Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR-ATHERECTOMY-TIBIOP-RT

Facility

$93,917.89

Service Code	HCPCS 37229RT
Hospital Charge Code	366837229R
Hospital Revenue Code	361
Min. Negotiated Rate	$14,087.68
Max. Negotiated Rate	$14,087.68
Rate for Payer: Qualcare PPO/HMO/WC	$14,087.68

IR-ATHERECTOMY-TIBIOP-RT

Facility

$8,231.00

Service Code	HCPCS 37229RT
Hospital Charge Code	7411937
Hospital Revenue Code	361
Min. Negotiated Rate	$1,234.65
Max. Negotiated Rate	$1,234.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,234.65

IR ATHERECTOMY VISCERAL

Facility

$3,084.40

Hospital Charge Code	2600047
Hospital Revenue Code	320
Min. Negotiated Rate	$74.33
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$1,172.07
Rate for Payer: Aetna Medicare Advantage	$925.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$786.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$786.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$786.52
Rate for Payer: Cigna Commercial	$1,542.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.32
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$462.66
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$74.33
Rate for Payer: Wellpoint Medicaid Managed Care	$81.74

IR ATHERECTOMY VISCERAL

Facility

$3,084.40

Hospital Charge Code	2600047
Hospital Revenue Code	320
Min. Negotiated Rate	$462.66
Max. Negotiated Rate	$462.66
Rate for Payer: Qualcare PPO/HMO/WC	$462.66

IR AV FISTULA OR GRAFT VENOUS

Facility

$21,962.30

Service Code	HCPCS 35476
Hospital Charge Code	5600184
Hospital Revenue Code	361
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR AV FISTULA OR GRAFT VENOUS

Facility

$21,962.30

Service Code	HCPCS 35476
Hospital Charge Code	5600184
Hospital Revenue Code	361
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) NJ Health	$1,626.00
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: Qualcare PPO/HMO/WC	$3,294.34
Rate for Payer: UnitedHealthcare Community & State	$529.29
Rate for Payer: Wellpoint Medicaid Managed Care	$582.00

IR AV FISTULA OR GRAFT VENOUS

Facility

$21,962.30

Service Code	HCPCS 35476
Hospital Charge Code	7411409
Hospital Revenue Code	361
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) NJ Health	$1,626.00
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: Qualcare PPO/HMO/WC	$3,294.34
Rate for Payer: UnitedHealthcare Community & State	$529.29
Rate for Payer: Wellpoint Medicaid Managed Care	$582.00

IR AV FISTULA OR GRAFT VENOUS

Facility

$21,962.30

Service Code	HCPCS 35476
Hospital Charge Code	7411409
Hospital Revenue Code	361
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

IR AVM THORACIC SPINAL CRD VES

Facility

$38,895.00

Service Code	HCPCS 63251
Hospital Charge Code	5700252
Hospital Revenue Code	361
Min. Negotiated Rate	$937.37
Max. Negotiated Rate	$19,447.50
Rate for Payer: Aetna Commercial	$14,780.10
Rate for Payer: Aetna Medicare Advantage	$11,668.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,918.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,918.23
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	$9,918.23
Rate for Payer: Cigna Commercial	$19,447.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,668.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,834.25
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$937.37
Rate for Payer: Wellpoint Medicaid Managed Care	$1,030.72

IR AVM THORACIC SPINAL CRD VES

Facility

$38,895.00

Service Code	HCPCS 63251
Hospital Charge Code	7411658
Hospital Revenue Code	361
Min. Negotiated Rate	$5,834.25
Max. Negotiated Rate	$5,834.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,834.25

IR AVM THORACIC SPINAL CRD VES

Facility

$38,895.00

Service Code	HCPCS 63251
Hospital Charge Code	7411658
Hospital Revenue Code	361
Min. Negotiated Rate	$937.37
Max. Negotiated Rate	$19,447.50
Rate for Payer: Aetna Commercial	$14,780.10
Rate for Payer: Aetna Medicare Advantage	$11,668.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,918.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,918.23
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	$9,918.23
Rate for Payer: Cigna Commercial	$19,447.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,668.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,834.25
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$937.37
Rate for Payer: Wellpoint Medicaid Managed Care	$1,030.72

IR AVM THORACIC SPINAL CRD VES

Facility

$38,895.00

Service Code	HCPCS 63251
Hospital Charge Code	5700252
Hospital Revenue Code	361
Min. Negotiated Rate	$5,834.25
Max. Negotiated Rate	$5,834.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,834.25

IRBESARTAN 150 MG TAB

Facility

$7.90

Hospital Charge Code	60629280
Hospital Revenue Code	250
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.19

IRBESARTAN 150 MG TAB

Facility

$7.90

Hospital Charge Code	60629280
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.95
Rate for Payer: Aetna Commercial	$3.00
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.01
Rate for Payer: Cigna Commercial	$3.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.37
Rate for Payer: Oxford Commercial	$1.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.19
Rate for Payer: UnitedHealthcare Commercial	$1.58
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

IR BILE STONE REMOVAL

Facility

$819.70

Hospital Charge Code	2101149
Hospital Revenue Code	320
Min. Negotiated Rate	$122.95
Max. Negotiated Rate	$122.95
Rate for Payer: Qualcare PPO/HMO/WC	$122.95

IR BILE STONE REMOVAL

Facility

$819.70

Hospital Charge Code	2101149
Hospital Revenue Code	320
Min. Negotiated Rate	$19.75
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$311.49
Rate for Payer: Aetna Medicare Advantage	$245.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.02
Rate for Payer: Cigna Commercial	$409.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.91
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.95
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$21.72

IR BILIARY ENDOSCOPY THRU SKIN

Facility

$4,222.25

Service Code	HCPCS 47555
Hospital Charge Code	2011295
Hospital Revenue Code	361
Min. Negotiated Rate	$101.76
Max. Negotiated Rate	$27,762.46
Rate for Payer: Aetna Commercial	$20,919.71
Rate for Payer: Aetna Medicare Advantage	$24,919.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,762.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,762.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,691.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,762.46
Rate for Payer: Cigna Commercial	$15,416.72
Rate for Payer: Cigna Medicare Advantage	$7,691.07
Rate for Payer: Clover Medicare Advantage	$7,306.52
Rate for Payer: EmblemHealth Commercial	$23,073.21
Rate for Payer: Humana Medicare Advantage	$7,921.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,691.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,266.67
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$633.34
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$101.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,691.07
Rate for Payer: Wellcare Medicare Advantage	$7,691.07
Rate for Payer: Wellpoint Medicaid Managed Care	$111.89

IR BILIARY ENDOSCOPY THRU SKIN

Facility

$4,222.25

Service Code	HCPCS 47555
Hospital Charge Code	7411572
Hospital Revenue Code	361
Min. Negotiated Rate	$101.76
Max. Negotiated Rate	$27,762.46
Rate for Payer: Aetna Commercial	$20,919.71
Rate for Payer: Aetna Medicare Advantage	$24,919.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,762.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,762.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,691.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,762.46
Rate for Payer: Cigna Commercial	$15,416.72
Rate for Payer: Cigna Medicare Advantage	$7,691.07
Rate for Payer: Clover Medicare Advantage	$7,306.52
Rate for Payer: EmblemHealth Commercial	$23,073.21
Rate for Payer: Humana Medicare Advantage	$7,921.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,691.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,266.67
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$633.34
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$101.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,691.07
Rate for Payer: Wellcare Medicare Advantage	$7,691.07
Rate for Payer: Wellpoint Medicaid Managed Care	$111.89

IR BILIARY ENDOSCOPY THRU SKIN

Facility

$4,222.25

Service Code	HCPCS 47555
Hospital Charge Code	7411572
Hospital Revenue Code	361
Min. Negotiated Rate	$633.34
Max. Negotiated Rate	$633.34
Rate for Payer: Qualcare PPO/HMO/WC	$633.34

IR BILIARY ENDOSCOPY THRU SKIN

Facility

$4,222.25

Service Code	HCPCS 47555
Hospital Charge Code	2011295
Hospital Revenue Code	361
Min. Negotiated Rate	$633.34
Max. Negotiated Rate	$633.34
Rate for Payer: Qualcare PPO/HMO/WC	$633.34

IR BILRY DUCT TRNSHPTIC DLATON

Facility

$2,088.00

Service Code	HCPCS 74363
Hospital Charge Code	2600050
Hospital Revenue Code	320
Min. Negotiated Rate	$313.20
Max. Negotiated Rate	$313.20
Rate for Payer: Qualcare PPO/HMO/WC	$313.20

IR BILRY DUCT TRNSHPTIC DLATON

Facility

$2,088.00

Service Code	HCPCS 74363
Hospital Charge Code	7411675
Hospital Revenue Code	320
Min. Negotiated Rate	$313.20
Max. Negotiated Rate	$313.20
Rate for Payer: Qualcare PPO/HMO/WC	$313.20

IR BILRY DUCT TRNSHPTIC DLATON

Facility

$2,088.00

Service Code	HCPCS 74363
Hospital Charge Code	7411675
Hospital Revenue Code	320
Min. Negotiated Rate	$50.32
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$793.44
Rate for Payer: Aetna Medicare Advantage	$626.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$532.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$532.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$532.44
Rate for Payer: Cigna Commercial	$1,044.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$626.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$313.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$50.32
Rate for Payer: Wellpoint Medicaid Managed Care	$55.33

IR BILRY DUCT TRNSHPTIC DLATON

Facility

$2,088.00

Service Code	HCPCS 74363
Hospital Charge Code	2600050
Hospital Revenue Code	320
Min. Negotiated Rate	$50.32
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$793.44
Rate for Payer: Aetna Medicare Advantage	$626.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$532.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$532.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$532.44
Rate for Payer: Cigna Commercial	$1,044.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$626.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$313.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$50.32
Rate for Payer: Wellpoint Medicaid Managed Care	$55.33

IR-BIOP SOFT TISS-DEEP-BI

Facility

$1,916.00

Service Code	HCPCS 2704150
Hospital Charge Code	2690345
Hospital Revenue Code	361
Min. Negotiated Rate	$46.18
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$728.08
Rate for Payer: Aetna Medicare Advantage	$574.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.58
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	$488.58
Rate for Payer: Cigna Commercial	$958.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.80
Rate for Payer: Qualcare PPO/HMO/WC	$287.40
Rate for Payer: UnitedHealthcare Community & State	$46.18
Rate for Payer: Wellpoint Medicaid Managed Care	$50.77

Know your out-of-pocket cost for care.

All Charges