75

HELICAL BLADE 11 X95

Facility

$3,290.85

Hospital Charge Code	270679080
Hospital Revenue Code	272
Min. Negotiated Rate	$493.63
Max. Negotiated Rate	$493.63
Rate for Payer: Qualcare PPO/HMO/WC	$493.63

HELICAL BLADE 11 X95

Facility

$3,290.85

Hospital Charge Code	270679080
Hospital Revenue Code	272
Min. Negotiated Rate	$79.31
Max. Negotiated Rate	$1,645.42
Rate for Payer: Aetna Commercial	$1,250.52
Rate for Payer: Aetna Medicare Advantage	$987.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$839.17
Rate for Payer: Cigna Commercial	$1,645.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$987.25
Rate for Payer: Oxford Commercial	$658.17
Rate for Payer: Qualcare PPO/HMO/WC	$493.63
Rate for Payer: UnitedHealthcare Commercial	$658.17
Rate for Payer: UnitedHealthcare Community & State	$79.31
Rate for Payer: Wellpoint Medicaid Managed Care	$87.21

HELICOBACTER PYELORO, AB

Facility

$1,080.00

Service Code	HCPCS 86677
Hospital Charge Code	38472493
Hospital Revenue Code	302
Min. Negotiated Rate	$13.48
Max. Negotiated Rate	$540.00
Rate for Payer: Aetna Commercial	$45.83
Rate for Payer: Aetna Medicare Advantage	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.82
Rate for Payer: Cigna Commercial	$540.00
Rate for Payer: Cigna Medicare Advantage	$16.85
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.85
Rate for Payer: Wellcare Medicare Advantage	$16.85
Rate for Payer: Wellpoint Medicaid Managed Care	$28.62

HELICOBACTER PYELORO, AB

Facility

$1,080.00

Service Code	HCPCS 86677
Hospital Charge Code	38472493
Hospital Revenue Code	302
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$162.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.00

HELICOBACTER PYLORI

Facility

$307.50

Service Code	HCPCS 83013
Hospital Charge Code	38477204
Hospital Revenue Code	301
Min. Negotiated Rate	$46.12
Max. Negotiated Rate	$46.12
Rate for Payer: Qualcare PPO/HMO/WC	$46.12

HELICOBACTER PYLORI

Facility

$307.50

Service Code	HCPCS 83013
Hospital Charge Code	38477204
Hospital Revenue Code	301
Min. Negotiated Rate	$8.15
Max. Negotiated Rate	$243.15
Rate for Payer: Aetna Commercial	$183.22
Rate for Payer: Aetna Medicare Advantage	$218.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$67.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.15
Rate for Payer: Cigna Commercial	$153.75
Rate for Payer: Cigna Medicare Advantage	$67.36
Rate for Payer: Clover Medicare Advantage	$63.99
Rate for Payer: EmblemHealth Commercial	$202.08
Rate for Payer: Humana Medicare Advantage	$69.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$67.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.12
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$53.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$67.36
Rate for Payer: Wellcare Medicare Advantage	$67.36
Rate for Payer: Wellpoint Medicaid Managed Care	$8.15

HELICOBACTER PYLORI ANTIGEN I

Facility

$390.00

Service Code	HCPCS 87338
Hospital Charge Code	399900534
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HELICOBACTER PYLORI ANTIGEN I

Facility

$390.00

Service Code	HCPCS 87338
Hospital Charge Code	399900534
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$39.11
Rate for Payer: Aetna Medicare Advantage	$46.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.91
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.38
Rate for Payer: Clover Medicare Advantage	$13.66
Rate for Payer: EmblemHealth Commercial	$43.14
Rate for Payer: Humana Medicare Advantage	$14.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.38
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	$11.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.38
Rate for Payer: Wellcare Medicare Advantage	$14.38
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

HELICOBACTER PYLORI IGG

Facility

$390.00

Service Code	HCPCS 86677
Hospital Charge Code	39900375
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$45.83
Rate for Payer: Aetna Medicare Advantage	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.82
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.85
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.85
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	$13.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.85
Rate for Payer: Wellcare Medicare Advantage	$16.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

HELICOBACTER PYLORI IGG

Facility

$390.00

Service Code	HCPCS 86677
Hospital Charge Code	39900375
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HELICOBACTER PYLORI STOOL AG

Facility

$942.45

Service Code	HCPCS 87338
Hospital Charge Code	3035048
Hospital Revenue Code	306
Min. Negotiated Rate	$11.50
Max. Negotiated Rate	$471.23
Rate for Payer: Aetna Commercial	$39.11
Rate for Payer: Aetna Medicare Advantage	$46.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.91
Rate for Payer: Cigna Commercial	$471.23
Rate for Payer: Cigna Medicare Advantage	$14.38
Rate for Payer: Clover Medicare Advantage	$13.66
Rate for Payer: EmblemHealth Commercial	$43.14
Rate for Payer: Humana Medicare Advantage	$14.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$282.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$141.37
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.38
Rate for Payer: Wellcare Medicare Advantage	$14.38
Rate for Payer: Wellpoint Medicaid Managed Care	$24.97

HELICOBACTER PYLORI STOOL AG

Facility

$942.45

Service Code	HCPCS 87338
Hospital Charge Code	3035048
Hospital Revenue Code	306
Min. Negotiated Rate	$141.37
Max. Negotiated Rate	$141.37
Rate for Payer: Qualcare PPO/HMO/WC	$141.37

HELICOBACTOR PYLORI IGG IGA

Facility

$268.85

Service Code	HCPCS 86677
Hospital Charge Code	3009439
Hospital Revenue Code	302
Min. Negotiated Rate	$40.33
Max. Negotiated Rate	$40.33
Rate for Payer: Qualcare PPO/HMO/WC	$40.33

HELICOBACTOR PYLORI IGG IGA

Facility

$268.85

Service Code	HCPCS 86677
Hospital Charge Code	3009439
Hospital Revenue Code	302
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$134.43
Rate for Payer: Aetna Commercial	$45.83
Rate for Payer: Aetna Medicare Advantage	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.82
Rate for Payer: Cigna Commercial	$134.43
Rate for Payer: Cigna Medicare Advantage	$16.85
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.33
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.85
Rate for Payer: Wellcare Medicare Advantage	$16.85
Rate for Payer: Wellpoint Medicaid Managed Care	$7.12

HELIOBACTER PYLORI AB IGG

Facility

$268.85

Service Code	HCPCS 86677
Hospital Charge Code	3009438
Hospital Revenue Code	302
Min. Negotiated Rate	$40.33
Max. Negotiated Rate	$40.33
Rate for Payer: Qualcare PPO/HMO/WC	$40.33

HELIOBACTER PYLORI AB IGG

Facility

$268.85

Service Code	HCPCS 86677
Hospital Charge Code	3009438
Hospital Revenue Code	302
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$134.43
Rate for Payer: Aetna Commercial	$45.83
Rate for Payer: Aetna Medicare Advantage	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.82
Rate for Payer: Cigna Commercial	$134.43
Rate for Payer: Cigna Medicare Advantage	$16.85
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.33
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.85
Rate for Payer: Wellcare Medicare Advantage	$16.85
Rate for Payer: Wellpoint Medicaid Managed Care	$7.12

HELIOCOIDAL RAS MED 3.2x18.3MM

Facility

$592.25

Hospital Charge Code	270672709
Hospital Revenue Code	272
Min. Negotiated Rate	$14.27
Max. Negotiated Rate	$296.12
Rate for Payer: Aetna Commercial	$225.06
Rate for Payer: Aetna Medicare Advantage	$177.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.02
Rate for Payer: Cigna Commercial	$296.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.68
Rate for Payer: Oxford Commercial	$118.45
Rate for Payer: Qualcare PPO/HMO/WC	$88.84
Rate for Payer: UnitedHealthcare Commercial	$118.45
Rate for Payer: UnitedHealthcare Community & State	$14.27
Rate for Payer: Wellpoint Medicaid Managed Care	$15.69

HELIOCOIDAL RAS MED 3.2x18.3MM

Facility

$592.25

Hospital Charge Code	270672709
Hospital Revenue Code	272
Min. Negotiated Rate	$88.84
Max. Negotiated Rate	$88.84
Rate for Payer: Qualcare PPO/HMO/WC	$88.84

HELIOGEN

Facility

$4,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270706148
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

HELIOGEN

Facility

$4,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270706148
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

HELIOX PER HOUR

Facility

$76.88

Hospital Charge Code	95090385
Hospital Revenue Code	270
Min. Negotiated Rate	$11.53
Max. Negotiated Rate	$11.53
Rate for Payer: Qualcare PPO/HMO/WC	$11.53

Know your out-of-pocket cost for care.

All Charges