Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KYPHON BONE BIOPSY DEVICE

Facility

$750.00

Hospital Charge Code	270339544
Hospital Revenue Code	272
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

KYPHON BONE BIOPSY DEVICE

Facility

$750.00

Hospital Charge Code	270339544
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

KYPHON INFLATION SYRINGE

Facility

$900.00

Hospital Charge Code	270339547
Hospital Revenue Code	272
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.00
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$180.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

KYPHON INFLATION SYRINGE

Facility

$900.00

Hospital Charge Code	270339547
Hospital Revenue Code	272
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

KYPHON XPEDE BONE CEMENT

Facility

$828.50

Service Code	HCPCS C1765
Hospital Charge Code	270704148
Hospital Revenue Code	278
Min. Negotiated Rate	$19.97
Max. Negotiated Rate	$414.25
Rate for Payer: Aetna Commercial	$314.83
Rate for Payer: Aetna Medicare Advantage	$248.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.27
Rate for Payer: Cigna Commercial	$414.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.27
Rate for Payer: Qualcare PPO/HMO/WC	$124.28
Rate for Payer: UnitedHealthcare Community & State	$19.97
Rate for Payer: Wellpoint Medicaid Managed Care	$21.96

KYPHON XPEDE BONE CEMENT

Facility

$828.50

Service Code	HCPCS C1765
Hospital Charge Code	270704148
Hospital Revenue Code	278
Min. Negotiated Rate	$124.28
Max. Negotiated Rate	$200.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.27
Rate for Payer: Qualcare PPO/HMO/WC	$124.28

KYPHOPLASTY BALLOONCATH10G15MM

Facility

$4,000.00

Hospital Charge Code	270699974
Hospital Revenue Code	272
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,200.00
Rate for Payer: Oxford Commercial	$800.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Commercial	$800.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

KYPHOPLASTY BALLOONCATH10G15MM

Facility

$4,000.00

Hospital Charge Code	270699974
Hospital Revenue Code	272
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

KYPHOPLASTY KIT G21

Facility

$21,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695718
Hospital Revenue Code	278
Min. Negotiated Rate	$512.12
Max. Negotiated Rate	$10,625.00
Rate for Payer: Aetna Commercial	$8,075.00
Rate for Payer: Aetna Medicare Advantage	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,418.75
Rate for Payer: Cigna Commercial	$10,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,675.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50
Rate for Payer: UnitedHealthcare Community & State	$512.12
Rate for Payer: Wellpoint Medicaid Managed Care	$563.12

KYPHOPLASTY KIT G21

Facility

$21,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695718
Hospital Revenue Code	278
Min. Negotiated Rate	$3,187.50
Max. Negotiated Rate	$5,142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,675.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50

KYPHX LATITUDE CURETTE A11B

Facility

$810.70

Hospital Charge Code	270633991
Hospital Revenue Code	272
Min. Negotiated Rate	$121.61
Max. Negotiated Rate	$121.61
Rate for Payer: Qualcare PPO/HMO/WC	$121.61

KYPHX LATITUDE CURETTE A11B

Facility

$810.70

Hospital Charge Code	270633991
Hospital Revenue Code	272
Min. Negotiated Rate	$19.54
Max. Negotiated Rate	$405.35
Rate for Payer: Aetna Commercial	$308.07
Rate for Payer: Aetna Medicare Advantage	$243.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.73
Rate for Payer: Cigna Commercial	$405.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.21
Rate for Payer: Oxford Commercial	$162.14
Rate for Payer: Qualcare PPO/HMO/WC	$121.61
Rate for Payer: UnitedHealthcare Commercial	$162.14
Rate for Payer: UnitedHealthcare Community & State	$19.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.48

KYTRIL SYRINGE 0.1 MG/0.1 ML

Facility

$96.85

Hospital Charge Code	60629358
Hospital Revenue Code	636
Min. Negotiated Rate	$14.53
Max. Negotiated Rate	$23.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.44
Rate for Payer: Qualcare PPO/HMO/WC	$14.53

KYTRIL SYRINGE 0.1 MG/0.1 ML

Facility

$96.85

Hospital Charge Code	60629358
Hospital Revenue Code	636
Min. Negotiated Rate	$2.33
Max. Negotiated Rate	$48.42
Rate for Payer: Aetna Commercial	$36.80
Rate for Payer: Aetna Medicare Advantage	$29.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.70
Rate for Payer: Cigna Commercial	$48.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.44
Rate for Payer: Qualcare PPO/HMO/WC	$14.53
Rate for Payer: UnitedHealthcare Community & State	$2.33
Rate for Payer: Wellpoint Medicaid Managed Care	$2.57

L-0-SLIDE REVIEW

Facility

$70.15

Service Code	HCPCS 88321
Hospital Charge Code	3035064
Hospital Revenue Code	319
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$120.69
Rate for Payer: Aetna Medicare Advantage	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.16
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$44.37
Rate for Payer: Clover Medicare Advantage	$42.15
Rate for Payer: EmblemHealth Commercial	$133.11
Rate for Payer: Humana Medicare Advantage	$45.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.52
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.37
Rate for Payer: Wellcare Medicare Advantage	$44.37
Rate for Payer: Wellpoint Medicaid Managed Care	$1.86

L-0-SLIDE REVIEW

Facility

$70.15

Service Code	HCPCS 88321
Hospital Charge Code	3035064
Hospital Revenue Code	319
Min. Negotiated Rate	$10.52
Max. Negotiated Rate	$10.52
Rate for Payer: Qualcare PPO/HMO/WC	$10.52

L-0 SLIDE REVIEW NO PREPOS

Facility

$335.00

Service Code	HCPCS 88325
Hospital Charge Code	3035064A
Hospital Revenue Code	319
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$730.60
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$730.60
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$8.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$8.88

L-0 SLIDE REVIEW NO PREPOS

Facility

$335.00

Service Code	HCPCS 88325
Hospital Charge Code	3035064A
Hospital Revenue Code	319
Min. Negotiated Rate	$50.25
Max. Negotiated Rate	$50.25
Rate for Payer: Qualcare PPO/HMO/WC	$50.25

L10-NERVE BIOPSY

Facility

$207.25

Service Code	HCPCS 88356
Hospital Charge Code	3035061
Hospital Revenue Code	310
Min. Negotiated Rate	$5.49
Max. Negotiated Rate	$223.48
Rate for Payer: Aetna Commercial	$168.40
Rate for Payer: Aetna Medicare Advantage	$200.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.48
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$61.91
Rate for Payer: Clover Medicare Advantage	$58.81
Rate for Payer: EmblemHealth Commercial	$185.73
Rate for Payer: Humana Medicare Advantage	$63.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$61.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.09
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$189.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.91
Rate for Payer: Wellcare Medicare Advantage	$61.91
Rate for Payer: Wellpoint Medicaid Managed Care	$5.49

L10-NERVE BIOPSY

Facility

$207.25

Service Code	HCPCS 88356
Hospital Charge Code	3035061
Hospital Revenue Code	310
Min. Negotiated Rate	$31.09
Max. Negotiated Rate	$31.09
Rate for Payer: Qualcare PPO/HMO/WC	$31.09

L7-KIDNEY BIOPSY ELECT MICRO

Facility

$1,188.85

Service Code	HCPCS 88348
Hospital Charge Code	3035063
Hospital Revenue Code	310
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$3,455.10
Rate for Payer: Aetna Commercial	$2,603.50
Rate for Payer: Aetna Medicare Advantage	$3,101.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,455.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,455.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$957.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,455.10
Rate for Payer: Cigna Commercial	$1,918.64
Rate for Payer: Cigna Medicare Advantage	$957.17
Rate for Payer: Clover Medicare Advantage	$909.31
Rate for Payer: EmblemHealth Commercial	$2,871.51
Rate for Payer: Humana Medicare Advantage	$985.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$957.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.65
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$178.33
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$397.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$957.17
Rate for Payer: Wellcare Medicare Advantage	$957.17
Rate for Payer: Wellpoint Medicaid Managed Care	$31.50

L7-KIDNEY BIOPSY ELECT MICRO

Facility

$1,188.85

Service Code	HCPCS 88348
Hospital Charge Code	3035063
Hospital Revenue Code	310
Min. Negotiated Rate	$178.33
Max. Negotiated Rate	$178.33
Rate for Payer: Qualcare PPO/HMO/WC	$178.33

L8-KIDNEY BIOPSY IMMUNO MICRO

Facility

$300.00

Service Code	HCPCS 88346
Hospital Charge Code	3035062A
Hospital Revenue Code	312
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$730.60
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$730.60
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$122.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

L8-KIDNEY BIOPSY IMMUNO MICRO

Facility

$300.00

Service Code	HCPCS 88346
Hospital Charge Code	3035062A
Hospital Revenue Code	312
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

L8-KIDNEY BIOPSY IMMUNO MICRO

Facility

$300.00

Service Code	HCPCS 88346
Hospital Charge Code	3035062
Hospital Revenue Code	312
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

Know your out-of-pocket cost for care.

All Charges