Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IDEALBINDE SS WHITE 15X

Facility

$44.45

Hospital Charge Code	270636430
Hospital Revenue Code	271
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$22.23
Rate for Payer: Aetna Commercial	$16.89
Rate for Payer: Aetna Medicare Advantage	$13.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.33
Rate for Payer: Cigna Commercial	$22.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.34
Rate for Payer: Oxford Commercial	$8.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.67
Rate for Payer: UnitedHealthcare Commercial	$8.89
Rate for Payer: UnitedHealthcare Community & State	$1.07
Rate for Payer: Wellpoint Medicaid Managed Care	$1.18

IDEALBINDE SS WHITE 15X

Facility

$44.45

Hospital Charge Code	270636430
Hospital Revenue Code	271
Min. Negotiated Rate	$6.67
Max. Negotiated Rate	$6.67
Rate for Payer: Qualcare PPO/HMO/WC	$6.67

I&D EAR ABSCESS COMPLICATED

Facility

$8,548.96

Service Code	HCPCS 69005
Hospital Charge Code	5780255
Hospital Revenue Code	450
Min. Negotiated Rate	$118.10
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	$118.10
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	$2,564.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.34
Rate for Payer: UnitedHealthcare Community & State	$140.00
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	$226.55

I&D EAR ABSCESS COMPLICATED

Facility

$8,548.96

Service Code	HCPCS 69005
Hospital Charge Code	5780255
Hospital Revenue Code	450
Min. Negotiated Rate	$1,282.34
Max. Negotiated Rate	$1,282.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.34

IDET 1 OR MORE LEVELS

Facility

$4,410.00

Service Code	HCPCS 22527
Hospital Charge Code	2690020
Hospital Revenue Code	361
Min. Negotiated Rate	$106.28
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$1,675.80
Rate for Payer: Aetna Medicare Advantage	$1,323.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,124.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,124.55
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	$1,124.55
Rate for Payer: Cigna Commercial	$2,205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,323.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$661.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$106.28
Rate for Payer: Wellpoint Medicaid Managed Care	$116.86

IDET 1 OR MORE LEVELS

Facility

$4,410.00

Service Code	HCPCS 22527
Hospital Charge Code	2690020
Hospital Revenue Code	361
Min. Negotiated Rate	$661.50
Max. Negotiated Rate	$661.50
Rate for Payer: Qualcare PPO/HMO/WC	$661.50

IDET 1 OR MORE LEVELS

Facility

$30,000.00

Service Code	HCPCS 22527
Hospital Charge Code	16000801
Hospital Revenue Code	360
Min. Negotiated Rate	$723.00
Max. Negotiated Rate	$15,000.00
Rate for Payer: Aetna Commercial	$11,400.00
Rate for Payer: Aetna Medicare Advantage	$9,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,650.00
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	$7,650.00
Rate for Payer: Cigna Commercial	$15,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,000.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$723.00
Rate for Payer: Wellpoint Medicaid Managed Care	$795.00

IDET 1 OR MORE LEVELS

Facility

$4,410.00

Service Code	HCPCS 22527
Hospital Charge Code	7411359
Hospital Revenue Code	361
Min. Negotiated Rate	$106.28
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$1,675.80
Rate for Payer: Aetna Medicare Advantage	$1,323.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,124.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,124.55
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	$1,124.55
Rate for Payer: Cigna Commercial	$2,205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,323.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$661.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$106.28
Rate for Payer: Wellpoint Medicaid Managed Care	$116.86

IDET 1 OR MORE LEVELS

Facility

$30,000.00

Service Code	HCPCS 22527
Hospital Charge Code	16000801
Hospital Revenue Code	360
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$4,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

IDET 1 OR MORE LEVELS

Facility

$4,410.00

Service Code	HCPCS 22527
Hospital Charge Code	7411359
Hospital Revenue Code	361
Min. Negotiated Rate	$661.50
Max. Negotiated Rate	$661.50
Rate for Payer: Qualcare PPO/HMO/WC	$661.50

IDET SINGLE LEVEL

Facility

$4,410.00

Service Code	HCPCS 22526
Hospital Charge Code	7411358
Hospital Revenue Code	361
Min. Negotiated Rate	$661.50
Max. Negotiated Rate	$661.50
Rate for Payer: Qualcare PPO/HMO/WC	$661.50

IDET SINGLE LEVEL

Facility

$4,410.00

Service Code	HCPCS 22526
Hospital Charge Code	2690015
Hospital Revenue Code	361
Min. Negotiated Rate	$661.50
Max. Negotiated Rate	$661.50
Rate for Payer: Qualcare PPO/HMO/WC	$661.50

IDET SINGLE LEVEL

Facility

$4,410.00

Service Code	HCPCS 22526
Hospital Charge Code	2690015
Hospital Revenue Code	361
Min. Negotiated Rate	$106.28
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$1,675.80
Rate for Payer: Aetna Medicare Advantage	$1,323.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,124.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,124.55
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	$1,124.55
Rate for Payer: Cigna Commercial	$2,205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,323.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$661.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$106.28

IDET SINGLE LEVEL

Facility

$4,410.00

Service Code	HCPCS 22526
Hospital Charge Code	7411358
Hospital Revenue Code	361
Min. Negotiated Rate	$106.28
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$1,675.80
Rate for Payer: Aetna Medicare Advantage	$1,323.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,124.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,124.55
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	$1,124.55
Rate for Payer: Cigna Commercial	$2,205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,323.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$661.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$106.28

IDET,SINGLE LEVEL--LT

Facility

$30,000.00

Service Code	HCPCS 22526
Hospital Charge Code	16000800
Hospital Revenue Code	360
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$4,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

IDET,SINGLE LEVEL--LT

Facility

$30,000.00

Service Code	HCPCS 22526
Hospital Charge Code	16000800
Hospital Revenue Code	360
Min. Negotiated Rate	$723.00
Max. Negotiated Rate	$15,000.00
Rate for Payer: Aetna Commercial	$11,400.00
Rate for Payer: Aetna Medicare Advantage	$9,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,650.00
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	$7,650.00
Rate for Payer: Cigna Commercial	$15,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,000.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$723.00

I&D EYELID ABSCESS

Facility

$1,578.95

Service Code	HCPCS 67700
Hospital Charge Code	5780250
Hospital Revenue Code	450
Min. Negotiated Rate	$236.84
Max. Negotiated Rate	$236.84
Rate for Payer: Qualcare PPO/HMO/WC	$236.84

I&D EYELID ABSCESS

Facility

$1,578.95

Service Code	HCPCS 67700
Hospital Charge Code	5780250
Hospital Revenue Code	450
Min. Negotiated Rate	$41.84
Max. Negotiated Rate	$1,361.18
Rate for Payer: Aetna Commercial	$1,025.68
Rate for Payer: Aetna Medicare Advantage	$1,221.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,361.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,361.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$377.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,361.18
Rate for Payer: Cigna Commercial	$755.86
Rate for Payer: Cigna Medicare Advantage	$377.09
Rate for Payer: Clover Medicare Advantage	$358.24
Rate for Payer: EmblemHealth Commercial	$1,131.27
Rate for Payer: Humana Medicare Advantage	$388.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$377.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$473.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$236.84
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$377.09
Rate for Payer: Wellcare Medicare Advantage	$377.09
Rate for Payer: Wellpoint Medicaid Managed Care	$41.84

I&D HEMATOMA

Facility

$882.00

Service Code	HCPCS 10140
Hospital Charge Code	87502125
Hospital Revenue Code	761
Min. Negotiated Rate	$132.30
Max. Negotiated Rate	$132.30
Rate for Payer: Qualcare PPO/HMO/WC	$132.30

I&D HEMATOMA

Facility

$882.00

Service Code	HCPCS 10140
Hospital Charge Code	87502125
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

I&D HEMATOMA/FLUID

Facility

$5,638.35

Service Code	HCPCS 10140
Hospital Charge Code	16000308
Hospital Revenue Code	360
Min. Negotiated Rate	$845.75
Max. Negotiated Rate	$845.75
Rate for Payer: Qualcare PPO/HMO/WC	$845.75

I&D HEMATOMA/FLUID

Facility

$5,638.35

Service Code	HCPCS 10140
Hospital Charge Code	16000308
Hospital Revenue Code	360
Min. Negotiated Rate	$135.88
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	$1,626.00
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	$1,691.51
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$845.75
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$135.88
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	$149.42

I&D LEG/ANKLE DEEP ABSC/HEMATO

Facility

$10,870.60

Service Code	HCPCS 27603
Hospital Charge Code	16000889
Hospital Revenue Code	360
Min. Negotiated Rate	$1,630.59
Max. Negotiated Rate	$1,630.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,630.59

I&D LEG/ANKLE DEEP ABSC/HEMATO

Facility

$10,870.60

Service Code	HCPCS 27603
Hospital Charge Code	16000889
Hospital Revenue Code	360
Min. Negotiated Rate	$261.98
Max. Negotiated Rate	$12,456.64
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,456.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,456.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,456.64
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,261.18
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,630.59
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$261.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$288.07

I&D OF SUBMUCOSAL ABSCESS,RCTM

Facility

$16,865.10

Service Code	HCPCS 45005
Hospital Charge Code	16000643
Hospital Revenue Code	360
Min. Negotiated Rate	$2,529.76
Max. Negotiated Rate	$2,529.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,529.76

Know your out-of-pocket cost for care.

All Charges