Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR CORPORA CAVERNOSOGRAPHY

Facility

$1,092.60

Service Code	HCPCS 74445
Hospital Charge Code	7411681
Hospital Revenue Code	320
Min. Negotiated Rate	$26.33
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$327.78
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$163.89
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$26.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$28.95

IR CORPORA CAVERNOSOGRAPHY

Facility

$1,092.60

Service Code	HCPCS 74445
Hospital Charge Code	7411681
Hospital Revenue Code	320
Min. Negotiated Rate	$163.89
Max. Negotiated Rate	$163.89
Rate for Payer: Qualcare PPO/HMO/WC	$163.89

IR CREATE PASSAGE TO KIDNEY

Facility

$8,535.00

Service Code	HCPCS 50395
Hospital Charge Code	7411605
Hospital Revenue Code	361
Min. Negotiated Rate	$1,280.25
Max. Negotiated Rate	$1,280.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,280.25

IR CREATE PASSAGE TO KIDNEY

Facility

$8,535.00

Service Code	HCPCS 50395
Hospital Charge Code	7411605
Hospital Revenue Code	361
Min. Negotiated Rate	$205.69
Max. Negotiated Rate	$4,267.50
Rate for Payer: Aetna Commercial	$3,243.30
Rate for Payer: Aetna Medicare Advantage	$2,560.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,176.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,176.43
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	$2,176.43
Rate for Payer: Cigna Commercial	$4,267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,560.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,280.25
Rate for Payer: UnitedHealthcare Community & State	$205.69
Rate for Payer: Wellpoint Medicaid Managed Care	$226.18

IR CREATE PASSAGE TO KIDNEY

Facility

$8,535.00

Service Code	HCPCS 50395
Hospital Charge Code	5600171
Hospital Revenue Code	361
Min. Negotiated Rate	$205.69
Max. Negotiated Rate	$4,267.50
Rate for Payer: Aetna Commercial	$3,243.30
Rate for Payer: Aetna Medicare Advantage	$2,560.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,176.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,176.43
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	$2,176.43
Rate for Payer: Cigna Commercial	$4,267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,560.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,280.25
Rate for Payer: UnitedHealthcare Community & State	$205.69
Rate for Payer: Wellpoint Medicaid Managed Care	$226.18

IR CREATE PASSAGE TO KIDNEY

Facility

$8,535.00

Service Code	HCPCS 50395
Hospital Charge Code	5600171
Hospital Revenue Code	361
Min. Negotiated Rate	$1,280.25
Max. Negotiated Rate	$1,280.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,280.25

IR CTA LOWER EXTREMITY W/WO CO

Facility

$2,013.25

Service Code	HCPCS 73706
Hospital Charge Code	2680300
Hospital Revenue Code	350
Min. Negotiated Rate	$48.52
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$566.79
Rate for Payer: Aetna Medicare Advantage	$675.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$208.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$362.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.19
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: Cigna Medicare Advantage	$145.87
Rate for Payer: Clover Medicare Advantage	$197.96
Rate for Payer: EmblemHealth Commercial	$625.14
Rate for Payer: Humana Medicare Advantage	$214.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$208.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$603.98
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$301.99
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$48.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$958.88
Rate for Payer: Wellpoint Medicaid Managed Care	$53.35

IR CTA LOWER EXTREMITY W/WO CO

Facility

$2,013.25

Service Code	HCPCS 73706
Hospital Charge Code	7411671
Hospital Revenue Code	350
Min. Negotiated Rate	$48.52
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$566.79
Rate for Payer: Aetna Medicare Advantage	$675.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$208.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$362.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.19
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: Cigna Medicare Advantage	$145.87
Rate for Payer: Clover Medicare Advantage	$197.96
Rate for Payer: EmblemHealth Commercial	$625.14
Rate for Payer: Humana Medicare Advantage	$214.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$208.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$603.98
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$301.99
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$48.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$958.88
Rate for Payer: Wellpoint Medicaid Managed Care	$53.35

IR CTA LOWER EXTREMITY W/WO CO

Facility

$2,013.25

Service Code	HCPCS 73706
Hospital Charge Code	7411671
Hospital Revenue Code	350
Min. Negotiated Rate	$301.99
Max. Negotiated Rate	$301.99
Rate for Payer: Qualcare PPO/HMO/WC	$301.99

IR CTA LOWER EXTREMITY W/WO CO

Facility

$2,013.25

Service Code	HCPCS 73706
Hospital Charge Code	2680300
Hospital Revenue Code	350
Min. Negotiated Rate	$301.99
Max. Negotiated Rate	$301.99
Rate for Payer: Qualcare PPO/HMO/WC	$301.99

IR CT ANGIO ABD AORTA BI ILIO

Facility

$2,010.00

Service Code	HCPCS 75635
Hospital Charge Code	2600155
Hospital Revenue Code	350
Min. Negotiated Rate	$48.44
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$566.79
Rate for Payer: Aetna Medicare Advantage	$675.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$208.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$356.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.19
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: Cigna Medicare Advantage	$145.87
Rate for Payer: Clover Medicare Advantage	$197.96
Rate for Payer: EmblemHealth Commercial	$625.14
Rate for Payer: Humana Medicare Advantage	$214.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$208.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$603.00
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$301.50
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$48.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellpoint Medicaid Managed Care	$53.27

IR CT ANGIO ABD AORTA BI ILIO

Facility

$2,010.00

Service Code	HCPCS 75635
Hospital Charge Code	2600155
Hospital Revenue Code	350
Min. Negotiated Rate	$301.50
Max. Negotiated Rate	$301.50
Rate for Payer: Qualcare PPO/HMO/WC	$301.50

IR CTA UPPER EXTRY W/WO CONTRA

Facility

$2,013.25

Service Code	HCPCS 73206
Hospital Charge Code	2680280
Hospital Revenue Code	359
Min. Negotiated Rate	$48.52
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$566.79
Rate for Payer: Aetna Medicare Advantage	$675.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$208.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$362.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.19
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: Cigna Medicare Advantage	$145.87
Rate for Payer: Clover Medicare Advantage	$197.96
Rate for Payer: EmblemHealth Commercial	$625.14
Rate for Payer: Humana Medicare Advantage	$214.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$208.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$603.98
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$301.99
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$48.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellpoint Medicaid Managed Care	$53.35

IR CTA UPPER EXTRY W/WO CONTRA

Facility

$2,013.25

Service Code	HCPCS 73206
Hospital Charge Code	2680280
Hospital Revenue Code	359
Min. Negotiated Rate	$301.99
Max. Negotiated Rate	$301.99
Rate for Payer: Qualcare PPO/HMO/WC	$301.99

IR CTA UPPER EXTRY W/WO CONTRA

Facility

$2,013.25

Service Code	HCPCS 73206
Hospital Charge Code	7411667
Hospital Revenue Code	359
Min. Negotiated Rate	$301.99
Max. Negotiated Rate	$301.99
Rate for Payer: Qualcare PPO/HMO/WC	$301.99

IR CTA UPPER EXTRY W/WO CONTRA

Facility

$2,013.25

Service Code	HCPCS 73206
Hospital Charge Code	7411667
Hospital Revenue Code	359
Min. Negotiated Rate	$48.52
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$566.79
Rate for Payer: Aetna Medicare Advantage	$675.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$208.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$362.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.19
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: Cigna Medicare Advantage	$145.87
Rate for Payer: Clover Medicare Advantage	$197.96
Rate for Payer: EmblemHealth Commercial	$625.14
Rate for Payer: Humana Medicare Advantage	$214.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$208.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$603.98
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$301.99
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$48.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellpoint Medicaid Managed Care	$53.35

IR-CTN INJ ABSCS/CYST VIA CATH

Facility

$599.00

Service Code	HCPCS 49424
Hospital Charge Code	2670150
Hospital Revenue Code	361
Min. Negotiated Rate	$14.44
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$227.62
Rate for Payer: Aetna Medicare Advantage	$179.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.75
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	$152.75
Rate for Payer: Cigna Commercial	$299.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.70
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.85
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$14.44
Rate for Payer: Wellpoint Medicaid Managed Care	$15.87

IR-CTN INJ ABSCS/CYST VIA CATH

Facility

$599.00

Service Code	HCPCS 49424
Hospital Charge Code	321049424
Hospital Revenue Code	361
Min. Negotiated Rate	$14.44
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$227.62
Rate for Payer: Aetna Medicare Advantage	$179.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.75
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	$152.75
Rate for Payer: Cigna Commercial	$299.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.70
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.85
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$14.44
Rate for Payer: Wellpoint Medicaid Managed Care	$15.87

IR-CTN INJ ABSCS/CYST VIA CATH

Facility

$599.00

Service Code	HCPCS 49424
Hospital Charge Code	2670150
Hospital Revenue Code	361
Min. Negotiated Rate	$89.85
Max. Negotiated Rate	$89.85
Rate for Payer: Qualcare PPO/HMO/WC	$89.85

IR-CTN INJ ABSCS/CYST VIA CATH

Facility

$599.00

Service Code	HCPCS 49424
Hospital Charge Code	7411591
Hospital Revenue Code	361
Min. Negotiated Rate	$89.85
Max. Negotiated Rate	$89.85
Rate for Payer: Qualcare PPO/HMO/WC	$89.85

IR-CTN INJ ABSCS/CYST VIA CATH

Facility

$599.00

Service Code	HCPCS 49424
Hospital Charge Code	7411591
Hospital Revenue Code	361
Min. Negotiated Rate	$14.44
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$227.62
Rate for Payer: Aetna Medicare Advantage	$179.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.75
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	$152.75
Rate for Payer: Cigna Commercial	$299.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.70
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.85
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$14.44
Rate for Payer: Wellpoint Medicaid Managed Care	$15.87

IR-CTN INJ ABSCS/CYST VIA CATH

Facility

$599.00

Service Code	HCPCS 49424
Hospital Charge Code	321049424
Hospital Revenue Code	361
Min. Negotiated Rate	$89.85
Max. Negotiated Rate	$89.85
Rate for Payer: Qualcare PPO/HMO/WC	$89.85

IR CYST ASP BREAST

Facility

$1,901.69

Service Code	HCPCS 19000
Hospital Charge Code	7411337
Hospital Revenue Code	361
Min. Negotiated Rate	$45.83
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,036.77
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$570.51
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$285.25
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$45.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$50.39

IR CYST ASP BREAST

Facility

$1,901.69

Service Code	HCPCS 19000
Hospital Charge Code	7411337
Hospital Revenue Code	361
Min. Negotiated Rate	$285.25
Max. Negotiated Rate	$285.25
Rate for Payer: Qualcare PPO/HMO/WC	$285.25

IR CYST ASP BREAST

Facility

$1,901.69

Service Code	HCPCS 19000
Hospital Charge Code	2680005
Hospital Revenue Code	361
Min. Negotiated Rate	$285.25
Max. Negotiated Rate	$285.25
Rate for Payer: Qualcare PPO/HMO/WC	$285.25

Know your out-of-pocket cost for care.

All Charges