Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR PERCUTANEOUS TRANS PORT

Facility

$13,436.40

Service Code	HCPCS 75885
Hospital Charge Code	2001628
Hospital Revenue Code	320
Min. Negotiated Rate	$2,015.46
Max. Negotiated Rate	$2,015.46
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46

IR PERCUTANEOUS TRANS PORT

Facility

$13,436.40

Service Code	HCPCS 75885
Hospital Charge Code	2001628
Hospital Revenue Code	320
Min. Negotiated Rate	$276.46
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	$276.46
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	$2,625.82
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	$4,030.92
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.46
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$323.82
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	$356.06

IR PERCUT VERTEBROPLASTY FLUOR

Facility

$980.50

Service Code	HCPCS 72291
Hospital Charge Code	2101179
Hospital Revenue Code	320
Min. Negotiated Rate	$23.63
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$372.59
Rate for Payer: Aetna Medicare Advantage	$294.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.03
Rate for Payer: Cigna Commercial	$490.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.07
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$23.63
Rate for Payer: Wellpoint Medicaid Managed Care	$25.98

IR PERCUT VERTEBROPLASTY FLUOR

Facility

$980.50

Service Code	HCPCS 72291
Hospital Charge Code	2101179
Hospital Revenue Code	320
Min. Negotiated Rate	$147.07
Max. Negotiated Rate	$147.07
Rate for Payer: Qualcare PPO/HMO/WC	$147.07

IR PERC VAC ASST BREAST BIOPSY

Facility

$6,096.00

Hospital Charge Code	26702042
Hospital Revenue Code	361
Min. Negotiated Rate	$146.91
Max. Negotiated Rate	$3,048.00
Rate for Payer: Aetna Commercial	$2,316.48
Rate for Payer: Aetna Medicare Advantage	$1,828.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,554.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,554.48
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	$1,554.48
Rate for Payer: Cigna Commercial	$3,048.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,828.80
Rate for Payer: Qualcare PPO/HMO/WC	$914.40
Rate for Payer: UnitedHealthcare Community & State	$146.91
Rate for Payer: Wellpoint Medicaid Managed Care	$161.54

IR PERC VAC ASST BREAST BIOPSY

Facility

$6,096.00

Hospital Charge Code	26702042
Hospital Revenue Code	361
Min. Negotiated Rate	$914.40
Max. Negotiated Rate	$914.40
Rate for Payer: Qualcare PPO/HMO/WC	$914.40

IR PERICARDIOCENTESIS INITIAL

Facility

$6,404.20

Service Code	HCPCS 33010
Hospital Charge Code	321033010
Hospital Revenue Code	361
Min. Negotiated Rate	$154.34
Max. Negotiated Rate	$3,202.10
Rate for Payer: Aetna Commercial	$2,433.60
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,633.07
Rate for Payer: Cigna Commercial	$3,202.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,921.26
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Community & State	$154.34
Rate for Payer: Wellpoint Medicaid Managed Care	$169.71

IR PERICARDIOCENTESIS INITIAL

Facility

$6,404.20

Service Code	HCPCS 33010
Hospital Charge Code	2680135
Hospital Revenue Code	361
Min. Negotiated Rate	$154.34
Max. Negotiated Rate	$3,202.10
Rate for Payer: Aetna Commercial	$2,433.60
Rate for Payer: Aetna Medicare Advantage	$1,921.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,633.07
Rate for Payer: Cigna Commercial	$3,202.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,921.26
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Community & State	$154.34
Rate for Payer: Wellpoint Medicaid Managed Care	$169.71

IR PERICARDIOCENTESIS INITIAL

Facility

$6,404.20

Service Code	HCPCS 33010
Hospital Charge Code	2680135
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

IR PERICARDIOCENTESIS INITIAL

Facility

$6,404.20

Service Code	HCPCS 33010
Hospital Charge Code	321033010
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

IR PERICARDIOCENTESIS SUBSEQUE

Facility

$2,289.68

Service Code	HCPCS 33011
Hospital Charge Code	2680140
Hospital Revenue Code	361
Min. Negotiated Rate	$55.18
Max. Negotiated Rate	$1,144.84
Rate for Payer: Aetna Commercial	$870.08
Rate for Payer: Aetna Medicare Advantage	$686.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$583.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$583.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$583.87
Rate for Payer: Cigna Commercial	$1,144.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$686.90
Rate for Payer: Qualcare PPO/HMO/WC	$343.45
Rate for Payer: UnitedHealthcare Community & State	$55.18
Rate for Payer: Wellpoint Medicaid Managed Care	$60.68

IR PERICARDIOCENTESIS SUBSEQUE

Facility

$2,289.68

Service Code	HCPCS 33011
Hospital Charge Code	2680140
Hospital Revenue Code	361
Min. Negotiated Rate	$343.45
Max. Negotiated Rate	$343.45
Rate for Payer: Qualcare PPO/HMO/WC	$343.45

IR PERITONEAL LAVAGE W/IMG

Facility

$2,289.68

Service Code	HCPCS 49084
Hospital Charge Code	2670110
Hospital Revenue Code	361
Min. Negotiated Rate	$343.45
Max. Negotiated Rate	$343.45
Rate for Payer: Qualcare PPO/HMO/WC	$343.45

IR PERITONEAL LAVAGE W/IMG

Facility

$2,289.68

Service Code	HCPCS 49084
Hospital Charge Code	7411577
Hospital Revenue Code	361
Min. Negotiated Rate	$55.18
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	$686.90
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$343.45
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$55.18
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	$60.68

IR PERITONEAL LAVAGE W/IMG

Facility

$2,289.68

Service Code	HCPCS 49084
Hospital Charge Code	7411577
Hospital Revenue Code	361
Min. Negotiated Rate	$343.45
Max. Negotiated Rate	$343.45
Rate for Payer: Qualcare PPO/HMO/WC	$343.45

IR PERITONEAL LAVAGE W/IMG

Facility

$2,289.68

Service Code	HCPCS 49084
Hospital Charge Code	2670110
Hospital Revenue Code	361
Min. Negotiated Rate	$55.18
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	$686.90
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$343.45
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$55.18
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	$60.68

IR PERITONEOCENTESIS W IMAGING

Facility

$2,422.65

Service Code	HCPCS 49083
Hospital Charge Code	2004042
Hospital Revenue Code	361
Min. Negotiated Rate	$58.39
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	$726.79
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$363.40
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$58.39
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	$64.20

IR PERITONEOCENTESIS W IMAGING

Facility

$2,422.65

Service Code	HCPCS 49083
Hospital Charge Code	2004042
Hospital Revenue Code	361
Min. Negotiated Rate	$363.40
Max. Negotiated Rate	$363.40
Rate for Payer: Qualcare PPO/HMO/WC	$363.40

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	7411847
Hospital Revenue Code	361
Min. Negotiated Rate	$906.51
Max. Negotiated Rate	$18,807.17
Rate for Payer: Aetna Commercial	$14,293.45
Rate for Payer: Aetna Medicare Advantage	$11,284.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,591.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,591.66
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	$9,591.66
Rate for Payer: Cigna Commercial	$18,807.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,284.31
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$906.51
Rate for Payer: Wellpoint Medicaid Managed Care	$996.78

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	32100075T
Hospital Revenue Code	361
Min. Negotiated Rate	$5,642.15
Max. Negotiated Rate	$5,642.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	32100075T
Hospital Revenue Code	361
Min. Negotiated Rate	$906.51
Max. Negotiated Rate	$18,807.17
Rate for Payer: Aetna Commercial	$14,293.45
Rate for Payer: Aetna Medicare Advantage	$11,284.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,591.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,591.66
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	$9,591.66
Rate for Payer: Cigna Commercial	$18,807.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,284.31
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$906.51
Rate for Payer: Wellpoint Medicaid Managed Care	$996.78

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	36680075T
Hospital Revenue Code	361
Min. Negotiated Rate	$906.51
Max. Negotiated Rate	$18,807.17
Rate for Payer: Aetna Commercial	$14,293.45
Rate for Payer: Aetna Medicare Advantage	$11,284.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,591.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,591.66
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	$9,591.66
Rate for Payer: Cigna Commercial	$18,807.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,284.31
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$906.51
Rate for Payer: Wellpoint Medicaid Managed Care	$996.78

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	7411847
Hospital Revenue Code	361
Min. Negotiated Rate	$5,642.15
Max. Negotiated Rate	$5,642.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	5700214
Hospital Revenue Code	361
Min. Negotiated Rate	$5,642.15
Max. Negotiated Rate	$5,642.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15

IR PERQ STENT CHEST VERT ART

Facility

$37,614.35

Service Code	HCPCS 0075T
Hospital Charge Code	5700214
Hospital Revenue Code	361
Min. Negotiated Rate	$906.51
Max. Negotiated Rate	$18,807.17
Rate for Payer: Aetna Commercial	$14,293.45
Rate for Payer: Aetna Medicare Advantage	$11,284.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,591.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,591.66
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	$9,591.66
Rate for Payer: Cigna Commercial	$18,807.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,284.31
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$906.51
Rate for Payer: Wellpoint Medicaid Managed Care	$996.78

Know your out-of-pocket cost for care.

All Charges