Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR-PERC BIOP ADR GLAND-RT

Facility

$2,866.00

Service Code	HCPCS 49180RT
Hospital Charge Code	2691525
Hospital Revenue Code	361
Min. Negotiated Rate	$429.90
Max. Negotiated Rate	$429.90
Rate for Payer: Qualcare PPO/HMO/WC	$429.90

IR-PERC BIOP ADR GLAND-RT

Facility

$2,866.00

Service Code	HCPCS 49180RT
Hospital Charge Code	2691525
Hospital Revenue Code	361
Min. Negotiated Rate	$69.07
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$1,089.08
Rate for Payer: Aetna Medicare Advantage	$859.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.83
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	$730.83
Rate for Payer: Cigna Commercial	$1,433.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$859.80
Rate for Payer: Qualcare PPO/HMO/WC	$429.90
Rate for Payer: UnitedHealthcare Community & State	$69.07
Rate for Payer: Wellpoint Medicaid Managed Care	$75.95

IR-PERC BIOP ADR GLAND-RT

Facility

$2,866.00

Service Code	HCPCS 49180RT
Hospital Charge Code	7411955
Hospital Revenue Code	361
Min. Negotiated Rate	$429.90
Max. Negotiated Rate	$429.90
Rate for Payer: Qualcare PPO/HMO/WC	$429.90

IR-PERC BIOP ADR GLAND-RT

Facility

$2,866.00

Service Code	HCPCS 49180RT
Hospital Charge Code	7411955
Hospital Revenue Code	361
Min. Negotiated Rate	$69.07
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$1,089.08
Rate for Payer: Aetna Medicare Advantage	$859.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.83
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	$730.83
Rate for Payer: Cigna Commercial	$1,433.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$859.80
Rate for Payer: Qualcare PPO/HMO/WC	$429.90
Rate for Payer: UnitedHealthcare Community & State	$69.07
Rate for Payer: Wellpoint Medicaid Managed Care	$75.95

IR-PERC BIOPSY BREAST-RT

Facility

$2,321.00

Hospital Charge Code	2690895
Hospital Revenue Code	361
Min. Negotiated Rate	$348.15
Max. Negotiated Rate	$348.15
Rate for Payer: Qualcare PPO/HMO/WC	$348.15

IR-PERC BIOPSY BREAST-RT

Facility

$2,321.00

Hospital Charge Code	2690895
Hospital Revenue Code	361
Min. Negotiated Rate	$55.94
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$881.98
Rate for Payer: Aetna Medicare Advantage	$696.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$591.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$591.86
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	$591.86
Rate for Payer: Cigna Commercial	$1,160.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$696.30
Rate for Payer: Qualcare PPO/HMO/WC	$348.15
Rate for Payer: UnitedHealthcare Community & State	$55.94
Rate for Payer: Wellpoint Medicaid Managed Care	$61.51

IR-PERC BIOPSY DISK

Facility

$758.00

Service Code	HCPCS 64999
Hospital Charge Code	2690245
Hospital Revenue Code	361
Min. Negotiated Rate	$18.27
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
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	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.40
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$113.70
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$18.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$20.09

IR-PERC BIOPSY DISK

Facility

$758.00

Service Code	HCPCS 64999
Hospital Charge Code	2690245
Hospital Revenue Code	361
Min. Negotiated Rate	$113.70
Max. Negotiated Rate	$113.70
Rate for Payer: Qualcare PPO/HMO/WC	$113.70

IR-PERC BIOPSY DISK

Facility

$758.00

Service Code	HCPCS 64999
Hospital Charge Code	7411659
Hospital Revenue Code	361
Min. Negotiated Rate	$113.70
Max. Negotiated Rate	$113.70
Rate for Payer: Qualcare PPO/HMO/WC	$113.70

IR-PERC BIOPSY DISK

Facility

$758.00

Service Code	HCPCS 64999
Hospital Charge Code	7411659
Hospital Revenue Code	361
Min. Negotiated Rate	$18.27
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
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	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.40
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$113.70
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$18.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$20.09

IR-PERC CHOLECYSTECTOMY

Facility

$17,259.20

Service Code	HCPCS 47490
Hospital Charge Code	2670170
Hospital Revenue Code	361
Min. Negotiated Rate	$2,588.88
Max. Negotiated Rate	$2,588.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

IR-PERC CHOLECYSTECTOMY

Facility

$17,259.20

Service Code	HCPCS 47490
Hospital Charge Code	2670170
Hospital Revenue Code	361
Min. Negotiated Rate	$415.95
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,177.76
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$415.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$457.37

IR-PERC CHOLECYSTECTOMY

Facility

$17,259.20

Service Code	HCPCS 47490
Hospital Charge Code	321047490
Hospital Revenue Code	361
Min. Negotiated Rate	$2,588.88
Max. Negotiated Rate	$2,588.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

IR-PERC CHOLECYSTECTOMY

Facility

$17,259.20

Service Code	HCPCS 47490
Hospital Charge Code	321047490
Hospital Revenue Code	361
Min. Negotiated Rate	$415.95
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,177.76
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$415.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$457.37

IR-PERC CHOLECYSTECTOMY

Facility

$12,976.00

Service Code	HCPCS 47490
Hospital Charge Code	7411559
Hospital Revenue Code	361
Min. Negotiated Rate	$1,946.40
Max. Negotiated Rate	$1,946.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.40

IR-PERC CHOLECYSTECTOMY

Facility

$12,976.00

Service Code	HCPCS 47490
Hospital Charge Code	7411559
Hospital Revenue Code	361
Min. Negotiated Rate	$312.72
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,892.80
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,946.40
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$312.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$343.86

IR PERC CRYO ABLATE RENAL TUMO

Facility

$21,118.85

Service Code	HCPCS 50593
Hospital Charge Code	7411613
Hospital Revenue Code	361
Min. Negotiated Rate	$3,167.83
Max. Negotiated Rate	$3,167.83
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.83

IR PERC CRYO ABLATE RENAL TUMO

Facility

$21,118.85

Service Code	HCPCS 50593
Hospital Charge Code	7411613
Hospital Revenue Code	361
Min. Negotiated Rate	$508.96
Max. Negotiated Rate	$45,585.17
Rate for Payer: Aetna Commercial	$34,349.57
Rate for Payer: Aetna Medicare Advantage	$40,916.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,585.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,585.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,628.52
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	$45,585.17
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: Cigna Medicare Advantage	$12,628.52
Rate for Payer: Clover Medicare Advantage	$11,997.09
Rate for Payer: EmblemHealth Commercial	$37,885.56
Rate for Payer: Humana Medicare Advantage	$13,007.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,628.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,335.65
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.83
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$508.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,628.52
Rate for Payer: Wellcare Medicare Advantage	$12,628.52
Rate for Payer: Wellpoint Medicaid Managed Care	$559.65

IR PERC CRYO ABLATE RENAL TUMO

Facility

$21,118.85

Service Code	HCPCS 50593
Hospital Charge Code	5600172
Hospital Revenue Code	361
Min. Negotiated Rate	$508.96
Max. Negotiated Rate	$45,585.17
Rate for Payer: Aetna Commercial	$34,349.57
Rate for Payer: Aetna Medicare Advantage	$40,916.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,585.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,585.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,628.52
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	$45,585.17
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: Cigna Medicare Advantage	$12,628.52
Rate for Payer: Clover Medicare Advantage	$11,997.09
Rate for Payer: EmblemHealth Commercial	$37,885.56
Rate for Payer: Humana Medicare Advantage	$13,007.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,628.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,335.65
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.83
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$508.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,628.52
Rate for Payer: Wellcare Medicare Advantage	$12,628.52
Rate for Payer: Wellpoint Medicaid Managed Care	$559.65

IR PERC CRYO ABLATE RENAL TUMO

Facility

$21,118.85

Service Code	HCPCS 50593
Hospital Charge Code	5600172
Hospital Revenue Code	361
Min. Negotiated Rate	$3,167.83
Max. Negotiated Rate	$3,167.83
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.83

IR-PERC DRAIN LESION-BIL

Facility

$985.00

Service Code	HCPCS 3220150
Hospital Charge Code	2690360
Hospital Revenue Code	761
Min. Negotiated Rate	$147.75
Max. Negotiated Rate	$147.75
Rate for Payer: Qualcare PPO/HMO/WC	$147.75

IR-PERC DRAIN LESION-BIL

Facility

$985.00

Service Code	HCPCS 3220150
Hospital Charge Code	2690360
Hospital Revenue Code	761
Min. Negotiated Rate	$23.74
Max. Negotiated Rate	$492.50
Rate for Payer: Aetna Commercial	$374.30
Rate for Payer: Aetna Medicare Advantage	$295.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.18
Rate for Payer: Cigna Commercial	$492.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.50
Rate for Payer: Oxford Commercial	$197.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.75
Rate for Payer: UnitedHealthcare Commercial	$197.00
Rate for Payer: UnitedHealthcare Community & State	$23.74
Rate for Payer: Wellpoint Medicaid Managed Care	$26.10

IR-PERC DRAIN LESION-LT

Facility

$985.00

Service Code	HCPCS 32201LT
Hospital Charge Code	2691000
Hospital Revenue Code	761
Min. Negotiated Rate	$147.75
Max. Negotiated Rate	$147.75
Rate for Payer: Qualcare PPO/HMO/WC	$147.75

IR-PERC DRAIN LESION-LT

Facility

$985.00

Service Code	HCPCS 32201LT
Hospital Charge Code	2691000
Hospital Revenue Code	761
Min. Negotiated Rate	$23.74
Max. Negotiated Rate	$492.50
Rate for Payer: Aetna Commercial	$374.30
Rate for Payer: Aetna Medicare Advantage	$295.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.18
Rate for Payer: Cigna Commercial	$492.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.50
Rate for Payer: Oxford Commercial	$197.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.75
Rate for Payer: UnitedHealthcare Commercial	$197.00
Rate for Payer: UnitedHealthcare Community & State	$23.74
Rate for Payer: Wellpoint Medicaid Managed Care	$26.10

IR-PERC DRAIN LESION-RT

Facility

$985.00

Service Code	HCPCS 32201RT
Hospital Charge Code	2691005
Hospital Revenue Code	761
Min. Negotiated Rate	$147.75
Max. Negotiated Rate	$147.75
Rate for Payer: Qualcare PPO/HMO/WC	$147.75

Know your out-of-pocket cost for care.

All Charges