Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

AP PARAESOPHAG HERN REPAIR

Facility

$39,439.32

Service Code	HCPCS 43281
Hospital Charge Code	16000744
Hospital Revenue Code	360
Min. Negotiated Rate	$950.49
Max. Negotiated Rate	$45,585.17
Rate for Payer: Aetna Commercial	$34,349.57
Rate for Payer: Aetna Medicare Advantage	$40,916.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,585.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,585.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,628.52
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	$45,585.17
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: Cigna Medicare Advantage	$12,628.52
Rate for Payer: Clover Medicare Advantage	$11,997.09
Rate for Payer: EmblemHealth Commercial	$37,885.56
Rate for Payer: Humana Medicare Advantage	$13,007.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,628.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,831.80
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,915.90
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$950.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,628.52
Rate for Payer: Wellcare Medicare Advantage	$12,628.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1,045.14

AP PARAESOPHAG HERN REPAIR

Facility

$39,439.32

Service Code	HCPCS 43281
Hospital Charge Code	16000744
Hospital Revenue Code	360
Min. Negotiated Rate	$5,915.90
Max. Negotiated Rate	$5,915.90
Rate for Payer: Qualcare PPO/HMO/WC	$5,915.90

APPENDECTOMY,LAPAROSCOPIC

Facility

$43,334.60

Service Code	HCPCS 44970
Hospital Charge Code	16000587
Hospital Revenue Code	360
Min. Negotiated Rate	$1,044.36
Max. Negotiated Rate	$25,925.77
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$25,925.77
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,000.38
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,044.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1,148.37

APPENDECTOMY,LAPAROSCOPIC

Facility

$43,334.60

Service Code	HCPCS 44970
Hospital Charge Code	16000587
Hospital Revenue Code	360
Min. Negotiated Rate	$6,500.19
Max. Negotiated Rate	$6,500.19
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19

APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS

Facility

$16,594.63

Service Code	APR-DRG 2332
Min. Negotiated Rate	$16,269.25
Max. Negotiated Rate	$16,594.63
Rate for Payer: UnitedHealthcare Community & State	$16,269.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,594.63
Rate for Payer: Wellpoint Medicaid Managed Care	$16,269.25

APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS

Facility

$36,404.09

Service Code	APR-DRG 2334
Min. Negotiated Rate	$35,690.28
Max. Negotiated Rate	$36,404.09
Rate for Payer: UnitedHealthcare Community & State	$35,690.28
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$36,404.09
Rate for Payer: Wellpoint Medicaid Managed Care	$35,690.28

APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS

Facility

$12,981.58

Service Code	APR-DRG 2331
Min. Negotiated Rate	$12,727.04
Max. Negotiated Rate	$12,981.58
Rate for Payer: UnitedHealthcare Community & State	$12,727.04
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,981.58
Rate for Payer: Wellpoint Medicaid Managed Care	$12,727.04

APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS

Facility

$23,330.58

Service Code	APR-DRG 2333
Min. Negotiated Rate	$22,873.12
Max. Negotiated Rate	$23,330.58
Rate for Payer: UnitedHealthcare Community & State	$22,873.12
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,330.58
Rate for Payer: Wellpoint Medicaid Managed Care	$22,873.12

APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS

Facility

$33,325.94

Service Code	APR-DRG 2344
Min. Negotiated Rate	$32,672.49
Max. Negotiated Rate	$33,325.94
Rate for Payer: UnitedHealthcare Community & State	$32,672.49
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$33,325.94
Rate for Payer: Wellpoint Medicaid Managed Care	$32,672.49

APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS

Facility

$10,425.57

Service Code	APR-DRG 2341
Min. Negotiated Rate	$10,221.15
Max. Negotiated Rate	$10,425.57
Rate for Payer: UnitedHealthcare Community & State	$10,221.15
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,425.57
Rate for Payer: Wellpoint Medicaid Managed Care	$10,221.15

APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS

Facility

$19,334.49

Service Code	APR-DRG 2343
Min. Negotiated Rate	$18,955.38
Max. Negotiated Rate	$19,334.49
Rate for Payer: UnitedHealthcare Community & State	$18,955.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,334.49
Rate for Payer: Wellpoint Medicaid Managed Care	$18,955.38

APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS

Facility

$13,261.18

Service Code	APR-DRG 2342
Min. Negotiated Rate	$13,001.16
Max. Negotiated Rate	$13,261.18
Rate for Payer: UnitedHealthcare Community & State	$13,001.16
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,261.18
Rate for Payer: Wellpoint Medicaid Managed Care	$13,001.16

APPENDETOMY,OPEN

Facility

$21,811.50

Service Code	HCPCS 44950
Hospital Charge Code	160000215
Hospital Revenue Code	360
Min. Negotiated Rate	$3,271.72
Max. Negotiated Rate	$3,271.72
Rate for Payer: Qualcare PPO/HMO/WC	$3,271.72

APPENDETOMY,OPEN

Facility

$21,811.50

Service Code	HCPCS 44950
Hospital Charge Code	160000215
Hospital Revenue Code	360
Min. Negotiated Rate	$525.66
Max. Negotiated Rate	$27,762.46
Rate for Payer: Aetna Commercial	$20,919.71
Rate for Payer: Aetna Medicare Advantage	$24,919.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,762.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,762.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,691.07
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	$27,762.46
Rate for Payer: Cigna Commercial	$15,416.72
Rate for Payer: Cigna Medicare Advantage	$7,691.07
Rate for Payer: Clover Medicare Advantage	$7,306.52
Rate for Payer: EmblemHealth Commercial	$23,073.21
Rate for Payer: Humana Medicare Advantage	$7,921.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,691.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,543.45
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,271.72
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$525.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,691.07
Rate for Payer: Wellcare Medicare Advantage	$7,691.07
Rate for Payer: Wellpoint Medicaid Managed Care	$578.00

APPENDIX PROCEDURES WITH CC

Facility

$51,056.12

Service Code	MSDRG 398
Min. Negotiated Rate	$15,545.93
Max. Negotiated Rate	$51,056.12
Rate for Payer: Aetna Commercial	$35,338.72
Rate for Payer: Aetna Medicare Advantage	$51,056.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,364.14
Rate for Payer: Cigna Commercial	$28,325.51
Rate for Payer: Cigna Medicare Advantage	$16,364.14
Rate for Payer: Clover Medicare Advantage	$15,545.93
Rate for Payer: EmblemHealth Commercial	$49,092.42
Rate for Payer: Humana Medicare Advantage	$16,855.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,364.14
Rate for Payer: Oxford Commercial	$20,357.92
Rate for Payer: UnitedHealthcare Commercial	$35,698.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,364.14
Rate for Payer: Wellcare Medicare Advantage	$16,364.14

APPENDIX PROCEDURES WITH MCC

Facility

$79,541.25

Service Code	MSDRG 397
Min. Negotiated Rate	$24,219.29
Max. Negotiated Rate	$79,541.25
Rate for Payer: Aetna Commercial	$54,911.23
Rate for Payer: Aetna Medicare Advantage	$79,541.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25,493.99
Rate for Payer: Cigna Commercial	$44,818.16
Rate for Payer: Cigna Medicare Advantage	$25,493.99
Rate for Payer: Clover Medicare Advantage	$24,219.29
Rate for Payer: EmblemHealth Commercial	$76,481.97
Rate for Payer: Humana Medicare Advantage	$26,258.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25,493.99
Rate for Payer: Oxford Commercial	$32,211.40
Rate for Payer: UnitedHealthcare Commercial	$56,483.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$25,493.99
Rate for Payer: Wellcare Medicare Advantage	$25,493.99

APPENDIX PROCEDURES WITHOUT CC/MCC

Facility

$39,132.69

Service Code	MSDRG 399
Min. Negotiated Rate	$11,915.40
Max. Negotiated Rate	$39,132.69
Rate for Payer: Aetna Commercial	$27,145.94
Rate for Payer: Aetna Medicare Advantage	$39,132.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,542.53
Rate for Payer: Cigna Commercial	$21,421.92
Rate for Payer: Cigna Medicare Advantage	$12,542.53
Rate for Payer: Clover Medicare Advantage	$11,915.40
Rate for Payer: EmblemHealth Commercial	$37,627.59
Rate for Payer: Humana Medicare Advantage	$12,918.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,542.53
Rate for Payer: Oxford Commercial	$15,396.22
Rate for Payer: UnitedHealthcare Commercial	$26,997.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,542.53
Rate for Payer: Wellcare Medicare Advantage	$12,542.53

APPILCATOR VISTASEAL 35 CM

Facility

$319.70

Hospital Charge Code	270688804
Hospital Revenue Code	272
Min. Negotiated Rate	$47.95
Max. Negotiated Rate	$47.95
Rate for Payer: Qualcare PPO/HMO/WC	$47.95

APPILCATOR VISTASEAL 35 CM

Facility

$319.70

Hospital Charge Code	270688804
Hospital Revenue Code	272
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$159.85
Rate for Payer: Aetna Commercial	$121.49
Rate for Payer: Aetna Medicare Advantage	$95.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.52
Rate for Payer: Cigna Commercial	$159.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.91
Rate for Payer: Oxford Commercial	$63.94
Rate for Payer: Qualcare PPO/HMO/WC	$47.95
Rate for Payer: UnitedHealthcare Commercial	$63.94
Rate for Payer: UnitedHealthcare Community & State	$7.70
Rate for Payer: Wellpoint Medicaid Managed Care	$8.47

APPLCTOR DISP F/1.5mm RFS-PA15

Facility

$395.00

Hospital Charge Code	270645093
Hospital Revenue Code	272
Min. Negotiated Rate	$59.25
Max. Negotiated Rate	$59.25
Rate for Payer: Qualcare PPO/HMO/WC	$59.25

APPLCTOR DISP F/1.5mm RFS-PA15

Facility

$395.00

Hospital Charge Code	270645093
Hospital Revenue Code	272
Min. Negotiated Rate	$9.52
Max. Negotiated Rate	$197.50
Rate for Payer: Aetna Commercial	$150.10
Rate for Payer: Aetna Medicare Advantage	$118.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.72
Rate for Payer: Cigna Commercial	$197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.50
Rate for Payer: Oxford Commercial	$79.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.25
Rate for Payer: UnitedHealthcare Commercial	$79.00
Rate for Payer: UnitedHealthcare Community & State	$9.52
Rate for Payer: Wellpoint Medicaid Managed Care	$10.47

APPLICATION CYLINDER CAST

Facility

$1,067.95

Service Code	HCPCS 29365
Hospital Charge Code	5780140
Hospital Revenue Code	450
Min. Negotiated Rate	$28.30
Max. Negotiated Rate	$1,199.43
Rate for Payer: Aetna Commercial	$903.80
Rate for Payer: Aetna Medicare Advantage	$1,076.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,199.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,199.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$332.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,199.43
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: Cigna Medicare Advantage	$332.28
Rate for Payer: Clover Medicare Advantage	$315.67
Rate for Payer: EmblemHealth Commercial	$996.84
Rate for Payer: Humana Medicare Advantage	$342.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$332.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$160.19
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.28
Rate for Payer: Wellcare Medicare Advantage	$332.28
Rate for Payer: Wellpoint Medicaid Managed Care	$28.30

APPLICATION CYLINDER CAST

Facility

$1,067.95

Service Code	HCPCS 29365
Hospital Charge Code	5780140
Hospital Revenue Code	450
Min. Negotiated Rate	$160.19
Max. Negotiated Rate	$160.19
Rate for Payer: Qualcare PPO/HMO/WC	$160.19

APPLICATION LONG ARM CAST

Facility

$1,360.45

Service Code	HCPCS 29065
Hospital Charge Code	412329065
Hospital Revenue Code	361
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

APPLICATION LONG ARM CAST

Facility

$1,360.45

Service Code	HCPCS 29065
Hospital Charge Code	412329065
Hospital Revenue Code	361
Min. Negotiated Rate	$32.79
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$903.80
Rate for Payer: Aetna Medicare Advantage	$1,076.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,199.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,199.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$332.28
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	$1,199.43
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: Cigna Medicare Advantage	$332.28
Rate for Payer: Clover Medicare Advantage	$315.67
Rate for Payer: EmblemHealth Commercial	$996.84
Rate for Payer: Humana Medicare Advantage	$342.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$332.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$408.13
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$204.07
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$32.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.28
Rate for Payer: Wellcare Medicare Advantage	$332.28
Rate for Payer: Wellpoint Medicaid Managed Care	$36.05

Know your out-of-pocket cost for care.

All Charges