Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR-BIOPSY KIDNEY-BI

Facility

$10,607.10

Service Code	HCPCS 5020050
Hospital Charge Code	2690605
Hospital Revenue Code	361
Min. Negotiated Rate	$255.63
Max. Negotiated Rate	$5,303.55
Rate for Payer: Aetna Commercial	$4,030.70
Rate for Payer: Aetna Medicare Advantage	$3,182.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,704.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,704.81
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	$2,704.81
Rate for Payer: Cigna Commercial	$5,303.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,182.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,591.07
Rate for Payer: UnitedHealthcare Community & State	$255.63
Rate for Payer: Wellpoint Medicaid Managed Care	$281.09

IR-BIOPSY KIDNEY-BI

Facility

$10,607.10

Service Code	HCPCS 5020050
Hospital Charge Code	7412039
Hospital Revenue Code	361
Min. Negotiated Rate	$255.63
Max. Negotiated Rate	$5,303.55
Rate for Payer: Aetna Commercial	$4,030.70
Rate for Payer: Aetna Medicare Advantage	$3,182.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,704.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,704.81
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	$2,704.81
Rate for Payer: Cigna Commercial	$5,303.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,182.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,591.07
Rate for Payer: UnitedHealthcare Community & State	$255.63
Rate for Payer: Wellpoint Medicaid Managed Care	$281.09

IR-BIOPSY KIDNEY-BI

Facility

$1,478.00

Service Code	HCPCS 5020050
Hospital Charge Code	7411818
Hospital Revenue Code	361
Min. Negotiated Rate	$35.62
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$561.64
Rate for Payer: Aetna Medicare Advantage	$443.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.89
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	$376.89
Rate for Payer: Cigna Commercial	$739.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$443.40
Rate for Payer: Qualcare PPO/HMO/WC	$221.70
Rate for Payer: UnitedHealthcare Community & State	$35.62
Rate for Payer: Wellpoint Medicaid Managed Care	$39.17

IR-BIOPSY KIDNEY-BI

Facility

$1,478.00

Service Code	HCPCS 5020050
Hospital Charge Code	7411818
Hospital Revenue Code	361
Min. Negotiated Rate	$221.70
Max. Negotiated Rate	$221.70
Rate for Payer: Qualcare PPO/HMO/WC	$221.70

IR-BIOPSY KIDNEY-LT

Facility

$8,054.80

Service Code	HCPCS 50200LT
Hospital Charge Code	2691540
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR-BIOPSY KIDNEY-LT

Facility

$8,054.80

Service Code	HCPCS 50200LT
Hospital Charge Code	321050200L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR-BIOPSY KIDNEY-LT

Facility

$8,054.80

Service Code	HCPCS 50200LT
Hospital Charge Code	2101202
Hospital Revenue Code	361
Min. Negotiated Rate	$194.12
Max. Negotiated Rate	$4,027.40
Rate for Payer: Aetna Commercial	$3,060.82
Rate for Payer: Aetna Medicare Advantage	$2,416.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,053.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,053.97
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	$2,053.97
Rate for Payer: Cigna Commercial	$4,027.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,416.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Community & State	$194.12
Rate for Payer: Wellpoint Medicaid Managed Care	$213.45

IR-BIOPSY KIDNEY-LT

Facility

$8,054.80

Service Code	HCPCS 50200LT
Hospital Charge Code	2101202
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR-BIOPSY KIDNEY-LT

Facility

$1,478.00

Service Code	HCPCS 50200LT
Hospital Charge Code	7411956
Hospital Revenue Code	361
Min. Negotiated Rate	$221.70
Max. Negotiated Rate	$221.70
Rate for Payer: Qualcare PPO/HMO/WC	$221.70

IR-BIOPSY KIDNEY-LT

Facility

$7,071.40

Service Code	HCPCS 50200LT
Hospital Charge Code	7412040
Hospital Revenue Code	361
Min. Negotiated Rate	$170.42
Max. Negotiated Rate	$3,535.70
Rate for Payer: Aetna Commercial	$2,687.13
Rate for Payer: Aetna Medicare Advantage	$2,121.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,803.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,803.21
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	$1,803.21
Rate for Payer: Cigna Commercial	$3,535.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,121.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71
Rate for Payer: UnitedHealthcare Community & State	$170.42
Rate for Payer: Wellpoint Medicaid Managed Care	$187.39

IR-BIOPSY KIDNEY-LT

Facility

$1,478.00

Service Code	HCPCS 50200LT
Hospital Charge Code	7411956
Hospital Revenue Code	361
Min. Negotiated Rate	$35.62
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$561.64
Rate for Payer: Aetna Medicare Advantage	$443.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.89
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	$376.89
Rate for Payer: Cigna Commercial	$739.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$443.40
Rate for Payer: Qualcare PPO/HMO/WC	$221.70
Rate for Payer: UnitedHealthcare Community & State	$35.62
Rate for Payer: Wellpoint Medicaid Managed Care	$39.17

IR-BIOPSY KIDNEY-LT

Facility

$7,071.40

Service Code	HCPCS 50200LT
Hospital Charge Code	7412040
Hospital Revenue Code	361
Min. Negotiated Rate	$1,060.71
Max. Negotiated Rate	$1,060.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71

IR-BIOPSY KIDNEY-LT

Facility

$8,054.80

Service Code	HCPCS 50200LT
Hospital Charge Code	2691540
Hospital Revenue Code	361
Min. Negotiated Rate	$194.12
Max. Negotiated Rate	$4,027.40
Rate for Payer: Aetna Commercial	$3,060.82
Rate for Payer: Aetna Medicare Advantage	$2,416.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,053.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,053.97
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	$2,053.97
Rate for Payer: Cigna Commercial	$4,027.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,416.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Community & State	$194.12
Rate for Payer: Wellpoint Medicaid Managed Care	$213.45

IR-BIOPSY KIDNEY-LT

Facility

$8,054.80

Service Code	HCPCS 50200LT
Hospital Charge Code	321050200L
Hospital Revenue Code	361
Min. Negotiated Rate	$194.12
Max. Negotiated Rate	$4,027.40
Rate for Payer: Aetna Commercial	$3,060.82
Rate for Payer: Aetna Medicare Advantage	$2,416.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,053.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,053.97
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	$2,053.97
Rate for Payer: Cigna Commercial	$4,027.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,416.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Community & State	$194.12
Rate for Payer: Wellpoint Medicaid Managed Care	$213.45

IR-BIOPSY KIDNEY-RT

Facility

$8,054.80

Service Code	HCPCS 50200RT
Hospital Charge Code	2691545
Hospital Revenue Code	361
Min. Negotiated Rate	$194.12
Max. Negotiated Rate	$4,027.40
Rate for Payer: Aetna Commercial	$3,060.82
Rate for Payer: Aetna Medicare Advantage	$2,416.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,053.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,053.97
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	$2,053.97
Rate for Payer: Cigna Commercial	$4,027.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,416.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Community & State	$194.12
Rate for Payer: Wellpoint Medicaid Managed Care	$213.45

IR-BIOPSY KIDNEY-RT

Facility

$8,054.80

Service Code	HCPCS 50200RT
Hospital Charge Code	2691545
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR-BIOPSY KIDNEY-RT

Facility

$7,071.40

Service Code	HCPCS 50200RT
Hospital Charge Code	7412041
Hospital Revenue Code	361
Min. Negotiated Rate	$1,060.71
Max. Negotiated Rate	$1,060.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71

IR-BIOPSY KIDNEY-RT

Facility

$1,478.00

Service Code	HCPCS 50200RT
Hospital Charge Code	7411957
Hospital Revenue Code	361
Min. Negotiated Rate	$35.62
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$561.64
Rate for Payer: Aetna Medicare Advantage	$443.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.89
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	$376.89
Rate for Payer: Cigna Commercial	$739.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$443.40
Rate for Payer: Qualcare PPO/HMO/WC	$221.70
Rate for Payer: UnitedHealthcare Community & State	$35.62
Rate for Payer: Wellpoint Medicaid Managed Care	$39.17

IR-BIOPSY KIDNEY-RT

Facility

$8,054.80

Service Code	HCPCS 50200RT
Hospital Charge Code	321050200R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR-BIOPSY KIDNEY-RT

Facility

$7,071.40

Service Code	HCPCS 50200RT
Hospital Charge Code	7412041
Hospital Revenue Code	361
Min. Negotiated Rate	$170.42
Max. Negotiated Rate	$3,535.70
Rate for Payer: Aetna Commercial	$2,687.13
Rate for Payer: Aetna Medicare Advantage	$2,121.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,803.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,803.21
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	$1,803.21
Rate for Payer: Cigna Commercial	$3,535.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,121.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.71
Rate for Payer: UnitedHealthcare Community & State	$170.42
Rate for Payer: Wellpoint Medicaid Managed Care	$187.39

IR-BIOPSY KIDNEY-RT

Facility

$1,478.00

Service Code	HCPCS 50200RT
Hospital Charge Code	7411957
Hospital Revenue Code	361
Min. Negotiated Rate	$221.70
Max. Negotiated Rate	$221.70
Rate for Payer: Qualcare PPO/HMO/WC	$221.70

IR-BIOPSY KIDNEY-RT

Facility

$8,054.80

Service Code	HCPCS 50200RT
Hospital Charge Code	321050200R
Hospital Revenue Code	361
Min. Negotiated Rate	$194.12
Max. Negotiated Rate	$4,027.40
Rate for Payer: Aetna Commercial	$3,060.82
Rate for Payer: Aetna Medicare Advantage	$2,416.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,053.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,053.97
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	$2,053.97
Rate for Payer: Cigna Commercial	$4,027.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,416.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Community & State	$194.12
Rate for Payer: Wellpoint Medicaid Managed Care	$213.45

IR-BIOPSY KIDNEY-RT

Facility

$8,054.80

Service Code	HCPCS 50200RT
Hospital Charge Code	2101203
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR-BIOPSY KIDNEY-RT

Facility

$8,054.80

Service Code	HCPCS 50200RT
Hospital Charge Code	2101203
Hospital Revenue Code	361
Min. Negotiated Rate	$194.12
Max. Negotiated Rate	$4,027.40
Rate for Payer: Aetna Commercial	$3,060.82
Rate for Payer: Aetna Medicare Advantage	$2,416.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,053.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,053.97
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	$2,053.97
Rate for Payer: Cigna Commercial	$4,027.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,416.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Community & State	$194.12
Rate for Payer: Wellpoint Medicaid Managed Care	$213.45

IR-BIOPSY LUNG

Facility

$4,709.90

Service Code	HCPCS 32405
Hospital Charge Code	7411377
Hospital Revenue Code	361
Min. Negotiated Rate	$113.51
Max. Negotiated Rate	$2,354.95
Rate for Payer: Aetna Commercial	$1,789.76
Rate for Payer: Aetna Medicare Advantage	$1,412.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,201.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,201.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,201.02
Rate for Payer: Cigna Commercial	$2,354.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,412.97
Rate for Payer: Qualcare PPO/HMO/WC	$706.49
Rate for Payer: UnitedHealthcare Community & State	$113.51
Rate for Payer: Wellpoint Medicaid Managed Care	$124.81

Know your out-of-pocket cost for care.

All Charges