Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LARGE ID PLAQUE CLEAR

Facility

$30.15

Hospital Charge Code	270665602
Hospital Revenue Code	270
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$4.52
Rate for Payer: Qualcare PPO/HMO/WC	$4.52

LARGE PHASIX PLUG WITH PATCH

Facility

$2,925.00

Service Code	HCPCS C1781
Hospital Charge Code	270683932
Hospital Revenue Code	278
Min. Negotiated Rate	$70.49
Max. Negotiated Rate	$1,462.50
Rate for Payer: Aetna Commercial	$1,111.50
Rate for Payer: Aetna Medicare Advantage	$877.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$745.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$745.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$745.88
Rate for Payer: Cigna Commercial	$1,462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$643.50
Rate for Payer: Qualcare PPO/HMO/WC	$438.75
Rate for Payer: UnitedHealthcare Community & State	$70.49
Rate for Payer: Wellpoint Medicaid Managed Care	$77.51

LARGE PHASIX PLUG WITH PATCH

Facility

$2,925.00

Service Code	HCPCS C1781
Hospital Charge Code	270683932
Hospital Revenue Code	278
Min. Negotiated Rate	$438.75
Max. Negotiated Rate	$707.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$643.50
Rate for Payer: Qualcare PPO/HMO/WC	$438.75

LARIAT SNARE

Facility

$75.00

Hospital Charge Code	270669843
Hospital Revenue Code	272
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

LARIAT SNARE

Facility

$75.00

Hospital Charge Code	270669843
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

LARYNGECTOMY TUBE 32.7 FR

Facility

$388.00

Hospital Charge Code	270331691
Hospital Revenue Code	272
Min. Negotiated Rate	$58.20
Max. Negotiated Rate	$58.20
Rate for Payer: Qualcare PPO/HMO/WC	$58.20

LARYNGECTOMY TUBE 32.7 FR

Facility

$388.00

Hospital Charge Code	270331691
Hospital Revenue Code	272
Min. Negotiated Rate	$9.35
Max. Negotiated Rate	$194.00
Rate for Payer: Aetna Commercial	$147.44
Rate for Payer: Aetna Medicare Advantage	$116.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.94
Rate for Payer: Cigna Commercial	$194.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.40
Rate for Payer: Oxford Commercial	$77.60
Rate for Payer: Qualcare PPO/HMO/WC	$58.20
Rate for Payer: UnitedHealthcare Commercial	$77.60
Rate for Payer: UnitedHealthcare Community & State	$9.35
Rate for Payer: Wellpoint Medicaid Managed Care	$10.28

LARYNGOSCOPE HANDLE MEDIUM

Facility

$105.00

Hospital Charge Code	270665161
Hospital Revenue Code	270
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

LARYNGOSCOPE HANDLE MEDIUM

Facility

$105.00

Hospital Charge Code	270665161
Hospital Revenue Code	270
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.50
Rate for Payer: Oxford Commercial	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Community & State	$2.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

LARYNGOSCOPE HANDLE PEDIATRIC

Facility

$105.00

Hospital Charge Code	270665160
Hospital Revenue Code	270
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.50
Rate for Payer: Oxford Commercial	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Community & State	$2.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

LARYNGOSCOPE HANDLE PEDIATRIC

Facility

$105.00

Hospital Charge Code	270665160
Hospital Revenue Code	270
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

LARYNGOSCOPY DIAGNOSTIC

Facility

$753.10

Service Code	HCPCS 31575
Hospital Charge Code	85000900
Hospital Revenue Code	361
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$645.02
Rate for Payer: Aetna Medicare Advantage	$768.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$237.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$856.00
Rate for Payer: Cigna Commercial	$475.34
Rate for Payer: Cigna Medicare Advantage	$237.14
Rate for Payer: Clover Medicare Advantage	$225.28
Rate for Payer: EmblemHealth Commercial	$711.42
Rate for Payer: Humana Medicare Advantage	$244.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$237.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.93
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.97
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$18.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$237.14
Rate for Payer: Wellcare Medicare Advantage	$237.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$528.97
Rate for Payer: Wellpoint Medicaid Managed Care	$518.60

LARYNGOSCOPY DIAGNOSTIC

Facility

$753.10

Service Code	HCPCS 31575
Hospital Charge Code	85000900
Hospital Revenue Code	361
Min. Negotiated Rate	$112.97
Max. Negotiated Rate	$112.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.97

LARYNGOSCOPY EXC NEWBORN

Facility

$2,140.00

Service Code	HCPCS 31525
Hospital Charge Code	5790080
Hospital Revenue Code	450
Min. Negotiated Rate	$321.00
Max. Negotiated Rate	$321.00
Rate for Payer: Qualcare PPO/HMO/WC	$321.00

LARYNGOSCOPY EXC NEWBORN

Facility

$2,140.00

Service Code	HCPCS 31525
Hospital Charge Code	5790080
Hospital Revenue Code	450
Min. Negotiated Rate	$56.71
Max. Negotiated Rate	$7,632.96
Rate for Payer: Aetna Commercial	$5,751.63
Rate for Payer: Aetna Medicare Advantage	$6,851.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,114.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,632.96
Rate for Payer: Cigna Commercial	$4,238.63
Rate for Payer: Cigna Medicare Advantage	$2,114.57
Rate for Payer: Clover Medicare Advantage	$2,008.84
Rate for Payer: EmblemHealth Commercial	$6,343.71
Rate for Payer: Humana Medicare Advantage	$2,178.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,114.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$642.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$321.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,594.28
Rate for Payer: Wellpoint Medicaid Managed Care	$56.71

LARYNGOSCOPY W/BIOPSY

Facility

$22,334.60

Service Code	HCPCS 31535
Hospital Charge Code	1600000256
Hospital Revenue Code	360
Min. Negotiated Rate	$538.26
Max. Negotiated Rate	$15,988.70
Rate for Payer: Aetna Commercial	$12,047.89
Rate for Payer: Aetna Medicare Advantage	$14,351.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,988.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,988.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,429.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,988.70
Rate for Payer: Cigna Commercial	$8,878.66
Rate for Payer: Cigna Medicare Advantage	$4,429.37
Rate for Payer: Clover Medicare Advantage	$4,207.90
Rate for Payer: EmblemHealth Commercial	$13,288.11
Rate for Payer: Humana Medicare Advantage	$4,562.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,429.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,700.38
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,350.19
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$538.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,429.37
Rate for Payer: Wellcare Medicare Advantage	$4,429.37
Rate for Payer: Wellpoint Medicaid Managed Care	$591.87

LARYNGOSCOPY W/BIOPSY

Facility

$22,334.60

Service Code	HCPCS 31535
Hospital Charge Code	1600000256
Hospital Revenue Code	360
Min. Negotiated Rate	$3,350.19
Max. Negotiated Rate	$3,350.19
Rate for Payer: Qualcare PPO/HMO/WC	$3,350.19

LARYNGOSCOPY W/BX & OP SCOPE

Facility

$22,334.60

Service Code	HCPCS 31536
Hospital Charge Code	1600000350
Hospital Revenue Code	360
Min. Negotiated Rate	$3,350.19
Max. Negotiated Rate	$3,350.19
Rate for Payer: Qualcare PPO/HMO/WC	$3,350.19

LARYNGOSCOPY W/BX & OP SCOPE

Facility

$22,334.60

Service Code	HCPCS 31536
Hospital Charge Code	1600000350
Hospital Revenue Code	360
Min. Negotiated Rate	$538.26
Max. Negotiated Rate	$15,988.70
Rate for Payer: Aetna Commercial	$12,047.89
Rate for Payer: Aetna Medicare Advantage	$14,351.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,988.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,988.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,429.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,988.70
Rate for Payer: Cigna Commercial	$8,878.66
Rate for Payer: Cigna Medicare Advantage	$4,429.37
Rate for Payer: Clover Medicare Advantage	$4,207.90
Rate for Payer: EmblemHealth Commercial	$13,288.11
Rate for Payer: Humana Medicare Advantage	$4,562.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,429.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,700.38
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,350.19
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$538.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,429.37
Rate for Payer: Wellcare Medicare Advantage	$4,429.37
Rate for Payer: Wellpoint Medicaid Managed Care	$591.87

LARYNGOSCOPY W/FB REMOVAL

Facility

$7,223.25

Service Code	HCPCS 31530
Hospital Charge Code	5792260
Hospital Revenue Code	450
Min. Negotiated Rate	$1,083.49
Max. Negotiated Rate	$1,083.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.49

LARYNGOSCOPY W/FB REMOVAL

Facility

$7,223.25

Service Code	HCPCS 31530
Hospital Charge Code	5792260
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$7,632.96
Rate for Payer: Aetna Commercial	$5,751.63
Rate for Payer: Aetna Medicare Advantage	$6,851.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,114.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$234.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,632.96
Rate for Payer: Cigna Commercial	$4,238.63
Rate for Payer: Cigna Medicare Advantage	$2,114.57
Rate for Payer: Clover Medicare Advantage	$2,008.84
Rate for Payer: EmblemHealth Commercial	$6,343.71
Rate for Payer: Humana Medicare Advantage	$2,178.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,114.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,166.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.49
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare Medicare Advantage	$2,114.57
Rate for Payer: Wellpoint Medicaid Managed Care	$191.42

LARYNSCOP W/TUMR EXC + SCOPE

Facility

$22,334.60

Service Code	HCPCS 31541
Hospital Charge Code	1600000285
Hospital Revenue Code	360
Min. Negotiated Rate	$538.26
Max. Negotiated Rate	$15,988.70
Rate for Payer: Aetna Commercial	$12,047.89
Rate for Payer: Aetna Medicare Advantage	$14,351.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,988.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,988.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,429.37
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	$15,988.70
Rate for Payer: Cigna Commercial	$8,878.66
Rate for Payer: Cigna Medicare Advantage	$4,429.37
Rate for Payer: Clover Medicare Advantage	$4,207.90
Rate for Payer: EmblemHealth Commercial	$13,288.11
Rate for Payer: Humana Medicare Advantage	$4,562.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,429.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,700.38
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,350.19
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$538.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,429.37
Rate for Payer: Wellcare Medicare Advantage	$4,429.37
Rate for Payer: Wellpoint Medicaid Managed Care	$591.87

LARYNSCOP W/TUMR EXC + SCOPE

Facility

$22,334.60

Service Code	HCPCS 31541
Hospital Charge Code	1600000285
Hospital Revenue Code	360
Min. Negotiated Rate	$3,350.19
Max. Negotiated Rate	$3,350.19
Rate for Payer: Qualcare PPO/HMO/WC	$3,350.19

LASER FIBER HOLMIUM 365 SURFLX

Facility

$1,180.00

Hospital Charge Code	270673928
Hospital Revenue Code	272
Min. Negotiated Rate	$177.00
Max. Negotiated Rate	$177.00
Rate for Payer: Qualcare PPO/HMO/WC	$177.00

LASER FIBER HOLMIUM 365 SURFLX

Facility

$1,180.00

Hospital Charge Code	270673928
Hospital Revenue Code	272
Min. Negotiated Rate	$28.44
Max. Negotiated Rate	$590.00
Rate for Payer: Aetna Commercial	$448.40
Rate for Payer: Aetna Medicare Advantage	$354.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$300.90
Rate for Payer: Cigna Commercial	$590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.00
Rate for Payer: Oxford Commercial	$236.00
Rate for Payer: Qualcare PPO/HMO/WC	$177.00
Rate for Payer: UnitedHealthcare Commercial	$236.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$31.27

Know your out-of-pocket cost for care.

All Charges