Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR VENOGRAPHY REN BILAT SELECT

Facility

$15,468.50

Service Code	HCPCS 75833
Hospital Charge Code	2002232
Hospital Revenue Code	320
Min. Negotiated Rate	$372.79
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$406.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$2,625.82
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.55
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$372.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$409.92

IR VENOUS MECH THROMBECTOMY LT

Facility

$27,397.00

Service Code	HCPCS 37187LT
Hospital Charge Code	366837187L
Hospital Revenue Code	361
Min. Negotiated Rate	$660.27
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,219.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$660.27
Rate for Payer: Wellpoint Medicaid Managed Care	$726.02

IR VENOUS MECH THROMBECTOMY LT

Facility

$27,397.00

Service Code	HCPCS 37187LT
Hospital Charge Code	411037187L
Hospital Revenue Code	361
Min. Negotiated Rate	$660.27
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,219.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$660.27
Rate for Payer: Wellpoint Medicaid Managed Care	$726.02

IR VENOUS MECH THROMBECTOMY LT

Facility

$18,307.80

Service Code	HCPCS 37187LT
Hospital Charge Code	7411916
Hospital Revenue Code	361
Min. Negotiated Rate	$2,746.17
Max. Negotiated Rate	$2,746.17
Rate for Payer: Qualcare PPO/HMO/WC	$2,746.17

IR VENOUS MECH THROMBECTOMY LT

Facility

$27,397.00

Service Code	HCPCS 37187LT
Hospital Charge Code	5700191
Hospital Revenue Code	361
Min. Negotiated Rate	$660.27
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,219.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$660.27
Rate for Payer: Wellpoint Medicaid Managed Care	$726.02

IR VENOUS MECH THROMBECTOMY LT

Facility

$27,397.00

Service Code	HCPCS 37187LT
Hospital Charge Code	411037187L
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS MECH THROMBECTOMY LT

Facility

$27,397.00

Service Code	HCPCS 37187LT
Hospital Charge Code	366837187L
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS MECH THROMBECTOMY LT

Facility

$18,307.80

Service Code	HCPCS 37187LT
Hospital Charge Code	7411916
Hospital Revenue Code	361
Min. Negotiated Rate	$441.22
Max. Negotiated Rate	$9,153.90
Rate for Payer: Aetna Commercial	$6,956.96
Rate for Payer: Aetna Medicare Advantage	$5,492.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,668.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,668.49
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	$4,668.49
Rate for Payer: Cigna Commercial	$9,153.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,492.34
Rate for Payer: Qualcare PPO/HMO/WC	$2,746.17
Rate for Payer: UnitedHealthcare Community & State	$441.22
Rate for Payer: Wellpoint Medicaid Managed Care	$485.16

IR VENOUS MECH THROMBECTOMY LT

Facility

$27,397.00

Service Code	HCPCS 37187LT
Hospital Charge Code	321037187L
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS MECH THROMBECTOMY LT

Facility

$27,397.00

Service Code	HCPCS 37187LT
Hospital Charge Code	321037187L
Hospital Revenue Code	361
Min. Negotiated Rate	$660.27
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,219.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$660.27
Rate for Payer: Wellpoint Medicaid Managed Care	$726.02

IR VENOUS MECH THROMBECTOMY LT

Facility

$27,397.00

Service Code	HCPCS 37187LT
Hospital Charge Code	5700191
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS MECH THROMBECTOMY RT

Facility

$27,397.00

Service Code	HCPCS 37187RT
Hospital Charge Code	366837187R
Hospital Revenue Code	361
Min. Negotiated Rate	$660.27
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,219.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$660.27
Rate for Payer: Wellpoint Medicaid Managed Care	$726.02

IR VENOUS MECH THROMBECTOMY RT

Facility

$27,397.00

Service Code	HCPCS 37187RT
Hospital Charge Code	366837187R
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS MECH THROMBECTOMY RT

Facility

$27,397.00

Service Code	HCPCS 37187RT
Hospital Charge Code	321037187R
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS MECH THROMBECTOMY RT

Facility

$27,397.00

Service Code	HCPCS 37187RT
Hospital Charge Code	5600190
Hospital Revenue Code	361
Min. Negotiated Rate	$660.27
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,219.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$660.27
Rate for Payer: Wellpoint Medicaid Managed Care	$726.02

IR VENOUS MECH THROMBECTOMY RT

Facility

$18,307.80

Service Code	HCPCS 37187RT
Hospital Charge Code	7411917
Hospital Revenue Code	361
Min. Negotiated Rate	$441.22
Max. Negotiated Rate	$9,153.90
Rate for Payer: Aetna Commercial	$6,956.96
Rate for Payer: Aetna Medicare Advantage	$5,492.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,668.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,668.49
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	$4,668.49
Rate for Payer: Cigna Commercial	$9,153.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,492.34
Rate for Payer: Qualcare PPO/HMO/WC	$2,746.17
Rate for Payer: UnitedHealthcare Community & State	$441.22
Rate for Payer: Wellpoint Medicaid Managed Care	$485.16

IR VENOUS MECH THROMBECTOMY RT

Facility

$27,397.00

Service Code	HCPCS 37187RT
Hospital Charge Code	321037187R
Hospital Revenue Code	361
Min. Negotiated Rate	$660.27
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,219.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$660.27
Rate for Payer: Wellpoint Medicaid Managed Care	$726.02

IR VENOUS MECH THROMBECTOMY RT

Facility

$27,397.00

Service Code	HCPCS 37187RT
Hospital Charge Code	5600190
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS MECH THROMBECTOMY RT

Facility

$18,307.80

Service Code	HCPCS 37187RT
Hospital Charge Code	7411917
Hospital Revenue Code	361
Min. Negotiated Rate	$2,746.17
Max. Negotiated Rate	$2,746.17
Rate for Payer: Qualcare PPO/HMO/WC	$2,746.17

IR VENOUS MECH THROMBECTOMY RT

Facility

$27,397.00

Service Code	HCPCS 37187RT
Hospital Charge Code	411037187R
Hospital Revenue Code	361
Min. Negotiated Rate	$660.27
Max. Negotiated Rate	$13,698.50
Rate for Payer: Aetna Commercial	$10,410.86
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,698.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,219.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Community & State	$660.27
Rate for Payer: Wellpoint Medicaid Managed Care	$726.02

IR VENOUS MECH THROMBECTOMY RT

Facility

$27,397.00

Service Code	HCPCS 37187RT
Hospital Charge Code	411037187R
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

IR VENOUS SAMPLING-RENINS

Facility

$2,640.00

Service Code	HCPCS 75893
Hospital Charge Code	2002129
Hospital Revenue Code	320
Min. Negotiated Rate	$63.62
Max. Negotiated Rate	$23,862.86
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,862.86
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$4,627.53
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$792.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$396.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$63.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$69.96

IR VENOUS SAMPLING-RENINS

Facility

$2,640.00

Service Code	HCPCS 75893
Hospital Charge Code	2002129
Hospital Revenue Code	320
Min. Negotiated Rate	$396.00
Max. Negotiated Rate	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$396.00

IR VENTRICULOGRAPHY

Facility

$3,646.49

Service Code	HCPCS 78635
Hospital Charge Code	2680365
Hospital Revenue Code	341
Min. Negotiated Rate	$546.97
Max. Negotiated Rate	$546.97
Rate for Payer: Qualcare PPO/HMO/WC	$546.97

IR VENTRICULOGRAPHY

Facility

$3,646.49

Service Code	HCPCS 78635
Hospital Charge Code	7411760
Hospital Revenue Code	341
Min. Negotiated Rate	$87.88
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$1,754.56
Rate for Payer: Aetna Medicare Advantage	$2,089.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,328.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,328.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$645.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,328.47
Rate for Payer: Cigna Commercial	$1,293.03
Rate for Payer: Cigna Medicare Advantage	$451.54
Rate for Payer: Clover Medicare Advantage	$612.81
Rate for Payer: EmblemHealth Commercial	$1,935.18
Rate for Payer: Humana Medicare Advantage	$664.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$645.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,093.95
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$546.97
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$87.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$645.06
Rate for Payer: Wellcare Medicare Advantage	$645.06
Rate for Payer: Wellpoint Medicaid Managed Care	$96.63

Know your out-of-pocket cost for care.

All Charges