Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IRR NOZZLE-SHORT F/E-PEN DRIVE

Facility

$833.00

Hospital Charge Code	270674694
Hospital Revenue Code	272
Min. Negotiated Rate	$20.08
Max. Negotiated Rate	$416.50
Rate for Payer: Aetna Commercial	$316.54
Rate for Payer: Aetna Medicare Advantage	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.41
Rate for Payer: Cigna Commercial	$416.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.90
Rate for Payer: Oxford Commercial	$166.60
Rate for Payer: Qualcare PPO/HMO/WC	$124.95
Rate for Payer: UnitedHealthcare Commercial	$166.60
Rate for Payer: UnitedHealthcare Community & State	$20.08
Rate for Payer: Wellpoint Medicaid Managed Care	$22.07

IRR NOZZLE-SHORT F/E-PEN DRIVE

Facility

$833.00

Hospital Charge Code	270674694
Hospital Revenue Code	272
Min. Negotiated Rate	$124.95
Max. Negotiated Rate	$124.95
Rate for Payer: Qualcare PPO/HMO/WC	$124.95

IRR NOZZLE XXL F/E-PEN DRIVE

Facility

$833.00

Hospital Charge Code	270674703
Hospital Revenue Code	272
Min. Negotiated Rate	$20.08
Max. Negotiated Rate	$416.50
Rate for Payer: Aetna Commercial	$316.54
Rate for Payer: Aetna Medicare Advantage	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.41
Rate for Payer: Cigna Commercial	$416.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.90
Rate for Payer: Oxford Commercial	$166.60
Rate for Payer: Qualcare PPO/HMO/WC	$124.95
Rate for Payer: UnitedHealthcare Commercial	$166.60
Rate for Payer: UnitedHealthcare Community & State	$20.08
Rate for Payer: Wellpoint Medicaid Managed Care	$22.07

IRR NOZZLE XXL F/E-PEN DRIVE

Facility

$833.00

Hospital Charge Code	270674703
Hospital Revenue Code	272
Min. Negotiated Rate	$124.95
Max. Negotiated Rate	$124.95
Rate for Payer: Qualcare PPO/HMO/WC	$124.95

IR RTRVL FRGN BDY INTRVSC PERC

Facility

$2,238.00

Hospital Charge Code	2600112
Hospital Revenue Code	320
Min. Negotiated Rate	$335.70
Max. Negotiated Rate	$335.70
Rate for Payer: Qualcare PPO/HMO/WC	$335.70

IR RTRVL FRGN BDY INTRVSC PERC

Facility

$2,238.00

Hospital Charge Code	2600112
Hospital Revenue Code	320
Min. Negotiated Rate	$53.94
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$850.44
Rate for Payer: Aetna Medicare Advantage	$671.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.69
Rate for Payer: Cigna Commercial	$1,119.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$671.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$335.70
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$53.94
Rate for Payer: Wellpoint Medicaid Managed Care	$59.31

IR-SEL CATH PLACET 1ST-BI

Facility

$242.00

Service Code	HCPCS 3601150
Hospital Charge Code	2690430
Hospital Revenue Code	761
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

IR-SEL CATH PLACET 1ST-BI

Facility

$242.00

Service Code	HCPCS 3601150
Hospital Charge Code	2690430
Hospital Revenue Code	761
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$121.00
Rate for Payer: Aetna Commercial	$91.96
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.71
Rate for Payer: Cigna Commercial	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Oxford Commercial	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Commercial	$48.40
Rate for Payer: UnitedHealthcare Community & State	$5.83
Rate for Payer: Wellpoint Medicaid Managed Care	$6.41

IR-SEL CATH PLACET 1ST-BI

Facility

$242.00

Service Code	HCPCS 3601150
Hospital Charge Code	7411790
Hospital Revenue Code	761
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

IR-SEL CATH PLACET 1ST-BI

Facility

$242.00

Service Code	HCPCS 3601150
Hospital Charge Code	7411790
Hospital Revenue Code	761
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$121.00
Rate for Payer: Aetna Commercial	$91.96
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.71
Rate for Payer: Cigna Commercial	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Oxford Commercial	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Commercial	$48.40
Rate for Payer: UnitedHealthcare Community & State	$5.83
Rate for Payer: Wellpoint Medicaid Managed Care	$6.41

IR-SEL CATH PLACET 1ST-LT

Facility

$242.00

Service Code	HCPCS 36011LT
Hospital Charge Code	7411897
Hospital Revenue Code	761
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

IR-SEL CATH PLACET 1ST-LT

Facility

$242.00

Service Code	HCPCS 36011LT
Hospital Charge Code	7411897
Hospital Revenue Code	761
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$121.00
Rate for Payer: Aetna Commercial	$91.96
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.71
Rate for Payer: Cigna Commercial	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Oxford Commercial	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Commercial	$48.40
Rate for Payer: UnitedHealthcare Community & State	$5.83
Rate for Payer: Wellpoint Medicaid Managed Care	$6.41

IR-SEL CATH PLACET 1ST-LT

Facility

$242.00

Service Code	HCPCS 36011LT
Hospital Charge Code	2691155
Hospital Revenue Code	761
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

IR-SEL CATH PLACET 1ST-LT

Facility

$242.00

Service Code	HCPCS 36011LT
Hospital Charge Code	2691155
Hospital Revenue Code	761
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$121.00
Rate for Payer: Aetna Commercial	$91.96
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.71
Rate for Payer: Cigna Commercial	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Oxford Commercial	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Commercial	$48.40
Rate for Payer: UnitedHealthcare Community & State	$5.83
Rate for Payer: Wellpoint Medicaid Managed Care	$6.41

IR-SEL CATH PLACET 1ST-RT

Facility

$242.00

Service Code	HCPCS 36011RT
Hospital Charge Code	2691160
Hospital Revenue Code	361
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

IR-SEL CATH PLACET 1ST-RT

Facility

$242.00

Service Code	HCPCS 36011RT
Hospital Charge Code	321036011R
Hospital Revenue Code	361
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$91.96
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
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	$61.71
Rate for Payer: Cigna Commercial	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Community & State	$5.83
Rate for Payer: Wellpoint Medicaid Managed Care	$6.41

IR-SEL CATH PLACET 1ST-RT

Facility

$242.00

Service Code	HCPCS 36011RT
Hospital Charge Code	7411898
Hospital Revenue Code	761
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

IR-SEL CATH PLACET 1ST-RT

Facility

$242.00

Service Code	HCPCS 36011RT
Hospital Charge Code	7411898
Hospital Revenue Code	761
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$121.00
Rate for Payer: Aetna Commercial	$91.96
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.71
Rate for Payer: Cigna Commercial	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Oxford Commercial	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Commercial	$48.40
Rate for Payer: UnitedHealthcare Community & State	$5.83
Rate for Payer: Wellpoint Medicaid Managed Care	$6.41

IR-SEL CATH PLACET 1ST-RT

Facility

$242.00

Service Code	HCPCS 36011RT
Hospital Charge Code	2691160
Hospital Revenue Code	361
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$91.96
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
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	$61.71
Rate for Payer: Cigna Commercial	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Community & State	$5.83
Rate for Payer: Wellpoint Medicaid Managed Care	$6.41

IR-SEL CATH PLACET 1ST-RT

Facility

$242.00

Service Code	HCPCS 36011RT
Hospital Charge Code	321036011R
Hospital Revenue Code	361
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

IR SEL EACH INTRACRANIAL BRANC

Facility

$18,125.00

Service Code	HCPCS 36228
Hospital Charge Code	7411430
Hospital Revenue Code	361
Min. Negotiated Rate	$2,718.75
Max. Negotiated Rate	$2,718.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75

IR SEL EACH INTRACRANIAL BRANC

Facility

$18,125.00

Service Code	HCPCS 36228
Hospital Charge Code	2680180
Hospital Revenue Code	361
Min. Negotiated Rate	$436.81
Max. Negotiated Rate	$9,062.50
Rate for Payer: Aetna Commercial	$6,887.50
Rate for Payer: Aetna Medicare Advantage	$5,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,621.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,621.88
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	$4,621.88
Rate for Payer: Cigna Commercial	$9,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,437.50
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$436.81
Rate for Payer: Wellpoint Medicaid Managed Care	$480.31

IR SEL EACH INTRACRANIAL BRANC

Facility

$18,125.00

Service Code	HCPCS 36228
Hospital Charge Code	2680180
Hospital Revenue Code	361
Min. Negotiated Rate	$2,718.75
Max. Negotiated Rate	$2,718.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75

IR SEL EACH INTRACRANIAL BRANC

Facility

$18,125.00

Service Code	HCPCS 36228
Hospital Charge Code	7411430
Hospital Revenue Code	361
Min. Negotiated Rate	$436.81
Max. Negotiated Rate	$9,062.50
Rate for Payer: Aetna Commercial	$6,887.50
Rate for Payer: Aetna Medicare Advantage	$5,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,621.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,621.88
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	$4,621.88
Rate for Payer: Cigna Commercial	$9,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,437.50
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$436.81
Rate for Payer: Wellpoint Medicaid Managed Care	$480.31

IR SEL VEN CATH 1ST ORD

Facility

$414.45

Service Code	HCPCS 36011
Hospital Charge Code	7411415
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

Know your out-of-pocket cost for care.

All Charges