Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR-ADD BREAST CYST-RT

Facility

$1,819.00

Service Code	HCPCS 19001RT
Hospital Charge Code	7411862
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-RT

Facility

$1,819.00

Service Code	HCPCS 19001RT
Hospital Charge Code	2690885
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-RT

Facility

$1,819.00

Service Code	HCPCS 19001RT
Hospital Charge Code	2690885
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-RT

Facility

$1,819.00

Service Code	HCPCS 19001RT
Hospital Charge Code	7411862
Hospital Revenue Code	361
Min. Negotiated Rate	$272.85
Max. Negotiated Rate	$272.85
Rate for Payer: Qualcare PPO/HMO/WC	$272.85

IR-AIR INJ INTO ABDOMENA

Facility

$154.00

Service Code	HCPCS 49400
Hospital Charge Code	2690140
Hospital Revenue Code	361
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

IR-AIR INJ INTO ABDOMENA

Facility

$154.00

Service Code	HCPCS 49400
Hospital Charge Code	7411579
Hospital Revenue Code	361
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

IR-AIR INJ INTO ABDOMENA

Facility

$154.00

Service Code	HCPCS 49400
Hospital Charge Code	2690140
Hospital Revenue Code	361
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$58.52
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
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	$39.27
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.20
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$3.71
Rate for Payer: Wellpoint Medicaid Managed Care	$4.08

IR-AIR INJ INTO ABDOMENA

Facility

$154.00

Service Code	HCPCS 49400
Hospital Charge Code	7411579
Hospital Revenue Code	361
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$58.52
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
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	$39.27
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.20
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$3.71
Rate for Payer: Wellpoint Medicaid Managed Care	$4.08

IR ANGIO AORTA,ABD BILAT ILEOF

Facility

$15,468.50

Service Code	HCPCS 75630
Hospital Charge Code	321075630
Hospital Revenue Code	323
Min. Negotiated Rate	$169.40
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	$169.40
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	$2,625.82
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	$4,640.55
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$372.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$409.92

IR ANGIO AORTA,ABD BILAT ILEOF

Facility

$15,468.50

Service Code	HCPCS 75630
Hospital Charge Code	2004851
Hospital Revenue Code	323
Min. Negotiated Rate	$169.40
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	$169.40
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	$2,625.82
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	$4,640.55
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$372.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$409.92

IR ANGIO AORTA,ABD BILAT ILEOF

Facility

$15,468.50

Service Code	HCPCS 75630
Hospital Charge Code	2004851
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR ANGIO AORTA,ABD BILAT ILEOF

Facility

$15,468.50

Service Code	HCPCS 75630
Hospital Charge Code	321075630
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR ANGIO AORTA-THORACIC

Facility

$13,436.40

Service Code	HCPCS 75605
Hospital Charge Code	2001337
Hospital Revenue Code	323
Min. Negotiated Rate	$277.49
Max. Negotiated Rate	$23,862.86
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,862.86
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$4,627.53
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,030.92
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$323.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$356.06

IR ANGIO AORTA-THORACIC

Facility

$13,436.40

Service Code	HCPCS 75605
Hospital Charge Code	2001337
Hospital Revenue Code	323
Min. Negotiated Rate	$2,015.46
Max. Negotiated Rate	$2,015.46
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46

IR ANGIO BALLON PERPHRAL ARTRY

Facility

$21,962.30

Service Code	HCPCS 75962
Hospital Charge Code	2600002
Hospital Revenue Code	320
Min. Negotiated Rate	$529.29
Max. Negotiated Rate	$10,981.15
Rate for Payer: Aetna Commercial	$8,345.67
Rate for Payer: Aetna Medicare Advantage	$6,588.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,600.39
Rate for Payer: Cigna Commercial	$10,981.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,588.69
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$529.29
Rate for Payer: Wellpoint Medicaid Managed Care	$582.00

IR ANGIO BALLON PERPHRAL ARTRY

Facility

$21,962.30

Service Code	HCPCS 75962
Hospital Charge Code	2600002
Hospital Revenue Code	320
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR ANGIO BALLON RENAL BILTERAL

Facility

$21,962.30

Service Code	HCPCS 75966
Hospital Charge Code	2600003
Hospital Revenue Code	320
Min. Negotiated Rate	$529.29
Max. Negotiated Rate	$10,981.15
Rate for Payer: Aetna Commercial	$8,345.67
Rate for Payer: Aetna Medicare Advantage	$6,588.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,600.39
Rate for Payer: Cigna Commercial	$10,981.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,588.69
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$529.29
Rate for Payer: Wellpoint Medicaid Managed Care	$582.00

IR ANGIO BALLON RENAL BILTERAL

Facility

$21,962.30

Service Code	HCPCS 75966
Hospital Charge Code	7411738
Hospital Revenue Code	320
Min. Negotiated Rate	$529.29
Max. Negotiated Rate	$10,981.15
Rate for Payer: Aetna Commercial	$8,345.67
Rate for Payer: Aetna Medicare Advantage	$6,588.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,600.39
Rate for Payer: Cigna Commercial	$10,981.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,588.69
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$529.29
Rate for Payer: Wellpoint Medicaid Managed Care	$582.00

IR ANGIO BALLON RENAL BILTERAL

Facility

$21,962.30

Service Code	HCPCS 75966
Hospital Charge Code	7411738
Hospital Revenue Code	320
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR ANGIO BALLON RENAL BILTERAL

Facility

$21,962.30

Service Code	HCPCS 75966
Hospital Charge Code	2600003
Hospital Revenue Code	320
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR ANGIO BALLOON RENAL LEFT

Facility

$21,962.30

Service Code	HCPCS 75966
Hospital Charge Code	2600004
Hospital Revenue Code	320
Min. Negotiated Rate	$529.29
Max. Negotiated Rate	$10,981.15
Rate for Payer: Aetna Commercial	$8,345.67
Rate for Payer: Aetna Medicare Advantage	$6,588.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,600.39
Rate for Payer: Cigna Commercial	$10,981.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,588.69
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$529.29
Rate for Payer: Wellpoint Medicaid Managed Care	$582.00

IR ANGIO BALLOON RENAL LEFT

Facility

$21,962.30

Service Code	HCPCS 75966
Hospital Charge Code	2600004
Hospital Revenue Code	320
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR ANGIO BALLOON RENAL RIGHT

Facility

$21,962.30

Service Code	HCPCS 75966
Hospital Charge Code	2600005
Hospital Revenue Code	320
Min. Negotiated Rate	$529.29
Max. Negotiated Rate	$10,981.15
Rate for Payer: Aetna Commercial	$8,345.67
Rate for Payer: Aetna Medicare Advantage	$6,588.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,600.39
Rate for Payer: Cigna Commercial	$10,981.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,588.69
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$529.29
Rate for Payer: Wellpoint Medicaid Managed Care	$582.00

IR ANGIO BALLOON RENAL RIGHT

Facility

$21,962.30

Service Code	HCPCS 75966
Hospital Charge Code	2600005
Hospital Revenue Code	320
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR ANGIO CAROTID CEREBRAL BI

Facility

$20,317.50

Hospital Charge Code	2000842
Hospital Revenue Code	323
Min. Negotiated Rate	$3,047.62
Max. Negotiated Rate	$3,047.62
Rate for Payer: Qualcare PPO/HMO/WC	$3,047.62

Know your out-of-pocket cost for care.

All Charges