Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR ABSCESS DRAINAGE EMPYEM HEM

Facility

$6,404.20

Service Code	HCPCS 32551
Hospital Charge Code	321032551
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

IR-ABSCESS DRAIN REN/PERIRENAL

Facility

$6,420.00

Service Code	HCPCS 49405
Hospital Charge Code	7411583
Hospital Revenue Code	361
Min. Negotiated Rate	$963.00
Max. Negotiated Rate	$963.00
Rate for Payer: Qualcare PPO/HMO/WC	$963.00

IR-ABSCESS DRAIN REN/PERIRENAL

Facility

$8,054.80

Service Code	HCPCS 49405
Hospital Charge Code	2680200
Hospital Revenue Code	361
Min. Negotiated Rate	$194.12
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,416.44
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$194.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$213.45

IR-ABSCESS DRAIN REN/PERIRENAL

Facility

$6,420.00

Service Code	HCPCS 49405
Hospital Charge Code	7411583
Hospital Revenue Code	361
Min. Negotiated Rate	$154.72
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,926.00
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$963.00
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$154.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$170.13

IR-ABSCESS DRAIN REN/PERIRENAL

Facility

$8,054.80

Service Code	HCPCS 49405
Hospital Charge Code	2680200
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR-ABSCESS DRAIN RETROPERITON

Facility

$4,597.00

Service Code	HCPCS 49406
Hospital Charge Code	7411585
Hospital Revenue Code	361
Min. Negotiated Rate	$689.55
Max. Negotiated Rate	$689.55
Rate for Payer: Qualcare PPO/HMO/WC	$689.55

IR-ABSCESS DRAIN RETROPERITON

Facility

$8,054.80

Service Code	HCPCS 49406
Hospital Charge Code	2670050
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR-ABSCESS DRAIN RETROPERITON

Facility

$8,054.80

Service Code	HCPCS 49406
Hospital Charge Code	2670050
Hospital Revenue Code	361
Min. Negotiated Rate	$194.12
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,416.44
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$194.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$213.45

IR-ABSCESS DRAIN RETROPERITON

Facility

$4,597.00

Service Code	HCPCS 49406
Hospital Charge Code	7411585
Hospital Revenue Code	361
Min. Negotiated Rate	$110.79
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,379.10
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$689.55
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$110.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$121.82

IR ABSCESS DRAIN SUBDIA SUBPHR

Facility

$6,139.10

Hospital Charge Code	2004018
Hospital Revenue Code	361
Min. Negotiated Rate	$147.95
Max. Negotiated Rate	$3,069.55
Rate for Payer: Aetna Commercial	$2,332.86
Rate for Payer: Aetna Medicare Advantage	$1,841.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,565.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,565.47
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	$1,565.47
Rate for Payer: Cigna Commercial	$3,069.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,841.73
Rate for Payer: Qualcare PPO/HMO/WC	$920.87
Rate for Payer: UnitedHealthcare Community & State	$147.95
Rate for Payer: Wellpoint Medicaid Managed Care	$162.69

IR ABSCESS DRAIN SUBDIA SUBPHR

Facility

$6,139.10

Hospital Charge Code	2004018
Hospital Revenue Code	361
Min. Negotiated Rate	$920.87
Max. Negotiated Rate	$920.87
Rate for Payer: Qualcare PPO/HMO/WC	$920.87

IR ABSCESS DRNGE PERITON PERC

Facility

$7,071.40

Service Code	HCPCS 49406
Hospital Charge Code	411049406
Hospital Revenue Code	361
Min. Negotiated Rate	$170.42
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,121.42
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$170.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$187.39

IR ABSCESS DRNGE PERITON PERC

Facility

$7,071.40

Service Code	HCPCS 49406
Hospital Charge Code	411049406
Hospital Revenue Code	361
Min. Negotiated Rate	$1,060.71
Max. Negotiated Rate	$1,060.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71

IR ABSCESS DRNGE PERITON PERC

Facility

$7,071.40

Service Code	HCPCS 49406
Hospital Charge Code	366849406
Hospital Revenue Code	361
Min. Negotiated Rate	$170.42
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,121.42
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$170.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$187.39

IR ABSCESS DRNGE PERITON PERC

Facility

$7,071.40

Service Code	HCPCS 49406
Hospital Charge Code	7411584
Hospital Revenue Code	361
Min. Negotiated Rate	$170.42
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,121.42
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$170.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$187.39

IR ABSCESS DRNGE PERITON PERC

Facility

$7,071.40

Service Code	HCPCS 49406
Hospital Charge Code	7411584
Hospital Revenue Code	361
Min. Negotiated Rate	$1,060.71
Max. Negotiated Rate	$1,060.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71

IR ABSCESS DRNGE PERITON PERC

Facility

$7,071.40

Service Code	HCPCS 49406
Hospital Charge Code	366849406
Hospital Revenue Code	361
Min. Negotiated Rate	$1,060.71
Max. Negotiated Rate	$1,060.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71

IR-ADD BREAST CYST-BI

Facility

$1,819.00

Service Code	HCPCS 1900150
Hospital Charge Code	7411771
Hospital Revenue Code	361
Min. Negotiated Rate	$272.85
Max. Negotiated Rate	$272.85
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

IR-ADD BREAST CYST-BI

Facility

$1,819.00

Service Code	HCPCS 1900150
Hospital Charge Code	7411771
Hospital Revenue Code	361
Min. Negotiated Rate	$43.84
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$691.22
Rate for Payer: Aetna Medicare Advantage	$545.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$463.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$463.85
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	$463.85
Rate for Payer: Cigna Commercial	$909.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.70
Rate for Payer: Qualcare PPO/HMO/WC	$272.85
Rate for Payer: UnitedHealthcare Community & State	$43.84
Rate for Payer: Wellpoint Medicaid Managed Care	$48.20

IR-ADD BREAST CYST-BI

Facility

$1,819.00

Service Code	HCPCS 1900150
Hospital Charge Code	2690305
Hospital Revenue Code	361
Min. Negotiated Rate	$272.85
Max. Negotiated Rate	$272.85
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

IR-ADD BREAST CYST-BI

Facility

$1,819.00

Service Code	HCPCS 1900150
Hospital Charge Code	2690305
Hospital Revenue Code	361
Min. Negotiated Rate	$43.84
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$691.22
Rate for Payer: Aetna Medicare Advantage	$545.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$463.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$463.85
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	$463.85
Rate for Payer: Cigna Commercial	$909.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.70
Rate for Payer: Qualcare PPO/HMO/WC	$272.85
Rate for Payer: UnitedHealthcare Community & State	$43.84
Rate for Payer: Wellpoint Medicaid Managed Care	$48.20

IR-ADD BREAST CYST-LT

Facility

$1,819.00

Service Code	HCPCS 19001LT
Hospital Charge Code	7411861
Hospital Revenue Code	361
Min. Negotiated Rate	$43.84
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$691.22
Rate for Payer: Aetna Medicare Advantage	$545.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$463.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$463.85
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	$463.85
Rate for Payer: Cigna Commercial	$909.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.70
Rate for Payer: Qualcare PPO/HMO/WC	$272.85
Rate for Payer: UnitedHealthcare Community & State	$43.84
Rate for Payer: Wellpoint Medicaid Managed Care	$48.20

IR-ADD BREAST CYST-LT

Facility

$1,819.00

Service Code	HCPCS 19001LT
Hospital Charge Code	2690880
Hospital Revenue Code	361
Min. Negotiated Rate	$43.84
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$691.22
Rate for Payer: Aetna Medicare Advantage	$545.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$463.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$463.85
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	$463.85
Rate for Payer: Cigna Commercial	$909.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.70
Rate for Payer: Qualcare PPO/HMO/WC	$272.85
Rate for Payer: UnitedHealthcare Community & State	$43.84
Rate for Payer: Wellpoint Medicaid Managed Care	$48.20

IR-ADD BREAST CYST-LT

Facility

$1,819.00

Service Code	HCPCS 19001LT
Hospital Charge Code	7411861
Hospital Revenue Code	361
Min. Negotiated Rate	$272.85
Max. Negotiated Rate	$272.85
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

IR-ADD BREAST CYST-LT

Facility

$1,819.00

Service Code	HCPCS 19001LT
Hospital Charge Code	2690880
Hospital Revenue Code	361
Min. Negotiated Rate	$272.85
Max. Negotiated Rate	$272.85
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

Know your out-of-pocket cost for care.

All Charges