Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LAPIPLASTY SYSTEM 3R SK23

Facility

$37,470.00

Service Code	HCPCS C1713
Hospital Charge Code	270697749
Hospital Revenue Code	278
Min. Negotiated Rate	$5,620.50
Max. Negotiated Rate	$9,067.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,494.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,067.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,243.40
Rate for Payer: Qualcare PPO/HMO/WC	$5,620.50

LAPIPLASTY SYSTEM S4A

Facility

$25,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270696718
Hospital Revenue Code	278
Min. Negotiated Rate	$626.00
Max. Negotiated Rate	$12,987.50
Rate for Payer: Aetna Commercial	$9,870.50
Rate for Payer: Aetna Medicare Advantage	$7,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,623.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,623.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,623.62
Rate for Payer: Cigna Commercial	$12,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,285.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,714.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,896.25
Rate for Payer: UnitedHealthcare Community & State	$626.00
Rate for Payer: Wellpoint Medicaid Managed Care	$688.34

LAPIPLASTY SYSTEM S4A

Facility

$25,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270696718
Hospital Revenue Code	278
Min. Negotiated Rate	$3,896.25
Max. Negotiated Rate	$6,285.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,285.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,714.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,896.25

LAPI SPEEDPLATE MIC QUAD 14MM

Facility

$19,370.00

Hospital Charge Code	270702793
Hospital Revenue Code	278
Min. Negotiated Rate	$2,905.50
Max. Negotiated Rate	$4,687.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,874.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,687.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,261.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,905.50

LAPI SPEEDPLATE MIC QUAD 14MM

Facility

$19,370.00

Hospital Charge Code	270702793
Hospital Revenue Code	278
Min. Negotiated Rate	$466.82
Max. Negotiated Rate	$9,685.00
Rate for Payer: Aetna Commercial	$7,360.60
Rate for Payer: Aetna Medicare Advantage	$5,811.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,939.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,939.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,874.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,939.35
Rate for Payer: Cigna Commercial	$9,685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,687.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,261.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,905.50
Rate for Payer: UnitedHealthcare Community & State	$466.82
Rate for Payer: Wellpoint Medicaid Managed Care	$513.30

LAPI SPEEDPLATE MIC QUAD 17MM

Facility

$19,370.00

Hospital Charge Code	270703012
Hospital Revenue Code	278
Min. Negotiated Rate	$466.82
Max. Negotiated Rate	$9,685.00
Rate for Payer: Aetna Commercial	$7,360.60
Rate for Payer: Aetna Medicare Advantage	$5,811.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,939.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,939.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,874.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,939.35
Rate for Payer: Cigna Commercial	$9,685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,687.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,261.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,905.50
Rate for Payer: UnitedHealthcare Community & State	$466.82
Rate for Payer: Wellpoint Medicaid Managed Care	$513.30

LAPI SPEEDPLATE MIC QUAD 17MM

Facility

$19,370.00

Hospital Charge Code	270703012
Hospital Revenue Code	278
Min. Negotiated Rate	$2,905.50
Max. Negotiated Rate	$4,687.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,874.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,687.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,261.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,905.50

LAP MOBIL SPLENIC FL ADD-ON

Facility

$33,620.30

Service Code	HCPCS 44213
Hospital Charge Code	16000746
Hospital Revenue Code	360
Min. Negotiated Rate	$5,043.05
Max. Negotiated Rate	$5,043.05
Rate for Payer: Qualcare PPO/HMO/WC	$5,043.05

LAP MOBIL SPLENIC FL ADD-ON

Facility

$33,620.30

Service Code	HCPCS 44213
Hospital Charge Code	16000746
Hospital Revenue Code	360
Min. Negotiated Rate	$810.25
Max. Negotiated Rate	$16,810.15
Rate for Payer: Aetna Commercial	$12,775.71
Rate for Payer: Aetna Medicare Advantage	$10,086.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,573.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,573.18
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	$8,573.18
Rate for Payer: Cigna Commercial	$16,810.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,086.09
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,043.05
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$810.25
Rate for Payer: Wellpoint Medicaid Managed Care	$890.94

LAP MVL GASTR ADJ ALL PARTS

Facility

$10,973.76

Service Code	HCPCS 43774
Hospital Charge Code	1600000580
Hospital Revenue Code	360
Min. Negotiated Rate	$264.47
Max. Negotiated Rate	$16,605.00
Rate for Payer: Aetna Commercial	$12,458.69
Rate for Payer: Aetna Medicare Advantage	$14,840.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,580.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12,971.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,120.00
Rate for Payer: Cigna Commercial	$9,181.40
Rate for Payer: Cigna Medicare Advantage	$4,580.40
Rate for Payer: Clover Medicare Advantage	$4,351.38
Rate for Payer: EmblemHealth Commercial	$13,741.20
Rate for Payer: Humana Medicare Advantage	$4,717.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,580.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,292.13
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,646.06
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$264.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,580.40
Rate for Payer: Wellcare Medicare Advantage	$4,580.40
Rate for Payer: Wellpoint Medicaid Managed Care	$290.80

LAP MVL GASTR ADJ ALL PARTS

Facility

$10,973.76

Service Code	HCPCS 43774
Hospital Charge Code	1600000580
Hospital Revenue Code	360
Min. Negotiated Rate	$1,646.06
Max. Negotiated Rate	$1,646.06
Rate for Payer: Qualcare PPO/HMO/WC	$1,646.06

LAP PARAESOPH HER RPR W/MESH

Facility

$30,381.68

Service Code	HCPCS 43282
Hospital Charge Code	1600000396
Hospital Revenue Code	360
Min. Negotiated Rate	$732.20
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	$9,114.50
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,557.25
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$732.20
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	$805.11

LAP PARAESOPH HER RPR W/MESH

Facility

$30,381.68

Service Code	HCPCS 43282
Hospital Charge Code	1600000396
Hospital Revenue Code	360
Min. Negotiated Rate	$4,557.25
Max. Negotiated Rate	$4,557.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,557.25

LAP PARTIAL COLECTOMY

Facility

$17,148.70

Service Code	HCPCS 44204
Hospital Charge Code	16000745
Hospital Revenue Code	360
Min. Negotiated Rate	$413.28
Max. Negotiated Rate	$12,870.00
Rate for Payer: Aetna Commercial	$6,516.51
Rate for Payer: Aetna Medicare Advantage	$5,144.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,372.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,372.92
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	$4,372.92
Rate for Payer: Cigna Commercial	$8,574.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,144.61
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,572.30
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$413.28
Rate for Payer: Wellpoint Medicaid Managed Care	$454.44

LAP PARTIAL COLECTOMY

Facility

$17,148.70

Service Code	HCPCS 44204
Hospital Charge Code	16000745
Hospital Revenue Code	360
Min. Negotiated Rate	$2,572.30
Max. Negotiated Rate	$2,572.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,572.30

LAP PROBE 10 MM

Facility

$664.00

Hospital Charge Code	270335112
Hospital Revenue Code	272
Min. Negotiated Rate	$16.00
Max. Negotiated Rate	$332.00
Rate for Payer: Aetna Commercial	$252.32
Rate for Payer: Aetna Medicare Advantage	$199.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.32
Rate for Payer: Cigna Commercial	$332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.20
Rate for Payer: Oxford Commercial	$132.80
Rate for Payer: Qualcare PPO/HMO/WC	$99.60
Rate for Payer: UnitedHealthcare Commercial	$132.80
Rate for Payer: UnitedHealthcare Community & State	$16.00
Rate for Payer: Wellpoint Medicaid Managed Care	$17.60

LAP PROBE 10 MM

Facility

$664.00

Hospital Charge Code	270335112
Hospital Revenue Code	272
Min. Negotiated Rate	$99.60
Max. Negotiated Rate	$99.60
Rate for Payer: Qualcare PPO/HMO/WC	$99.60

LAP RADICAL HYST

Facility

$48,210.00

Service Code	HCPCS 58548
Hospital Charge Code	1600000258
Hospital Revenue Code	360
Min. Negotiated Rate	$7,231.50
Max. Negotiated Rate	$7,231.50
Rate for Payer: Qualcare PPO/HMO/WC	$7,231.50

LAP RADICAL HYST

Facility

$48,210.00

Service Code	HCPCS 58548
Hospital Charge Code	1600000258
Hospital Revenue Code	360
Min. Negotiated Rate	$1,161.86
Max. Negotiated Rate	$24,105.00
Rate for Payer: Aetna Commercial	$18,319.80
Rate for Payer: Aetna Medicare Advantage	$14,463.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,293.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,293.55
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	$12,293.55
Rate for Payer: Cigna Commercial	$24,105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,463.00
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,231.50
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$1,161.86
Rate for Payer: Wellpoint Medicaid Managed Care	$1,277.57

LAP RMVL GASTR ADJ DEVICE

Facility

$12,867.57

Service Code	HCPCS 43772
Hospital Charge Code	1600000419
Hospital Revenue Code	360
Min. Negotiated Rate	$310.11
Max. Negotiated Rate	$14,840.50
Rate for Payer: Aetna Commercial	$12,458.69
Rate for Payer: Aetna Medicare Advantage	$14,840.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,580.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12,971.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,120.00
Rate for Payer: Cigna Commercial	$9,181.40
Rate for Payer: Cigna Medicare Advantage	$4,580.40
Rate for Payer: Clover Medicare Advantage	$4,351.38
Rate for Payer: EmblemHealth Commercial	$13,741.20
Rate for Payer: Humana Medicare Advantage	$4,717.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,580.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,860.27
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,930.14
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$310.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,580.40
Rate for Payer: Wellcare Medicare Advantage	$4,580.40
Rate for Payer: Wellpoint Medicaid Managed Care	$340.99

LAP RMVL GASTR ADJ DEVICE

Facility

$12,867.57

Service Code	HCPCS 43772
Hospital Charge Code	1600000419
Hospital Revenue Code	360
Min. Negotiated Rate	$1,930.14
Max. Negotiated Rate	$1,930.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,930.14

LAPRO PRO SPERMATIC CORD

Facility

$17,954.72

Service Code	HCPCS 55559
Hospital Charge Code	1600000329
Hospital Revenue Code	360
Min. Negotiated Rate	$2,693.21
Max. Negotiated Rate	$2,693.21
Rate for Payer: Qualcare PPO/HMO/WC	$2,693.21

LAPRO PRO SPERMATIC CORD

Facility

$17,954.72

Service Code	HCPCS 55559
Hospital Charge Code	1600000329
Hospital Revenue Code	360
Min. Negotiated Rate	$432.71
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	$5,386.42
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,693.21
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$432.71
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	$475.80

LAP ROUX AND Y GASTRIC BYPASS

Facility

$112,126.91

Service Code	HCPCS 43644
Hospital Charge Code	1600168
Hospital Revenue Code	361
Min. Negotiated Rate	$16,819.04
Max. Negotiated Rate	$16,819.04
Rate for Payer: Qualcare PPO/HMO/WC	$16,819.04

LAP ROUX AND Y GASTRIC BYPASS

Facility

$112,126.91

Service Code	HCPCS 43644
Hospital Charge Code	1600168
Hospital Revenue Code	361
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$56,063.46
Rate for Payer: Aetna Commercial	$42,608.23
Rate for Payer: Aetna Medicare Advantage	$33,638.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,592.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,592.36
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	$28,592.36
Rate for Payer: Cigna Commercial	$56,063.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33,638.07
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$16,819.04
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$2,702.26
Rate for Payer: Wellpoint Medicaid Managed Care	$2,971.36

Know your out-of-pocket cost for care.

All Charges