Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LAP BAND PORT 2 LOW PROFILE ST

Facility

$17,975.00

Hospital Charge Code	270662075
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 2 LOW PROFILE ST

Facility

$17,975.00

Hospital Charge Code	270662075
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 2 LOW PROFILE ST

Facility

$17,975.00

Hospital Charge Code	S2083
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 2 LOW PROFILE ST

Facility

$17,975.00

Hospital Charge Code	S2083
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

LAPBAND W/ACS PRT 0-10 APS2240

Facility

$17,975.00

Hospital Charge Code	270641066
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

LAPBAND W/ACS PRT 0-10 APS2240

Facility

$17,975.00

Hospital Charge Code	270641066
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

LAPBAND W/ACS PRT 0-14 APL2245

Facility

$13,345.00

Hospital Charge Code	270641067
Hospital Revenue Code	272
Min. Negotiated Rate	$321.61
Max. Negotiated Rate	$6,672.50
Rate for Payer: Aetna Commercial	$5,071.10
Rate for Payer: Aetna Medicare Advantage	$4,003.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,402.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,402.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,402.97
Rate for Payer: Cigna Commercial	$6,672.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,003.50
Rate for Payer: Oxford Commercial	$2,669.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,001.75
Rate for Payer: UnitedHealthcare Commercial	$2,669.00
Rate for Payer: UnitedHealthcare Community & State	$321.61
Rate for Payer: Wellpoint Medicaid Managed Care	$353.64

LAPBAND W/ACS PRT 0-14 APL2245

Facility

$13,345.00

Hospital Charge Code	270641067
Hospital Revenue Code	272
Min. Negotiated Rate	$2,001.75
Max. Negotiated Rate	$2,001.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,001.75

LAP,CHOLCYSTMY W CHLNGIGR

Facility

$43,334.60

Service Code	HCPCS 47563
Hospital Charge Code	16000644
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

LAP,CHOLCYSTMY W CHLNGIGR

Facility

$43,334.60

Service Code	HCPCS 47563
Hospital Charge Code	16000644
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

LAP CLOSE ENTEROSTOMY

Facility

$22,413.00

Service Code	HCPCS 44227
Hospital Charge Code	1600000763
Hospital Revenue Code	360
Min. Negotiated Rate	$540.15
Max. Negotiated Rate	$11,206.50
Rate for Payer: Aetna Commercial	$8,516.94
Rate for Payer: Aetna Medicare Advantage	$6,723.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,715.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,715.31
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	$5,715.31
Rate for Payer: Cigna Commercial	$11,206.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,723.90
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,361.95
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$540.15
Rate for Payer: Wellpoint Medicaid Managed Care	$593.94

LAP CLOSE ENTEROSTOMY

Facility

$22,413.00

Service Code	HCPCS 44227
Hospital Charge Code	1600000763
Hospital Revenue Code	360
Min. Negotiated Rate	$3,361.95
Max. Negotiated Rate	$3,361.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,361.95

LAPCOLECTOMY PART W/ILEUM

Facility

$14,324.36

Service Code	HCPCS 44205
Hospital Charge Code	1600000447
Hospital Revenue Code	360
Min. Negotiated Rate	$345.22
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,443.26
Rate for Payer: Aetna Medicare Advantage	$4,297.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,652.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,652.71
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	$3,652.71
Rate for Payer: Cigna Commercial	$7,162.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,297.31
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,148.65
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$345.22
Rate for Payer: Wellpoint Medicaid Managed Care	$379.60

LAPCOLECTOMY PART W/ILEUM

Facility

$14,324.36

Service Code	HCPCS 44205
Hospital Charge Code	1600000447
Hospital Revenue Code	360
Min. Negotiated Rate	$2,148.65
Max. Negotiated Rate	$2,148.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,148.65

LAP COLOSTOMY

Facility

$10,955.74

Service Code	HCPCS 44188
Hospital Charge Code	16000970
Hospital Revenue Code	360
Min. Negotiated Rate	$1,643.36
Max. Negotiated Rate	$1,643.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,643.36

LAP COLOSTOMY

Facility

$10,955.74

Service Code	HCPCS 44188
Hospital Charge Code	16000970
Hospital Revenue Code	360
Min. Negotiated Rate	$264.03
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$4,163.18
Rate for Payer: Aetna Medicare Advantage	$3,286.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,793.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,793.71
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	$2,793.71
Rate for Payer: Cigna Commercial	$5,477.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,286.72
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,643.36
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$264.03
Rate for Payer: Wellpoint Medicaid Managed Care	$290.33

LAP DISC HAND ACC DEVICE LD111

Facility

$2,535.75

Hospital Charge Code	270628294
Hospital Revenue Code	272
Min. Negotiated Rate	$61.11
Max. Negotiated Rate	$1,267.88
Rate for Payer: Aetna Commercial	$963.59
Rate for Payer: Aetna Medicare Advantage	$760.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$646.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$646.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$646.62
Rate for Payer: Cigna Commercial	$1,267.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$760.73
Rate for Payer: Oxford Commercial	$507.15
Rate for Payer: Qualcare PPO/HMO/WC	$380.36
Rate for Payer: UnitedHealthcare Commercial	$507.15
Rate for Payer: UnitedHealthcare Community & State	$61.11
Rate for Payer: Wellpoint Medicaid Managed Care	$67.20

LAP DISC HAND ACC DEVICE LD111

Facility

$2,535.75

Hospital Charge Code	270628294
Hospital Revenue Code	272
Min. Negotiated Rate	$380.36
Max. Negotiated Rate	$380.36
Rate for Payer: Qualcare PPO/HMO/WC	$380.36

LAP DISC HND ACCSS DVCE LD112

Facility

$2,604.00

Hospital Charge Code	270635333
Hospital Revenue Code	272
Min. Negotiated Rate	$390.60
Max. Negotiated Rate	$390.60
Rate for Payer: Qualcare PPO/HMO/WC	$390.60

LAP DISC HND ACCSS DVCE LD112

Facility

$2,604.00

Hospital Charge Code	270635333
Hospital Revenue Code	272
Min. Negotiated Rate	$62.76
Max. Negotiated Rate	$1,302.00
Rate for Payer: Aetna Commercial	$989.52
Rate for Payer: Aetna Medicare Advantage	$781.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$664.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$664.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$664.02
Rate for Payer: Cigna Commercial	$1,302.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.20
Rate for Payer: Oxford Commercial	$520.80
Rate for Payer: Qualcare PPO/HMO/WC	$390.60
Rate for Payer: UnitedHealthcare Commercial	$520.80
Rate for Payer: UnitedHealthcare Community & State	$62.76
Rate for Payer: Wellpoint Medicaid Managed Care	$69.01

LAP ENTERECTOMY

Facility

$8,576.55

Service Code	HCPCS 44202
Hospital Charge Code	1600000632
Hospital Revenue Code	360
Min. Negotiated Rate	$1,286.48
Max. Negotiated Rate	$1,286.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,286.48

LAP ENTERECTOMY

Facility

$8,576.55

Service Code	HCPCS 44202
Hospital Charge Code	1600000632
Hospital Revenue Code	360
Min. Negotiated Rate	$206.69
Max. Negotiated Rate	$12,870.00
Rate for Payer: Aetna Commercial	$3,259.09
Rate for Payer: Aetna Medicare Advantage	$2,572.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,187.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,187.02
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	$2,187.02
Rate for Payer: Cigna Commercial	$4,288.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,572.97
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,286.48
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$206.69
Rate for Payer: Wellpoint Medicaid Managed Care	$227.28

LAP ENTEROLYSIS

Facility

$58,549.97

Service Code	HCPCS 44180
Hospital Charge Code	16000586
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	$1,626.00
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	$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

LAP ENTEROLYSIS

Facility

$58,549.97

Service Code	HCPCS 44180
Hospital Charge Code	16000586
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

LAP GASTRIC BYPASS/ROUX-EN-Y

Facility

$14,821.52

Service Code	HCPCS 43644
Hospital Charge Code	1600000388
Hospital Revenue Code	360
Min. Negotiated Rate	$357.20
Max. Negotiated Rate	$14,834.00
Rate for Payer: Aetna Commercial	$5,632.18
Rate for Payer: Aetna Medicare Advantage	$4,446.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,779.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,779.49
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	$3,779.49
Rate for Payer: Cigna Commercial	$7,410.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,446.46
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,223.23
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$357.20
Rate for Payer: Wellpoint Medicaid Managed Care	$392.77

Know your out-of-pocket cost for care.

All Charges