Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ANGIOTENSIN II

Facility

$145.34

Service Code	HCPCS 82163
Hospital Charge Code	38477167
Hospital Revenue Code	301
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$55.81
Rate for Payer: Aetna Medicare Advantage	$66.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.07
Rate for Payer: Cigna Commercial	$72.67
Rate for Payer: Cigna Medicare Advantage	$20.52
Rate for Payer: Clover Medicare Advantage	$19.49
Rate for Payer: EmblemHealth Commercial	$61.56
Rate for Payer: Humana Medicare Advantage	$21.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.52
Rate for Payer: Wellcare Medicare Advantage	$20.52
Rate for Payer: Wellpoint Medicaid Managed Care	$3.85

ANGIOTENSIN II

Facility

$145.34

Service Code	HCPCS 82163
Hospital Charge Code	38477167
Hospital Revenue Code	301
Min. Negotiated Rate	$21.80
Max. Negotiated Rate	$21.80
Rate for Payer: Qualcare PPO/HMO/WC	$21.80

ANGIO THRU EX CATH F/U EMB INF

Facility

$1,008.00

Service Code	HCPCS 75898
Hospital Charge Code	5100432
Hospital Revenue Code	320
Min. Negotiated Rate	$24.29
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$212.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$2,625.82
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$151.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$24.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$26.71

ANGIO THRU EX CATH F/U EMB INF

Facility

$1,008.00

Service Code	HCPCS 75898
Hospital Charge Code	5100432
Hospital Revenue Code	320
Min. Negotiated Rate	$151.20
Max. Negotiated Rate	$151.20
Rate for Payer: Qualcare PPO/HMO/WC	$151.20

ANGIO THRU EX CATH F/U EMB INF

Facility

$1,008.00

Service Code	HCPCS 75898
Hospital Charge Code	74110047
Hospital Revenue Code	320
Min. Negotiated Rate	$151.20
Max. Negotiated Rate	$151.20
Rate for Payer: Qualcare PPO/HMO/WC	$151.20

ANGIO THRU EX CATH F/U EMB INF

Facility

$1,008.00

Service Code	HCPCS 75898
Hospital Charge Code	74110047
Hospital Revenue Code	320
Min. Negotiated Rate	$24.29
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$212.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$2,625.82
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$151.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$24.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$26.71

ANGIO THRU EXISTING CATH

Facility

$971.00

Hospital Charge Code	2009105
Hospital Revenue Code	320
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$368.98
Rate for Payer: Aetna Medicare Advantage	$291.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.60
Rate for Payer: Cigna Commercial	$485.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.30
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.65
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$23.40
Rate for Payer: Wellpoint Medicaid Managed Care	$25.73

ANGIO THRU EXISTING CATH

Facility

$971.00

Hospital Charge Code	2009105
Hospital Revenue Code	320
Min. Negotiated Rate	$145.65
Max. Negotiated Rate	$145.65
Rate for Payer: Qualcare PPO/HMO/WC	$145.65

ANGIO THRU EXISTING CATH FUP**

Facility

$901.00

Service Code	HCPCS 75898
Hospital Charge Code	5100553
Hospital Revenue Code	320
Min. Negotiated Rate	$21.71
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$212.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$2,625.82
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.30
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.15
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$21.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$23.88

ANGIO THRU EXISTING CATH FUP**

Facility

$901.00

Service Code	HCPCS 75898
Hospital Charge Code	5100553
Hospital Revenue Code	320
Min. Negotiated Rate	$135.15
Max. Negotiated Rate	$135.15
Rate for Payer: Qualcare PPO/HMO/WC	$135.15

ANGIO TRAY

Facility

$67.00

Hospital Charge Code	4800955
Hospital Revenue Code	272
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

ANGIO TRAY

Facility

$67.00

Hospital Charge Code	4800955
Hospital Revenue Code	272
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$33.50
Rate for Payer: Aetna Commercial	$25.46
Rate for Payer: Aetna Medicare Advantage	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.09
Rate for Payer: Cigna Commercial	$33.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.10
Rate for Payer: Oxford Commercial	$13.40
Rate for Payer: Qualcare PPO/HMO/WC	$10.05
Rate for Payer: UnitedHealthcare Commercial	$13.40
Rate for Payer: UnitedHealthcare Community & State	$1.61
Rate for Payer: Wellpoint Medicaid Managed Care	$1.78

ANGLED ATTACHMENT

Facility

$4,986.60

Hospital Charge Code	270657060
Hospital Revenue Code	278
Min. Negotiated Rate	$120.18
Max. Negotiated Rate	$2,493.30
Rate for Payer: Aetna Commercial	$1,894.91
Rate for Payer: Aetna Medicare Advantage	$1,495.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,271.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,271.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$997.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,271.58
Rate for Payer: Cigna Commercial	$2,493.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,206.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,097.05
Rate for Payer: Qualcare PPO/HMO/WC	$747.99
Rate for Payer: UnitedHealthcare Community & State	$120.18
Rate for Payer: Wellpoint Medicaid Managed Care	$132.14

ANGLED ATTACHMENT

Facility

$4,986.60

Hospital Charge Code	270657060
Hospital Revenue Code	278
Min. Negotiated Rate	$747.99
Max. Negotiated Rate	$1,206.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$997.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,206.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,097.05
Rate for Payer: Qualcare PPO/HMO/WC	$747.99

ANGLED LIGHTS MODULE

Facility

$3,260.00

Hospital Charge Code	270657292
Hospital Revenue Code	278
Min. Negotiated Rate	$78.57
Max. Negotiated Rate	$1,630.00
Rate for Payer: Aetna Commercial	$1,238.80
Rate for Payer: Aetna Medicare Advantage	$978.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$831.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$831.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$652.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$831.30
Rate for Payer: Cigna Commercial	$1,630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$788.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$717.20
Rate for Payer: Qualcare PPO/HMO/WC	$489.00
Rate for Payer: UnitedHealthcare Community & State	$78.57
Rate for Payer: Wellpoint Medicaid Managed Care	$86.39

ANGLED LIGHTS MODULE

Facility

$3,260.00

Hospital Charge Code	270657292
Hospital Revenue Code	278
Min. Negotiated Rate	$489.00
Max. Negotiated Rate	$788.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$652.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$788.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$717.20
Rate for Payer: Qualcare PPO/HMO/WC	$489.00

ANGLED PHALANX SMALL

Facility

$5,390.00

Service Code	HCPCS C1776
Hospital Charge Code	270678675
Hospital Revenue Code	278
Min. Negotiated Rate	$808.50
Max. Negotiated Rate	$1,304.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,078.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,304.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,185.80
Rate for Payer: Qualcare PPO/HMO/WC	$808.50

ANGLED PHALANX SMALL

Facility

$5,390.00

Service Code	HCPCS C1776
Hospital Charge Code	270678675
Hospital Revenue Code	278
Min. Negotiated Rate	$129.90
Max. Negotiated Rate	$2,695.00
Rate for Payer: Aetna Commercial	$2,048.20
Rate for Payer: Aetna Medicare Advantage	$1,617.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,374.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,374.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,078.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,374.45
Rate for Payer: Cigna Commercial	$2,695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,304.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,185.80
Rate for Payer: Qualcare PPO/HMO/WC	$808.50
Rate for Payer: UnitedHealthcare Community & State	$129.90
Rate for Payer: Wellpoint Medicaid Managed Care	$142.84

ANGLE GLIDEWIRE .035 260

Facility

$230.41

Hospital Charge Code	2709000699
Hospital Revenue Code	272
Min. Negotiated Rate	$34.56
Max. Negotiated Rate	$34.56
Rate for Payer: Qualcare PPO/HMO/WC	$34.56

ANGLE GLIDEWIRE .035 260

Facility

$230.41

Hospital Charge Code	2709000699
Hospital Revenue Code	272
Min. Negotiated Rate	$5.55
Max. Negotiated Rate	$115.20
Rate for Payer: Aetna Commercial	$87.56
Rate for Payer: Aetna Medicare Advantage	$69.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.75
Rate for Payer: Cigna Commercial	$115.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.12
Rate for Payer: Oxford Commercial	$46.08
Rate for Payer: Qualcare PPO/HMO/WC	$34.56
Rate for Payer: UnitedHealthcare Commercial	$46.08
Rate for Payer: UnitedHealthcare Community & State	$5.55
Rate for Payer: Wellpoint Medicaid Managed Care	$6.11

ANGLE SCREW SELF DRILL 3.8X16

Facility

$2,500.00

Hospital Charge Code	270703196
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

ANGLE SCREW SELF DRILL 3.8X16

Facility

$2,500.00

Hospital Charge Code	270703196
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

ANIPULATE HIP JNT W ANESTH

Facility

$6,527.12

Service Code	HCPCS 27275
Hospital Charge Code	16000330
Hospital Revenue Code	360
Min. Negotiated Rate	$979.07
Max. Negotiated Rate	$979.07
Rate for Payer: Qualcare PPO/HMO/WC	$979.07

ANIPULATE HIP JNT W ANESTH

Facility

$6,527.12

Service Code	HCPCS 27275
Hospital Charge Code	16000330
Hospital Revenue Code	360
Min. Negotiated Rate	$157.30
Max. Negotiated Rate	$6,895.75
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
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	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,958.14
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$979.07
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$157.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$172.97

ANISTREPLASE INJ 30 UNIT

Facility

$13,138.60

Hospital Charge Code	6008510
Hospital Revenue Code	636
Min. Negotiated Rate	$1,970.79
Max. Negotiated Rate	$3,179.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,179.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,970.79

Know your out-of-pocket cost for care.

All Charges