Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR STENT TRANSCATH PERC INIT

Facility

$56,620.95

Service Code	HCPCS 37236
Hospital Charge Code	321037236
Hospital Revenue Code	361
Min. Negotiated Rate	$1,364.56
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,986.28
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,364.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,500.46

IR STENT TRANSCATH PERC INIT

Facility

$56,620.95

Service Code	HCPCS 37236
Hospital Charge Code	2011160
Hospital Revenue Code	361
Min. Negotiated Rate	$1,364.56
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,986.28
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,364.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,500.46

IR STENT TRANSCTH PER EA ADD

Facility

$15,615.00

Service Code	HCPCS 37237
Hospital Charge Code	321037237
Hospital Revenue Code	361
Min. Negotiated Rate	$376.32
Max. Negotiated Rate	$14,834.00
Rate for Payer: Aetna Commercial	$5,933.70
Rate for Payer: Aetna Medicare Advantage	$4,684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,981.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,981.82
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	$3,981.82
Rate for Payer: Cigna Commercial	$7,807.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,684.50
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,342.25
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$376.32
Rate for Payer: Wellpoint Medicaid Managed Care	$413.80

IR STENT TRANSCTH PER EA ADD

Facility

$15,615.00

Service Code	HCPCS 37237
Hospital Charge Code	2011165
Hospital Revenue Code	361
Min. Negotiated Rate	$376.32
Max. Negotiated Rate	$14,834.00
Rate for Payer: Aetna Commercial	$5,933.70
Rate for Payer: Aetna Medicare Advantage	$4,684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,981.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,981.82
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	$3,981.82
Rate for Payer: Cigna Commercial	$7,807.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,684.50
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,342.25
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$376.32
Rate for Payer: Wellpoint Medicaid Managed Care	$413.80

IR STENT TRANSCTH PER EA ADD

Facility

$15,615.00

Service Code	HCPCS 37237
Hospital Charge Code	321037237
Hospital Revenue Code	361
Min. Negotiated Rate	$2,342.25
Max. Negotiated Rate	$2,342.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,342.25

IR STENT TRANSCTH PER EA ADD

Facility

$15,615.00

Service Code	HCPCS 37237
Hospital Charge Code	2011165
Hospital Revenue Code	361
Min. Negotiated Rate	$2,342.25
Max. Negotiated Rate	$2,342.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,342.25

IR STNT PLCMT INTRVSC PERC/OPN

Facility

$2,237.55

Hospital Charge Code	2600113
Hospital Revenue Code	320
Min. Negotiated Rate	$335.63
Max. Negotiated Rate	$335.63
Rate for Payer: Qualcare PPO/HMO/WC	$335.63

IR STNT PLCMT INTRVSC PERC/OPN

Facility

$2,237.55

Hospital Charge Code	2600113
Hospital Revenue Code	320
Min. Negotiated Rate	$53.92
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$850.27
Rate for Payer: Aetna Medicare Advantage	$671.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.58
Rate for Payer: Cigna Commercial	$1,118.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$671.26
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$335.63
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$53.92
Rate for Payer: Wellpoint Medicaid Managed Care	$59.30

IR SUTURE DRESSING TRAY/SUPPLI

Facility

$15.00

Hospital Charge Code	4800970
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$3.00
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

IR SUTURE DRESSING TRAY/SUPPLI

Facility

$15.00

Hospital Charge Code	4800970
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

IR TBE OR CTH CHNG GSTRINTSTNL

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	7411744
Hospital Revenue Code	320
Min. Negotiated Rate	$38.77
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$611.36
Rate for Payer: Aetna Medicare Advantage	$482.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.26
Rate for Payer: Cigna Commercial	$804.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.65
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.33
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$38.77
Rate for Payer: Wellpoint Medicaid Managed Care	$42.63

IR TBE OR CTH CHNG GSTRINTSTNL

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	2600119
Hospital Revenue Code	320
Min. Negotiated Rate	$241.33
Max. Negotiated Rate	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$241.33

IR TBE OR CTH CHNG GSTRINTSTNL

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	2600119
Hospital Revenue Code	320
Min. Negotiated Rate	$38.77
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$611.36
Rate for Payer: Aetna Medicare Advantage	$482.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.26
Rate for Payer: Cigna Commercial	$804.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.65
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.33
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$38.77
Rate for Payer: Wellpoint Medicaid Managed Care	$42.63

IR TBE OR CTH CHNG GSTRINTSTNL

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	7411744
Hospital Revenue Code	320
Min. Negotiated Rate	$241.33
Max. Negotiated Rate	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$241.33

IR TEMPOROMANDIBULAR JNT ARTHR

Facility

$1,667.37

Service Code	HCPCS 70332
Hospital Charge Code	2680245
Hospital Revenue Code	320
Min. Negotiated Rate	$250.11
Max. Negotiated Rate	$250.11
Rate for Payer: Qualcare PPO/HMO/WC	$250.11

IR TEMPOROMANDIBULAR JNT ARTHR

Facility

$1,667.37

Service Code	HCPCS 70332
Hospital Charge Code	2680245
Hospital Revenue Code	320
Min. Negotiated Rate	$40.18
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$198.43
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.11
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$40.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$44.19

IR TEMPOROMANDIBULAR JNT ARTHR

Facility

$1,667.37

Service Code	HCPCS 70332
Hospital Charge Code	7411660
Hospital Revenue Code	320
Min. Negotiated Rate	$40.18
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$198.43
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.11
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$40.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$44.19

IR TEMPOROMANDIBULAR JNT ARTHR

Facility

$1,667.37

Service Code	HCPCS 70332
Hospital Charge Code	7411660
Hospital Revenue Code	320
Min. Negotiated Rate	$250.11
Max. Negotiated Rate	$250.11
Rate for Payer: Qualcare PPO/HMO/WC	$250.11

IR-THORACENTESIS-BI

Facility

$5,466.05

Service Code	HCPCS 3255550
Hospital Charge Code	2690375
Hospital Revenue Code	361
Min. Negotiated Rate	$819.91
Max. Negotiated Rate	$819.91
Rate for Payer: Qualcare PPO/HMO/WC	$819.91

IR-THORACENTESIS-BI

Facility

$5,466.05

Service Code	HCPCS 3255550
Hospital Charge Code	321032555B
Hospital Revenue Code	361
Min. Negotiated Rate	$819.91
Max. Negotiated Rate	$819.91
Rate for Payer: Qualcare PPO/HMO/WC	$819.91

IR-THORACENTESIS-BI

Facility

$5,466.05

Service Code	HCPCS 3255550
Hospital Charge Code	2690375
Hospital Revenue Code	361
Min. Negotiated Rate	$131.73
Max. Negotiated Rate	$2,733.03
Rate for Payer: Aetna Commercial	$2,077.10
Rate for Payer: Aetna Medicare Advantage	$1,639.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,393.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,393.84
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	$1,393.84
Rate for Payer: Cigna Commercial	$2,733.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,639.82
Rate for Payer: Qualcare PPO/HMO/WC	$819.91
Rate for Payer: UnitedHealthcare Community & State	$131.73
Rate for Payer: Wellpoint Medicaid Managed Care	$144.85

IR-THORACENTESIS-BI

Facility

$5,466.05

Service Code	HCPCS 3255550
Hospital Charge Code	321032555B
Hospital Revenue Code	361
Min. Negotiated Rate	$131.73
Max. Negotiated Rate	$2,733.03
Rate for Payer: Aetna Commercial	$2,077.10
Rate for Payer: Aetna Medicare Advantage	$1,639.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,393.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,393.84
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	$1,393.84
Rate for Payer: Cigna Commercial	$2,733.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,639.82
Rate for Payer: Qualcare PPO/HMO/WC	$819.91
Rate for Payer: UnitedHealthcare Community & State	$131.73
Rate for Payer: Wellpoint Medicaid Managed Care	$144.85

IR-THORACENTESIS-LT

Facility

$3,630.70

Service Code	HCPCS 32555
Hospital Charge Code	321032555L
Hospital Revenue Code	361
Min. Negotiated Rate	$544.61
Max. Negotiated Rate	$544.61
Rate for Payer: Qualcare PPO/HMO/WC	$544.61

IR-THORACENTESIS-LT

Facility

$605.45

Service Code	HCPCS 32555
Hospital Charge Code	7411383
Hospital Revenue Code	361
Min. Negotiated Rate	$90.82
Max. Negotiated Rate	$90.82
Rate for Payer: Qualcare PPO/HMO/WC	$90.82

IR-THORACENTESIS-LT

Facility

$3,630.70

Service Code	HCPCS 32555
Hospital Charge Code	2691040
Hospital Revenue Code	361
Min. Negotiated Rate	$87.50
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,027.08
Rate for Payer: Aetna Medicare Advantage	$2,414.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$745.25
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	$2,690.13
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: Cigna Medicare Advantage	$745.25
Rate for Payer: Clover Medicare Advantage	$707.99
Rate for Payer: EmblemHealth Commercial	$2,235.75
Rate for Payer: Humana Medicare Advantage	$767.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.21
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$544.61
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$87.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$745.25
Rate for Payer: Wellcare Medicare Advantage	$745.25
Rate for Payer: Wellpoint Medicaid Managed Care	$96.21

Know your out-of-pocket cost for care.

All Charges