Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR-LYMPH NODE-SUPER-RT

Facility

$6,202.00

Service Code	HCPCS 38505RT
Hospital Charge Code	2009205
Hospital Revenue Code	361
Min. Negotiated Rate	$149.47
Max. Negotiated Rate	$3,101.00
Rate for Payer: Aetna Commercial	$2,356.76
Rate for Payer: Aetna Medicare Advantage	$1,860.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.51
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	$1,581.51
Rate for Payer: Cigna Commercial	$3,101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,860.60
Rate for Payer: Qualcare PPO/HMO/WC	$930.30
Rate for Payer: UnitedHealthcare Community & State	$149.47
Rate for Payer: Wellpoint Medicaid Managed Care	$164.35

IR-LYMPH NODE-SUPER-RT

Facility

$6,202.00

Service Code	HCPCS 38505RT
Hospital Charge Code	2009205
Hospital Revenue Code	361
Min. Negotiated Rate	$930.30
Max. Negotiated Rate	$930.30
Rate for Payer: Qualcare PPO/HMO/WC	$930.30

IR-MEASUR KIDNEY PRESS-BI

Facility

$316.00

Service Code	HCPCS 5039650
Hospital Charge Code	7411825
Hospital Revenue Code	361
Min. Negotiated Rate	$47.40
Max. Negotiated Rate	$47.40
Rate for Payer: Qualcare PPO/HMO/WC	$47.40

IR-MEASUR KIDNEY PRESS-BI

Facility

$316.00

Service Code	HCPCS 5039650
Hospital Charge Code	2690655
Hospital Revenue Code	361
Min. Negotiated Rate	$7.62
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$120.08
Rate for Payer: Aetna Medicare Advantage	$94.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.58
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	$80.58
Rate for Payer: Cigna Commercial	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.80
Rate for Payer: Qualcare PPO/HMO/WC	$47.40
Rate for Payer: UnitedHealthcare Community & State	$7.62
Rate for Payer: Wellpoint Medicaid Managed Care	$8.37

IR-MEASUR KIDNEY PRESS-BI

Facility

$316.00

Service Code	HCPCS 5039650
Hospital Charge Code	2690655
Hospital Revenue Code	361
Min. Negotiated Rate	$47.40
Max. Negotiated Rate	$47.40
Rate for Payer: Qualcare PPO/HMO/WC	$47.40

IR-MEASUR KIDNEY PRESS-BI

Facility

$316.00

Service Code	HCPCS 5039650
Hospital Charge Code	7411825
Hospital Revenue Code	361
Min. Negotiated Rate	$7.62
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$120.08
Rate for Payer: Aetna Medicare Advantage	$94.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.58
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	$80.58
Rate for Payer: Cigna Commercial	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.80
Rate for Payer: Qualcare PPO/HMO/WC	$47.40
Rate for Payer: UnitedHealthcare Community & State	$7.62
Rate for Payer: Wellpoint Medicaid Managed Care	$8.37

IR-MEASUR KIDNEY PRESS-LT

Facility

$316.00

Service Code	HCPCS 50396LT
Hospital Charge Code	2691640
Hospital Revenue Code	361
Min. Negotiated Rate	$47.40
Max. Negotiated Rate	$47.40
Rate for Payer: Qualcare PPO/HMO/WC	$47.40

IR-MEASUR KIDNEY PRESS-LT

Facility

$316.00

Service Code	HCPCS 50396LT
Hospital Charge Code	7411970
Hospital Revenue Code	361
Min. Negotiated Rate	$47.40
Max. Negotiated Rate	$47.40
Rate for Payer: Qualcare PPO/HMO/WC	$47.40

IR-MEASUR KIDNEY PRESS-LT

Facility

$316.00

Service Code	HCPCS 50396LT
Hospital Charge Code	7411970
Hospital Revenue Code	361
Min. Negotiated Rate	$7.62
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$120.08
Rate for Payer: Aetna Medicare Advantage	$94.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.58
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	$80.58
Rate for Payer: Cigna Commercial	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.80
Rate for Payer: Qualcare PPO/HMO/WC	$47.40
Rate for Payer: UnitedHealthcare Community & State	$7.62
Rate for Payer: Wellpoint Medicaid Managed Care	$8.37

IR-MEASUR KIDNEY PRESS-LT

Facility

$316.00

Service Code	HCPCS 50396LT
Hospital Charge Code	2691640
Hospital Revenue Code	361
Min. Negotiated Rate	$7.62
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$120.08
Rate for Payer: Aetna Medicare Advantage	$94.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.58
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	$80.58
Rate for Payer: Cigna Commercial	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.80
Rate for Payer: Qualcare PPO/HMO/WC	$47.40
Rate for Payer: UnitedHealthcare Community & State	$7.62
Rate for Payer: Wellpoint Medicaid Managed Care	$8.37

IR-MEASUR KIDNEY PRESS-RT

Facility

$316.00

Service Code	HCPCS 50396RT
Hospital Charge Code	7411971
Hospital Revenue Code	361
Min. Negotiated Rate	$7.62
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$120.08
Rate for Payer: Aetna Medicare Advantage	$94.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.58
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	$80.58
Rate for Payer: Cigna Commercial	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.80
Rate for Payer: Qualcare PPO/HMO/WC	$47.40
Rate for Payer: UnitedHealthcare Community & State	$7.62
Rate for Payer: Wellpoint Medicaid Managed Care	$8.37

IR-MEASUR KIDNEY PRESS-RT

Facility

$316.00

Service Code	HCPCS 50396RT
Hospital Charge Code	2691645
Hospital Revenue Code	361
Min. Negotiated Rate	$47.40
Max. Negotiated Rate	$47.40
Rate for Payer: Qualcare PPO/HMO/WC	$47.40

IR-MEASUR KIDNEY PRESS-RT

Facility

$316.00

Service Code	HCPCS 50396RT
Hospital Charge Code	7411971
Hospital Revenue Code	361
Min. Negotiated Rate	$47.40
Max. Negotiated Rate	$47.40
Rate for Payer: Qualcare PPO/HMO/WC	$47.40

IR-MEASUR KIDNEY PRESS-RT

Facility

$316.00

Service Code	HCPCS 50396RT
Hospital Charge Code	2691645
Hospital Revenue Code	361
Min. Negotiated Rate	$7.62
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$120.08
Rate for Payer: Aetna Medicare Advantage	$94.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.58
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	$80.58
Rate for Payer: Cigna Commercial	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.80
Rate for Payer: Qualcare PPO/HMO/WC	$47.40
Rate for Payer: UnitedHealthcare Community & State	$7.62
Rate for Payer: Wellpoint Medicaid Managed Care	$8.37

IR MYELOGRAM 2 OR MORE REGIONS

Facility

$3,939.00

Service Code	HCPCS 62305
Hospital Charge Code	7411657
Hospital Revenue Code	361
Min. Negotiated Rate	$590.85
Max. Negotiated Rate	$590.85
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR MYELOGRAM 2 OR MORE REGIONS

Facility

$3,939.00

Service Code	HCPCS 62305
Hospital Charge Code	7411657
Hospital Revenue Code	361
Min. Negotiated Rate	$94.93
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,533.19
Rate for Payer: Aetna Medicare Advantage	$3,017.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,361.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,361.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$931.32
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	$3,361.79
Rate for Payer: Cigna Commercial	$1,866.82
Rate for Payer: Cigna Medicare Advantage	$931.32
Rate for Payer: Clover Medicare Advantage	$884.75
Rate for Payer: EmblemHealth Commercial	$2,793.96
Rate for Payer: Humana Medicare Advantage	$959.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$931.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,181.70
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$590.85
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$94.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$931.32
Rate for Payer: Wellcare Medicare Advantage	$931.32
Rate for Payer: Wellpoint Medicaid Managed Care	$104.38

IR MYELOGRAM 2 OR MORE REGIONS

Facility

$3,939.00

Hospital Charge Code	2692126
Hospital Revenue Code	361
Min. Negotiated Rate	$94.93
Max. Negotiated Rate	$1,969.50
Rate for Payer: Aetna Commercial	$1,496.82
Rate for Payer: Aetna Medicare Advantage	$1,181.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,004.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,004.45
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	$1,004.45
Rate for Payer: Cigna Commercial	$1,969.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,181.70
Rate for Payer: Qualcare PPO/HMO/WC	$590.85
Rate for Payer: UnitedHealthcare Community & State	$94.93
Rate for Payer: Wellpoint Medicaid Managed Care	$104.38

IR MYELOGRAM 2 OR MORE REGIONS

Facility

$3,939.00

Hospital Charge Code	2692126
Hospital Revenue Code	361
Min. Negotiated Rate	$590.85
Max. Negotiated Rate	$590.85
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR MYELOGRAM CERVICAL

Facility

$3,939.00

Service Code	HCPCS 62302
Hospital Charge Code	7411654
Hospital Revenue Code	361
Min. Negotiated Rate	$94.93
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,533.19
Rate for Payer: Aetna Medicare Advantage	$3,017.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,361.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,361.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$931.32
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	$3,361.79
Rate for Payer: Cigna Commercial	$1,866.82
Rate for Payer: Cigna Medicare Advantage	$931.32
Rate for Payer: Clover Medicare Advantage	$884.75
Rate for Payer: EmblemHealth Commercial	$2,793.96
Rate for Payer: Humana Medicare Advantage	$959.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$931.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,181.70
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$590.85
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$94.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$931.32
Rate for Payer: Wellcare Medicare Advantage	$931.32
Rate for Payer: Wellpoint Medicaid Managed Care	$104.38

IR MYELOGRAM CERVICAL

Facility

$3,939.00

Service Code	HCPCS 62302
Hospital Charge Code	7411654
Hospital Revenue Code	361
Min. Negotiated Rate	$590.85
Max. Negotiated Rate	$590.85
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR MYELOGRAM CERVICAL

Facility

$3,939.00

Hospital Charge Code	2692122
Hospital Revenue Code	361
Min. Negotiated Rate	$94.93
Max. Negotiated Rate	$1,969.50
Rate for Payer: Aetna Commercial	$1,496.82
Rate for Payer: Aetna Medicare Advantage	$1,181.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,004.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,004.45
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	$1,004.45
Rate for Payer: Cigna Commercial	$1,969.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,181.70
Rate for Payer: Qualcare PPO/HMO/WC	$590.85
Rate for Payer: UnitedHealthcare Community & State	$94.93
Rate for Payer: Wellpoint Medicaid Managed Care	$104.38

IR MYELOGRAM CERVICAL

Facility

$3,939.00

Hospital Charge Code	2692122
Hospital Revenue Code	361
Min. Negotiated Rate	$590.85
Max. Negotiated Rate	$590.85
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR-MYELOGRAM INJECTION

Facility

$678.00

Service Code	HCPCS 62284
Hospital Charge Code	7411652
Hospital Revenue Code	361
Min. Negotiated Rate	$16.34
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$257.64
Rate for Payer: Aetna Medicare Advantage	$203.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.89
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	$172.89
Rate for Payer: Cigna Commercial	$339.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.40
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$101.70
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$16.34

IR-MYELOGRAM INJECTION

Facility

$678.00

Service Code	HCPCS 62284
Hospital Charge Code	2670220
Hospital Revenue Code	361
Min. Negotiated Rate	$16.34
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$257.64
Rate for Payer: Aetna Medicare Advantage	$203.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.89
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	$172.89
Rate for Payer: Cigna Commercial	$339.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.40
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$101.70
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$16.34

IR-MYELOGRAM INJECTION

Facility

$678.00

Service Code	HCPCS 62284
Hospital Charge Code	7411652
Hospital Revenue Code	361
Min. Negotiated Rate	$101.70
Max. Negotiated Rate	$101.70
Rate for Payer: Qualcare PPO/HMO/WC	$101.70

Know your out-of-pocket cost for care.

All Charges