Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$508.88
Max. Negotiated Rate	$508.88
Rate for Payer: Qualcare PPO/HMO/WC	$508.88

IR ASP BLADDER W INS SUPRAPUB

Facility

$8,477.85

Service Code	HCPCS 51102
Hospital Charge Code	366851102
Hospital Revenue Code	361
Min. Negotiated Rate	$204.32
Max. Negotiated Rate	$8,964.44
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
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	$8,964.44
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,543.36
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.68
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$204.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$224.66

IR ASP BLADDER W INS SUPRAPUB

Facility

$8,477.85

Service Code	HCPCS 51102
Hospital Charge Code	366851102
Hospital Revenue Code	361
Min. Negotiated Rate	$1,271.68
Max. Negotiated Rate	$1,271.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.68

IR ASP BLADDER W INS SUPRAPUB

Facility

$8,477.85

Service Code	HCPCS 51102
Hospital Charge Code	411051102
Hospital Revenue Code	361
Min. Negotiated Rate	$1,271.68
Max. Negotiated Rate	$1,271.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.68

IR ASP BLADDER W INS SUPRAPUB

Facility

$10,187.80

Service Code	HCPCS 51102
Hospital Charge Code	2670001
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR ASP BLADDER W INS SUPRAPUB

Facility

$8,477.85

Service Code	HCPCS 51102
Hospital Charge Code	411051102
Hospital Revenue Code	361
Min. Negotiated Rate	$204.32
Max. Negotiated Rate	$8,964.44
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
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	$8,964.44
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,543.36
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.68
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$204.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$224.66

IR ASP BLADDER W INS SUPRAPUB

Facility

$10,187.80

Service Code	HCPCS 51102
Hospital Charge Code	321051102
Hospital Revenue Code	361
Min. Negotiated Rate	$245.53
Max. Negotiated Rate	$8,964.44
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
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	$8,964.44
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,056.34
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$245.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$269.98

IR ASP BLADDER W INS SUPRAPUB

Facility

$10,187.80

Service Code	HCPCS 51102
Hospital Charge Code	321051102
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR ASP BLADDER W INS SUPRAPUB

Facility

$8,499.52

Service Code	HCPCS 51102
Hospital Charge Code	7411622
Hospital Revenue Code	361
Min. Negotiated Rate	$1,274.93
Max. Negotiated Rate	$1,274.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.93

IR ASP BLADDER W INS SUPRAPUB

Facility

$8,499.52

Service Code	HCPCS 51102
Hospital Charge Code	7411622
Hospital Revenue Code	361
Min. Negotiated Rate	$204.84
Max. Negotiated Rate	$8,964.44
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
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	$8,964.44
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,549.86
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.93
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$204.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$225.24

IR ASP BLADDER W INS SUPRAPUB

Facility

$10,187.80

Service Code	HCPCS 51102
Hospital Charge Code	2670001
Hospital Revenue Code	361
Min. Negotiated Rate	$245.53
Max. Negotiated Rate	$8,964.44
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
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	$8,964.44
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,056.34
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$245.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$269.98

IR ASPIRATION BLADDER W CATH

Facility

$10,952.70

Service Code	HCPCS 51102
Hospital Charge Code	5700200
Hospital Revenue Code	361
Min. Negotiated Rate	$1,642.90
Max. Negotiated Rate	$1,642.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,642.90

IR ASPIRATION BLADDER W CATH

Facility

$10,952.70

Service Code	HCPCS 51102
Hospital Charge Code	5700200
Hospital Revenue Code	361
Min. Negotiated Rate	$263.96
Max. Negotiated Rate	$8,964.44
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
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	$8,964.44
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,285.81
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,642.90
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$263.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$290.25

IR ATHERECTMY PERPHERAL ARTERY

Facility

$4,665.90

Hospital Charge Code	2600045
Hospital Revenue Code	320
Min. Negotiated Rate	$699.88
Max. Negotiated Rate	$699.88
Rate for Payer: Qualcare PPO/HMO/WC	$699.88

IR ATHERECTMY PERPHERAL ARTERY

Facility

$4,665.90

Hospital Charge Code	2600045
Hospital Revenue Code	320
Min. Negotiated Rate	$112.45
Max. Negotiated Rate	$2,332.95
Rate for Payer: Aetna Commercial	$1,773.04
Rate for Payer: Aetna Medicare Advantage	$1,399.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,189.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,189.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,189.80
Rate for Payer: Cigna Commercial	$2,332.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,399.77
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$699.88
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$112.45
Rate for Payer: Wellpoint Medicaid Managed Care	$123.65

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	321037225B
Hospital Revenue Code	361
Min. Negotiated Rate	$12,904.22
Max. Negotiated Rate	$12,904.22
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	2690520
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$43,014.07
Rate for Payer: Aetna Commercial	$32,690.70
Rate for Payer: Aetna Medicare Advantage	$25,808.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,937.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,937.18
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	$21,937.18
Rate for Payer: Cigna Commercial	$43,014.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25,808.44
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22
Rate for Payer: UnitedHealthcare Community & State	$2,073.28
Rate for Payer: Wellpoint Medicaid Managed Care	$2,279.75

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	3668372255
Hospital Revenue Code	361
Min. Negotiated Rate	$12,904.22
Max. Negotiated Rate	$12,904.22
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	3668372255
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$43,014.07
Rate for Payer: Aetna Commercial	$32,690.70
Rate for Payer: Aetna Medicare Advantage	$25,808.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,937.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,937.18
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	$21,937.18
Rate for Payer: Cigna Commercial	$43,014.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25,808.44
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22
Rate for Payer: UnitedHealthcare Community & State	$2,073.28
Rate for Payer: Wellpoint Medicaid Managed Care	$2,279.75

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	321037225B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$43,014.07
Rate for Payer: Aetna Commercial	$32,690.70
Rate for Payer: Aetna Medicare Advantage	$25,808.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,937.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,937.18
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	$21,937.18
Rate for Payer: Cigna Commercial	$43,014.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25,808.44
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22
Rate for Payer: UnitedHealthcare Community & State	$2,073.28
Rate for Payer: Wellpoint Medicaid Managed Care	$2,279.75

IR-ATHERECTOMY-FEM POP-BI

Facility

$75,737.34

Service Code	HCPCS 3722550
Hospital Charge Code	7411803
Hospital Revenue Code	361
Min. Negotiated Rate	$11,360.60
Max. Negotiated Rate	$11,360.60
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	2690520
Hospital Revenue Code	361
Min. Negotiated Rate	$12,904.22
Max. Negotiated Rate	$12,904.22
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	411037225B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$43,014.07
Rate for Payer: Aetna Commercial	$32,690.70
Rate for Payer: Aetna Medicare Advantage	$25,808.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,937.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,937.18
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	$21,937.18
Rate for Payer: Cigna Commercial	$43,014.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25,808.44
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22
Rate for Payer: UnitedHealthcare Community & State	$2,073.28
Rate for Payer: Wellpoint Medicaid Managed Care	$2,279.75

IR-ATHERECTOMY-FEM POP-BI

Facility

$86,028.15

Service Code	HCPCS 3722550
Hospital Charge Code	411037225B
Hospital Revenue Code	361
Min. Negotiated Rate	$12,904.22
Max. Negotiated Rate	$12,904.22
Rate for Payer: Qualcare PPO/HMO/WC	$12,904.22

IR-ATHERECTOMY-FEM POP-BI

Facility

$75,737.34

Service Code	HCPCS 3722550
Hospital Charge Code	7411803
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$37,868.67
Rate for Payer: Aetna Commercial	$28,780.19
Rate for Payer: Aetna Medicare Advantage	$22,721.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,313.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,313.02
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	$19,313.02
Rate for Payer: Cigna Commercial	$37,868.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,721.20
Rate for Payer: Qualcare PPO/HMO/WC	$11,360.60
Rate for Payer: UnitedHealthcare Community & State	$1,825.27
Rate for Payer: Wellpoint Medicaid Managed Care	$2,007.04

Know your out-of-pocket cost for care.

All Charges