Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR EXCH PREV ART CATH THROMB

Facility

$4,328.00

Service Code	HCPCS 37213
Hospital Charge Code	2011167
Hospital Revenue Code	361
Min. Negotiated Rate	$104.30
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,298.40
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$649.20
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$104.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$114.69

IR EXCH PREV ART CATH THROMB

Facility

$4,328.00

Service Code	HCPCS 37213
Hospital Charge Code	366837213
Hospital Revenue Code	361
Min. Negotiated Rate	$649.20
Max. Negotiated Rate	$649.20
Rate for Payer: Qualcare PPO/HMO/WC	$649.20

IR EXCH PREV ART CATH W/ CONT

Facility

$3,360.00

Hospital Charge Code	2001255
Hospital Revenue Code	320
Min. Negotiated Rate	$504.00
Max. Negotiated Rate	$504.00
Rate for Payer: Qualcare PPO/HMO/WC	$504.00

IR EXCH PREV ART CATH W/ CONT

Facility

$3,360.00

Hospital Charge Code	2001255
Hospital Revenue Code	320
Min. Negotiated Rate	$80.98
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$1,276.80
Rate for Payer: Aetna Medicare Advantage	$1,008.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$856.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$856.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$856.80
Rate for Payer: Cigna Commercial	$1,680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,008.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$504.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$80.98
Rate for Payer: Wellpoint Medicaid Managed Care	$89.04

IR EXOPHAGEAL DILATION

Facility

$2,033.75

Service Code	HCPCS 74360
Hospital Charge Code	2600084
Hospital Revenue Code	320
Min. Negotiated Rate	$305.06
Max. Negotiated Rate	$305.06
Rate for Payer: Qualcare PPO/HMO/WC	$305.06

IR EXOPHAGEAL DILATION

Facility

$2,033.75

Service Code	HCPCS 74360
Hospital Charge Code	2600084
Hospital Revenue Code	320
Min. Negotiated Rate	$49.01
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$772.83
Rate for Payer: Aetna Medicare Advantage	$610.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$518.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$518.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$518.61
Rate for Payer: Cigna Commercial	$1,016.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$610.12
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$305.06
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$49.01
Rate for Payer: Wellpoint Medicaid Managed Care	$53.89

IR-EXT CANN DECLOTING/W @ CATH

Facility

$15,530.27

Service Code	HCPCS 36861
Hospital Charge Code	7411489
Hospital Revenue Code	361
Min. Negotiated Rate	$2,329.54
Max. Negotiated Rate	$2,329.54
Rate for Payer: Qualcare PPO/HMO/WC	$2,329.54

IR-EXT CANN DECLOTING/W @ CATH

Facility

$15,530.27

Service Code	HCPCS 36861
Hospital Charge Code	7411489
Hospital Revenue Code	361
Min. Negotiated Rate	$374.28
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	$1,355.00
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	$4,659.08
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,329.54
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$374.28
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	$411.55

IR-EXT CANN DECLOTING/W @ CATH

Facility

$15,530.27

Service Code	HCPCS 36861
Hospital Charge Code	2670180
Hospital Revenue Code	361
Min. Negotiated Rate	$374.28
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	$1,355.00
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	$4,659.08
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,329.54
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$374.28
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	$411.55

IR-EXT CANN DECLOTING/W @ CATH

Facility

$15,530.27

Service Code	HCPCS 36861
Hospital Charge Code	2670180
Hospital Revenue Code	361
Min. Negotiated Rate	$2,329.54
Max. Negotiated Rate	$2,329.54
Rate for Payer: Qualcare PPO/HMO/WC	$2,329.54

IR-EXT VENOGRAPHY INJ-BI

Facility

$523.00

Service Code	HCPCS 3600550
Hospital Charge Code	321036005B
Hospital Revenue Code	361
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-BI

Facility

$523.00

Service Code	HCPCS 3600550
Hospital Charge Code	321036005B
Hospital Revenue Code	361
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$198.74
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
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	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.90
Rate for Payer: Qualcare PPO/HMO/WC	$78.45
Rate for Payer: UnitedHealthcare Community & State	$12.60
Rate for Payer: Wellpoint Medicaid Managed Care	$13.86

IR-EXT VENOGRAPHY INJ-BI

Facility

$523.00

Service Code	HCPCS 3600550
Hospital Charge Code	2690425
Hospital Revenue Code	361
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$198.74
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
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	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.90
Rate for Payer: Qualcare PPO/HMO/WC	$78.45
Rate for Payer: UnitedHealthcare Community & State	$12.60
Rate for Payer: Wellpoint Medicaid Managed Care	$13.86

IR-EXT VENOGRAPHY INJ-BI

Facility

$523.00

Service Code	HCPCS 3600550
Hospital Charge Code	7411789
Hospital Revenue Code	361
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$198.74
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
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	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.90
Rate for Payer: Qualcare PPO/HMO/WC	$78.45
Rate for Payer: UnitedHealthcare Community & State	$12.60
Rate for Payer: Wellpoint Medicaid Managed Care	$13.86

IR-EXT VENOGRAPHY INJ-BI

Facility

$523.00

Service Code	HCPCS 3600550
Hospital Charge Code	7411789
Hospital Revenue Code	361
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-BI

Facility

$523.00

Service Code	HCPCS 3600550
Hospital Charge Code	2690425
Hospital Revenue Code	361
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36005LT
Hospital Charge Code	321036005L
Hospital Revenue Code	361
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$198.74
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
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	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.90
Rate for Payer: Qualcare PPO/HMO/WC	$78.45
Rate for Payer: UnitedHealthcare Community & State	$12.60
Rate for Payer: Wellpoint Medicaid Managed Care	$13.86

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36005LT
Hospital Charge Code	2691145
Hospital Revenue Code	361
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$198.74
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
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	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.90
Rate for Payer: Qualcare PPO/HMO/WC	$78.45
Rate for Payer: UnitedHealthcare Community & State	$12.60
Rate for Payer: Wellpoint Medicaid Managed Care	$13.86

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36005LT
Hospital Charge Code	2691145
Hospital Revenue Code	361
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36500LT
Hospital Charge Code	366836500L
Hospital Revenue Code	361
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36005LT
Hospital Charge Code	321036005L
Hospital Revenue Code	361
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36500LT
Hospital Charge Code	411036005L
Hospital Revenue Code	361
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$198.74
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
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	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.90
Rate for Payer: Qualcare PPO/HMO/WC	$78.45
Rate for Payer: UnitedHealthcare Community & State	$12.60
Rate for Payer: Wellpoint Medicaid Managed Care	$13.86

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36005LT
Hospital Charge Code	7411895
Hospital Revenue Code	761
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36005LT
Hospital Charge Code	7411895
Hospital Revenue Code	761
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$261.50
Rate for Payer: Aetna Commercial	$198.74
Rate for Payer: Aetna Medicare Advantage	$156.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.37
Rate for Payer: Cigna Commercial	$261.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.90
Rate for Payer: Oxford Commercial	$104.60
Rate for Payer: Qualcare PPO/HMO/WC	$78.45
Rate for Payer: UnitedHealthcare Commercial	$104.60
Rate for Payer: UnitedHealthcare Community & State	$12.60
Rate for Payer: Wellpoint Medicaid Managed Care	$13.86

IR-EXT VENOGRAPHY INJ-LT

Facility

$523.00

Service Code	HCPCS 36500LT
Hospital Charge Code	411036005L
Hospital Revenue Code	361
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

Know your out-of-pocket cost for care.

All Charges