Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4511704
Hospital Revenue Code	914
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4502704
Hospital Revenue Code	914
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4510704
Hospital Revenue Code	914
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4509704
Hospital Revenue Code	914
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4527704
Hospital Revenue Code	914
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4535704
Hospital Revenue Code	914
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4824704
Hospital Revenue Code	914
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4517704
Hospital Revenue Code	914
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4527704
Hospital Revenue Code	914
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4517704
Hospital Revenue Code	914
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4546704
Hospital Revenue Code	914
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4510704
Hospital Revenue Code	914
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

IND PSYCHOTX W E&M MD 30MIN

Facility

$375.00

Service Code	HCPCS 90833
Hospital Charge Code	4546704
Hospital Revenue Code	914
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73.61
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

IND PSYCHOTX W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4517705
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

IND PSYCHOTX W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4822705
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

IND PSYCHOTX W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4518705
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

IND PSYCHOTX W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4535705
Hospital Revenue Code	914
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

IND PSYCHOTX W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4546705
Hospital Revenue Code	914
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

IND PSYCHOTX W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4546705
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

IND PSYCHOTX W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4832705
Hospital Revenue Code	914
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

IND PSYCHOTX W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4511705
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

IND PSYCHOTX W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4511705
Hospital Revenue Code	914
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

IND PSYCHOTX W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4509705
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

IND PSYCHOTX W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4509705
Hospital Revenue Code	914
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

IND PSYCHOTX W E&M MD 45 MIN

Facility

$425.00

Service Code	HCPCS 90836
Hospital Charge Code	4515705
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

Know your out-of-pocket cost for care.

All Charges