Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR TUBE OR CATH CHANGE

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	7411745
Hospital Revenue Code	320
Min. Negotiated Rate	$241.33
Max. Negotiated Rate	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$241.33

IR TUBE OR CATH CHANGE BILIARY

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	2600118
Hospital Revenue Code	320
Min. Negotiated Rate	$241.33
Max. Negotiated Rate	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$241.33

IR TUBE OR CATH CHANGE BILIARY

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	7411746
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 TUBE OR CATH CHANGE BILIARY

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	2600118
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 TUBE OR CATH CHANGE BILIARY

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	7411746
Hospital Revenue Code	320
Min. Negotiated Rate	$241.33
Max. Negotiated Rate	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$241.33

IR TUBE OR CATH CHNGE URETERAL

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	2600120
Hospital Revenue Code	320
Min. Negotiated Rate	$241.33
Max. Negotiated Rate	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$241.33

IR TUBE OR CATH CHNGE URETERAL

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	2600120
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 TUBE OR CATH CHNGE URETERAL

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	7411747
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 TUBE OR CATH CHNGE URETERAL

Facility

$1,608.85

Service Code	HCPCS 75984
Hospital Charge Code	7411747
Hospital Revenue Code	320
Min. Negotiated Rate	$241.33
Max. Negotiated Rate	$241.33
Rate for Payer: Qualcare PPO/HMO/WC	$241.33

IR TUBETMORACOSTOMY

Facility

$2,422.65

Service Code	HCPCS 32551
Hospital Charge Code	2004891
Hospital Revenue Code	361
Min. Negotiated Rate	$58.39
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	$1,626.00
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	$726.79
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$363.40
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$58.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$2,475.28
Rate for Payer: Wellpoint Medicaid Managed Care	$2,426.75

IR TUBETMORACOSTOMY

Facility

$2,422.65

Service Code	HCPCS 32551
Hospital Charge Code	2004891
Hospital Revenue Code	361
Min. Negotiated Rate	$363.40
Max. Negotiated Rate	$363.40
Rate for Payer: Qualcare PPO/HMO/WC	$363.40

IR-TX COLLAPSED LUNG-LT

Facility

$838.00

Hospital Charge Code	2691050
Hospital Revenue Code	361
Min. Negotiated Rate	$20.20
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$318.44
Rate for Payer: Aetna Medicare Advantage	$251.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$213.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$213.69
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	$213.69
Rate for Payer: Cigna Commercial	$419.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$251.40
Rate for Payer: Qualcare PPO/HMO/WC	$125.70
Rate for Payer: UnitedHealthcare Community & State	$20.20
Rate for Payer: Wellpoint Medicaid Managed Care	$22.21

IR-TX COLLAPSED LUNG-LT

Facility

$838.00

Hospital Charge Code	2691050
Hospital Revenue Code	361
Min. Negotiated Rate	$125.70
Max. Negotiated Rate	$125.70
Rate for Payer: Qualcare PPO/HMO/WC	$125.70

IR-TX COLLASPED LUNG-BI

Facility

$834.00

Hospital Charge Code	2690380
Hospital Revenue Code	361
Min. Negotiated Rate	$125.10
Max. Negotiated Rate	$125.10
Rate for Payer: Qualcare PPO/HMO/WC	$125.10

IR-TX COLLASPED LUNG-BI

Facility

$834.00

Hospital Charge Code	2690380
Hospital Revenue Code	361
Min. Negotiated Rate	$20.10
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$316.92
Rate for Payer: Aetna Medicare Advantage	$250.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.67
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	$212.67
Rate for Payer: Cigna Commercial	$417.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.20
Rate for Payer: Qualcare PPO/HMO/WC	$125.10
Rate for Payer: UnitedHealthcare Community & State	$20.10
Rate for Payer: Wellpoint Medicaid Managed Care	$22.10

IR-TX COLLASPED LUNG-RT

Facility

$834.00

Hospital Charge Code	2691055
Hospital Revenue Code	361
Min. Negotiated Rate	$125.10
Max. Negotiated Rate	$125.10
Rate for Payer: Qualcare PPO/HMO/WC	$125.10

IR-TX COLLASPED LUNG-RT

Facility

$834.00

Hospital Charge Code	2691055
Hospital Revenue Code	361
Min. Negotiated Rate	$20.10
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$316.92
Rate for Payer: Aetna Medicare Advantage	$250.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.67
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	$212.67
Rate for Payer: Cigna Commercial	$417.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.20
Rate for Payer: Qualcare PPO/HMO/WC	$125.10
Rate for Payer: UnitedHealthcare Community & State	$20.10
Rate for Payer: Wellpoint Medicaid Managed Care	$22.10

IR UNLISTED PROCEDURE - LIVER

Facility

$3,392.55

Service Code	HCPCS 47399
Hospital Charge Code	5600188
Hospital Revenue Code	361
Min. Negotiated Rate	$508.88
Max. Negotiated Rate	$508.88
Rate for Payer: Qualcare PPO/HMO/WC	$508.88

IR UNLISTED PROCEDURE - LIVER

Facility

$2,864.05

Service Code	HCPCS 47399
Hospital Charge Code	411047399
Hospital Revenue Code	361
Min. Negotiated Rate	$429.61
Max. Negotiated Rate	$429.61
Rate for Payer: Qualcare PPO/HMO/WC	$429.61

IR UNLISTED PROCEDURE - LIVER

Facility

$2,864.05

Service Code	HCPCS 47399
Hospital Charge Code	411047399
Hospital Revenue Code	361
Min. Negotiated Rate	$69.02
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,036.77
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$859.22
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$429.61
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$69.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$75.90

IR UNLISTED PROCEDURE - LIVER

Facility

$2,864.05

Service Code	HCPCS 47399
Hospital Charge Code	366847399
Hospital Revenue Code	361
Min. Negotiated Rate	$429.61
Max. Negotiated Rate	$429.61
Rate for Payer: Qualcare PPO/HMO/WC	$429.61

IR UNLISTED PROCEDURE - LIVER

Facility

$2,864.05

Service Code	HCPCS 47399
Hospital Charge Code	366847399
Hospital Revenue Code	361
Min. Negotiated Rate	$69.02
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,036.77
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$859.22
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$429.61
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$69.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$75.90

IR UNLISTED PROCEDURE - LIVER

Facility

$3,392.55

Service Code	HCPCS 47399
Hospital Charge Code	5600188
Hospital Revenue Code	361
Min. Negotiated Rate	$81.76
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,036.77
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,017.76
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$508.88
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$81.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$89.90

IR UNLISTED PROCEDURE - LIVER

Facility

$3,392.55

Service Code	HCPCS 47399
Hospital Charge Code	321047399
Hospital Revenue Code	361
Min. Negotiated Rate	$81.76
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,036.77
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,017.76
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$508.88
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$81.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$89.90

IR UNLISTED PROCEDURE - LIVER

Facility

$2,392.95

Service Code	HCPCS 47399
Hospital Charge Code	7411556
Hospital Revenue Code	361
Min. Negotiated Rate	$57.67
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,036.77
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$717.88
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$358.94
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$57.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$63.41

Know your out-of-pocket cost for care.

All Charges