Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ANES IV SED FIRST HR

Facility

$667.67

Hospital Charge Code	1650015
Hospital Revenue Code	370
Min. Negotiated Rate	$100.15
Max. Negotiated Rate	$100.15
Rate for Payer: Qualcare PPO/HMO/WC	$100.15

ANES POP NERVE BLOCK

Facility

$3,506.55

Service Code	HCPCS 64450
Hospital Charge Code	1650098
Hospital Revenue Code	361
Min. Negotiated Rate	$84.51
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,281.02
Rate for Payer: Aetna Medicare Advantage	$2,717.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$838.61
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	$3,027.13
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: Cigna Medicare Advantage	$838.61
Rate for Payer: Clover Medicare Advantage	$796.68
Rate for Payer: EmblemHealth Commercial	$2,515.83
Rate for Payer: Humana Medicare Advantage	$863.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$838.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,051.96
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.98
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$84.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$92.92

ANES POP NERVE BLOCK

Facility

$3,506.55

Service Code	HCPCS 64450
Hospital Charge Code	1650098
Hospital Revenue Code	361
Min. Negotiated Rate	$525.98
Max. Negotiated Rate	$525.98
Rate for Payer: Qualcare PPO/HMO/WC	$525.98

ANES - PROC ONLY

Facility

$2,802.00

Hospital Charge Code	73190160
Hospital Revenue Code	370
Min. Negotiated Rate	$67.53
Max. Negotiated Rate	$1,401.00
Rate for Payer: Aetna Commercial	$1,064.76
Rate for Payer: Aetna Medicare Advantage	$840.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.51
Rate for Payer: Cigna Commercial	$1,401.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.60
Rate for Payer: Oxford Commercial	$560.40
Rate for Payer: Qualcare PPO/HMO/WC	$420.30
Rate for Payer: UnitedHealthcare Commercial	$560.40
Rate for Payer: UnitedHealthcare Community & State	$67.53
Rate for Payer: Wellpoint Medicaid Managed Care	$74.25

ANES - PROC ONLY

Facility

$2,802.00

Hospital Charge Code	73190160
Hospital Revenue Code	370
Min. Negotiated Rate	$420.30
Max. Negotiated Rate	$420.30
Rate for Payer: Qualcare PPO/HMO/WC	$420.30

ANESTHESIA ADDITIONAL 30 MINS

Facility

$630.00

Hospital Charge Code	1650012
Hospital Revenue Code	370
Min. Negotiated Rate	$94.50
Max. Negotiated Rate	$94.50
Rate for Payer: Qualcare PPO/HMO/WC	$94.50

ANESTHESIA ADDITIONAL 30 MINS

Facility

$630.00

Hospital Charge Code	1650012
Hospital Revenue Code	370
Min. Negotiated Rate	$15.18
Max. Negotiated Rate	$315.00
Rate for Payer: Aetna Commercial	$239.40
Rate for Payer: Aetna Medicare Advantage	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.65
Rate for Payer: Cigna Commercial	$315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.00
Rate for Payer: Oxford Commercial	$126.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.50
Rate for Payer: UnitedHealthcare Commercial	$126.00
Rate for Payer: UnitedHealthcare Community & State	$15.18
Rate for Payer: Wellpoint Medicaid Managed Care	$16.70

ANESTHESIA AX BLOCK W US

Facility

$700.00

Hospital Charge Code	1650055
Hospital Revenue Code	370
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

ANESTHESIA AX BLOCK W US

Facility

$700.00

Hospital Charge Code	1650055
Hospital Revenue Code	370
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$140.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

ANESTHESIA AX BLOCK W US PROC

Facility

$700.00

Hospital Charge Code	1650093
Hospital Revenue Code	361
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
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	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

ANESTHESIA AX BLOCK W US PROC

Facility

$700.00

Hospital Charge Code	1650094
Hospital Revenue Code	361
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
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	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

ANESTHESIA AX BLOCK W US PROC

Facility

$700.00

Hospital Charge Code	1650093
Hospital Revenue Code	361
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

ANESTHESIA AX BLOCK W US PROC

Facility

$700.00

Hospital Charge Code	1650094
Hospital Revenue Code	361
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

ANESTHESIA AXILLARY BLOCK

Facility

$600.00

Hospital Charge Code	1650045
Hospital Revenue Code	370
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.00
Rate for Payer: Oxford Commercial	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Commercial	$120.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

ANESTHESIA AXILLARY BLOCK

Facility

$600.00

Hospital Charge Code	1650045
Hospital Revenue Code	370
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

ANESTHESIA AXILLARY BLOCK PROC

Facility

$600.00

Hospital Charge Code	1650092
Hospital Revenue Code	361
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
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	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

ANESTHESIA AXILLARY BLOCK PROC

Facility

$600.00

Hospital Charge Code	1650092
Hospital Revenue Code	361
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

ANESTHESIA BIER BLOCK

Facility

$448.00

Hospital Charge Code	1650050
Hospital Revenue Code	370
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$224.00
Rate for Payer: Aetna Commercial	$170.24
Rate for Payer: Aetna Medicare Advantage	$134.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.24
Rate for Payer: Cigna Commercial	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.40
Rate for Payer: Oxford Commercial	$89.60
Rate for Payer: Qualcare PPO/HMO/WC	$67.20
Rate for Payer: UnitedHealthcare Commercial	$89.60
Rate for Payer: UnitedHealthcare Community & State	$10.80
Rate for Payer: Wellpoint Medicaid Managed Care	$11.87

ANESTHESIA BIER BLOCK

Facility

$448.00

Hospital Charge Code	1650050
Hospital Revenue Code	370
Min. Negotiated Rate	$67.20
Max. Negotiated Rate	$67.20
Rate for Payer: Qualcare PPO/HMO/WC	$67.20

ANESTHESIA BRC PLEXUS BLOCK

Facility

$600.00

Hospital Charge Code	1650080
Hospital Revenue Code	370
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

ANESTHESIA BRC PLEXUS BLOCK

Facility

$600.00

Hospital Charge Code	1650080
Hospital Revenue Code	370
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.00
Rate for Payer: Oxford Commercial	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Commercial	$120.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

ANESTHESIA BRC PLEXUS BLOCK US

Facility

$700.00

Hospital Charge Code	1650085
Hospital Revenue Code	370
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

ANESTHESIA BRC PLEXUS BLOCK US

Facility

$700.00

Hospital Charge Code	1650085
Hospital Revenue Code	370
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$140.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

ANESTHESIA EPIDURAL

Facility

$560.00

Hospital Charge Code	1650035
Hospital Revenue Code	370
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.00
Rate for Payer: Oxford Commercial	$112.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Commercial	$112.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

ANESTHESIA EPIDURAL

Facility

$560.00

Hospital Charge Code	1650035
Hospital Revenue Code	370
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$84.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

Know your out-of-pocket cost for care.

All Charges