Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INJECTION SYRINGE

Facility

$3,350.00

Hospital Charge Code	270659099
Hospital Revenue Code	278
Min. Negotiated Rate	$502.50
Max. Negotiated Rate	$810.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$810.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$737.00
Rate for Payer: Qualcare PPO/HMO/WC	$502.50

INJECTION SYRINGE

Facility

$3,350.00

Hospital Charge Code	270659099
Hospital Revenue Code	278
Min. Negotiated Rate	$80.73
Max. Negotiated Rate	$1,675.00
Rate for Payer: Aetna Commercial	$1,273.00
Rate for Payer: Aetna Medicare Advantage	$1,005.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$854.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$854.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$854.25
Rate for Payer: Cigna Commercial	$1,675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$810.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$737.00
Rate for Payer: Qualcare PPO/HMO/WC	$502.50
Rate for Payer: UnitedHealthcare Community & State	$80.73
Rate for Payer: Wellpoint Medicaid Managed Care	$88.78

INJECTION TENDON ORIGIN

Facility

$1,449.20

Service Code	HCPCS 20551
Hospital Charge Code	412320551
Hospital Revenue Code	510
Min. Negotiated Rate	$217.38
Max. Negotiated Rate	$217.38
Rate for Payer: Qualcare PPO/HMO/WC	$217.38

INJECTION TENDON ORIGIN

Facility

$1,449.20

Service Code	HCPCS 20551
Hospital Charge Code	412320551
Hospital Revenue Code	510
Min. Negotiated Rate	$34.93
Max. Negotiated Rate	$1,316.35
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.76
Rate for Payer: Qualcare PPO/HMO/WC	$217.38
Rate for Payer: UnitedHealthcare Community & State	$34.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$38.40

INJECTION THERAPY OF VEIN

Facility

$2,127.90

Service Code	HCPCS 36470
Hospital Charge Code	421036470
Hospital Revenue Code	761
Min. Negotiated Rate	$319.19
Max. Negotiated Rate	$319.19
Rate for Payer: Qualcare PPO/HMO/WC	$319.19

INJECTION THERAPY OF VEIN

Facility

$2,127.90

Service Code	HCPCS 36470
Hospital Charge Code	421036470
Hospital Revenue Code	761
Min. Negotiated Rate	$27.10
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$638.37
Rate for Payer: Oxford Commercial	$425.58
Rate for Payer: Qualcare PPO/HMO/WC	$319.19
Rate for Payer: UnitedHealthcare Commercial	$425.58
Rate for Payer: UnitedHealthcare Community & State	$51.28
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$56.39

INJECTION THERAPY OF VEINS

Facility

$2,127.90

Service Code	HCPCS 36471
Hospital Charge Code	421036471
Hospital Revenue Code	761
Min. Negotiated Rate	$319.19
Max. Negotiated Rate	$319.19
Rate for Payer: Qualcare PPO/HMO/WC	$319.19

INJECTION THERAPY OF VEINS

Facility

$2,127.90

Service Code	HCPCS 36471
Hospital Charge Code	421036471
Hospital Revenue Code	761
Min. Negotiated Rate	$34.85
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
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	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$638.37
Rate for Payer: Oxford Commercial	$425.58
Rate for Payer: Qualcare PPO/HMO/WC	$319.19
Rate for Payer: UnitedHealthcare Commercial	$425.58
Rate for Payer: UnitedHealthcare Community & State	$51.28
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$56.39

INJECTION THERAPY OF VEINS

Facility

$1,243.20

Service Code	HCPCS 36471
Hospital Charge Code	1600000779
Hospital Revenue Code	360
Min. Negotiated Rate	$29.96
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
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	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.96
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$186.48
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$29.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$32.94

INJECTION THERAPY OF VEINS

Facility

$1,243.20

Service Code	HCPCS 36471
Hospital Charge Code	1600000779
Hospital Revenue Code	360
Min. Negotiated Rate	$186.48
Max. Negotiated Rate	$186.48
Rate for Payer: Qualcare PPO/HMO/WC	$186.48

INJECTION TREATMENT OF NERVE

Facility

$5,111.97

Service Code	HCPCS 64640
Hospital Charge Code	321564640
Hospital Revenue Code	361
Min. Negotiated Rate	$766.80
Max. Negotiated Rate	$766.80
Rate for Payer: Qualcare PPO/HMO/WC	$766.80

INJECTION TREATMENT OF NERVE

Facility

$4,216.24

Service Code	HCPCS 64620
Hospital Charge Code	1600000781
Hospital Revenue Code	360
Min. Negotiated Rate	$632.44
Max. Negotiated Rate	$632.44
Rate for Payer: Qualcare PPO/HMO/WC	$632.44

INJECTION TREATMENT OF NERVE

Facility

$11,498.50

Service Code	HCPCS 64605
Hospital Charge Code	1600000527
Hospital Revenue Code	360
Min. Negotiated Rate	$277.11
Max. Negotiated Rate	$8,374.11
Rate for Payer: Aetna Commercial	$6,310.10
Rate for Payer: Aetna Medicare Advantage	$7,516.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,374.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,374.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,319.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,374.11
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: Cigna Medicare Advantage	$2,319.89
Rate for Payer: Clover Medicare Advantage	$2,203.90
Rate for Payer: EmblemHealth Commercial	$6,959.67
Rate for Payer: Humana Medicare Advantage	$2,389.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,319.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,449.55
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,724.78
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$277.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,656.68
Rate for Payer: Wellpoint Medicaid Managed Care	$5,545.76

INJECTION TREATMENT OF NERVE

Facility

$4,216.24

Service Code	HCPCS 64620
Hospital Charge Code	1600000781
Hospital Revenue Code	360
Min. Negotiated Rate	$101.61
Max. Negotiated Rate	$3,793.00
Rate for Payer: Aetna Commercial	$2,858.12
Rate for Payer: Aetna Medicare Advantage	$3,404.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,050.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,793.00
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: Cigna Medicare Advantage	$1,050.78
Rate for Payer: Clover Medicare Advantage	$998.24
Rate for Payer: EmblemHealth Commercial	$3,152.34
Rate for Payer: Humana Medicare Advantage	$1,082.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,050.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,264.87
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$632.44
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$101.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,050.78
Rate for Payer: Wellcare Medicare Advantage	$1,050.78
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$2,311.74
Rate for Payer: Wellpoint Medicaid Managed Care	$2,266.41

INJECTION TREATMENT OF NERVE

Facility

$5,111.97

Service Code	HCPCS 64640
Hospital Charge Code	321564640
Hospital Revenue Code	361
Min. Negotiated Rate	$123.20
Max. Negotiated Rate	$3,793.00
Rate for Payer: Aetna Commercial	$2,858.12
Rate for Payer: Aetna Medicare Advantage	$3,404.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,050.78
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	$3,793.00
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: Cigna Medicare Advantage	$1,050.78
Rate for Payer: Clover Medicare Advantage	$998.24
Rate for Payer: EmblemHealth Commercial	$3,152.34
Rate for Payer: Humana Medicare Advantage	$1,082.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,050.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,533.59
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$766.80
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$123.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,050.78
Rate for Payer: Wellcare Medicare Advantage	$1,050.78
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$2,311.74
Rate for Payer: Wellpoint Medicaid Managed Care	$2,266.41

INJECTION TREATMENT OF NERVE

Facility

$11,498.50

Service Code	HCPCS 64605
Hospital Charge Code	1600000527
Hospital Revenue Code	360
Min. Negotiated Rate	$1,724.78
Max. Negotiated Rate	$1,724.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,724.78

INJECTOR BONE CEMENT

Facility

$205.00

Hospital Charge Code	270600344
Hospital Revenue Code	272
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$102.50
Rate for Payer: Aetna Commercial	$77.90
Rate for Payer: Aetna Medicare Advantage	$61.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.27
Rate for Payer: Cigna Commercial	$102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.50
Rate for Payer: Oxford Commercial	$41.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.75
Rate for Payer: UnitedHealthcare Commercial	$41.00
Rate for Payer: UnitedHealthcare Community & State	$4.94
Rate for Payer: Wellpoint Medicaid Managed Care	$5.43

INJECTOR BONE CEMENT

Facility

$205.00

Hospital Charge Code	270600344
Hospital Revenue Code	272
Min. Negotiated Rate	$30.75
Max. Negotiated Rate	$30.75
Rate for Payer: Qualcare PPO/HMO/WC	$30.75

INJECTOR CT SYRINGE FL DUAL

Facility

$71.94

Hospital Charge Code	270690349
Hospital Revenue Code	272
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$35.97
Rate for Payer: Aetna Commercial	$27.34
Rate for Payer: Aetna Medicare Advantage	$21.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.34
Rate for Payer: Cigna Commercial	$35.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.58
Rate for Payer: Oxford Commercial	$14.39
Rate for Payer: Qualcare PPO/HMO/WC	$10.79
Rate for Payer: UnitedHealthcare Commercial	$14.39
Rate for Payer: UnitedHealthcare Community & State	$1.73
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

INJECTOR CT SYRINGE FL DUAL

Facility

$71.94

Hospital Charge Code	270690349
Hospital Revenue Code	272
Min. Negotiated Rate	$10.79
Max. Negotiated Rate	$10.79
Rate for Payer: Qualcare PPO/HMO/WC	$10.79

INJECTOR CT SYRINGE FL SINGLE

Facility

$35.80

Hospital Charge Code	270690350
Hospital Revenue Code	272
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$5.37
Rate for Payer: Qualcare PPO/HMO/WC	$5.37

INJECTOR CT SYRINGE FL SINGLE

Facility

$35.80

Hospital Charge Code	270690350
Hospital Revenue Code	272
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$17.90
Rate for Payer: Aetna Commercial	$13.60
Rate for Payer: Aetna Medicare Advantage	$10.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.13
Rate for Payer: Cigna Commercial	$17.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.74
Rate for Payer: Oxford Commercial	$7.16
Rate for Payer: Qualcare PPO/HMO/WC	$5.37
Rate for Payer: UnitedHealthcare Commercial	$7.16
Rate for Payer: UnitedHealthcare Community & State	$0.86
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

INJECTOR FOR STAR LENS MSI-PR

Facility

$145.00

Hospital Charge Code	270638365
Hospital Revenue Code	276
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$55.10
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Community & State	$3.49
Rate for Payer: Wellpoint Medicaid Managed Care	$3.84

INJECTOR FOR STAR LENS MSI-PR

Facility

$145.00

Hospital Charge Code	270638365
Hospital Revenue Code	276
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

INJECTOR INLINE *******

Facility

$43.00

Hospital Charge Code	8003188
Hospital Revenue Code	279
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

Know your out-of-pocket cost for care.

All Charges