Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR-DRAN CEREB SPINAL FLUD

Facility

$3,506.55

Service Code	HCPCS 62272
Hospital Charge Code	321062272
Hospital Revenue Code	361
Min. Negotiated Rate	$84.51
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,281.02
Rate for Payer: Aetna Medicare Advantage	$2,717.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$838.61
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	$3,027.13
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: Cigna Medicare Advantage	$838.61
Rate for Payer: Clover Medicare Advantage	$796.68
Rate for Payer: EmblemHealth Commercial	$2,515.83
Rate for Payer: Humana Medicare Advantage	$863.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$838.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,051.96
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.98
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$84.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$92.92

IR DX-FLUORO GUIDANCE/LOC NEED

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	321077002
Hospital Revenue Code	320
Min. Negotiated Rate	$55.45
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

IR DX-FLUORO GUIDANCE/LOC NEED

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	2670020
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR DX-FLUORO GUIDANCE/LOC NEED

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	411077002
Hospital Revenue Code	320
Min. Negotiated Rate	$55.45
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

IR DX-FLUORO GUIDANCE/LOC NEED

Facility

$1,508.00

Service Code	HCPCS 77002
Hospital Charge Code	7411755
Hospital Revenue Code	320
Min. Negotiated Rate	$36.34
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$573.04
Rate for Payer: Aetna Medicare Advantage	$452.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$384.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$384.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$384.54
Rate for Payer: Cigna Commercial	$754.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$452.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$226.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$36.34
Rate for Payer: Wellpoint Medicaid Managed Care	$39.96

IR DX-FLUORO GUIDANCE/LOC NEED

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	366877002
Hospital Revenue Code	320
Min. Negotiated Rate	$55.45
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

IR DX-FLUORO GUIDANCE/LOC NEED

Facility

$1,508.00

Service Code	HCPCS 77002
Hospital Charge Code	7411755
Hospital Revenue Code	320
Min. Negotiated Rate	$226.20
Max. Negotiated Rate	$226.20
Rate for Payer: Qualcare PPO/HMO/WC	$226.20

IR DX-FLUORO GUIDANCE/LOC NEED

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	366877002
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR DX-FLUORO GUIDANCE/LOC NEED

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	2670020
Hospital Revenue Code	320
Min. Negotiated Rate	$55.45
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

IR DX-FLUORO GUIDANCE/LOC NEED

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	411077002
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR DX-FLUORO GUIDANCE/LOC NEED

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	321077002
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR ECHO GUIDANCE RADIOTHERAPY

Facility

$752.50

Service Code	HCPCS 76965
Hospital Charge Code	2101158
Hospital Revenue Code	402
Min. Negotiated Rate	$18.14
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$285.95
Rate for Payer: Aetna Medicare Advantage	$225.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$332.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.89
Rate for Payer: Cigna Commercial	$376.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.75
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.88
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$18.14
Rate for Payer: Wellpoint Medicaid Managed Care	$19.94

IR ECHO GUIDANCE RADIOTHERAPY

Facility

$752.50

Service Code	HCPCS 76965
Hospital Charge Code	2101158
Hospital Revenue Code	402
Min. Negotiated Rate	$112.88
Max. Negotiated Rate	$112.88
Rate for Payer: Qualcare PPO/HMO/WC	$112.88

IR ELBOW ARTHROGRAPHY

Facility

$1,667.37

Service Code	HCPCS 73085
Hospital Charge Code	7411665
Hospital Revenue Code	322
Min. Negotiated Rate	$35.14
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$1,127.36
Rate for Payer: Aetna Medicare Advantage	$1,342.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$414.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,496.11
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: Cigna Medicare Advantage	$290.13
Rate for Payer: Clover Medicare Advantage	$393.75
Rate for Payer: EmblemHealth Commercial	$1,243.41
Rate for Payer: Humana Medicare Advantage	$426.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$414.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.11
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$40.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$414.47
Rate for Payer: Wellcare Medicare Advantage	$414.47
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$607.00
Rate for Payer: Wellpoint Medicaid Managed Care	$44.19

IR ELBOW ARTHROGRAPHY

Facility

$1,667.37

Service Code	HCPCS 73085
Hospital Charge Code	2680270
Hospital Revenue Code	322
Min. Negotiated Rate	$35.14
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$1,127.36
Rate for Payer: Aetna Medicare Advantage	$1,342.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$414.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,496.11
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: Cigna Medicare Advantage	$290.13
Rate for Payer: Clover Medicare Advantage	$393.75
Rate for Payer: EmblemHealth Commercial	$1,243.41
Rate for Payer: Humana Medicare Advantage	$426.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$414.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.11
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$40.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$414.47
Rate for Payer: Wellcare Medicare Advantage	$414.47
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$607.00
Rate for Payer: Wellpoint Medicaid Managed Care	$44.19

IR ELBOW ARTHROGRAPHY

Facility

$1,667.37

Service Code	HCPCS 73085
Hospital Charge Code	2680270
Hospital Revenue Code	322
Min. Negotiated Rate	$250.11
Max. Negotiated Rate	$250.11
Rate for Payer: Qualcare PPO/HMO/WC	$250.11

IR ELBOW ARTHROGRAPHY

Facility

$1,667.37

Service Code	HCPCS 73085
Hospital Charge Code	7411665
Hospital Revenue Code	322
Min. Negotiated Rate	$250.11
Max. Negotiated Rate	$250.11
Rate for Payer: Qualcare PPO/HMO/WC	$250.11

IR EMBOLECTOMY FEMORPO LEG INC

Facility

$22,371.25

Service Code	HCPCS 34201
Hospital Charge Code	7411391
Hospital Revenue Code	361
Min. Negotiated Rate	$3,355.69
Max. Negotiated Rate	$3,355.69
Rate for Payer: Qualcare PPO/HMO/WC	$3,355.69

IR EMBOLECTOMY FEMORPO LEG INC

Facility

$22,371.25

Service Code	HCPCS 34201
Hospital Charge Code	7411391
Hospital Revenue Code	361
Min. Negotiated Rate	$539.15
Max. Negotiated Rate	$23,862.86
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
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	$23,862.86
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$6,610.76
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,711.38
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,355.69
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$539.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$592.84

IR EMBOLECTOMY FEMORPO LEG INC

Facility

$22,371.25

Service Code	HCPCS 34201
Hospital Charge Code	5600195
Hospital Revenue Code	361
Min. Negotiated Rate	$3,355.69
Max. Negotiated Rate	$3,355.69
Rate for Payer: Qualcare PPO/HMO/WC	$3,355.69

IR EMBOLECTOMY FEMORPO LEG INC

Facility

$22,371.25

Service Code	HCPCS 34201
Hospital Charge Code	5600195
Hospital Revenue Code	361
Min. Negotiated Rate	$539.15
Max. Negotiated Rate	$23,862.86
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
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	$23,862.86
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$6,610.76
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,711.38
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,355.69
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$539.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$592.84

IR EMBOLIZATION ANY METHOD

Facility

$5,100.00

Service Code	HCPCS 75894
Hospital Charge Code	7411728
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR EMBOLIZATION ANY METHOD

Facility

$5,100.00

Service Code	HCPCS 75894
Hospital Charge Code	2600072
Hospital Revenue Code	320
Min. Negotiated Rate	$122.91
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$487.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

IR EMBOLIZATION ANY METHOD

Facility

$5,100.00

Service Code	HCPCS 75894
Hospital Charge Code	366875894
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR EMBOLIZATION ANY METHOD

Facility

$5,100.00

Service Code	HCPCS 75894
Hospital Charge Code	2600072
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

Know your out-of-pocket cost for care.

All Charges