Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INJECTION FOR CHOLANGIOGRAM

Facility

$11,644.64

Service Code	HCPCS 47531
Hospital Charge Code	16000982
Hospital Revenue Code	360
Min. Negotiated Rate	$1,746.70
Max. Negotiated Rate	$1,746.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,746.70

INJECTION FOR CHOLANGIOGRAM

Facility

$14,313.70

Service Code	HCPCS 47531
Hospital Charge Code	2011600
Hospital Revenue Code	361
Min. Negotiated Rate	$2,147.05
Max. Negotiated Rate	$2,147.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,147.05

INJECTION FOR CHOLANGIOGRAM

Facility

$14,313.70

Service Code	HCPCS 47531
Hospital Charge Code	7412075
Hospital Revenue Code	361
Min. Negotiated Rate	$344.96
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,294.11
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,147.05
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$344.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$379.31

INJECTION FOR CHOLANGIOGRAM

Facility

$11,644.64

Service Code	HCPCS 47531
Hospital Charge Code	16000982
Hospital Revenue Code	360
Min. Negotiated Rate	$280.64
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,493.39
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,746.70
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$280.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$308.58

INJECTION FOR HEART X-RAYS

Facility

$1,600.00

Service Code	HCPCS 93566
Hospital Charge Code	5100590
Hospital Revenue Code	481
Min. Negotiated Rate	$38.56
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$608.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$408.00
Rate for Payer: Cigna Commercial	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$480.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$38.56
Rate for Payer: Wellpoint Medicaid Managed Care	$42.40

INJECTION FOR HEART X-RAYS

Facility

$1,600.00

Service Code	HCPCS 93566
Hospital Charge Code	5100590
Hospital Revenue Code	481
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$240.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

INJECTION FOR LUNG ANGIOGRAM

Facility

$1,280.00

Service Code	HCPCS 93541
Hospital Charge Code	5100093
Hospital Revenue Code	481
Min. Negotiated Rate	$192.00
Max. Negotiated Rate	$192.00
Rate for Payer: Qualcare PPO/HMO/WC	$192.00

INJECTION FOR LUNG ANGIOGRAM

Facility

$1,280.00

Service Code	HCPCS 93541
Hospital Charge Code	5100093
Hospital Revenue Code	481
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$486.40
Rate for Payer: Aetna Medicare Advantage	$384.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$326.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$326.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$326.40
Rate for Payer: Cigna Commercial	$640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$192.00
Rate for Payer: UnitedHealthcare Community & State	$30.85
Rate for Payer: Wellpoint Medicaid Managed Care	$33.92

INJECTION IA NON-CHEMO

Facility

$250.00

Service Code	HCPCS 96373
Hospital Charge Code	3400257
Hospital Revenue Code	260
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

INJECTION IA NON-CHEMO

Facility

$250.00

Service Code	HCPCS 96373
Hospital Charge Code	3400257
Hospital Revenue Code	260
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$912.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$912.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$912.17
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	4501031
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	84509060
Hospital Revenue Code	260
Min. Negotiated Rate	$22.71
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.77
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$67.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$74.20

INJECTION IM/SUBQ

Facility

$320.48

Service Code	HCPCS 96372
Hospital Charge Code	2250410
Hospital Revenue Code	260
Min. Negotiated Rate	$48.07
Max. Negotiated Rate	$48.07
Rate for Payer: Qualcare PPO/HMO/WC	$48.07

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	74308250
Hospital Revenue Code	260
Min. Negotiated Rate	$22.71
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.77
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$67.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$74.20

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	74308250
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INJECTION IM/SUBQ

Facility

$206.86

Service Code	HCPCS 96372
Hospital Charge Code	36540003
Hospital Revenue Code	260
Min. Negotiated Rate	$31.03
Max. Negotiated Rate	$31.03
Rate for Payer: Qualcare PPO/HMO/WC	$31.03

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	75190155
Hospital Revenue Code	260
Min. Negotiated Rate	$22.71
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.77
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$67.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$74.20

INJECTION IM/SUBQ

Facility

$320.48

Service Code	HCPCS 96372
Hospital Charge Code	5700254
Hospital Revenue Code	260
Min. Negotiated Rate	$7.72
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.77
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.14
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.07
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$7.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$8.49

INJECTION IM/SUBQ

Facility

$345.05

Service Code	HCPCS 96372
Hospital Charge Code	84310135
Hospital Revenue Code	510
Min. Negotiated Rate	$51.76
Max. Negotiated Rate	$51.76
Rate for Payer: Qualcare PPO/HMO/WC	$51.76

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	3400256
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	2301091
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	73237024
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INJECTION IM/SUBQ

Facility

$345.05

Service Code	HCPCS 96372
Hospital Charge Code	83652387
Hospital Revenue Code	510
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$308.77
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.77
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.52
Rate for Payer: Qualcare PPO/HMO/WC	$51.76
Rate for Payer: UnitedHealthcare Community & State	$8.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$9.14

INJECTION IM/SUBQ

Facility

$345.05

Service Code	HCPCS 96372
Hospital Charge Code	83652387
Hospital Revenue Code	510
Min. Negotiated Rate	$51.76
Max. Negotiated Rate	$51.76
Rate for Payer: Qualcare PPO/HMO/WC	$51.76

INJECTION IM/SUBQ

Facility

$201.60

Service Code	HCPCS 96372
Hospital Charge Code	3400256M
Hospital Revenue Code	260
Min. Negotiated Rate	$30.24
Max. Negotiated Rate	$30.24
Rate for Payer: Qualcare PPO/HMO/WC	$30.24

Know your out-of-pocket cost for care.

All Charges