Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INFUSION THERAPY 6-8 HRS****

Facility

$287.00

Hospital Charge Code	3401016
Hospital Revenue Code	289
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$2,789.00
Rate for Payer: Aetna Commercial	$109.06
Rate for Payer: Aetna Medicare Advantage	$86.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.19
Rate for Payer: Cigna Commercial	$143.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.10
Rate for Payer: Oxford Commercial	$1,591.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.05
Rate for Payer: UnitedHealthcare Commercial	$2,789.00
Rate for Payer: UnitedHealthcare Community & State	$6.92
Rate for Payer: Wellpoint Medicaid Managed Care	$7.61

INFUSION THER/DIAG CONCURRENT

Facility

$116.48

Service Code	HCPCS 90768
Hospital Charge Code	3401075
Hospital Revenue Code	260
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$17.47
Rate for Payer: Qualcare PPO/HMO/WC	$17.47

INFUSION THER/DIAG CONCURRENT

Facility

$116.48

Service Code	HCPCS 90768
Hospital Charge Code	3401075
Hospital Revenue Code	260
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$44.26
Rate for Payer: Aetna Medicare Advantage	$34.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.70
Rate for Payer: Cigna Commercial	$58.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.94
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.47
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$2.81
Rate for Payer: Wellpoint Medicaid Managed Care	$3.09

INFUS KIT 5.2FR 30cm 500-52130

Facility

$12,475.00

Hospital Charge Code	270637509V
Hospital Revenue Code	278
Min. Negotiated Rate	$300.65
Max. Negotiated Rate	$6,237.50
Rate for Payer: Aetna Commercial	$4,740.50
Rate for Payer: Aetna Medicare Advantage	$3,742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,181.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,181.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,181.12
Rate for Payer: Cigna Commercial	$6,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,018.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,744.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,871.25
Rate for Payer: UnitedHealthcare Community & State	$300.65
Rate for Payer: Wellpoint Medicaid Managed Care	$330.59

INFUS KIT 5.2FR 30cm 500-52130

Facility

$12,475.00

Hospital Charge Code	270637509V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,871.25
Max. Negotiated Rate	$3,018.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,018.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,744.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,871.25

INFUS KIT 5.2FR 40cm 500-52140

Facility

$12,475.00

Hospital Charge Code	270637510V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,871.25
Max. Negotiated Rate	$3,018.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,018.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,744.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,871.25

INFUS KIT 5.2FR 40cm 500-52140

Facility

$12,475.00

Hospital Charge Code	270637510V
Hospital Revenue Code	278
Min. Negotiated Rate	$300.65
Max. Negotiated Rate	$6,237.50
Rate for Payer: Aetna Commercial	$4,740.50
Rate for Payer: Aetna Medicare Advantage	$3,742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,181.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,181.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,181.12
Rate for Payer: Cigna Commercial	$6,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,018.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,744.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,871.25
Rate for Payer: UnitedHealthcare Community & State	$300.65
Rate for Payer: Wellpoint Medicaid Managed Care	$330.59

INFUS KIT 5.2FR 50cm 500-52150

Facility

$11,975.00

Hospital Charge Code	270637511V
Hospital Revenue Code	278
Min. Negotiated Rate	$288.60
Max. Negotiated Rate	$5,987.50
Rate for Payer: Aetna Commercial	$4,550.50
Rate for Payer: Aetna Medicare Advantage	$3,592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,053.62
Rate for Payer: Cigna Commercial	$5,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,634.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25
Rate for Payer: UnitedHealthcare Community & State	$288.60
Rate for Payer: Wellpoint Medicaid Managed Care	$317.34

INFUS KIT 5.2FR 50cm 500-52150

Facility

$11,975.00

Hospital Charge Code	270637511V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,796.25
Max. Negotiated Rate	$2,897.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,897.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,634.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25

INFUSOR PRESSURE 1000CC DISP

Facility

$41.21

Hospital Charge Code	270658033
Hospital Revenue Code	270
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$20.61
Rate for Payer: Aetna Commercial	$15.66
Rate for Payer: Aetna Medicare Advantage	$12.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.51
Rate for Payer: Cigna Commercial	$20.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.36
Rate for Payer: Oxford Commercial	$8.24
Rate for Payer: Qualcare PPO/HMO/WC	$6.18
Rate for Payer: UnitedHealthcare Commercial	$8.24
Rate for Payer: UnitedHealthcare Community & State	$0.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1.09

INFUSOR PRESSURE 1000CC DISP

Facility

$41.21

Hospital Charge Code	270658033
Hospital Revenue Code	270
Min. Negotiated Rate	$6.18
Max. Negotiated Rate	$6.18
Rate for Payer: Qualcare PPO/HMO/WC	$6.18

INGEV MRI IS-1BI+FX RARV 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270679666
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

INGEV MRI IS-1BI+FX RARV 52CM

Facility

$4,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270679666
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC

Facility

$51,408.43

Service Code	MSDRG 351
Min. Negotiated Rate	$15,653.21
Max. Negotiated Rate	$51,408.43
Rate for Payer: Aetna Commercial	$35,580.79
Rate for Payer: Aetna Medicare Advantage	$51,408.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,961.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,961.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,477.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33,961.06
Rate for Payer: Cigna Commercial	$28,529.49
Rate for Payer: Cigna Medicare Advantage	$16,477.06
Rate for Payer: Clover Medicare Advantage	$15,653.21
Rate for Payer: EmblemHealth Commercial	$49,431.18
Rate for Payer: Humana Medicare Advantage	$16,971.37
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,477.06
Rate for Payer: Oxford Commercial	$20,504.53
Rate for Payer: UnitedHealthcare Commercial	$35,955.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,477.06
Rate for Payer: Wellcare Medicare Advantage	$16,477.06

INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC

Facility

$82,676.41

Service Code	MSDRG 350
Min. Negotiated Rate	$25,173.91
Max. Negotiated Rate	$82,676.41
Rate for Payer: Aetna Commercial	$57,065.45
Rate for Payer: Aetna Medicare Advantage	$82,676.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,826.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,826.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26,498.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55,826.40
Rate for Payer: Cigna Commercial	$46,633.42
Rate for Payer: Cigna Medicare Advantage	$26,498.85
Rate for Payer: Clover Medicare Advantage	$25,173.91
Rate for Payer: EmblemHealth Commercial	$79,496.55
Rate for Payer: Humana Medicare Advantage	$27,293.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26,498.85
Rate for Payer: Oxford Commercial	$33,516.06
Rate for Payer: UnitedHealthcare Commercial	$58,771.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$26,498.85
Rate for Payer: Wellcare Medicare Advantage	$26,498.85

INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC

Facility

$39,879.31

Service Code	MSDRG 352
Min. Negotiated Rate	$12,142.74
Max. Negotiated Rate	$39,879.31
Rate for Payer: Aetna Commercial	$27,658.94
Rate for Payer: Aetna Medicare Advantage	$39,879.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,819.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,819.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,781.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,819.71
Rate for Payer: Cigna Commercial	$21,854.21
Rate for Payer: Cigna Medicare Advantage	$12,781.83
Rate for Payer: Clover Medicare Advantage	$12,142.74
Rate for Payer: EmblemHealth Commercial	$38,345.49
Rate for Payer: Humana Medicare Advantage	$13,165.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,781.83
Rate for Payer: Oxford Commercial	$15,706.91
Rate for Payer: UnitedHealthcare Commercial	$27,542.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,781.83
Rate for Payer: Wellcare Medicare Advantage	$12,781.83

INGUINAL BLOCK

Facility

$2,196.25

Service Code	HCPCS 64425
Hospital Charge Code	1650117A
Hospital Revenue Code	361
Min. Negotiated Rate	$52.93
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,281.02
Rate for Payer: Aetna Medicare Advantage	$2,717.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$838.61
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	$3,027.13
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: Cigna Medicare Advantage	$838.61
Rate for Payer: Clover Medicare Advantage	$796.68
Rate for Payer: EmblemHealth Commercial	$2,515.83
Rate for Payer: Humana Medicare Advantage	$863.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$838.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$658.88
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$329.44
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$52.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$58.20

INGUINAL BLOCK

Facility

$2,196.25

Service Code	HCPCS 64425
Hospital Charge Code	1650117A
Hospital Revenue Code	361
Min. Negotiated Rate	$329.44
Max. Negotiated Rate	$329.44
Rate for Payer: Qualcare PPO/HMO/WC	$329.44

INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES

Facility

$14,341.27

Service Code	APR-DRG 2282
Min. Negotiated Rate	$14,060.07
Max. Negotiated Rate	$14,341.27
Rate for Payer: UnitedHealthcare Community & State	$14,060.07
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,341.27
Rate for Payer: Wellpoint Medicaid Managed Care	$14,060.07

INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES

Facility

$11,282.25

Service Code	APR-DRG 2281
Min. Negotiated Rate	$11,061.03
Max. Negotiated Rate	$11,282.25
Rate for Payer: UnitedHealthcare Community & State	$11,061.03
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,282.25
Rate for Payer: Wellpoint Medicaid Managed Care	$11,061.03

INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES

Facility

$36,719.42

Service Code	APR-DRG 2284
Min. Negotiated Rate	$35,999.43
Max. Negotiated Rate	$36,719.42
Rate for Payer: UnitedHealthcare Community & State	$35,999.43
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$36,719.42
Rate for Payer: Wellpoint Medicaid Managed Care	$35,999.43

INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES

Facility

$19,645.99

Service Code	APR-DRG 2283
Min. Negotiated Rate	$19,260.77
Max. Negotiated Rate	$19,645.99
Rate for Payer: UnitedHealthcare Community & State	$19,260.77
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,645.99
Rate for Payer: Wellpoint Medicaid Managed Care	$19,260.77

INHALATION TREATMENT

Facility

$1,122.00

Service Code	HCPCS 94640
Hospital Charge Code	412394640
Hospital Revenue Code	410
Min. Negotiated Rate	$27.04
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$707.61
Rate for Payer: Aetna Medicare Advantage	$842.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$939.06
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: Cigna Medicare Advantage	$260.15
Rate for Payer: Clover Medicare Advantage	$247.14
Rate for Payer: EmblemHealth Commercial	$780.45
Rate for Payer: Humana Medicare Advantage	$267.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$260.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.60
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.30
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$27.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$29.73

INHALATION TREATMENT

Facility

$1,122.00

Service Code	HCPCS 94640
Hospital Charge Code	412394640
Hospital Revenue Code	410
Min. Negotiated Rate	$168.30
Max. Negotiated Rate	$168.30
Rate for Payer: Qualcare PPO/HMO/WC	$168.30

INHIBIN A

Facility

$110.00

Service Code	HCPCS 86336
Hospital Charge Code	38479406
Hospital Revenue Code	302
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$42.40
Rate for Payer: Aetna Medicare Advantage	$50.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.28
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: Cigna Medicare Advantage	$15.59
Rate for Payer: Clover Medicare Advantage	$14.81
Rate for Payer: EmblemHealth Commercial	$46.77
Rate for Payer: Humana Medicare Advantage	$16.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.59
Rate for Payer: Wellcare Medicare Advantage	$15.59
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

Know your out-of-pocket cost for care.

All Charges