Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR FLUOR GUID CV ACCESS DEVICE

Facility

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	321077001
Hospital Revenue Code	320
Min. Negotiated Rate	$55.45
Max. Negotiated Rate	$4,346.30
Rate for Payer: Aetna Commercial	$3,303.19
Rate for Payer: Aetna Medicare Advantage	$2,607.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,216.61
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	$2,216.61
Rate for Payer: Cigna Commercial	$4,346.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,607.78
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$209.49
Rate for Payer: Wellpoint Medicaid Managed Care	$230.35

IR FLUOR GUID CV ACCESS DEVICE

Facility

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	7411754
Hospital Revenue Code	320
Min. Negotiated Rate	$55.45
Max. Negotiated Rate	$4,346.30
Rate for Payer: Aetna Commercial	$3,303.19
Rate for Payer: Aetna Medicare Advantage	$2,607.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,216.61
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	$2,216.61
Rate for Payer: Cigna Commercial	$4,346.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,607.78
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$209.49
Rate for Payer: Wellpoint Medicaid Managed Care	$230.35

IR FLUOROGUIDE FOR SPINE INJ

Facility

$1,507.85

Service Code	HCPCS 77003
Hospital Charge Code	2600150
Hospital Revenue Code	320
Min. Negotiated Rate	$36.34
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$572.98
Rate for Payer: Aetna Medicare Advantage	$452.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$384.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$384.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$384.50
Rate for Payer: Cigna Commercial	$753.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$452.36
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$226.18
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 FLUOROGUIDE FOR SPINE INJ

Facility

$1,507.85

Service Code	HCPCS 77003
Hospital Charge Code	2600150
Hospital Revenue Code	320
Min. Negotiated Rate	$226.18
Max. Negotiated Rate	$226.18
Rate for Payer: Qualcare PPO/HMO/WC	$226.18

IR FLUORO GUID NEEDLE PLCMENT

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	2004890
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR FLUORO GUID NEEDLE PLCMENT

Facility

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	2004890
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/GASTRO/CECO/COLON TUBE

Facility

$1,891.00

Service Code	HCPCS 49450
Hospital Charge Code	7411597
Hospital Revenue Code	361
Min. Negotiated Rate	$45.57
Max. Negotiated Rate	$5,311.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,889.52
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$567.30
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$283.65
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$45.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$50.11

IR/GASTRO/CECO/COLON TUBE

Facility

$4,459.55

Service Code	HCPCS 49450
Hospital Charge Code	2690165
Hospital Revenue Code	361
Min. Negotiated Rate	$668.93
Max. Negotiated Rate	$668.93
Rate for Payer: Qualcare PPO/HMO/WC	$668.93

IR/GASTRO/CECO/COLON TUBE

Facility

$1,891.00

Service Code	HCPCS 49450
Hospital Charge Code	7411597
Hospital Revenue Code	361
Min. Negotiated Rate	$283.65
Max. Negotiated Rate	$283.65
Rate for Payer: Qualcare PPO/HMO/WC	$283.65

IR/GASTRO/CECO/COLON TUBE

Facility

$3,717.20

Service Code	HCPCS 49450
Hospital Charge Code	411049450
Hospital Revenue Code	361
Min. Negotiated Rate	$557.58
Max. Negotiated Rate	$557.58
Rate for Payer: Qualcare PPO/HMO/WC	$557.58

IR/GASTRO/CECO/COLON TUBE

Facility

$4,459.55

Service Code	HCPCS 49450
Hospital Charge Code	321049450
Hospital Revenue Code	361
Min. Negotiated Rate	$107.48
Max. Negotiated Rate	$5,311.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,889.52
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,337.87
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$668.93
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$107.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$118.18

IR/GASTRO/CECO/COLON TUBE

Facility

$3,717.20

Service Code	HCPCS 49450
Hospital Charge Code	366849450
Hospital Revenue Code	361
Min. Negotiated Rate	$89.58
Max. Negotiated Rate	$5,311.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,889.52
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,115.16
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$557.58
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$89.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$98.51

IR/GASTRO/CECO/COLON TUBE

Facility

$4,459.55

Service Code	HCPCS 49450
Hospital Charge Code	321049450
Hospital Revenue Code	361
Min. Negotiated Rate	$668.93
Max. Negotiated Rate	$668.93
Rate for Payer: Qualcare PPO/HMO/WC	$668.93

IR/GASTRO/CECO/COLON TUBE

Facility

$4,459.55

Service Code	HCPCS 49450
Hospital Charge Code	2690165
Hospital Revenue Code	361
Min. Negotiated Rate	$107.48
Max. Negotiated Rate	$5,311.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,889.52
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,337.87
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$668.93
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$107.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$118.18

IR/GASTRO/CECO/COLON TUBE

Facility

$3,717.20

Service Code	HCPCS 49450
Hospital Charge Code	411049450
Hospital Revenue Code	361
Min. Negotiated Rate	$89.58
Max. Negotiated Rate	$5,311.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,889.52
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,115.16
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$557.58
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$89.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$98.51

IR/GASTRO/CECO/COLON TUBE

Facility

$3,717.20

Service Code	HCPCS 49450
Hospital Charge Code	366849450
Hospital Revenue Code	361
Min. Negotiated Rate	$557.58
Max. Negotiated Rate	$557.58
Rate for Payer: Qualcare PPO/HMO/WC	$557.58

IR GI TUBE PLACEMENT

Facility

$1,268.00

Service Code	HCPCS 74340
Hospital Charge Code	2600088
Hospital Revenue Code	320
Min. Negotiated Rate	$30.56
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$481.84
Rate for Payer: Aetna Medicare Advantage	$380.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$323.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$323.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$323.34
Rate for Payer: Cigna Commercial	$634.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$190.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$30.56
Rate for Payer: Wellpoint Medicaid Managed Care	$33.60

IR GI TUBE PLACEMENT

Facility

$1,268.00

Service Code	HCPCS 74340
Hospital Charge Code	2600088
Hospital Revenue Code	320
Min. Negotiated Rate	$190.20
Max. Negotiated Rate	$190.20
Rate for Payer: Qualcare PPO/HMO/WC	$190.20

IR GI TUBE PLACEMENT

Facility

$1,268.00

Service Code	HCPCS 74340
Hospital Charge Code	7411672
Hospital Revenue Code	320
Min. Negotiated Rate	$190.20
Max. Negotiated Rate	$190.20
Rate for Payer: Qualcare PPO/HMO/WC	$190.20

IR GI TUBE PLACEMENT

Facility

$1,268.00

Service Code	HCPCS 74340
Hospital Charge Code	7411672
Hospital Revenue Code	320
Min. Negotiated Rate	$30.56
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$481.84
Rate for Payer: Aetna Medicare Advantage	$380.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$323.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$323.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$323.34
Rate for Payer: Cigna Commercial	$634.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$190.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$30.56
Rate for Payer: Wellpoint Medicaid Managed Care	$33.60

IR GUIDE VASCULAR ACCESS SITE

Facility

$6,700.00

Service Code	HCPCS 76937
Hospital Charge Code	366876937
Hospital Revenue Code	402
Min. Negotiated Rate	$56.14
Max. Negotiated Rate	$3,350.00
Rate for Payer: Aetna Commercial	$2,546.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$161.47
Rate for Payer: Wellpoint Medicaid Managed Care	$177.55

IR GUIDE VASCULAR ACCESS SITE

Facility

$6,700.00

Service Code	HCPCS 76937
Hospital Charge Code	321076937
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

IR GUIDE VASCULAR ACCESS SITE

Facility

$6,700.00

Service Code	HCPCS 76937
Hospital Charge Code	7411752
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

IR GUIDE VASCULAR ACCESS SITE

Facility

$6,700.00

Service Code	HCPCS 76937
Hospital Charge Code	7411752
Hospital Revenue Code	402
Min. Negotiated Rate	$56.14
Max. Negotiated Rate	$3,350.00
Rate for Payer: Aetna Commercial	$2,546.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$161.47
Rate for Payer: Wellpoint Medicaid Managed Care	$177.55

IR GUIDE VASCULAR ACCESS SITE

Facility

$6,700.00

Service Code	HCPCS 76937
Hospital Charge Code	366876937
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

Know your out-of-pocket cost for care.

All Charges