Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INTRO VISTABRITE 8FR 403-8553A

Facility

$281.85

Service Code	HCPCS C1887
Hospital Charge Code	270624374C
Hospital Revenue Code	278
Min. Negotiated Rate	$42.28
Max. Negotiated Rate	$68.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$62.01
Rate for Payer: Qualcare PPO/HMO/WC	$42.28

INTRO VISTABRITE 8FR 403-8553A

Facility

$281.85

Service Code	HCPCS C1887
Hospital Charge Code	270624374C
Hospital Revenue Code	278
Min. Negotiated Rate	$6.79
Max. Negotiated Rate	$140.93
Rate for Payer: Aetna Commercial	$107.10
Rate for Payer: Aetna Medicare Advantage	$84.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.87
Rate for Payer: Cigna Commercial	$140.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$62.01
Rate for Payer: Qualcare PPO/HMO/WC	$42.28
Rate for Payer: UnitedHealthcare Community & State	$6.79
Rate for Payer: Wellpoint Medicaid Managed Care	$7.47

INTRO VISTABRITE 8FR 403-8553A

Facility

$650.00

Service Code	HCPCS C1887
Hospital Charge Code	270624374N
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

INTRPHALANG TOE JNT EXC EA SGL

Facility

$19,998.60

Service Code	HCPCS 28160
Hospital Charge Code	16000402
Hospital Revenue Code	360
Min. Negotiated Rate	$2,999.79
Max. Negotiated Rate	$2,999.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79

INTRPHALANG TOE JNT EXC EA SGL

Facility

$19,998.60

Service Code	HCPCS 28160
Hospital Charge Code	16000402
Hospital Revenue Code	360
Min. Negotiated Rate	$481.97
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,999.58
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$481.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$529.96

INTRVASC US NONCORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	411037252
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

INTRVASC US NONCORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	366837252
Hospital Revenue Code	361
Min. Negotiated Rate	$124.60
Max. Negotiated Rate	$2,585.15
Rate for Payer: Aetna Commercial	$1,964.71
Rate for Payer: Aetna Medicare Advantage	$1,551.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,318.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,318.43
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	$1,318.43
Rate for Payer: Cigna Commercial	$2,585.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,551.09
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$775.54
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$124.60
Rate for Payer: Wellpoint Medicaid Managed Care	$137.01

INTRVASC US NONCORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	411037252
Hospital Revenue Code	361
Min. Negotiated Rate	$124.60
Max. Negotiated Rate	$2,585.15
Rate for Payer: Aetna Commercial	$1,964.71
Rate for Payer: Aetna Medicare Advantage	$1,551.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,318.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,318.43
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	$1,318.43
Rate for Payer: Cigna Commercial	$2,585.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,551.09
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$775.54
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$124.60
Rate for Payer: Wellpoint Medicaid Managed Care	$137.01

INTRVASC US NONCORONARY 1ST

Facility

$5,170.30

Service Code	HCPCS 37252
Hospital Charge Code	366837252
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

INTRVASC US NONCORONARY ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	366837253
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

INTRVASC US NONCORONARY ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	411037253
Hospital Revenue Code	361
Min. Negotiated Rate	$775.54
Max. Negotiated Rate	$775.54
Rate for Payer: Qualcare PPO/HMO/WC	$775.54

INTRVASC US NONCORONARY ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	411037253
Hospital Revenue Code	361
Min. Negotiated Rate	$124.60
Max. Negotiated Rate	$2,585.15
Rate for Payer: Aetna Commercial	$1,964.71
Rate for Payer: Aetna Medicare Advantage	$1,551.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,318.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,318.43
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	$1,318.43
Rate for Payer: Cigna Commercial	$2,585.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,551.09
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$775.54
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$124.60
Rate for Payer: Wellpoint Medicaid Managed Care	$137.01

INTRVASC US NONCORONARY ADDL

Facility

$5,170.30

Service Code	HCPCS 37253
Hospital Charge Code	366837253
Hospital Revenue Code	361
Min. Negotiated Rate	$124.60
Max. Negotiated Rate	$2,585.15
Rate for Payer: Aetna Commercial	$1,964.71
Rate for Payer: Aetna Medicare Advantage	$1,551.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,318.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,318.43
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	$1,318.43
Rate for Payer: Cigna Commercial	$2,585.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,551.09
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$775.54
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$124.60
Rate for Payer: Wellpoint Medicaid Managed Care	$137.01

INTRVU

Facility

$2,750.00

Hospital Charge Code	270705987
Hospital Revenue Code	279
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.00
Rate for Payer: Oxford Commercial	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Commercial	$550.00
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

INTRVU

Facility

$2,750.00

Hospital Charge Code	270705987
Hospital Revenue Code	279
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

INT TRANSF PEDICLE FLAP

Facility

$16,584.80

Service Code	HCPCS 15650
Hospital Charge Code	16000370
Hospital Revenue Code	360
Min. Negotiated Rate	$2,487.72
Max. Negotiated Rate	$2,487.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,487.72

INT TRANSF PEDICLE FLAP

Facility

$16,584.80

Service Code	HCPCS 15650
Hospital Charge Code	16000370
Hospital Revenue Code	360
Min. Negotiated Rate	$399.69
Max. Negotiated Rate	$8,848.20
Rate for Payer: Aetna Commercial	$6,667.35
Rate for Payer: Aetna Medicare Advantage	$7,941.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,848.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,848.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,451.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,742.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,848.20
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: Cigna Medicare Advantage	$2,451.23
Rate for Payer: Clover Medicare Advantage	$2,328.67
Rate for Payer: EmblemHealth Commercial	$7,353.69
Rate for Payer: Humana Medicare Advantage	$2,524.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,451.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,975.44
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,487.72
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$399.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,451.23
Rate for Payer: Wellcare Medicare Advantage	$2,451.23
Rate for Payer: Wellpoint Medicaid Managed Care	$439.50

INTUBATING AIRWAY FIBEROPTIC O

Facility

$32.50

Hospital Charge Code	270662677
Hospital Revenue Code	270
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$16.25
Rate for Payer: Aetna Commercial	$12.35
Rate for Payer: Aetna Medicare Advantage	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.29
Rate for Payer: Cigna Commercial	$16.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.88
Rate for Payer: UnitedHealthcare Commercial	$6.50
Rate for Payer: UnitedHealthcare Community & State	$0.78
Rate for Payer: Wellpoint Medicaid Managed Care	$0.86

INTUBATING AIRWAY FIBEROPTIC O

Facility

$32.50

Hospital Charge Code	270662677
Hospital Revenue Code	270
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$4.88
Rate for Payer: Qualcare PPO/HMO/WC	$4.88

INTUBATION ENDOTRACHEAL

Facility

$1,278.15

Service Code	HCPCS 31500
Hospital Charge Code	5100662
Hospital Revenue Code	361
Min. Negotiated Rate	$30.80
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$765.35
Rate for Payer: Aetna Medicare Advantage	$911.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,015.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,015.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$281.38
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	$1,015.70
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: Cigna Medicare Advantage	$281.38
Rate for Payer: Clover Medicare Advantage	$267.31
Rate for Payer: EmblemHealth Commercial	$844.14
Rate for Payer: Humana Medicare Advantage	$289.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$281.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.44
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$191.72
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$30.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$281.38
Rate for Payer: Wellcare Medicare Advantage	$281.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$640.73
Rate for Payer: Wellpoint Medicaid Managed Care	$628.17

INTUBATION ENDOTRACHEAL

Facility

$1,278.15

Service Code	HCPCS 31500
Hospital Charge Code	5100662
Hospital Revenue Code	361
Min. Negotiated Rate	$191.72
Max. Negotiated Rate	$191.72
Rate for Payer: Qualcare PPO/HMO/WC	$191.72

INTUBATION ENDOTRACHEAL

Facility

$903.25

Service Code	HCPCS 31500
Hospital Charge Code	74110063
Hospital Revenue Code	361
Min. Negotiated Rate	$21.77
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$765.35
Rate for Payer: Aetna Medicare Advantage	$911.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,015.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,015.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$281.38
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	$1,015.70
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: Cigna Medicare Advantage	$281.38
Rate for Payer: Clover Medicare Advantage	$267.31
Rate for Payer: EmblemHealth Commercial	$844.14
Rate for Payer: Humana Medicare Advantage	$289.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$281.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.98
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.49
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$21.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$281.38
Rate for Payer: Wellcare Medicare Advantage	$281.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$640.73
Rate for Payer: Wellpoint Medicaid Managed Care	$628.17

INTUBATION ENDOTRACHEAL

Facility

$1,278.15

Service Code	HCPCS 31500
Hospital Charge Code	9500055
Hospital Revenue Code	361
Min. Negotiated Rate	$191.72
Max. Negotiated Rate	$191.72
Rate for Payer: Qualcare PPO/HMO/WC	$191.72

INTUBATION ENDOTRACHEAL

Facility

$1,278.15

Service Code	HCPCS 31500
Hospital Charge Code	9500055
Hospital Revenue Code	361
Min. Negotiated Rate	$30.80
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$765.35
Rate for Payer: Aetna Medicare Advantage	$911.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,015.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,015.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$281.38
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	$1,015.70
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: Cigna Medicare Advantage	$281.38
Rate for Payer: Clover Medicare Advantage	$267.31
Rate for Payer: EmblemHealth Commercial	$844.14
Rate for Payer: Humana Medicare Advantage	$289.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$281.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.44
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$191.72
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$30.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$281.38
Rate for Payer: Wellcare Medicare Advantage	$281.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$640.73
Rate for Payer: Wellpoint Medicaid Managed Care	$628.17

INTUBATION ENDOTRACHEAL

Facility

$903.25

Service Code	HCPCS 31500
Hospital Charge Code	74110063
Hospital Revenue Code	361
Min. Negotiated Rate	$135.49
Max. Negotiated Rate	$135.49
Rate for Payer: Qualcare PPO/HMO/WC	$135.49

Know your out-of-pocket cost for care.

All Charges