Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR-BIOP SOFT TISS-DEEP-BI

Facility

$1,916.00

Service Code	HCPCS 2704150
Hospital Charge Code	7411777
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

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	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BIOP SOFT TISS-DEEP-BI

Facility

$1,916.00

Service Code	HCPCS 2704150
Hospital Charge Code	7411777
Hospital Revenue Code	361
Min. Negotiated Rate	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BIOP SOFT TISS-DEEP-LT

Facility

$1,916.00

Service Code	HCPCS 27041LT
Hospital Charge Code	2690970
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

IR-BIOP SOFT TISS-DEEP-LT

Facility

$1,916.00

Service Code	HCPCS 27041LT
Hospital Charge Code	2690970
Hospital Revenue Code	361
Min. Negotiated Rate	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BIOP SOFT TISS-DEEP-LT

Facility

$1,916.00

Service Code	HCPCS 27041LT
Hospital Charge Code	7411873
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

IR-BIOP SOFT TISS-DEEP-LT

Facility

$1,916.00

Service Code	HCPCS 27041LT
Hospital Charge Code	7411873
Hospital Revenue Code	361
Min. Negotiated Rate	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BIOP SOFT TISS-DEEP-RT

Facility

$1,916.00

Service Code	HCPCS 27041RT
Hospital Charge Code	2690975
Hospital Revenue Code	361
Min. Negotiated Rate	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BIOP SOFT TISS-DEEP-RT

Facility

$1,916.00

Service Code	HCPCS 27041RT
Hospital Charge Code	2690975
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

IR-BIOP SOFT TISS-DEEP-RT

Facility

$1,916.00

Service Code	HCPCS 27041RT
Hospital Charge Code	7411874
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

IR-BIOP SOFT TISS-DEEP-RT

Facility

$1,916.00

Service Code	HCPCS 27041RT
Hospital Charge Code	7411874
Hospital Revenue Code	361
Min. Negotiated Rate	$287.40
Max. Negotiated Rate	$287.40
Rate for Payer: Qualcare PPO/HMO/WC	$287.40

IR-BIOPSY EPIDIDYMIS-BI

Facility

$431.00

Service Code	HCPCS 5480050
Hospital Charge Code	2690695
Hospital Revenue Code	361
Min. Negotiated Rate	$10.39
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$163.78
Rate for Payer: Aetna Medicare Advantage	$129.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.91
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	$109.91
Rate for Payer: Cigna Commercial	$215.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.30
Rate for Payer: Qualcare PPO/HMO/WC	$64.65
Rate for Payer: UnitedHealthcare Community & State	$10.39
Rate for Payer: Wellpoint Medicaid Managed Care	$11.42

IR-BIOPSY EPIDIDYMIS-BI

Facility

$431.00

Service Code	HCPCS 5480050
Hospital Charge Code	2690695
Hospital Revenue Code	361
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY EPIDIDYMIS-BI

Facility

$431.00

Service Code	HCPCS 5480050
Hospital Charge Code	7411832
Hospital Revenue Code	361
Min. Negotiated Rate	$10.39
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$163.78
Rate for Payer: Aetna Medicare Advantage	$129.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.91
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	$109.91
Rate for Payer: Cigna Commercial	$215.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.30
Rate for Payer: Qualcare PPO/HMO/WC	$64.65
Rate for Payer: UnitedHealthcare Community & State	$10.39
Rate for Payer: Wellpoint Medicaid Managed Care	$11.42

IR-BIOPSY EPIDIDYMIS-BI

Facility

$431.00

Service Code	HCPCS 5480050
Hospital Charge Code	7411832
Hospital Revenue Code	361
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY EPIDIDYMIS-LT

Facility

$431.00

Service Code	HCPCS 54800LT
Hospital Charge Code	2691730
Hospital Revenue Code	361
Min. Negotiated Rate	$10.39
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$163.78
Rate for Payer: Aetna Medicare Advantage	$129.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.91
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	$109.91
Rate for Payer: Cigna Commercial	$215.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.30
Rate for Payer: Qualcare PPO/HMO/WC	$64.65
Rate for Payer: UnitedHealthcare Community & State	$10.39
Rate for Payer: Wellpoint Medicaid Managed Care	$11.42

IR-BIOPSY EPIDIDYMIS-LT

Facility

$431.00

Service Code	HCPCS 54800LT
Hospital Charge Code	2691730
Hospital Revenue Code	361
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY EPIDIDYMIS-LT

Facility

$431.00

Service Code	HCPCS 54800LT
Hospital Charge Code	7411986
Hospital Revenue Code	361
Min. Negotiated Rate	$10.39
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$163.78
Rate for Payer: Aetna Medicare Advantage	$129.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.91
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	$109.91
Rate for Payer: Cigna Commercial	$215.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.30
Rate for Payer: Qualcare PPO/HMO/WC	$64.65
Rate for Payer: UnitedHealthcare Community & State	$10.39
Rate for Payer: Wellpoint Medicaid Managed Care	$11.42

IR-BIOPSY EPIDIDYMIS-LT

Facility

$431.00

Service Code	HCPCS 54800LT
Hospital Charge Code	7411986
Hospital Revenue Code	361
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY EPIDIDYMIS-RT

Facility

$431.00

Service Code	HCPCS 54800RT
Hospital Charge Code	2691735
Hospital Revenue Code	361
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY EPIDIDYMIS-RT

Facility

$431.00

Service Code	HCPCS 54800RT
Hospital Charge Code	2691735
Hospital Revenue Code	361
Min. Negotiated Rate	$10.39
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$163.78
Rate for Payer: Aetna Medicare Advantage	$129.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.91
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	$109.91
Rate for Payer: Cigna Commercial	$215.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.30
Rate for Payer: Qualcare PPO/HMO/WC	$64.65
Rate for Payer: UnitedHealthcare Community & State	$10.39
Rate for Payer: Wellpoint Medicaid Managed Care	$11.42

IR-BIOPSY EPIDIDYMIS-RT

Facility

$431.00

Service Code	HCPCS 54800RT
Hospital Charge Code	7411987
Hospital Revenue Code	361
Min. Negotiated Rate	$10.39
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$163.78
Rate for Payer: Aetna Medicare Advantage	$129.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.91
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	$109.91
Rate for Payer: Cigna Commercial	$215.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.30
Rate for Payer: Qualcare PPO/HMO/WC	$64.65
Rate for Payer: UnitedHealthcare Community & State	$10.39
Rate for Payer: Wellpoint Medicaid Managed Care	$11.42

IR-BIOPSY EPIDIDYMIS-RT

Facility

$431.00

Service Code	HCPCS 54800RT
Hospital Charge Code	7411987
Hospital Revenue Code	361
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

IR-BIOPSY KIDNEY-BI

Facility

$10,607.10

Service Code	HCPCS 5020050
Hospital Charge Code	7412039
Hospital Revenue Code	361
Min. Negotiated Rate	$1,591.07
Max. Negotiated Rate	$1,591.07
Rate for Payer: Qualcare PPO/HMO/WC	$1,591.07

IR-BIOPSY KIDNEY-BI

Facility

$10,607.10

Service Code	HCPCS 5020050
Hospital Charge Code	2690605
Hospital Revenue Code	361
Min. Negotiated Rate	$1,591.07
Max. Negotiated Rate	$1,591.07
Rate for Payer: Qualcare PPO/HMO/WC	$1,591.07

Know your out-of-pocket cost for care.

All Charges