Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$2,223.23
Max. Negotiated Rate	$2,223.23
Rate for Payer: Qualcare PPO/HMO/WC	$2,223.23

LAP GASTRIC & SM INTEST RECON

Facility

$112,136.91

Service Code	HCPCS 43645
Hospital Charge Code	1600174
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$56,068.46
Rate for Payer: Aetna Commercial	$42,612.03
Rate for Payer: Aetna Medicare Advantage	$33,641.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,594.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,594.91
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	$28,594.91
Rate for Payer: Cigna Commercial	$56,068.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33,641.07
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$16,820.54
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$2,702.50
Rate for Payer: Wellpoint Medicaid Managed Care	$2,971.63

LAP GASTRIC & SM INTEST RECON

Facility

$112,136.91

Service Code	HCPCS 43645
Hospital Charge Code	1600174
Hospital Revenue Code	361
Min. Negotiated Rate	$16,820.54
Max. Negotiated Rate	$16,820.54
Rate for Payer: Qualcare PPO/HMO/WC	$16,820.54

LAP GYN KIT

Facility

$347.00

Hospital Charge Code	270338738
Hospital Revenue Code	272
Min. Negotiated Rate	$52.05
Max. Negotiated Rate	$52.05
Rate for Payer: Qualcare PPO/HMO/WC	$52.05

LAP GYN KIT

Facility

$347.00

Hospital Charge Code	270338738
Hospital Revenue Code	272
Min. Negotiated Rate	$8.36
Max. Negotiated Rate	$173.50
Rate for Payer: Aetna Commercial	$131.86
Rate for Payer: Aetna Medicare Advantage	$104.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.48
Rate for Payer: Cigna Commercial	$173.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.10
Rate for Payer: Oxford Commercial	$69.40
Rate for Payer: Qualcare PPO/HMO/WC	$52.05
Rate for Payer: UnitedHealthcare Commercial	$69.40
Rate for Payer: UnitedHealthcare Community & State	$8.36
Rate for Payer: Wellpoint Medicaid Managed Care	$9.20

LAP HANDSWITCH ELECTRODE

Facility

$600.00

Hospital Charge Code	270335111
Hospital Revenue Code	272
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.00
Rate for Payer: Oxford Commercial	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Commercial	$120.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

LAP HANDSWITCH ELECTRODE

Facility

$600.00

Hospital Charge Code	270335111
Hospital Revenue Code	272
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

LAPIDUS 3.5MMX24MM SCREW

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688235
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$333.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$303.60
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

LAPIDUS 3.5MMX24MM SCREW

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688235
Hospital Revenue Code	278
Min. Negotiated Rate	$33.26
Max. Negotiated Rate	$690.00
Rate for Payer: Aetna Commercial	$524.40
Rate for Payer: Aetna Medicare Advantage	$414.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.90
Rate for Payer: Cigna Commercial	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$303.60
Rate for Payer: Qualcare PPO/HMO/WC	$207.00
Rate for Payer: UnitedHealthcare Community & State	$33.26
Rate for Payer: Wellpoint Medicaid Managed Care	$36.57

LAPIDUS PLATE LEFT

Facility

$9,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687468
Hospital Revenue Code	278
Min. Negotiated Rate	$216.90
Max. Negotiated Rate	$4,500.00
Rate for Payer: Aetna Commercial	$3,420.00
Rate for Payer: Aetna Medicare Advantage	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,295.00
Rate for Payer: Cigna Commercial	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,980.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00
Rate for Payer: UnitedHealthcare Community & State	$216.90
Rate for Payer: Wellpoint Medicaid Managed Care	$238.50

LAPIDUS PLATE LEFT

Facility

$9,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687468
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$2,178.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,980.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

LAP ILEO/JEJUNO-STOMY

Facility

$130,620.30

Service Code	HCPCS 44187
Hospital Charge Code	1600000266
Hospital Revenue Code	360
Min. Negotiated Rate	$19,593.04
Max. Negotiated Rate	$19,593.04
Rate for Payer: Qualcare PPO/HMO/WC	$19,593.04

LAP ILEO/JEJUNO-STOMY

Facility

$130,620.30

Service Code	HCPCS 44187
Hospital Charge Code	1600000266
Hospital Revenue Code	360
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$65,310.15
Rate for Payer: Aetna Commercial	$49,635.71
Rate for Payer: Aetna Medicare Advantage	$39,186.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,308.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,308.18
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	$33,308.18
Rate for Payer: Cigna Commercial	$65,310.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39,186.09
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$19,593.04
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$3,147.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3,461.44

LAP INC HERNIA REPAIR RECUR

Facility

$63,727.20

Service Code	HCPCS 49656
Hospital Charge Code	1600000445
Hospital Revenue Code	360
Min. Negotiated Rate	$9,559.08
Max. Negotiated Rate	$9,559.08
Rate for Payer: Qualcare PPO/HMO/WC	$9,559.08

LAP INC HERNIA REPAIR RECUR

Facility

$63,727.20

Service Code	HCPCS 49656
Hospital Charge Code	1600000445
Hospital Revenue Code	360
Min. Negotiated Rate	$1,535.83
Max. Negotiated Rate	$31,863.60
Rate for Payer: Aetna Commercial	$24,216.34
Rate for Payer: Aetna Medicare Advantage	$19,118.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,250.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,250.44
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	$16,250.44
Rate for Payer: Cigna Commercial	$31,863.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19,118.16
Rate for Payer: Qualcare PPO/HMO/WC	$9,559.08
Rate for Payer: UnitedHealthcare Community & State	$1,535.83
Rate for Payer: Wellpoint Medicaid Managed Care	$1,688.77

LAP INC HERN RECUR COMP

Facility

$39,439.32

Service Code	HCPCS 49657
Hospital Charge Code	16000994
Hospital Revenue Code	360
Min. Negotiated Rate	$950.49
Max. Negotiated Rate	$19,719.66
Rate for Payer: Aetna Commercial	$14,986.94
Rate for Payer: Aetna Medicare Advantage	$11,831.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,057.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,057.03
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	$10,057.03
Rate for Payer: Cigna Commercial	$19,719.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,831.80
Rate for Payer: Qualcare PPO/HMO/WC	$5,915.90
Rate for Payer: UnitedHealthcare Community & State	$950.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1,045.14

LAP INC HERN RECUR COMP

Facility

$39,439.32

Service Code	HCPCS 49657
Hospital Charge Code	16000994
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

LAP ING HERNIA REPAIR INIT--RT

Facility

$43,334.60

Service Code	HCPCS 49650
Hospital Charge Code	16000646
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 ING HERNIA REPAIR INIT--RT

Facility

$43,334.60

Service Code	HCPCS 49650
Hospital Charge Code	16000646
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 ING HERNIA REPAIR RECUR RT

Facility

$44,604.55

Service Code	HCPCS 49651
Hospital Charge Code	1600000328
Hospital Revenue Code	360
Min. Negotiated Rate	$6,690.68
Max. Negotiated Rate	$6,690.68
Rate for Payer: Qualcare PPO/HMO/WC	$6,690.68

LAP ING HERNIA REPAIR RECUR RT

Facility

$44,604.55

Service Code	HCPCS 49651
Hospital Charge Code	1600000328
Hospital Revenue Code	360
Min. Negotiated Rate	$1,074.97
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	$1,936.00
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	$13,381.36
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,690.68
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,074.97
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	$1,182.02

LAP INSERTION PERM IP CATH

Facility

$34,812.50

Service Code	HCPCS 49324
Hospital Charge Code	16000988
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

LAP INSERTION PERM IP CATH

Facility

$34,812.50

Service Code	HCPCS 49324
Hospital Charge Code	16000988
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

LAP INSUFFLATOR TUBE/FILTER

Facility

$300.00

Hospital Charge Code	270335094
Hospital Revenue Code	272
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

LAP INSUFFLATOR TUBE/FILTER

Facility

$300.00

Hospital Charge Code	270335094
Hospital Revenue Code	272
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