Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR-RFA LUNG-BIL

Facility

$15,231.00

Service Code	HCPCS 3299850
Hospital Charge Code	2690400
Hospital Revenue Code	361
Min. Negotiated Rate	$2,284.65
Max. Negotiated Rate	$2,284.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA LUNG-RT

Facility

$15,231.00

Service Code	HCPCS 32998RT
Hospital Charge Code	2691100
Hospital Revenue Code	361
Min. Negotiated Rate	$367.07
Max. Negotiated Rate	$7,615.50
Rate for Payer: Aetna Commercial	$5,787.78
Rate for Payer: Aetna Medicare Advantage	$4,569.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,883.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,883.91
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	$3,883.91
Rate for Payer: Cigna Commercial	$7,615.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,569.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65
Rate for Payer: UnitedHealthcare Community & State	$367.07
Rate for Payer: Wellpoint Medicaid Managed Care	$403.62

IR-RFA LUNG-RT

Facility

$15,231.00

Service Code	HCPCS 32998RT
Hospital Charge Code	7411890
Hospital Revenue Code	361
Min. Negotiated Rate	$367.07
Max. Negotiated Rate	$7,615.50
Rate for Payer: Aetna Commercial	$5,787.78
Rate for Payer: Aetna Medicare Advantage	$4,569.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,883.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,883.91
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	$3,883.91
Rate for Payer: Cigna Commercial	$7,615.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,569.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65
Rate for Payer: UnitedHealthcare Community & State	$367.07
Rate for Payer: Wellpoint Medicaid Managed Care	$403.62

IR-RFA LUNG-RT

Facility

$15,231.00

Service Code	HCPCS 32998RT
Hospital Charge Code	2691100
Hospital Revenue Code	361
Min. Negotiated Rate	$2,284.65
Max. Negotiated Rate	$2,284.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IR-RFA LUNG-RT

Facility

$15,231.00

Service Code	HCPCS 32998RT
Hospital Charge Code	7411890
Hospital Revenue Code	361
Min. Negotiated Rate	$2,284.65
Max. Negotiated Rate	$2,284.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,284.65

IRRIG 0.9% NACL 1000ML *****

Facility

$10.00

Hospital Charge Code	7000128
Hospital Revenue Code	258
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$3.80
Rate for Payer: Aetna Medicare Advantage	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.55
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.00
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$2.00
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

IRRIG 0.9% NACL 1000ML *****

Facility

$10.00

Hospital Charge Code	7000128
Hospital Revenue Code	258
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

IRRIGANT GU 0.9% NACL 1000ML

Facility

$22.50

Hospital Charge Code	270040040
Hospital Revenue Code	270
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

IRRIGANT GU 0.9% NACL 1000ML

Facility

$22.50

Hospital Charge Code	270040040
Hospital Revenue Code	270
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.75
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$4.50
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.60

IRRIGANT GU 0.9% NACL 3000ML

Facility

$35.00

Hospital Charge Code	270061485
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$17.50
Rate for Payer: Aetna Commercial	$13.30
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.50
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$7.00
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

IRRIGANT GU 0.9% NACL 3000ML

Facility

$35.00

Hospital Charge Code	270061485
Hospital Revenue Code	272
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

IRRIGANT LR 3000CC 782808

Facility

$30.45

Hospital Charge Code	270622530
Hospital Revenue Code	270
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$15.22
Rate for Payer: Aetna Commercial	$11.57
Rate for Payer: Aetna Medicare Advantage	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.76
Rate for Payer: Cigna Commercial	$15.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.13
Rate for Payer: Oxford Commercial	$6.09
Rate for Payer: Qualcare PPO/HMO/WC	$4.57
Rate for Payer: UnitedHealthcare Commercial	$6.09
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

IRRIGANT LR 3000CC 782808

Facility

$30.45

Hospital Charge Code	270622530
Hospital Revenue Code	270
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$4.57
Rate for Payer: Qualcare PPO/HMO/WC	$4.57

IRRIGATING CYSTITOMES 25G

Facility

$50.00

Hospital Charge Code	270331005
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

IRRIGATING CYSTITOMES 25G

Facility

$50.00

Hospital Charge Code	270331005
Hospital Revenue Code	272
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$10.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

IRRIGATING TUBING 3318503E

Facility

$90.00

Hospital Charge Code	270639697
Hospital Revenue Code	272
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.00
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

IRRIGATING TUBING 3318503E

Facility

$90.00

Hospital Charge Code	270639697
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

IRRIGATION CATH 6FR 80CM

Facility

$182.00

Hospital Charge Code	270331055
Hospital Revenue Code	272
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$27.30

IRRIGATION CATH 6FR 80CM

Facility

$182.00

Hospital Charge Code	270331055
Hospital Revenue Code	272
Min. Negotiated Rate	$4.39
Max. Negotiated Rate	$91.00
Rate for Payer: Aetna Commercial	$69.16
Rate for Payer: Aetna Medicare Advantage	$54.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.41
Rate for Payer: Cigna Commercial	$91.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.60
Rate for Payer: Oxford Commercial	$36.40
Rate for Payer: Qualcare PPO/HMO/WC	$27.30
Rate for Payer: UnitedHealthcare Commercial	$36.40
Rate for Payer: UnitedHealthcare Community & State	$4.39
Rate for Payer: Wellpoint Medicaid Managed Care	$4.82

IRRIGATION CLIP

Facility

$601.25

Hospital Charge Code	270690849
Hospital Revenue Code	272
Min. Negotiated Rate	$14.49
Max. Negotiated Rate	$300.62
Rate for Payer: Aetna Commercial	$228.47
Rate for Payer: Aetna Medicare Advantage	$180.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.32
Rate for Payer: Cigna Commercial	$300.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.38
Rate for Payer: Oxford Commercial	$120.25
Rate for Payer: Qualcare PPO/HMO/WC	$90.19
Rate for Payer: UnitedHealthcare Commercial	$120.25
Rate for Payer: UnitedHealthcare Community & State	$14.49
Rate for Payer: Wellpoint Medicaid Managed Care	$15.93

IRRIGATION CLIP

Facility

$601.25

Hospital Charge Code	270690849
Hospital Revenue Code	272
Min. Negotiated Rate	$90.19
Max. Negotiated Rate	$90.19
Rate for Payer: Qualcare PPO/HMO/WC	$90.19

IRRIGATION CONTROL BUTTON

Facility

$83.00

Hospital Charge Code	270332495
Hospital Revenue Code	272
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$41.50
Rate for Payer: Aetna Commercial	$31.54
Rate for Payer: Aetna Medicare Advantage	$24.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.16
Rate for Payer: Cigna Commercial	$41.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.90
Rate for Payer: Oxford Commercial	$16.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.45
Rate for Payer: UnitedHealthcare Commercial	$16.60
Rate for Payer: UnitedHealthcare Community & State	$2.00
Rate for Payer: Wellpoint Medicaid Managed Care	$2.20

IRRIGATION CONTROL BUTTON

Facility

$83.00

Hospital Charge Code	270332495
Hospital Revenue Code	272
Min. Negotiated Rate	$12.45
Max. Negotiated Rate	$12.45
Rate for Payer: Qualcare PPO/HMO/WC	$12.45

IRRIGATION CYSTOTOME 25G.

Facility

$33.00

Hospital Charge Code	270331399
Hospital Revenue Code	272
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$12.54
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.90
Rate for Payer: Oxford Commercial	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$6.60
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

IRRIGATION CYSTOTOME 25G.

Facility

$33.00

Hospital Charge Code	270331399
Hospital Revenue Code	272
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

Know your out-of-pocket cost for care.

All Charges