Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR ARTHROCENTESIS MAJOR JOINT

Facility

$1,091.00

Service Code	HCPCS 20610
Hospital Charge Code	2680035
Hospital Revenue Code	361
Min. Negotiated Rate	$163.65
Max. Negotiated Rate	$163.65
Rate for Payer: Qualcare PPO/HMO/WC	$163.65

IR ARTHROCENTESIS MAJOR JOINT

Facility

$1,091.00

Service Code	HCPCS 20610
Hospital Charge Code	7411346
Hospital Revenue Code	361
Min. Negotiated Rate	$26.29
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$327.30
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$163.65
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$26.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$28.91

IR ARTHROGRAM TRAY

Facility

$360.00

Hospital Charge Code	4800975
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

IR ARTHROGRAM TRAY

Facility

$360.00

Hospital Charge Code	4800975
Hospital Revenue Code	272
Min. Negotiated Rate	$8.68
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$136.80
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.00
Rate for Payer: Oxford Commercial	$72.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$72.00
Rate for Payer: UnitedHealthcare Community & State	$8.68
Rate for Payer: Wellpoint Medicaid Managed Care	$9.54

IR ARTHRO SHOULDER

Facility

$1,667.37

Service Code	HCPCS 73040
Hospital Charge Code	2680265
Hospital Revenue Code	322
Min. Negotiated Rate	$40.18
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$1,127.36
Rate for Payer: Aetna Medicare Advantage	$1,342.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$414.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,496.11
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: Cigna Medicare Advantage	$290.13
Rate for Payer: Clover Medicare Advantage	$393.75
Rate for Payer: EmblemHealth Commercial	$1,243.41
Rate for Payer: Humana Medicare Advantage	$426.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$414.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.11
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$40.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$414.47
Rate for Payer: Wellcare Medicare Advantage	$414.47
Rate for Payer: Wellpoint Medicaid Managed Care	$44.19

IR ARTHRO SHOULDER

Facility

$1,667.37

Service Code	HCPCS 73040
Hospital Charge Code	2680265
Hospital Revenue Code	322
Min. Negotiated Rate	$250.11
Max. Negotiated Rate	$250.11
Rate for Payer: Qualcare PPO/HMO/WC	$250.11

IR ARTHRO SHOULDER

Facility

$1,667.37

Service Code	HCPCS 73040
Hospital Charge Code	7411664
Hospital Revenue Code	322
Min. Negotiated Rate	$40.18
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$1,127.36
Rate for Payer: Aetna Medicare Advantage	$1,342.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$414.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,496.11
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: Cigna Medicare Advantage	$290.13
Rate for Payer: Clover Medicare Advantage	$393.75
Rate for Payer: EmblemHealth Commercial	$1,243.41
Rate for Payer: Humana Medicare Advantage	$426.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$414.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.11
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$40.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$414.47
Rate for Payer: Wellcare Medicare Advantage	$414.47
Rate for Payer: Wellpoint Medicaid Managed Care	$44.19

IR ARTHRO SHOULDER

Facility

$1,667.37

Service Code	HCPCS 73040LT
Hospital Charge Code	2007050
Hospital Revenue Code	322
Min. Negotiated Rate	$250.11
Max. Negotiated Rate	$250.11
Rate for Payer: Qualcare PPO/HMO/WC	$250.11

IR ARTHRO SHOULDER

Facility

$1,667.37

Service Code	HCPCS 73040LT
Hospital Charge Code	2007050
Hospital Revenue Code	322
Min. Negotiated Rate	$40.18
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$633.60
Rate for Payer: Aetna Medicare Advantage	$500.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$425.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$425.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$425.18
Rate for Payer: Cigna Commercial	$833.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.11
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$40.18
Rate for Payer: Wellpoint Medicaid Managed Care	$44.19

IR ARTHRO SHOULDER

Facility

$1,667.37

Service Code	HCPCS 73040
Hospital Charge Code	7411664
Hospital Revenue Code	322
Min. Negotiated Rate	$250.11
Max. Negotiated Rate	$250.11
Rate for Payer: Qualcare PPO/HMO/WC	$250.11

IR ARTRIAL LINE INSERT PERCU

Facility

$959.80

Service Code	HCPCS 36620
Hospital Charge Code	7411480
Hospital Revenue Code	361
Min. Negotiated Rate	$23.13
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$364.72
Rate for Payer: Aetna Medicare Advantage	$287.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.75
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	$244.75
Rate for Payer: Cigna Commercial	$479.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.94
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$143.97
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$23.13

IR ARTRIAL LINE INSERT PERCU

Facility

$959.80

Service Code	HCPCS 36620
Hospital Charge Code	321036620
Hospital Revenue Code	361
Min. Negotiated Rate	$143.97
Max. Negotiated Rate	$143.97
Rate for Payer: Qualcare PPO/HMO/WC	$143.97

IR ARTRIAL LINE INSERT PERCU

Facility

$959.80

Service Code	HCPCS 36620
Hospital Charge Code	411036620
Hospital Revenue Code	361
Min. Negotiated Rate	$23.13
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$364.72
Rate for Payer: Aetna Medicare Advantage	$287.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.75
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	$244.75
Rate for Payer: Cigna Commercial	$479.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.94
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$143.97
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$23.13

IR ARTRIAL LINE INSERT PERCU

Facility

$959.80

Service Code	HCPCS 36620
Hospital Charge Code	321036620
Hospital Revenue Code	361
Min. Negotiated Rate	$23.13
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$364.72
Rate for Payer: Aetna Medicare Advantage	$287.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.75
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	$244.75
Rate for Payer: Cigna Commercial	$479.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.94
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$143.97
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$23.13

IR ARTRIAL LINE INSERT PERCU

Facility

$959.80

Service Code	HCPCS 36620
Hospital Charge Code	5600151
Hospital Revenue Code	361
Min. Negotiated Rate	$143.97
Max. Negotiated Rate	$143.97
Rate for Payer: Qualcare PPO/HMO/WC	$143.97

IR ARTRIAL LINE INSERT PERCU

Facility

$959.80

Service Code	HCPCS 36620
Hospital Charge Code	411036620
Hospital Revenue Code	361
Min. Negotiated Rate	$143.97
Max. Negotiated Rate	$143.97
Rate for Payer: Qualcare PPO/HMO/WC	$143.97

IR ARTRIAL LINE INSERT PERCU

Facility

$959.80

Service Code	HCPCS 36620
Hospital Charge Code	7411480
Hospital Revenue Code	361
Min. Negotiated Rate	$143.97
Max. Negotiated Rate	$143.97
Rate for Payer: Qualcare PPO/HMO/WC	$143.97

IR ARTRIAL LINE INSERT PERCU

Facility

$959.80

Service Code	HCPCS 36620
Hospital Charge Code	366836620
Hospital Revenue Code	361
Min. Negotiated Rate	$143.97
Max. Negotiated Rate	$143.97
Rate for Payer: Qualcare PPO/HMO/WC	$143.97

IR ARTRIAL LINE INSERT PERCU

Facility

$959.80

Service Code	HCPCS 36620
Hospital Charge Code	366836620
Hospital Revenue Code	361
Min. Negotiated Rate	$23.13
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$364.72
Rate for Payer: Aetna Medicare Advantage	$287.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.75
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	$244.75
Rate for Payer: Cigna Commercial	$479.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.94
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$143.97
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$23.13

IR ARTRIAL LINE INSERT PERCU

Facility

$959.80

Service Code	HCPCS 36620
Hospital Charge Code	5600151
Hospital Revenue Code	361
Min. Negotiated Rate	$23.13
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$364.72
Rate for Payer: Aetna Medicare Advantage	$287.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.75
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	$244.75
Rate for Payer: Cigna Commercial	$479.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.94
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$143.97
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$23.13

IR ASPAND/OR INJ THYROID CYST

Facility

$3,392.55

Service Code	HCPCS 60300
Hospital Charge Code	2670030
Hospital Revenue Code	361
Min. Negotiated Rate	$81.76
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,036.77
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,017.76
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$508.88
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$81.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$89.90

IR ASPAND/OR INJ THYROID CYST

Facility

$1,901.69

Service Code	HCPCS 60300
Hospital Charge Code	7411639
Hospital Revenue Code	361
Min. Negotiated Rate	$285.25
Max. Negotiated Rate	$285.25
Rate for Payer: Qualcare PPO/HMO/WC	$285.25

IR ASPAND/OR INJ THYROID CYST

Facility

$3,392.55

Service Code	HCPCS 60300
Hospital Charge Code	321060300
Hospital Revenue Code	361
Min. Negotiated Rate	$81.76
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,036.77
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,017.76
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$508.88
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$81.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$89.90

IR ASPAND/OR INJ THYROID CYST

Facility

$1,901.69

Service Code	HCPCS 60300
Hospital Charge Code	7411639
Hospital Revenue Code	361
Min. Negotiated Rate	$45.83
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,036.77
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$570.51
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$285.25
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$45.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$50.39

IR ASPAND/OR INJ THYROID CYST

Facility

$3,392.55

Service Code	HCPCS 60300
Hospital Charge Code	321060300
Hospital Revenue Code	361
Min. Negotiated Rate	$508.88
Max. Negotiated Rate	$508.88
Rate for Payer: Qualcare PPO/HMO/WC	$508.88

Know your out-of-pocket cost for care.

All Charges