Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR-URETHROGRAM VOIDING

Facility

$769.00

Service Code	HCPCS 51600
Hospital Charge Code	321051600
Hospital Revenue Code	361
Min. Negotiated Rate	$115.35
Max. Negotiated Rate	$115.35
Rate for Payer: Qualcare PPO/HMO/WC	$115.35

IR-URETHROGRAM VOIDING

Facility

$769.00

Service Code	HCPCS 51600
Hospital Charge Code	2670225
Hospital Revenue Code	361
Min. Negotiated Rate	$18.53
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$292.22
Rate for Payer: Aetna Medicare Advantage	$230.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.09
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	$196.09
Rate for Payer: Cigna Commercial	$384.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.70
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$115.35
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$18.53
Rate for Payer: Wellpoint Medicaid Managed Care	$20.38

IR-URETHROGRAM VOIDING

Facility

$769.00

Service Code	HCPCS 51600
Hospital Charge Code	321051600
Hospital Revenue Code	361
Min. Negotiated Rate	$18.53
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$292.22
Rate for Payer: Aetna Medicare Advantage	$230.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.09
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	$196.09
Rate for Payer: Cigna Commercial	$384.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.70
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$115.35
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$18.53
Rate for Payer: Wellpoint Medicaid Managed Care	$20.38

IR-URETHROGRAM VOIDING

Facility

$769.00

Service Code	HCPCS 51600
Hospital Charge Code	7411623
Hospital Revenue Code	361
Min. Negotiated Rate	$18.53
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$292.22
Rate for Payer: Aetna Medicare Advantage	$230.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.09
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	$196.09
Rate for Payer: Cigna Commercial	$384.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.70
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$115.35
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$18.53
Rate for Payer: Wellpoint Medicaid Managed Care	$20.38

IR-URETHROGRAM VOIDING

Facility

$769.00

Service Code	HCPCS 51600
Hospital Charge Code	7411623
Hospital Revenue Code	361
Min. Negotiated Rate	$115.35
Max. Negotiated Rate	$115.35
Rate for Payer: Qualcare PPO/HMO/WC	$115.35

IR URTRAL CTH/STNT PLC PERC LF

Facility

$1,962.45

Hospital Charge Code	2600121
Hospital Revenue Code	320
Min. Negotiated Rate	$47.30
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$745.73
Rate for Payer: Aetna Medicare Advantage	$588.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$500.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$500.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$500.42
Rate for Payer: Cigna Commercial	$981.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$588.74
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$294.37
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$47.30
Rate for Payer: Wellpoint Medicaid Managed Care	$52.00

IR URTRAL CTH/STNT PLC PERC LF

Facility

$1,962.45

Hospital Charge Code	2600121
Hospital Revenue Code	320
Min. Negotiated Rate	$294.37
Max. Negotiated Rate	$294.37
Rate for Payer: Qualcare PPO/HMO/WC	$294.37

IR URTRAL CTH/STNT PLC PERC RG

Facility

$1,962.45

Hospital Charge Code	2600122
Hospital Revenue Code	320
Min. Negotiated Rate	$294.37
Max. Negotiated Rate	$294.37
Rate for Payer: Qualcare PPO/HMO/WC	$294.37

IR URTRAL CTH/STNT PLC PERC RG

Facility

$1,962.45

Hospital Charge Code	2600122
Hospital Revenue Code	320
Min. Negotiated Rate	$47.30
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$745.73
Rate for Payer: Aetna Medicare Advantage	$588.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$500.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$500.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$500.42
Rate for Payer: Cigna Commercial	$981.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$588.74
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$294.37
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$47.30
Rate for Payer: Wellpoint Medicaid Managed Care	$52.00

IR VASC SEL CATH 1ST A/P/LE

Facility

$364.00

Service Code	HCPCS 36245
Hospital Charge Code	2004273
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR VASC SEL CATH 1ST A/P/LE

Facility

$364.00

Service Code	HCPCS 36245
Hospital Charge Code	321036245
Hospital Revenue Code	361
Min. Negotiated Rate	$8.77
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$138.32
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.20
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$8.77
Rate for Payer: Wellpoint Medicaid Managed Care	$9.65

IR VASC SEL CATH 1ST A/P/LE

Facility

$364.00

Service Code	HCPCS 36245
Hospital Charge Code	321036245
Hospital Revenue Code	361
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

IR VASC SEL CATH 1ST A/P/LE

Facility

$364.00

Service Code	HCPCS 36245
Hospital Charge Code	2004273
Hospital Revenue Code	361
Min. Negotiated Rate	$8.77
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$138.32
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
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	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.20
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$8.77
Rate for Payer: Wellpoint Medicaid Managed Care	$9.65

IR VASC SEL CATH 2ND A/P/LE

Facility

$8,697.00

Service Code	HCPCS 36246
Hospital Charge Code	321036246
Hospital Revenue Code	361
Min. Negotiated Rate	$1,304.55
Max. Negotiated Rate	$1,304.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.55

IR VASC SEL CATH 2ND A/P/LE

Facility

$8,697.00

Service Code	HCPCS 36246
Hospital Charge Code	366836246
Hospital Revenue Code	361
Min. Negotiated Rate	$209.60
Max. Negotiated Rate	$4,348.50
Rate for Payer: Aetna Commercial	$3,304.86
Rate for Payer: Aetna Medicare Advantage	$2,609.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,217.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,217.74
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	$2,217.74
Rate for Payer: Cigna Commercial	$4,348.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,609.10
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.55
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$209.60
Rate for Payer: Wellpoint Medicaid Managed Care	$230.47

IR VASC SEL CATH 2ND A/P/LE

Facility

$8,697.00

Service Code	HCPCS 36246
Hospital Charge Code	7411431
Hospital Revenue Code	361
Min. Negotiated Rate	$1,304.55
Max. Negotiated Rate	$1,304.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.55

IR VASC SEL CATH 2ND A/P/LE

Facility

$8,697.00

Service Code	HCPCS 36246
Hospital Charge Code	7411431
Hospital Revenue Code	361
Min. Negotiated Rate	$209.60
Max. Negotiated Rate	$4,348.50
Rate for Payer: Aetna Commercial	$3,304.86
Rate for Payer: Aetna Medicare Advantage	$2,609.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,217.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,217.74
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	$2,217.74
Rate for Payer: Cigna Commercial	$4,348.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,609.10
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.55
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$209.60
Rate for Payer: Wellpoint Medicaid Managed Care	$230.47

IR VASC SEL CATH 2ND A/P/LE

Facility

$8,697.00

Service Code	HCPCS 36246
Hospital Charge Code	321036246
Hospital Revenue Code	361
Min. Negotiated Rate	$209.60
Max. Negotiated Rate	$4,348.50
Rate for Payer: Aetna Commercial	$3,304.86
Rate for Payer: Aetna Medicare Advantage	$2,609.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,217.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,217.74
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	$2,217.74
Rate for Payer: Cigna Commercial	$4,348.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,609.10
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.55
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$209.60
Rate for Payer: Wellpoint Medicaid Managed Care	$230.47

IR VASC SEL CATH 2ND A/P/LE

Facility

$8,697.00

Service Code	HCPCS 36246
Hospital Charge Code	411036246
Hospital Revenue Code	361
Min. Negotiated Rate	$209.60
Max. Negotiated Rate	$4,348.50
Rate for Payer: Aetna Commercial	$3,304.86
Rate for Payer: Aetna Medicare Advantage	$2,609.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,217.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,217.74
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	$2,217.74
Rate for Payer: Cigna Commercial	$4,348.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,609.10
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.55
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$209.60
Rate for Payer: Wellpoint Medicaid Managed Care	$230.47

IR VASC SEL CATH 2ND A/P/LE

Facility

$8,697.00

Service Code	HCPCS 36246
Hospital Charge Code	366836246
Hospital Revenue Code	361
Min. Negotiated Rate	$1,304.55
Max. Negotiated Rate	$1,304.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.55

IR VASC SEL CATH 2ND A/P/LE

Facility

$8,697.00

Service Code	HCPCS 36246
Hospital Charge Code	411036246
Hospital Revenue Code	361
Min. Negotiated Rate	$1,304.55
Max. Negotiated Rate	$1,304.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.55

IR VASC SEL CATH 2ND A/P/LE

Facility

$8,697.00

Service Code	HCPCS 36246
Hospital Charge Code	2004265
Hospital Revenue Code	361
Min. Negotiated Rate	$1,304.55
Max. Negotiated Rate	$1,304.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.55

IR VASC SEL CATH 2ND A/P/LE

Facility

$8,697.00

Service Code	HCPCS 36246
Hospital Charge Code	2004265
Hospital Revenue Code	361
Min. Negotiated Rate	$209.60
Max. Negotiated Rate	$4,348.50
Rate for Payer: Aetna Commercial	$3,304.86
Rate for Payer: Aetna Medicare Advantage	$2,609.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,217.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,217.74
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	$2,217.74
Rate for Payer: Cigna Commercial	$4,348.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,609.10
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.55
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$209.60
Rate for Payer: Wellpoint Medicaid Managed Care	$230.47

IR VASC SEL CATH 3RD A/P/LE

Facility

$8,697.00

Service Code	HCPCS 36247
Hospital Charge Code	366836247
Hospital Revenue Code	361
Min. Negotiated Rate	$1,304.55
Max. Negotiated Rate	$1,304.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.55

IR VASC SEL CATH 3RD A/P/LE

Facility

$8,697.00

Service Code	HCPCS 36247
Hospital Charge Code	366836247
Hospital Revenue Code	361
Min. Negotiated Rate	$209.60
Max. Negotiated Rate	$4,348.50
Rate for Payer: Aetna Commercial	$3,304.86
Rate for Payer: Aetna Medicare Advantage	$2,609.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,217.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,217.74
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	$2,217.74
Rate for Payer: Cigna Commercial	$4,348.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,609.10
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,304.55
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$209.60
Rate for Payer: Wellpoint Medicaid Managed Care	$230.47

Know your out-of-pocket cost for care.

All Charges