Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ANESTHESIA SPINAL

Facility

$560.00

Hospital Charge Code	1650030
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 SPINAL

Facility

$560.00

Hospital Charge Code	1650030
Hospital Revenue Code	370
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$84.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

ANESTHESIA SPINAL 1ST HR

Facility

$420.00

Hospital Charge Code	1650110
Hospital Revenue Code	370
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$210.00
Rate for Payer: Aetna Commercial	$159.60
Rate for Payer: Aetna Medicare Advantage	$126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.10
Rate for Payer: Cigna Commercial	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.00
Rate for Payer: Oxford Commercial	$84.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.00
Rate for Payer: UnitedHealthcare Commercial	$84.00
Rate for Payer: UnitedHealthcare Community & State	$10.12
Rate for Payer: Wellpoint Medicaid Managed Care	$11.13

ANESTHESIA SPINAL 1ST HR

Facility

$420.00

Hospital Charge Code	1650110
Hospital Revenue Code	370
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$63.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

ANESTHESIA SPINAL EA ADD HR

Facility

$140.00

Hospital Charge Code	1650111
Hospital Revenue Code	370
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$70.00
Rate for Payer: Aetna Commercial	$53.20
Rate for Payer: Aetna Medicare Advantage	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.70
Rate for Payer: Cigna Commercial	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.00
Rate for Payer: Oxford Commercial	$28.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00
Rate for Payer: UnitedHealthcare Commercial	$28.00
Rate for Payer: UnitedHealthcare Community & State	$3.37
Rate for Payer: Wellpoint Medicaid Managed Care	$3.71

ANESTHESIA SPINAL EA ADD HR

Facility

$140.00

Hospital Charge Code	1650111
Hospital Revenue Code	370
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

ANES - VAG DELIVERY

Facility

$2,563.00

Hospital Charge Code	73190157
Hospital Revenue Code	370
Min. Negotiated Rate	$61.77
Max. Negotiated Rate	$1,281.50
Rate for Payer: Aetna Commercial	$973.94
Rate for Payer: Aetna Medicare Advantage	$768.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$653.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$653.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$653.57
Rate for Payer: Cigna Commercial	$1,281.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$768.90
Rate for Payer: Oxford Commercial	$512.60
Rate for Payer: Qualcare PPO/HMO/WC	$384.45
Rate for Payer: UnitedHealthcare Commercial	$512.60
Rate for Payer: UnitedHealthcare Community & State	$61.77
Rate for Payer: Wellpoint Medicaid Managed Care	$67.92

ANES - VAG DELIVERY

Facility

$2,563.00

Hospital Charge Code	73190157
Hospital Revenue Code	370
Min. Negotiated Rate	$384.45
Max. Negotiated Rate	$384.45
Rate for Payer: Qualcare PPO/HMO/WC	$384.45

ANGEL PRP KIT

Facility

$1,625.00

Hospital Charge Code	270690216
Hospital Revenue Code	271
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$243.75
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

ANGEL PRP KIT

Facility

$1,625.00

Hospital Charge Code	270690216
Hospital Revenue Code	271
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.50
Rate for Payer: Oxford Commercial	$325.00
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Commercial	$325.00
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

ANGINA PECTORIS

Facility

$24,820.63

Service Code	MSDRG 311
Min. Negotiated Rate	$7,557.56
Max. Negotiated Rate	$24,820.63
Rate for Payer: Aetna Commercial	$17,311.92
Rate for Payer: Aetna Medicare Advantage	$24,820.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,282.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,282.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,955.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16,282.70
Rate for Payer: Cigna Commercial	$13,135.36
Rate for Payer: Cigna Medicare Advantage	$7,955.33
Rate for Payer: Clover Medicare Advantage	$7,557.56
Rate for Payer: EmblemHealth Commercial	$23,865.99
Rate for Payer: Humana Medicare Advantage	$8,193.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,955.33
Rate for Payer: Oxford Commercial	$9,440.56
Rate for Payer: UnitedHealthcare Commercial	$16,554.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,955.33
Rate for Payer: Wellcare Medicare Advantage	$7,955.33

ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS

Facility

$16,405.70

Service Code	APR-DRG 1984
Min. Negotiated Rate	$16,084.02
Max. Negotiated Rate	$16,405.70
Rate for Payer: UnitedHealthcare Community & State	$16,084.02
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,405.70
Rate for Payer: Wellpoint Medicaid Managed Care	$16,084.02

ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS

Facility

$9,137.42

Service Code	APR-DRG 1983
Min. Negotiated Rate	$8,958.25
Max. Negotiated Rate	$9,137.42
Rate for Payer: UnitedHealthcare Community & State	$8,958.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,137.42
Rate for Payer: Wellpoint Medicaid Managed Care	$8,958.25

ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS

Facility

$5,854.98

Service Code	APR-DRG 1981
Min. Negotiated Rate	$5,740.18
Max. Negotiated Rate	$5,854.98
Rate for Payer: UnitedHealthcare Community & State	$5,740.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,854.98
Rate for Payer: Wellpoint Medicaid Managed Care	$5,740.18

ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS

Facility

$6,958.04

Service Code	APR-DRG 1982
Min. Negotiated Rate	$6,821.61
Max. Negotiated Rate	$6,958.04
Rate for Payer: UnitedHealthcare Community & State	$6,821.61
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,958.04
Rate for Payer: Wellpoint Medicaid Managed Care	$6,821.61

ANGIO ACUVANCE 18GX1-1/4 3355

Facility

$11.65

Hospital Charge Code	270621009
Hospital Revenue Code	272
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$1.75
Rate for Payer: Qualcare PPO/HMO/WC	$1.75

ANGIO ACUVANCE 18GX1-1/4 3355

Facility

$11.65

Hospital Charge Code	270621009
Hospital Revenue Code	272
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$5.83
Rate for Payer: Aetna Commercial	$4.43
Rate for Payer: Aetna Medicare Advantage	$3.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.97
Rate for Payer: Cigna Commercial	$5.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.50
Rate for Payer: Oxford Commercial	$2.33
Rate for Payer: Qualcare PPO/HMO/WC	$1.75
Rate for Payer: UnitedHealthcare Commercial	$2.33
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.31

ANGIO ACUVANCE 18GX1-3/4 3354

Facility

$11.57

Hospital Charge Code	270621008
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$1.74
Rate for Payer: Qualcare PPO/HMO/WC	$1.74

ANGIO ACUVANCE 18GX1-3/4 3354

Facility

$11.57

Hospital Charge Code	270621008
Hospital Revenue Code	272
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$5.79
Rate for Payer: Aetna Commercial	$4.40
Rate for Payer: Aetna Medicare Advantage	$3.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.95
Rate for Payer: Cigna Commercial	$5.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.47
Rate for Payer: Oxford Commercial	$2.31
Rate for Payer: Qualcare PPO/HMO/WC	$1.74
Rate for Payer: UnitedHealthcare Commercial	$2.31
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.31

ANGIO ACUVANCE 20GX1-1/4 3356

Facility

$11.25

Hospital Charge Code	270621010
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

ANGIO ACUVANCE 20GX1-1/4 3356

Facility

$11.25

Hospital Charge Code	270621010
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

ANGIO ACUVANCE 20GX1-3/4 3359

Facility

$11.75

Hospital Charge Code	270621124
Hospital Revenue Code	272
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$5.88
Rate for Payer: Aetna Commercial	$4.46
Rate for Payer: Aetna Medicare Advantage	$3.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.00
Rate for Payer: Cigna Commercial	$5.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.52
Rate for Payer: Oxford Commercial	$2.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.76
Rate for Payer: UnitedHealthcare Commercial	$2.35
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.31

ANGIO ACUVANCE 20GX1-3/4 3359

Facility

$11.75

Hospital Charge Code	270621124
Hospital Revenue Code	272
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$1.76
Rate for Payer: Qualcare PPO/HMO/WC	$1.76

ANGIO AV SHUNT COMPLETE

Facility

$1,310.20

Service Code	HCPCS 75791
Hospital Charge Code	5100652
Hospital Revenue Code	350
Min. Negotiated Rate	$31.58
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$497.88
Rate for Payer: Aetna Medicare Advantage	$393.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$334.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$334.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$334.10
Rate for Payer: Cigna Commercial	$655.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.06
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$196.53
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$31.58
Rate for Payer: Wellpoint Medicaid Managed Care	$34.72

ANGIO AV SHUNT COMPLETE

Facility

$1,310.20

Service Code	HCPCS 75791
Hospital Charge Code	74110062
Hospital Revenue Code	350
Min. Negotiated Rate	$196.53
Max. Negotiated Rate	$196.53
Rate for Payer: Qualcare PPO/HMO/WC	$196.53

Know your out-of-pocket cost for care.

All Charges