Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR BLRY DRAIN TRSHP PERC W/CNT

Facility

$2,516.85

Hospital Charge Code	2600049
Hospital Revenue Code	320
Min. Negotiated Rate	$377.53
Max. Negotiated Rate	$377.53
Rate for Payer: Qualcare PPO/HMO/WC	$377.53

IR BONE MARROW,BX,NEEDLE-TROCA

Facility

$1,529.00

Service Code	HCPCS 38221
Hospital Charge Code	7411543
Hospital Revenue Code	361
Min. Negotiated Rate	$229.35
Max. Negotiated Rate	$229.35
Rate for Payer: Qualcare PPO/HMO/WC	$229.35

IR BONE MARROW,BX,NEEDLE-TROCA

Facility

$1,529.00

Service Code	HCPCS 38221
Hospital Charge Code	7411543
Hospital Revenue Code	361
Min. Negotiated Rate	$36.85
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$458.70
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$229.35
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$36.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$40.52

IR BONE MARROW,BX,NEEDLE-TROCA

Facility

$1,529.00

Service Code	HCPCS 38221
Hospital Charge Code	2680195
Hospital Revenue Code	361
Min. Negotiated Rate	$229.35
Max. Negotiated Rate	$229.35
Rate for Payer: Qualcare PPO/HMO/WC	$229.35

IR BONE MARROW,BX,NEEDLE-TROCA

Facility

$1,529.00

Service Code	HCPCS 38221
Hospital Charge Code	2680195
Hospital Revenue Code	361
Min. Negotiated Rate	$36.85
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$458.70
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$229.35
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$36.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$40.52

IR BRACHIAL CATH INTRO RETRO

Facility

$414.45

Service Code	HCPCS 36120
Hospital Charge Code	7411421
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR BRACHIAL CATH INTRO RETRO

Facility

$414.45

Service Code	HCPCS 36120
Hospital Charge Code	7411421
Hospital Revenue Code	361
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$157.49
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.33
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Community & State	$9.99
Rate for Payer: Wellpoint Medicaid Managed Care	$10.98

IR BRACHIAL CATH INTRO RETRO

Facility

$414.45

Service Code	HCPCS 36120
Hospital Charge Code	2004331
Hospital Revenue Code	361
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$157.49
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.33
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Community & State	$9.99
Rate for Payer: Wellpoint Medicaid Managed Care	$10.98

IR BRACHIAL CATH INTRO RETRO

Facility

$414.45

Service Code	HCPCS 36120
Hospital Charge Code	2004331
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR BREAST BIOPSY

Facility

$3,390.78

Hospital Charge Code	2680010
Hospital Revenue Code	361
Min. Negotiated Rate	$508.62
Max. Negotiated Rate	$508.62
Rate for Payer: Qualcare PPO/HMO/WC	$508.62

IR BREAST BIOPSY

Facility

$3,390.78

Hospital Charge Code	2680010
Hospital Revenue Code	361
Min. Negotiated Rate	$81.72
Max. Negotiated Rate	$1,695.39
Rate for Payer: Aetna Commercial	$1,288.50
Rate for Payer: Aetna Medicare Advantage	$1,017.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.65
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	$864.65
Rate for Payer: Cigna Commercial	$1,695.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,017.23
Rate for Payer: Qualcare PPO/HMO/WC	$508.62
Rate for Payer: UnitedHealthcare Community & State	$81.72
Rate for Payer: Wellpoint Medicaid Managed Care	$89.86

IR-BRONCH CLEAR AIRWAYS

Facility

$2,959.00

Service Code	HCPCS 31645
Hospital Charge Code	2690040
Hospital Revenue Code	761
Min. Negotiated Rate	$71.31
Max. Negotiated Rate	$7,632.96
Rate for Payer: Aetna Commercial	$5,751.63
Rate for Payer: Aetna Medicare Advantage	$6,851.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,114.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,632.96
Rate for Payer: Cigna Commercial	$4,238.63
Rate for Payer: Cigna Medicare Advantage	$2,114.57
Rate for Payer: Clover Medicare Advantage	$2,008.84
Rate for Payer: EmblemHealth Commercial	$6,343.71
Rate for Payer: Humana Medicare Advantage	$2,178.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,114.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$887.70
Rate for Payer: Oxford Commercial	$591.80
Rate for Payer: Qualcare PPO/HMO/WC	$443.85
Rate for Payer: UnitedHealthcare Commercial	$591.80
Rate for Payer: UnitedHealthcare Community & State	$71.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,594.28
Rate for Payer: Wellpoint Medicaid Managed Care	$78.41

IR-BRONCH CLEAR AIRWAYS

Facility

$2,959.00

Service Code	HCPCS 31645
Hospital Charge Code	7411375
Hospital Revenue Code	761
Min. Negotiated Rate	$71.31
Max. Negotiated Rate	$7,632.96
Rate for Payer: Aetna Commercial	$5,751.63
Rate for Payer: Aetna Medicare Advantage	$6,851.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,114.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,632.96
Rate for Payer: Cigna Commercial	$4,238.63
Rate for Payer: Cigna Medicare Advantage	$2,114.57
Rate for Payer: Clover Medicare Advantage	$2,008.84
Rate for Payer: EmblemHealth Commercial	$6,343.71
Rate for Payer: Humana Medicare Advantage	$2,178.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,114.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$887.70
Rate for Payer: Oxford Commercial	$591.80
Rate for Payer: Qualcare PPO/HMO/WC	$443.85
Rate for Payer: UnitedHealthcare Commercial	$591.80
Rate for Payer: UnitedHealthcare Community & State	$71.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,594.28
Rate for Payer: Wellpoint Medicaid Managed Care	$78.41

IR-BRONCH CLEAR AIRWAYS

Facility

$2,959.00

Service Code	HCPCS 31645
Hospital Charge Code	7411375
Hospital Revenue Code	761
Min. Negotiated Rate	$443.85
Max. Negotiated Rate	$443.85
Rate for Payer: Qualcare PPO/HMO/WC	$443.85

IR-BRONCH CLEAR AIRWAYS

Facility

$2,959.00

Service Code	HCPCS 31645
Hospital Charge Code	2690040
Hospital Revenue Code	761
Min. Negotiated Rate	$443.85
Max. Negotiated Rate	$443.85
Rate for Payer: Qualcare PPO/HMO/WC	$443.85

IR BRONCHOSCOPY FLUOROSCOPIC W

Facility

$4,353.37

Service Code	HCPCS 31625
Hospital Charge Code	2680110
Hospital Revenue Code	361
Min. Negotiated Rate	$104.92
Max. Negotiated Rate	$7,632.96
Rate for Payer: Aetna Commercial	$5,751.63
Rate for Payer: Aetna Medicare Advantage	$6,851.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,114.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,632.96
Rate for Payer: Cigna Commercial	$4,238.63
Rate for Payer: Cigna Medicare Advantage	$2,114.57
Rate for Payer: Clover Medicare Advantage	$2,008.84
Rate for Payer: EmblemHealth Commercial	$6,343.71
Rate for Payer: Humana Medicare Advantage	$2,178.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,114.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.01
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$653.01
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$104.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare Medicare Advantage	$2,114.57
Rate for Payer: Wellpoint Medicaid Managed Care	$115.36

IR BRONCHOSCOPY FLUOROSCOPIC W

Facility

$4,353.37

Service Code	HCPCS 31625
Hospital Charge Code	2680110
Hospital Revenue Code	361
Min. Negotiated Rate	$653.01
Max. Negotiated Rate	$653.01
Rate for Payer: Qualcare PPO/HMO/WC	$653.01

IR BRONCHOSCOPY FLUOROSCOPIC W

Facility

$4,353.37

Service Code	HCPCS 31625
Hospital Charge Code	7411374
Hospital Revenue Code	361
Min. Negotiated Rate	$653.01
Max. Negotiated Rate	$653.01
Rate for Payer: Qualcare PPO/HMO/WC	$653.01

IR BRONCHOSCOPY FLUOROSCOPIC W

Facility

$4,353.37

Service Code	HCPCS 31625
Hospital Charge Code	7411374
Hospital Revenue Code	361
Min. Negotiated Rate	$104.92
Max. Negotiated Rate	$7,632.96
Rate for Payer: Aetna Commercial	$5,751.63
Rate for Payer: Aetna Medicare Advantage	$6,851.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,114.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,632.96
Rate for Payer: Cigna Commercial	$4,238.63
Rate for Payer: Cigna Medicare Advantage	$2,114.57
Rate for Payer: Clover Medicare Advantage	$2,008.84
Rate for Payer: EmblemHealth Commercial	$6,343.71
Rate for Payer: Humana Medicare Advantage	$2,178.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,114.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.01
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$653.01
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$104.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare Medicare Advantage	$2,114.57
Rate for Payer: Wellpoint Medicaid Managed Care	$115.36

IR BRONCH WITH TRACHAEL STENT

Facility

$6,764.50

Service Code	HCPCS 31631
Hospital Charge Code	2600151
Hospital Revenue Code	361
Min. Negotiated Rate	$1,014.67
Max. Negotiated Rate	$1,014.67
Rate for Payer: Qualcare PPO/HMO/WC	$1,014.67

IR BRONCH WITH TRACHAEL STENT

Facility

$6,764.50

Service Code	HCPCS 31631
Hospital Charge Code	2600151
Hospital Revenue Code	361
Min. Negotiated Rate	$163.02
Max. Negotiated Rate	$30,265.35
Rate for Payer: Aetna Commercial	$22,805.70
Rate for Payer: Aetna Medicare Advantage	$27,165.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,265.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,265.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,384.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30,265.35
Rate for Payer: Cigna Commercial	$16,806.60
Rate for Payer: Cigna Medicare Advantage	$8,384.45
Rate for Payer: Clover Medicare Advantage	$7,965.23
Rate for Payer: EmblemHealth Commercial	$25,153.35
Rate for Payer: Humana Medicare Advantage	$8,635.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,384.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,029.35
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,014.67
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$163.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,384.45
Rate for Payer: Wellcare Medicare Advantage	$8,384.45
Rate for Payer: Wellpoint Medicaid Managed Care	$179.26

IR-BX BRST PRCT W/DEVC-BI

Facility

$1,746.00

Hospital Charge Code	2690310
Hospital Revenue Code	361
Min. Negotiated Rate	$42.08
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$663.48
Rate for Payer: Aetna Medicare Advantage	$523.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$445.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$445.23
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	$445.23
Rate for Payer: Cigna Commercial	$873.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$523.80
Rate for Payer: Qualcare PPO/HMO/WC	$261.90
Rate for Payer: UnitedHealthcare Community & State	$42.08
Rate for Payer: Wellpoint Medicaid Managed Care	$46.27

IR-BX BRST PRCT W/DEVC-BI

Facility

$1,746.00

Hospital Charge Code	2690310
Hospital Revenue Code	361
Min. Negotiated Rate	$261.90
Max. Negotiated Rate	$261.90
Rate for Payer: Qualcare PPO/HMO/WC	$261.90

IR-BX BRST PRCT W/DEVC-LT

Facility

$1,746.00

Hospital Charge Code	2690900
Hospital Revenue Code	361
Min. Negotiated Rate	$261.90
Max. Negotiated Rate	$261.90
Rate for Payer: Qualcare PPO/HMO/WC	$261.90

IR-BX BRST PRCT W/DEVC-LT

Facility

$1,746.00

Hospital Charge Code	2690900
Hospital Revenue Code	361
Min. Negotiated Rate	$42.08
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$663.48
Rate for Payer: Aetna Medicare Advantage	$523.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$445.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$445.23
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	$445.23
Rate for Payer: Cigna Commercial	$873.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$523.80
Rate for Payer: Qualcare PPO/HMO/WC	$261.90
Rate for Payer: UnitedHealthcare Community & State	$42.08
Rate for Payer: Wellpoint Medicaid Managed Care	$46.27

Know your out-of-pocket cost for care.

All Charges