Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LAPAROSCOPIC TUBING

Facility

$65.41

Hospital Charge Code	270664808
Hospital Revenue Code	270
Min. Negotiated Rate	$9.81
Max. Negotiated Rate	$9.81
Rate for Payer: Qualcare PPO/HMO/WC	$9.81

LAPAROSCOPY CHOLECYSTECOMY

Facility

$58,549.97

Service Code	HCPCS 47562
Hospital Charge Code	16000590
Hospital Revenue Code	360
Min. Negotiated Rate	$1,411.05
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	$1,742.00
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	$17,564.99
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,782.50
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,411.05
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	$1,551.57

LAPAROSCOPY CHOLECYSTECOMY

Facility

$58,549.97

Service Code	HCPCS 47562
Hospital Charge Code	16000590
Hospital Revenue Code	360
Min. Negotiated Rate	$8,782.50
Max. Negotiated Rate	$8,782.50
Rate for Payer: Qualcare PPO/HMO/WC	$8,782.50

LAPAROSCOPY FUNDOPLASTY

Facility

$35,624.77

Service Code	HCPCS 43280
Hospital Charge Code	1600000491
Hospital Revenue Code	360
Min. Negotiated Rate	$858.56
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	$10,687.43
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,343.72
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$858.56
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	$944.06

LAPAROSCOPY FUNDOPLASTY

Facility

$35,624.77

Service Code	HCPCS 43280
Hospital Charge Code	1600000672
Hospital Revenue Code	360
Min. Negotiated Rate	$5,343.72
Max. Negotiated Rate	$5,343.72
Rate for Payer: Qualcare PPO/HMO/WC	$5,343.72

LAPAROSCOPY FUNDOPLASTY

Facility

$35,624.77

Service Code	HCPCS 43280
Hospital Charge Code	1600000672
Hospital Revenue Code	360
Min. Negotiated Rate	$858.56
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	$10,687.43
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,343.72
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$858.56
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	$944.06

LAPAROSCOPY FUNDOPLASTY

Facility

$35,624.77

Service Code	HCPCS 43280
Hospital Charge Code	1600000491
Hospital Revenue Code	360
Min. Negotiated Rate	$5,343.72
Max. Negotiated Rate	$5,343.72
Rate for Payer: Qualcare PPO/HMO/WC	$5,343.72

LAPAROSCOPY LYMPHADENECTOMY

Facility

$33,033.35

Service Code	HCPCS 38572
Hospital Charge Code	1600000516
Hospital Revenue Code	360
Min. Negotiated Rate	$4,955.00
Max. Negotiated Rate	$4,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,955.00

LAPAROSCOPY LYMPHADENECTOMY

Facility

$33,033.35

Service Code	HCPCS 38572
Hospital Charge Code	1600000516
Hospital Revenue Code	360
Min. Negotiated Rate	$796.10
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	$9,910.00
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,955.00
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$796.10
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	$875.38

LAPAROSCOPY SPLENECTOMY

Facility

$61,304.40

Service Code	HCPCS 38120
Hospital Charge Code	1600000676
Hospital Revenue Code	360
Min. Negotiated Rate	$9,195.66
Max. Negotiated Rate	$9,195.66
Rate for Payer: Qualcare PPO/HMO/WC	$9,195.66

LAPAROSCOPY SPLENECTOMY

Facility

$61,304.40

Service Code	HCPCS 38120
Hospital Charge Code	1600000676
Hospital Revenue Code	360
Min. Negotiated Rate	$1,477.44
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	$18,391.32
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,195.66
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,477.44
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	$1,624.57

LAPAROSCPIC MYOMECTMY =<250 GM

Facility

$34,812.50

Service Code	HCPCS 58545
Hospital Charge Code	16000761
Hospital Revenue Code	360
Min. Negotiated Rate	$838.98
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	$10,443.75
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,221.88
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$838.98
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	$922.53

LAPAROSCPIC MYOMECTMY =<250 GM

Facility

$34,812.50

Service Code	HCPCS 58545
Hospital Charge Code	16000761
Hospital Revenue Code	360
Min. Negotiated Rate	$5,221.88
Max. Negotiated Rate	$5,221.88
Rate for Payer: Qualcare PPO/HMO/WC	$5,221.88

LAPARO SLING OPERATION

Facility

$21,530.28

Service Code	HCPCS 51992
Hospital Charge Code	16000997
Hospital Revenue Code	360
Min. Negotiated Rate	$518.88
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	$1,742.00
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	$6,459.08
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,229.54
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$518.88
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	$570.55

LAPARO SLING OPERATION

Facility

$21,530.28

Service Code	HCPCS 51992
Hospital Charge Code	16000997
Hospital Revenue Code	360
Min. Negotiated Rate	$3,229.54
Max. Negotiated Rate	$3,229.54
Rate for Payer: Qualcare PPO/HMO/WC	$3,229.54

LAPAROS,W LYSIS OF ADHESIONS

Facility

$43,334.60

Service Code	HCPCS 58660
Hospital Charge Code	160000180
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

LAPAROS,W LYSIS OF ADHESIONS

Facility

$43,334.60

Service Code	HCPCS 58660
Hospital Charge Code	160000180
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	$1,742.00
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

LAP BAND AP SYS STD W/LOW PROF

Facility

$17,975.00

Hospital Charge Code	270664441
Hospital Revenue Code	272
Min. Negotiated Rate	$433.20
Max. Negotiated Rate	$8,987.50
Rate for Payer: Aetna Commercial	$6,830.50
Rate for Payer: Aetna Medicare Advantage	$5,392.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,583.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,583.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,583.62
Rate for Payer: Cigna Commercial	$8,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,392.50
Rate for Payer: Oxford Commercial	$3,595.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,696.25
Rate for Payer: UnitedHealthcare Commercial	$3,595.00
Rate for Payer: UnitedHealthcare Community & State	$433.20
Rate for Payer: Wellpoint Medicaid Managed Care	$476.34

LAP BAND AP SYS STD W/LOW PROF

Facility

$17,975.00

Hospital Charge Code	270664441
Hospital Revenue Code	272
Min. Negotiated Rate	$2,696.25
Max. Negotiated Rate	$2,696.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,696.25

LAP-BAND AP SYSTEM STANDARD AP

Facility

$18,875.00

Hospital Charge Code	27064441
Hospital Revenue Code	272
Min. Negotiated Rate	$454.89
Max. Negotiated Rate	$9,437.50
Rate for Payer: Aetna Commercial	$7,172.50
Rate for Payer: Aetna Medicare Advantage	$5,662.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,813.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,813.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,813.12
Rate for Payer: Cigna Commercial	$9,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,662.50
Rate for Payer: Oxford Commercial	$3,775.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,831.25
Rate for Payer: UnitedHealthcare Commercial	$3,775.00
Rate for Payer: UnitedHealthcare Community & State	$454.89
Rate for Payer: Wellpoint Medicaid Managed Care	$500.19

LAP-BAND AP SYSTEM STANDARD AP

Facility

$18,875.00

Hospital Charge Code	27064441
Hospital Revenue Code	272
Min. Negotiated Rate	$2,831.25
Max. Negotiated Rate	$2,831.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,831.25

LAP BAND LG STD LOW PROFILE 14

Facility

$17,975.00

Hospital Charge Code	270662076
Hospital Revenue Code	272
Min. Negotiated Rate	$2,696.25
Max. Negotiated Rate	$2,696.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,696.25

LAP BAND LG STD LOW PROFILE 14

Facility

$17,975.00

Hospital Charge Code	270662076
Hospital Revenue Code	272
Min. Negotiated Rate	$433.20
Max. Negotiated Rate	$8,987.50
Rate for Payer: Aetna Commercial	$6,830.50
Rate for Payer: Aetna Medicare Advantage	$5,392.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,583.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,583.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,583.62
Rate for Payer: Cigna Commercial	$8,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,392.50
Rate for Payer: Oxford Commercial	$3,595.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,696.25
Rate for Payer: UnitedHealthcare Commercial	$3,595.00
Rate for Payer: UnitedHealthcare Community & State	$433.20
Rate for Payer: Wellpoint Medicaid Managed Care	$476.34

LAP BAND PORT 1 LG STD 14CC

Facility

$17,975.00

Hospital Charge Code	270662079
Hospital Revenue Code	272
Min. Negotiated Rate	$2,696.25
Max. Negotiated Rate	$2,696.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,696.25

LAP BAND PORT 1 LG STD 14CC

Facility

$17,975.00

Hospital Charge Code	270662079
Hospital Revenue Code	272
Min. Negotiated Rate	$433.20
Max. Negotiated Rate	$8,987.50
Rate for Payer: Aetna Commercial	$6,830.50
Rate for Payer: Aetna Medicare Advantage	$5,392.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,583.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,583.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,583.62
Rate for Payer: Cigna Commercial	$8,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,392.50
Rate for Payer: Oxford Commercial	$3,595.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,696.25
Rate for Payer: UnitedHealthcare Commercial	$3,595.00
Rate for Payer: UnitedHealthcare Community & State	$433.20
Rate for Payer: Wellpoint Medicaid Managed Care	$476.34

Know your out-of-pocket cost for care.

All Charges