Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INS CATH ABD/L-EXT ART 1ST

Facility

$3,632.92

Service Code	HCPCS 36245
Hospital Charge Code	16000580
Hospital Revenue Code	360
Min. Negotiated Rate	$87.55
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,380.51
Rate for Payer: Aetna Medicare Advantage	$1,089.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$926.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$926.39
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	$926.39
Rate for Payer: Cigna Commercial	$1,816.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$544.94
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$87.55
Rate for Payer: Wellpoint Medicaid Managed Care	$96.27

INS CATH ABD/L-EXT ART ADDL

Facility

$484.00

Service Code	HCPCS 36248
Hospital Charge Code	366836248
Hospital Revenue Code	361
Min. Negotiated Rate	$72.60
Max. Negotiated Rate	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

INS CATH ABD/L-EXT ART ADDL

Facility

$484.00

Service Code	HCPCS 36248
Hospital Charge Code	366836248
Hospital Revenue Code	361
Min. Negotiated Rate	$11.66
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$183.92
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
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	$123.42
Rate for Payer: Cigna Commercial	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.60
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$11.66
Rate for Payer: Wellpoint Medicaid Managed Care	$12.83

INS CATH ABD/L-EXT ART ADDL

Facility

$2,620.78

Service Code	HCPCS 36248
Hospital Charge Code	16000733
Hospital Revenue Code	360
Min. Negotiated Rate	$393.12
Max. Negotiated Rate	$393.12
Rate for Payer: Qualcare PPO/HMO/WC	$393.12

INS CATH ABD/L-EXT ART ADDL

Facility

$2,620.78

Service Code	HCPCS 36248
Hospital Charge Code	16000733
Hospital Revenue Code	360
Min. Negotiated Rate	$63.16
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$995.90
Rate for Payer: Aetna Medicare Advantage	$786.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$668.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$668.30
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	$668.30
Rate for Payer: Cigna Commercial	$1,310.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.23
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$393.12
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$63.16
Rate for Payer: Wellpoint Medicaid Managed Care	$69.45

INS CATH REN ART 1ST BILAT

Facility

$12,462.85

Service Code	HCPCS 36252
Hospital Charge Code	411036252
Hospital Revenue Code	361
Min. Negotiated Rate	$1,869.43
Max. Negotiated Rate	$1,869.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43

INS CATH REN ART 1ST BILAT

Facility

$12,462.85

Service Code	HCPCS 36252
Hospital Charge Code	366836252
Hospital Revenue Code	361
Min. Negotiated Rate	$300.35
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	$1,626.00
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	$3,751.17
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	$3,738.86
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$300.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,216.80
Rate for Payer: Wellpoint Medicaid Managed Care	$7,075.29

INS CATH REN ART 1ST BILAT

Facility

$12,462.85

Service Code	HCPCS 36252
Hospital Charge Code	366836252
Hospital Revenue Code	361
Min. Negotiated Rate	$1,869.43
Max. Negotiated Rate	$1,869.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43

INS CATH REN ART 1ST BILAT

Facility

$12,462.85

Service Code	HCPCS 36252
Hospital Charge Code	411036252
Hospital Revenue Code	361
Min. Negotiated Rate	$300.35
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	$1,626.00
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	$3,751.17
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	$3,738.86
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$300.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,216.80
Rate for Payer: Wellpoint Medicaid Managed Care	$7,075.29

INS CATH REN ART 1ST UNILAT

Facility

$12,462.85

Service Code	HCPCS 36251
Hospital Charge Code	411036251
Hospital Revenue Code	361
Min. Negotiated Rate	$1,869.43
Max. Negotiated Rate	$1,869.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43

INS CATH REN ART 1ST UNILAT

Facility

$12,462.85

Service Code	HCPCS 36251
Hospital Charge Code	411036251
Hospital Revenue Code	361
Min. Negotiated Rate	$300.35
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	$1,626.00
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	$3,751.17
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	$3,738.86
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,869.43
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$300.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,216.80
Rate for Payer: Wellpoint Medicaid Managed Care	$7,075.29

INS DRL SLV3.5/2.5m4808-035-02

Facility

$344.00

Hospital Charge Code	270634936
Hospital Revenue Code	272
Min. Negotiated Rate	$51.60
Max. Negotiated Rate	$51.60
Rate for Payer: Qualcare PPO/HMO/WC	$51.60

INS DRL SLV3.5/2.5m4808-035-02

Facility

$344.00

Hospital Charge Code	270634936
Hospital Revenue Code	272
Min. Negotiated Rate	$8.29
Max. Negotiated Rate	$172.00
Rate for Payer: Aetna Commercial	$130.72
Rate for Payer: Aetna Medicare Advantage	$103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.72
Rate for Payer: Cigna Commercial	$172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.20
Rate for Payer: Oxford Commercial	$68.80
Rate for Payer: Qualcare PPO/HMO/WC	$51.60
Rate for Payer: UnitedHealthcare Commercial	$68.80
Rate for Payer: UnitedHealthcare Community & State	$8.29
Rate for Payer: Wellpoint Medicaid Managed Care	$9.12

INSECT VEN, PAPER WASP

Facility

$46.25

Hospital Charge Code	3035148
Hospital Revenue Code	301
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$17.57
Rate for Payer: Aetna Medicare Advantage	$13.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.79
Rate for Payer: Cigna Commercial	$23.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.88
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.94
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$1.23

INSECT VEN, PAPER WASP

Facility

$46.25

Hospital Charge Code	3035148
Hospital Revenue Code	301
Min. Negotiated Rate	$6.94
Max. Negotiated Rate	$6.94
Rate for Payer: Qualcare PPO/HMO/WC	$6.94

INSER PERIPH STENT S&I NON-COR

Facility

$1,648.00

Hospital Charge Code	5100340
Hospital Revenue Code	320
Min. Negotiated Rate	$39.72
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$626.24
Rate for Payer: Aetna Medicare Advantage	$494.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.24
Rate for Payer: Cigna Commercial	$824.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$494.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$39.72
Rate for Payer: Wellpoint Medicaid Managed Care	$43.67

INSER PERIPH STENT S&I NON-COR

Facility

$1,648.00

Hospital Charge Code	5100340
Hospital Revenue Code	320
Min. Negotiated Rate	$247.20
Max. Negotiated Rate	$247.20
Rate for Payer: Qualcare PPO/HMO/WC	$247.20

INSER PIC LINE FLURO/ULTRA S&I

Facility

$608.00

Service Code	HCPCS 36489
Hospital Charge Code	5100575
Hospital Revenue Code	320
Min. Negotiated Rate	$91.20
Max. Negotiated Rate	$91.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.20

INSER PIC LINE FLURO/ULTRA S&I

Facility

$608.00

Service Code	HCPCS 36489
Hospital Charge Code	5100575
Hospital Revenue Code	320
Min. Negotiated Rate	$14.65
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$231.04
Rate for Payer: Aetna Medicare Advantage	$182.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.04
Rate for Payer: Cigna Commercial	$304.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$14.65
Rate for Payer: Wellpoint Medicaid Managed Care	$16.11

INSERT 12X63/62 183622

Facility

$4,975.00

Hospital Charge Code	270639115
Hospital Revenue Code	272
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$746.25
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

INSERT 12X63/62 183622

Facility

$4,975.00

Hospital Charge Code	270639115
Hospital Revenue Code	272
Min. Negotiated Rate	$119.90
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,890.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,492.50
Rate for Payer: Oxford Commercial	$995.00
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Commercial	$995.00
Rate for Payer: UnitedHealthcare Community & State	$119.90
Rate for Payer: Wellpoint Medicaid Managed Care	$131.84

INSERT 12x63/67 183722

Facility

$5,370.00

Hospital Charge Code	270639168
Hospital Revenue Code	272
Min. Negotiated Rate	$805.50
Max. Negotiated Rate	$805.50
Rate for Payer: Qualcare PPO/HMO/WC	$805.50

INSERT 12x63/67 183722

Facility

$5,370.00

Hospital Charge Code	270639168
Hospital Revenue Code	272
Min. Negotiated Rate	$129.42
Max. Negotiated Rate	$2,685.00
Rate for Payer: Aetna Commercial	$2,040.60
Rate for Payer: Aetna Medicare Advantage	$1,611.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,369.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,369.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,369.35
Rate for Payer: Cigna Commercial	$2,685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.00
Rate for Payer: Oxford Commercial	$1,074.00
Rate for Payer: Qualcare PPO/HMO/WC	$805.50
Rate for Payer: UnitedHealthcare Commercial	$1,074.00
Rate for Payer: UnitedHealthcare Community & State	$129.42
Rate for Payer: Wellpoint Medicaid Managed Care	$142.31

INSERT 12 X 67 11146532

Facility

$4,459.10

Hospital Charge Code	270633958
Hospital Revenue Code	272
Min. Negotiated Rate	$668.87
Max. Negotiated Rate	$668.87
Rate for Payer: Qualcare PPO/HMO/WC	$668.87

INSERT 12 X 67 11146532

Facility

$4,459.10

Hospital Charge Code	270633958
Hospital Revenue Code	272
Min. Negotiated Rate	$107.46
Max. Negotiated Rate	$2,229.55
Rate for Payer: Aetna Commercial	$1,694.46
Rate for Payer: Aetna Medicare Advantage	$1,337.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,137.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,137.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,137.07
Rate for Payer: Cigna Commercial	$2,229.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,337.73
Rate for Payer: Oxford Commercial	$891.82
Rate for Payer: Qualcare PPO/HMO/WC	$668.87
Rate for Payer: UnitedHealthcare Commercial	$891.82
Rate for Payer: UnitedHealthcare Community & State	$107.46
Rate for Payer: Wellpoint Medicaid Managed Care	$118.17

Know your out-of-pocket cost for care.

All Charges