Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR ANGIOGRAM SPINE SELECTIVE

Facility

$13,436.40

Service Code	HCPCS 75705
Hospital Charge Code	7411689
Hospital Revenue Code	323
Min. Negotiated Rate	$323.82
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	$344.80
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 ANGIOGRAM VERTEBRAL

Facility

$7,240.05

Hospital Charge Code	2600039
Hospital Revenue Code	323
Min. Negotiated Rate	$1,086.01
Max. Negotiated Rate	$1,086.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01

IR ANGIOGRAM VERTEBRAL

Facility

$7,240.05

Hospital Charge Code	2600039
Hospital Revenue Code	323
Min. Negotiated Rate	$174.49
Max. Negotiated Rate	$3,620.03
Rate for Payer: Aetna Commercial	$2,751.22
Rate for Payer: Aetna Medicare Advantage	$2,172.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,846.21
Rate for Payer: Cigna Commercial	$3,620.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,172.01
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$174.49
Rate for Payer: Wellpoint Medicaid Managed Care	$191.86

IR ANGIOGRAPHY AORTIC ARCH

Facility

$20,317.50

Hospital Charge Code	2001113
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

IR ANGIOGRAPHY AORTIC ARCH

Facility

$20,317.50

Hospital Charge Code	2001113
Hospital Revenue Code	323
Min. Negotiated Rate	$489.65
Max. Negotiated Rate	$10,158.75
Rate for Payer: Aetna Commercial	$7,720.65
Rate for Payer: Aetna Medicare Advantage	$6,095.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,180.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,180.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,180.96
Rate for Payer: Cigna Commercial	$10,158.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,095.25
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,047.62
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$489.65
Rate for Payer: Wellpoint Medicaid Managed Care	$538.41

IR ANGIOGRAPHY BRACHIAL RETRO

Facility

$4,605.65

Service Code	HCPCS 75658
Hospital Charge Code	7411688
Hospital Revenue Code	323
Min. Negotiated Rate	$111.00
Max. Negotiated Rate	$2,302.82
Rate for Payer: Aetna Commercial	$1,750.15
Rate for Payer: Aetna Medicare Advantage	$1,381.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,174.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,174.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,174.44
Rate for Payer: Cigna Commercial	$2,302.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,381.69
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$690.85
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$111.00
Rate for Payer: Wellpoint Medicaid Managed Care	$122.05

IR ANGIOGRAPHY BRACHIAL RETRO

Facility

$4,605.65

Service Code	HCPCS 75658
Hospital Charge Code	7411688
Hospital Revenue Code	323
Min. Negotiated Rate	$690.85
Max. Negotiated Rate	$690.85
Rate for Payer: Qualcare PPO/HMO/WC	$690.85

IR ANGIOGRAPHY BRACHIAL RETRO

Facility

$4,605.65

Service Code	HCPCS 75658
Hospital Charge Code	2000719
Hospital Revenue Code	323
Min. Negotiated Rate	$690.85
Max. Negotiated Rate	$690.85
Rate for Payer: Qualcare PPO/HMO/WC	$690.85

IR ANGIOGRAPHY BRACHIAL RETRO

Facility

$4,605.65

Service Code	HCPCS 75658
Hospital Charge Code	2000719
Hospital Revenue Code	323
Min. Negotiated Rate	$111.00
Max. Negotiated Rate	$2,302.82
Rate for Payer: Aetna Commercial	$1,750.15
Rate for Payer: Aetna Medicare Advantage	$1,381.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,174.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,174.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,174.44
Rate for Payer: Cigna Commercial	$2,302.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,381.69
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$690.85
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$111.00
Rate for Payer: Wellpoint Medicaid Managed Care	$122.05

IR ANGIOGRAPHY THRU X CATH F/U

Facility

$1,008.00

Service Code	HCPCS 75898
Hospital Charge Code	2001250
Hospital Revenue Code	323
Min. Negotiated Rate	$24.29
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	$212.96
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	$302.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$151.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$24.29
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	$26.71

IR ANGIOGRAPHY THRU X CATH F/U

Facility

$1,008.00

Service Code	HCPCS 75898
Hospital Charge Code	2001250
Hospital Revenue Code	323
Min. Negotiated Rate	$151.20
Max. Negotiated Rate	$151.20
Rate for Payer: Qualcare PPO/HMO/WC	$151.20

IR ANGIO HEPATIC SELECTIVE

Facility

$3,054.00

Service Code	HCPCS 75774
Hospital Charge Code	2001246
Hospital Revenue Code	323
Min. Negotiated Rate	$458.10
Max. Negotiated Rate	$458.10
Rate for Payer: Qualcare PPO/HMO/WC	$458.10

IR ANGIO HEPATIC SELECTIVE

Facility

$3,958.15

Service Code	HCPCS 75774
Hospital Charge Code	366875774
Hospital Revenue Code	323
Min. Negotiated Rate	$593.72
Max. Negotiated Rate	$593.72
Rate for Payer: Qualcare PPO/HMO/WC	$593.72

IR ANGIO HEPATIC SELECTIVE

Facility

$3,958.15

Service Code	HCPCS 75774
Hospital Charge Code	7411702
Hospital Revenue Code	323
Min. Negotiated Rate	$593.72
Max. Negotiated Rate	$593.72
Rate for Payer: Qualcare PPO/HMO/WC	$593.72

IR ANGIO HEPATIC SELECTIVE

Facility

$3,958.15

Service Code	HCPCS 75774
Hospital Charge Code	366875774
Hospital Revenue Code	323
Min. Negotiated Rate	$95.39
Max. Negotiated Rate	$1,979.08
Rate for Payer: Aetna Commercial	$1,504.10
Rate for Payer: Aetna Medicare Advantage	$1,187.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,009.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,009.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$352.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,009.33
Rate for Payer: Cigna Commercial	$1,979.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,187.44
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$593.72
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$95.39
Rate for Payer: Wellpoint Medicaid Managed Care	$104.89

IR ANGIO HEPATIC SELECTIVE

Facility

$3,958.15

Service Code	HCPCS 75774
Hospital Charge Code	411075774
Hospital Revenue Code	323
Min. Negotiated Rate	$95.39
Max. Negotiated Rate	$1,979.08
Rate for Payer: Aetna Commercial	$1,504.10
Rate for Payer: Aetna Medicare Advantage	$1,187.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,009.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,009.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$352.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,009.33
Rate for Payer: Cigna Commercial	$1,979.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,187.44
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$593.72
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$95.39
Rate for Payer: Wellpoint Medicaid Managed Care	$104.89

IR ANGIO HEPATIC SELECTIVE

Facility

$3,958.15

Service Code	HCPCS 75774
Hospital Charge Code	411075774
Hospital Revenue Code	323
Min. Negotiated Rate	$593.72
Max. Negotiated Rate	$593.72
Rate for Payer: Qualcare PPO/HMO/WC	$593.72

IR ANGIO HEPATIC SELECTIVE

Facility

$3,054.00

Service Code	HCPCS 75774
Hospital Charge Code	2001246
Hospital Revenue Code	323
Min. Negotiated Rate	$73.60
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$1,160.52
Rate for Payer: Aetna Medicare Advantage	$916.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$778.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$778.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$352.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$778.77
Rate for Payer: Cigna Commercial	$1,527.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$916.20
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$458.10
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$73.60
Rate for Payer: Wellpoint Medicaid Managed Care	$80.93

IR ANGIO HEPATIC SELECTIVE

Facility

$3,958.15

Service Code	HCPCS 75774
Hospital Charge Code	7411702
Hospital Revenue Code	323
Min. Negotiated Rate	$95.39
Max. Negotiated Rate	$1,979.08
Rate for Payer: Aetna Commercial	$1,504.10
Rate for Payer: Aetna Medicare Advantage	$1,187.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,009.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,009.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$352.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,009.33
Rate for Payer: Cigna Commercial	$1,979.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,187.44
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$593.72
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$95.39
Rate for Payer: Wellpoint Medicaid Managed Care	$104.89

IR ANGIO MESENTERIC INF

Facility

$13,436.40

Service Code	HCPCS 75726
Hospital Charge Code	7411691
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 MESENTERIC INF

Facility

$13,436.40

Service Code	HCPCS 75726
Hospital Charge Code	2001279
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 MESENTERIC INF

Facility

$13,436.40

Service Code	HCPCS 75726
Hospital Charge Code	2001279
Hospital Revenue Code	323
Min. Negotiated Rate	$275.92
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	$275.92
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 MESENTERIC INF

Facility

$13,436.40

Service Code	HCPCS 75726
Hospital Charge Code	7411691
Hospital Revenue Code	323
Min. Negotiated Rate	$275.92
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	$275.92
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 MESENTERIC SUP

Facility

$13,436.40

Service Code	HCPCS 75726
Hospital Charge Code	7411692
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 MESENTERIC SUP

Facility

$13,436.40

Service Code	HCPCS 75726
Hospital Charge Code	7411692
Hospital Revenue Code	323
Min. Negotiated Rate	$275.92
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	$275.92
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

Know your out-of-pocket cost for care.

All Charges