Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INDIVID NON MD 45-50 MIN

Facility

$1,423.80

Service Code	HCPCS 90834
Hospital Charge Code	84509009
Hospital Revenue Code	914
Min. Negotiated Rate	$34.31
Max. Negotiated Rate	$761.18
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$761.18
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$427.14
Rate for Payer: Qualcare PPO/HMO/WC	$213.57
Rate for Payer: UnitedHealthcare Community & State	$34.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46
Rate for Payer: Wellpoint Medicaid Managed Care	$37.73

INDIVIDUAL DX SESSION 1 HR****

Facility

$131.00

Service Code	HCPCS 90801
Hospital Charge Code	9300039
Hospital Revenue Code	910
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$19.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

INDIVIDUAL DX SESSION 1 HR****

Facility

$131.00

Service Code	HCPCS 90801
Hospital Charge Code	9300039
Hospital Revenue Code	910
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$65.50
Rate for Payer: Aetna Commercial	$49.78
Rate for Payer: Aetna Medicare Advantage	$39.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.41
Rate for Payer: Cigna Commercial	$65.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.30
Rate for Payer: Qualcare PPO/HMO/WC	$19.65
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$3.47

INDIVIDUAL MEDS MANAGEMENT

Facility

$446.00

Service Code	HCPCS 90862
Hospital Charge Code	83246020
Hospital Revenue Code	910
Min. Negotiated Rate	$66.90
Max. Negotiated Rate	$66.90
Rate for Payer: Qualcare PPO/HMO/WC	$66.90

INDIVIDUAL MEDS MANAGEMENT

Facility

$446.00

Service Code	HCPCS 90862
Hospital Charge Code	83246020
Hospital Revenue Code	910
Min. Negotiated Rate	$10.75
Max. Negotiated Rate	$223.00
Rate for Payer: Aetna Commercial	$169.48
Rate for Payer: Aetna Medicare Advantage	$133.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.73
Rate for Payer: Cigna Commercial	$223.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.80
Rate for Payer: Qualcare PPO/HMO/WC	$66.90
Rate for Payer: UnitedHealthcare Community & State	$10.75
Rate for Payer: Wellpoint Medicaid Managed Care	$11.82

INDIVIDUAL SESSION*****

Facility

$220.00

Service Code	HCPCS 90804
Hospital Charge Code	9310020
Hospital Revenue Code	914
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

INDIVIDUAL SESSION*****

Facility

$220.00

Service Code	HCPCS 90804
Hospital Charge Code	9310020
Hospital Revenue Code	914
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$83.60
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Community & State	$5.30
Rate for Payer: Wellpoint Medicaid Managed Care	$5.83

INDIVIDUAL THERAPY 45-50 MINS

Facility

$1,423.80

Service Code	HCPCS 90834
Hospital Charge Code	84504025
Hospital Revenue Code	914
Min. Negotiated Rate	$34.31
Max. Negotiated Rate	$761.18
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$761.18
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$427.14
Rate for Payer: Qualcare PPO/HMO/WC	$213.57
Rate for Payer: UnitedHealthcare Community & State	$34.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46
Rate for Payer: Wellpoint Medicaid Managed Care	$37.73

INDIVIDUAL THERAPY 45-50 MINS

Facility

$1,423.80

Service Code	HCPCS 90834
Hospital Charge Code	84504025
Hospital Revenue Code	914
Min. Negotiated Rate	$213.57
Max. Negotiated Rate	$213.57
Rate for Payer: Qualcare PPO/HMO/WC	$213.57

INDIVIDUAL THERAPY INTENSIVE

Facility

$671.00

Service Code	HCPCS 90808
Hospital Charge Code	83246015
Hospital Revenue Code	914
Min. Negotiated Rate	$100.65
Max. Negotiated Rate	$100.65
Rate for Payer: Qualcare PPO/HMO/WC	$100.65

INDIVIDUAL THERAPY INTENSIVE

Facility

$671.00

Service Code	HCPCS 90808
Hospital Charge Code	83246015
Hospital Revenue Code	914
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$335.50
Rate for Payer: Aetna Commercial	$254.98
Rate for Payer: Aetna Medicare Advantage	$201.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.10
Rate for Payer: Cigna Commercial	$335.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.30
Rate for Payer: Qualcare PPO/HMO/WC	$100.65
Rate for Payer: UnitedHealthcare Community & State	$16.17
Rate for Payer: Wellpoint Medicaid Managed Care	$17.78

INDIVIDUAL TRAINING EACH 30 MI

Facility

$112.00

Service Code	HCPCS 98960
Hospital Charge Code	9200043
Hospital Revenue Code	942
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$1,202.00
Rate for Payer: Aetna Commercial	$42.56
Rate for Payer: Aetna Medicare Advantage	$33.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.56
Rate for Payer: Cigna Commercial	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.60
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.80
Rate for Payer: UnitedHealthcare Commercial	$1,202.00
Rate for Payer: UnitedHealthcare Community & State	$2.70
Rate for Payer: Wellpoint Medicaid Managed Care	$2.97

INDIVIDUAL TRAINING EACH 30 MI

Facility

$112.00

Service Code	HCPCS 98960
Hospital Charge Code	9200043
Hospital Revenue Code	942
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$16.80

INDIV NUTR INIT ASSES 15 MIN

Facility

$2,700.00

Service Code	HCPCS 97802
Hospital Charge Code	9300001
Hospital Revenue Code	942
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$405.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

INDIV NUTR INIT ASSES 15 MIN

Facility

$2,700.00

Service Code	HCPCS 97802
Hospital Charge Code	9300001
Hospital Revenue Code	942
Min. Negotiated Rate	$42.59
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,026.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$810.00
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00
Rate for Payer: UnitedHealthcare Commercial	$1,202.00
Rate for Payer: UnitedHealthcare Community & State	$65.07
Rate for Payer: Wellpoint Medicaid Managed Care	$71.55

INDIV NUTR REASSES 15 MIN

Facility

$2,700.00

Service Code	HCPCS 97803
Hospital Charge Code	9300002
Hospital Revenue Code	942
Min. Negotiated Rate	$34.85
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,026.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$810.00
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00
Rate for Payer: UnitedHealthcare Commercial	$1,202.00
Rate for Payer: UnitedHealthcare Community & State	$65.07
Rate for Payer: Wellpoint Medicaid Managed Care	$71.55

INDIV NUTR REASSES 15 MIN

Facility

$2,700.00

Service Code	HCPCS 97803
Hospital Charge Code	9300002
Hospital Revenue Code	942
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$405.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

INDIV PTHERAP OP 20-30M W/O EM

Facility

$668.00

Service Code	HCPCS 90804
Hospital Charge Code	7500040
Hospital Revenue Code	914
Min. Negotiated Rate	$100.20
Max. Negotiated Rate	$100.20
Rate for Payer: Qualcare PPO/HMO/WC	$100.20

INDIV PTHERAP OP 20-30M W/O EM

Facility

$668.00

Service Code	HCPCS 90804
Hospital Charge Code	7500040
Hospital Revenue Code	914
Min. Negotiated Rate	$16.10
Max. Negotiated Rate	$334.00
Rate for Payer: Aetna Commercial	$253.84
Rate for Payer: Aetna Medicare Advantage	$200.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.34
Rate for Payer: Cigna Commercial	$334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.40
Rate for Payer: Qualcare PPO/HMO/WC	$100.20
Rate for Payer: UnitedHealthcare Community & State	$16.10
Rate for Payer: Wellpoint Medicaid Managed Care	$17.70

INDIV PTHERAP OP 45-50M W/O EM

Facility

$939.25

Service Code	HCPCS 90806
Hospital Charge Code	7500045
Hospital Revenue Code	914
Min. Negotiated Rate	$140.89
Max. Negotiated Rate	$140.89
Rate for Payer: Qualcare PPO/HMO/WC	$140.89

INDIV PTHERAP OP 45-50M W/O EM

Facility

$939.25

Service Code	HCPCS 90806
Hospital Charge Code	7500045
Hospital Revenue Code	914
Min. Negotiated Rate	$22.64
Max. Negotiated Rate	$469.62
Rate for Payer: Aetna Commercial	$356.92
Rate for Payer: Aetna Medicare Advantage	$281.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.51
Rate for Payer: Cigna Commercial	$469.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.77
Rate for Payer: Qualcare PPO/HMO/WC	$140.89
Rate for Payer: UnitedHealthcare Community & State	$22.64
Rate for Payer: Wellpoint Medicaid Managed Care	$24.89

INDIV PT IP/PH 20-30M W/ E/M**

Facility

$596.00

Service Code	HCPCS 90817
Hospital Charge Code	50015
Hospital Revenue Code	914
Min. Negotiated Rate	$14.36
Max. Negotiated Rate	$298.00
Rate for Payer: Aetna Commercial	$226.48
Rate for Payer: Aetna Medicare Advantage	$178.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.98
Rate for Payer: Cigna Commercial	$298.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.80
Rate for Payer: Qualcare PPO/HMO/WC	$89.40
Rate for Payer: UnitedHealthcare Community & State	$14.36
Rate for Payer: Wellpoint Medicaid Managed Care	$15.79

INDIV PT IP/PH 20-30M W/ E/M**

Facility

$596.00

Service Code	HCPCS 90817
Hospital Charge Code	50015
Hospital Revenue Code	914
Min. Negotiated Rate	$89.40
Max. Negotiated Rate	$89.40
Rate for Payer: Qualcare PPO/HMO/WC	$89.40

INDIV PT IP/PH 20-30M W/O E/M

Facility

$122.25

Service Code	HCPCS 90816
Hospital Charge Code	50008
Hospital Revenue Code	914
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$18.34
Rate for Payer: Qualcare PPO/HMO/WC	$18.34

INDIV PT IP/PH 20-30M W/O E/M

Facility

$122.25

Service Code	HCPCS 90816
Hospital Charge Code	50008
Hospital Revenue Code	914
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$61.12
Rate for Payer: Aetna Commercial	$46.45
Rate for Payer: Aetna Medicare Advantage	$36.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.17
Rate for Payer: Cigna Commercial	$61.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.67
Rate for Payer: Qualcare PPO/HMO/WC	$18.34
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

Know your out-of-pocket cost for care.

All Charges