Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR VASC SEL CATH 3RD A/P/LE

Facility

$8,697.00

Service Code	HCPCS 36247
Hospital Charge Code	411036247
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	321036247
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	411036247
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	7411432
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	2004257
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	2004257
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	7411432
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	321036247
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 INTR 1ST T/B

Facility

$1,517.65

Service Code	HCPCS 36215
Hospital Charge Code	7411426
Hospital Revenue Code	361
Min. Negotiated Rate	$227.65
Max. Negotiated Rate	$227.65
Rate for Payer: Qualcare PPO/HMO/WC	$227.65

IR VASC SEL CATH INTR 1ST T/B

Facility

$1,517.65

Service Code	HCPCS 36215
Hospital Charge Code	7411426
Hospital Revenue Code	361
Min. Negotiated Rate	$36.58
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$576.71
Rate for Payer: Aetna Medicare Advantage	$455.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$387.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$387.00
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	$387.00
Rate for Payer: Cigna Commercial	$758.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$455.30
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$227.65
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$36.58
Rate for Payer: Wellpoint Medicaid Managed Care	$40.22

IR VASC SEL CATH INTR 1ST T/B

Facility

$1,517.65

Service Code	HCPCS 36215
Hospital Charge Code	2004307
Hospital Revenue Code	361
Min. Negotiated Rate	$36.58
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$576.71
Rate for Payer: Aetna Medicare Advantage	$455.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$387.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$387.00
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	$387.00
Rate for Payer: Cigna Commercial	$758.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$455.30
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$227.65
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$36.58
Rate for Payer: Wellpoint Medicaid Managed Care	$40.22

IR VASC SEL CATH INTR 1ST T/B

Facility

$1,517.65

Service Code	HCPCS 36215
Hospital Charge Code	2004307
Hospital Revenue Code	361
Min. Negotiated Rate	$227.65
Max. Negotiated Rate	$227.65
Rate for Payer: Qualcare PPO/HMO/WC	$227.65

IR VASC SEL CATH INTRO 2ND T/B

Facility

$414.45

Service Code	HCPCS 36216
Hospital Charge Code	7411427
Hospital Revenue Code	361
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$157.49
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.33
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$9.99
Rate for Payer: Wellpoint Medicaid Managed Care	$10.98

IR VASC SEL CATH INTRO 2ND T/B

Facility

$414.45

Service Code	HCPCS 36216
Hospital Charge Code	2004315
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR VASC SEL CATH INTRO 2ND T/B

Facility

$414.45

Service Code	HCPCS 36216
Hospital Charge Code	2004315
Hospital Revenue Code	361
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$157.49
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.33
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$9.99
Rate for Payer: Wellpoint Medicaid Managed Care	$10.98

IR VASC SEL CATH INTRO 2ND T/B

Facility

$414.45

Service Code	HCPCS 36216
Hospital Charge Code	7411427
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR VASC SEL CATH INTRO 3RD T/B

Facility

$486.00

Service Code	HCPCS 36217
Hospital Charge Code	321036217
Hospital Revenue Code	361
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$72.90
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR VASC SEL CATH INTRO 3RD T/B

Facility

$414.45

Service Code	HCPCS 36217
Hospital Charge Code	7411428
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR VASC SEL CATH INTRO 3RD T/B

Facility

$486.00

Service Code	HCPCS 36217
Hospital Charge Code	2004158
Hospital Revenue Code	361
Min. Negotiated Rate	$11.71
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$184.68
Rate for Payer: Aetna Medicare Advantage	$145.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.93
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	$123.93
Rate for Payer: Cigna Commercial	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.80
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.90
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$11.71
Rate for Payer: Wellpoint Medicaid Managed Care	$12.88

IR VASC SEL CATH INTRO 3RD T/B

Facility

$414.45

Service Code	HCPCS 36217
Hospital Charge Code	7411428
Hospital Revenue Code	361
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$157.49
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.33
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$9.99
Rate for Payer: Wellpoint Medicaid Managed Care	$10.98

IR VASC SEL CATH INTRO 3RD T/B

Facility

$486.00

Service Code	HCPCS 36217
Hospital Charge Code	321036217
Hospital Revenue Code	361
Min. Negotiated Rate	$11.71
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$184.68
Rate for Payer: Aetna Medicare Advantage	$145.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.93
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	$123.93
Rate for Payer: Cigna Commercial	$243.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.80
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.90
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$11.71
Rate for Payer: Wellpoint Medicaid Managed Care	$12.88

IR VASC SEL CATH INTRO 3RD T/B

Facility

$486.00

Service Code	HCPCS 36217
Hospital Charge Code	2004158
Hospital Revenue Code	361
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$72.90
Rate for Payer: Qualcare PPO/HMO/WC	$72.90

IR VASOGRAPHY

Facility

$906.25

Service Code	HCPCS 74440
Hospital Charge Code	2600123
Hospital Revenue Code	320
Min. Negotiated Rate	$135.94
Max. Negotiated Rate	$135.94
Rate for Payer: Qualcare PPO/HMO/WC	$135.94

IR VASOGRAPHY

Facility

$906.25

Service Code	HCPCS 74440
Hospital Charge Code	2600123
Hospital Revenue Code	320
Min. Negotiated Rate	$21.84
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	$46.85
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	$271.88
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.94
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$21.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$24.02

IR VASOGRAPHY VESICULOGRAPHYEP

Facility

$1,092.60

Service Code	HCPCS 74440
Hospital Charge Code	2680305
Hospital Revenue Code	320
Min. Negotiated Rate	$163.89
Max. Negotiated Rate	$163.89
Rate for Payer: Qualcare PPO/HMO/WC	$163.89

Know your out-of-pocket cost for care.

All Charges