Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR PLACE GASTROSTOMY TUBE PERC

Facility

$6,674.15

Service Code	HCPCS 49440
Hospital Charge Code	7411593
Hospital Revenue Code	361
Min. Negotiated Rate	$1,001.12
Max. Negotiated Rate	$1,001.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,001.12

IR PLACE GASTROSTOMY TUBE PERC

Facility

$8,686.35

Service Code	HCPCS 49440
Hospital Charge Code	5600159
Hospital Revenue Code	361
Min. Negotiated Rate	$1,302.95
Max. Negotiated Rate	$1,302.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,302.95

IR-PLACEMENT OF MARKER

Facility

$1,023.00

Hospital Charge Code	2680020
Hospital Revenue Code	361
Min. Negotiated Rate	$24.65
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$388.74
Rate for Payer: Aetna Medicare Advantage	$306.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.87
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	$260.87
Rate for Payer: Cigna Commercial	$511.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$306.90
Rate for Payer: Qualcare PPO/HMO/WC	$153.45
Rate for Payer: UnitedHealthcare Community & State	$24.65
Rate for Payer: Wellpoint Medicaid Managed Care	$27.11

IR-PLACEMENT OF MARKER

Facility

$1,023.00

Hospital Charge Code	2680020
Hospital Revenue Code	361
Min. Negotiated Rate	$153.45
Max. Negotiated Rate	$153.45
Rate for Payer: Qualcare PPO/HMO/WC	$153.45

IR PLACEMNT CENTRL VENOUS CATH

Facility

$15,468.50

Service Code	HCPCS 36561
Hospital Charge Code	2011168
Hospital Revenue Code	361
Min. Negotiated Rate	$372.79
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	$1,355.00
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	$4,640.55
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$372.79
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	$409.92

IR PLACEMNT CENTRL VENOUS CATH

Facility

$8,696.85

Service Code	HCPCS 36561
Hospital Charge Code	7411454
Hospital Revenue Code	361
Min. Negotiated Rate	$209.59
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	$1,355.00
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	$2,609.05
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.53
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$209.59
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	$230.47

IR PLACEMNT CENTRL VENOUS CATH

Facility

$8,696.85

Service Code	HCPCS 36561
Hospital Charge Code	366836561
Hospital Revenue Code	361
Min. Negotiated Rate	$1,304.53
Max. Negotiated Rate	$1,304.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.53

IR PLACEMNT CENTRL VENOUS CATH

Facility

$8,696.85

Service Code	HCPCS 36561
Hospital Charge Code	366836561
Hospital Revenue Code	361
Min. Negotiated Rate	$209.59
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	$1,355.00
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	$2,609.05
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.53
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$209.59
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	$230.47

IR PLACEMNT CENTRL VENOUS CATH

Facility

$8,696.85

Service Code	HCPCS 36561
Hospital Charge Code	7411454
Hospital Revenue Code	361
Min. Negotiated Rate	$1,304.53
Max. Negotiated Rate	$1,304.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.53

IR PLACEMNT CENTRL VENOUS CATH

Facility

$15,468.50

Service Code	HCPCS 36561
Hospital Charge Code	2011168
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR-PLACE NDLE WIRE BREAST

Facility

$133.00

Hospital Charge Code	2690010
Hospital Revenue Code	761
Min. Negotiated Rate	$19.95
Max. Negotiated Rate	$19.95
Rate for Payer: Qualcare PPO/HMO/WC	$19.95

IR-PLACE NDLE WIRE BREAST

Facility

$133.00

Hospital Charge Code	2690010
Hospital Revenue Code	761
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$66.50
Rate for Payer: Aetna Commercial	$50.54
Rate for Payer: Aetna Medicare Advantage	$39.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.91
Rate for Payer: Cigna Commercial	$66.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.90
Rate for Payer: Oxford Commercial	$26.60
Rate for Payer: Qualcare PPO/HMO/WC	$19.95
Rate for Payer: UnitedHealthcare Commercial	$26.60
Rate for Payer: UnitedHealthcare Community & State	$3.21
Rate for Payer: Wellpoint Medicaid Managed Care	$3.52

IR=PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	3668362455
Hospital Revenue Code	361
Min. Negotiated Rate	$8.77
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$138.32
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Community & State	$8.77
Rate for Payer: Wellpoint Medicaid Managed Care	$9.65

IR=PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	411036245
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR=PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	2690475
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR=PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	2690475
Hospital Revenue Code	361
Min. Negotiated Rate	$8.77
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$138.32
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Community & State	$8.77
Rate for Payer: Wellpoint Medicaid Managed Care	$9.65

IR=PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	3668362455
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR=PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	321036245B
Hospital Revenue Code	361
Min. Negotiated Rate	$8.77
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$138.32
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Community & State	$8.77
Rate for Payer: Wellpoint Medicaid Managed Care	$9.65

IR=PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	411036245
Hospital Revenue Code	361
Min. Negotiated Rate	$8.77
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$138.32
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Community & State	$8.77
Rate for Payer: Wellpoint Medicaid Managed Care	$9.65

IR=PL CATH ART 1ST A/P-BI

Facility

$364.00

Service Code	HCPCS 3624550
Hospital Charge Code	321036245B
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR-PL CATH ART 1ST A/P-LT

Facility

$364.00

Service Code	HCPCS 36245LT
Hospital Charge Code	2691260
Hospital Revenue Code	361
Min. Negotiated Rate	$8.77
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$138.32
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Community & State	$8.77
Rate for Payer: Wellpoint Medicaid Managed Care	$9.65

IR-PL CATH ART 1ST A/P-LT

Facility

$364.00

Service Code	HCPCS 36245LT
Hospital Charge Code	2691260
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR-PL CATH ART 1ST A/P-LT

Facility

$364.00

Service Code	HCPCS 36245LT
Hospital Charge Code	321036245L
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR-PL CATH ART 1ST A/P-LT

Facility

$364.00

Service Code	HCPCS 36245LT
Hospital Charge Code	321036245L
Hospital Revenue Code	361
Min. Negotiated Rate	$8.77
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$138.32
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Community & State	$8.77
Rate for Payer: Wellpoint Medicaid Managed Care	$9.65

IR-PL CATH ART 1ST A/P-RT

Facility

$364.00

Service Code	HCPCS 36245RT
Hospital Charge Code	2691265
Hospital Revenue Code	361
Min. Negotiated Rate	$8.77
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$138.32
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Community & State	$8.77
Rate for Payer: Wellpoint Medicaid Managed Care	$9.65

Know your out-of-pocket cost for care.

All Charges