Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR REPLACE PICC CATH

Facility

$4,914.50

Service Code	HCPCS 36584
Hospital Charge Code	366836584
Hospital Revenue Code	361
Min. Negotiated Rate	$118.44
Max. Negotiated Rate	$6,750.64
Rate for Payer: Aetna Commercial	$5,086.78
Rate for Payer: Aetna Medicare Advantage	$6,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,750.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,750.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,870.14
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	$6,750.64
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: Cigna Medicare Advantage	$1,870.14
Rate for Payer: Clover Medicare Advantage	$1,776.63
Rate for Payer: EmblemHealth Commercial	$5,610.42
Rate for Payer: Humana Medicare Advantage	$1,926.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,870.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,474.35
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$737.17
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$118.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellpoint Medicaid Managed Care	$130.23

IR REPLACE PICC CATH

Facility

$2,024.90

Service Code	HCPCS 36584
Hospital Charge Code	7411469
Hospital Revenue Code	361
Min. Negotiated Rate	$48.80
Max. Negotiated Rate	$6,750.64
Rate for Payer: Aetna Commercial	$5,086.78
Rate for Payer: Aetna Medicare Advantage	$6,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,750.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,750.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,870.14
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	$6,750.64
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: Cigna Medicare Advantage	$1,870.14
Rate for Payer: Clover Medicare Advantage	$1,776.63
Rate for Payer: EmblemHealth Commercial	$5,610.42
Rate for Payer: Humana Medicare Advantage	$1,926.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,870.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$607.47
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$303.74
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$48.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellpoint Medicaid Managed Care	$53.66

IR REPLACE PICC CATH

Facility

$6,404.20

Service Code	HCPCS 36584
Hospital Charge Code	2011284
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

IR REPLACE PICC CATH

Facility

$4,914.50

Service Code	HCPCS 36584
Hospital Charge Code	366836584
Hospital Revenue Code	361
Min. Negotiated Rate	$737.17
Max. Negotiated Rate	$737.17
Rate for Payer: Qualcare PPO/HMO/WC	$737.17

IR REPLACE PICC CATH

Facility

$2,024.90

Service Code	HCPCS 36584
Hospital Charge Code	7411469
Hospital Revenue Code	361
Min. Negotiated Rate	$303.74
Max. Negotiated Rate	$303.74
Rate for Payer: Qualcare PPO/HMO/WC	$303.74

IR REPLACE PICC CATH

Facility

$6,404.20

Service Code	HCPCS 36584
Hospital Charge Code	321036584
Hospital Revenue Code	361
Min. Negotiated Rate	$154.34
Max. Negotiated Rate	$6,750.64
Rate for Payer: Aetna Commercial	$5,086.78
Rate for Payer: Aetna Medicare Advantage	$6,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,750.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,750.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,870.14
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	$6,750.64
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: Cigna Medicare Advantage	$1,870.14
Rate for Payer: Clover Medicare Advantage	$1,776.63
Rate for Payer: EmblemHealth Commercial	$5,610.42
Rate for Payer: Humana Medicare Advantage	$1,926.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,870.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,921.26
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$154.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellpoint Medicaid Managed Care	$169.71

IR REPLACE PIC VAD CATH

Facility

$11,315.45

Service Code	HCPCS 3658559
Hospital Charge Code	2101163
Hospital Revenue Code	361
Min. Negotiated Rate	$1,697.32
Max. Negotiated Rate	$1,697.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,697.32

IR REPLACE PIC VAD CATH

Facility

$11,315.45

Service Code	HCPCS 3658559
Hospital Charge Code	2101163
Hospital Revenue Code	361
Min. Negotiated Rate	$272.70
Max. Negotiated Rate	$5,657.73
Rate for Payer: Aetna Commercial	$4,299.87
Rate for Payer: Aetna Medicare Advantage	$3,394.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,885.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,885.44
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	$2,885.44
Rate for Payer: Cigna Commercial	$5,657.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,394.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,697.32
Rate for Payer: UnitedHealthcare Community & State	$272.70
Rate for Payer: Wellpoint Medicaid Managed Care	$299.86

IR-REPL EXT URET STENT-BI

Facility

$10,187.80

Service Code	HCPCS 5038750
Hospital Charge Code	3668503875
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REPL EXT URET STENT-BI

Facility

$10,187.80

Service Code	HCPCS 5038750
Hospital Charge Code	411050387B
Hospital Revenue Code	361
Min. Negotiated Rate	$245.53
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,871.36
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,056.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Community & State	$245.53
Rate for Payer: Wellpoint Medicaid Managed Care	$269.98

IR-REPL EXT URET STENT-BI

Facility

$10,187.80

Service Code	HCPCS 5038750
Hospital Charge Code	2690620
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REPL EXT URET STENT-BI

Facility

$10,187.80

Service Code	HCPCS 5038750
Hospital Charge Code	411050387B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REPL EXT URET STENT-BI

Facility

$10,187.80

Service Code	HCPCS 5038750
Hospital Charge Code	321050387B
Hospital Revenue Code	361
Min. Negotiated Rate	$245.53
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,871.36
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,056.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Community & State	$245.53
Rate for Payer: Wellpoint Medicaid Managed Care	$269.98

IR-REPL EXT URET STENT-BI

Facility

$10,187.80

Service Code	HCPCS 5038750
Hospital Charge Code	321050387B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REPL EXT URET STENT-BI

Facility

$4,540.00

Service Code	HCPCS 5038750
Hospital Charge Code	7411821
Hospital Revenue Code	361
Min. Negotiated Rate	$109.41
Max. Negotiated Rate	$2,270.00
Rate for Payer: Aetna Commercial	$1,725.20
Rate for Payer: Aetna Medicare Advantage	$1,362.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,157.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,157.70
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	$1,157.70
Rate for Payer: Cigna Commercial	$2,270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,362.00
Rate for Payer: Qualcare PPO/HMO/WC	$681.00
Rate for Payer: UnitedHealthcare Community & State	$109.41
Rate for Payer: Wellpoint Medicaid Managed Care	$120.31

IR-REPL EXT URET STENT-BI

Facility

$4,540.00

Service Code	HCPCS 5038750
Hospital Charge Code	7411821
Hospital Revenue Code	361
Min. Negotiated Rate	$681.00
Max. Negotiated Rate	$681.00
Rate for Payer: Qualcare PPO/HMO/WC	$681.00

IR-REPL EXT URET STENT-BI

Facility

$10,187.80

Service Code	HCPCS 5038750
Hospital Charge Code	2690620
Hospital Revenue Code	361
Min. Negotiated Rate	$245.53
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,871.36
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,056.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Community & State	$245.53
Rate for Payer: Wellpoint Medicaid Managed Care	$269.98

IR-REPL EXT URET STENT-BI

Facility

$10,187.80

Service Code	HCPCS 5038750
Hospital Charge Code	3668503875
Hospital Revenue Code	361
Min. Negotiated Rate	$245.53
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,871.36
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,056.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Community & State	$245.53
Rate for Payer: Wellpoint Medicaid Managed Care	$269.98

IR-REPL EXT URET STENT-LT

Facility

$10,187.80

Service Code	HCPCS 50387LT
Hospital Charge Code	2691570
Hospital Revenue Code	361
Min. Negotiated Rate	$245.53
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,871.36
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,056.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Community & State	$245.53
Rate for Payer: Wellpoint Medicaid Managed Care	$269.98

IR-REPL EXT URET STENT-LT

Facility

$10,187.80

Service Code	HCPCS 50387LT
Hospital Charge Code	321050387L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REPL EXT URET STENT-LT

Facility

$4,540.00

Service Code	HCPCS 50387LT
Hospital Charge Code	7411962
Hospital Revenue Code	361
Min. Negotiated Rate	$681.00
Max. Negotiated Rate	$681.00
Rate for Payer: Qualcare PPO/HMO/WC	$681.00

IR-REPL EXT URET STENT-LT

Facility

$10,187.80

Service Code	HCPCS 50387LT
Hospital Charge Code	366850387L
Hospital Revenue Code	361
Min. Negotiated Rate	$245.53
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,871.36
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,056.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Community & State	$245.53
Rate for Payer: Wellpoint Medicaid Managed Care	$269.98

IR-REPL EXT URET STENT-LT

Facility

$10,187.80

Service Code	HCPCS 50387LT
Hospital Charge Code	366850387L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REPL EXT URET STENT-LT

Facility

$10,187.80

Service Code	HCPCS 50387LT
Hospital Charge Code	411050387L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

IR-REPL EXT URET STENT-LT

Facility

$10,187.80

Service Code	HCPCS 50387LT
Hospital Charge Code	411050387L
Hospital Revenue Code	361
Min. Negotiated Rate	$245.53
Max. Negotiated Rate	$5,093.90
Rate for Payer: Aetna Commercial	$3,871.36
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,056.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Community & State	$245.53
Rate for Payer: Wellpoint Medicaid Managed Care	$269.98

Know your out-of-pocket cost for care.

All Charges