Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LASER FIBER LIT PROFLEX 273 M

Facility

$1,785.00

Hospital Charge Code	270682487
Hospital Revenue Code	272
Min. Negotiated Rate	$267.75
Max. Negotiated Rate	$267.75
Rate for Payer: Qualcare PPO/HMO/WC	$267.75

LASER FIBER LIT PROFLEX 273 M

Facility

$1,785.00

Hospital Charge Code	270682487
Hospital Revenue Code	272
Min. Negotiated Rate	$43.02
Max. Negotiated Rate	$892.50
Rate for Payer: Aetna Commercial	$678.30
Rate for Payer: Aetna Medicare Advantage	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$455.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$455.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$455.18
Rate for Payer: Cigna Commercial	$892.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$535.50
Rate for Payer: Oxford Commercial	$357.00
Rate for Payer: Qualcare PPO/HMO/WC	$267.75
Rate for Payer: UnitedHealthcare Commercial	$357.00
Rate for Payer: UnitedHealthcare Community & State	$43.02
Rate for Payer: Wellpoint Medicaid Managed Care	$47.30

LASER FIBER LIT PROFLEX 365 M

Facility

$1,327.85

Hospital Charge Code	270682488
Hospital Revenue Code	272
Min. Negotiated Rate	$199.18
Max. Negotiated Rate	$199.18
Rate for Payer: Qualcare PPO/HMO/WC	$199.18

LASER FIBER LIT PROFLEX 365 M

Facility

$1,327.85

Hospital Charge Code	270682488
Hospital Revenue Code	272
Min. Negotiated Rate	$32.00
Max. Negotiated Rate	$663.92
Rate for Payer: Aetna Commercial	$504.58
Rate for Payer: Aetna Medicare Advantage	$398.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$338.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$338.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$338.60
Rate for Payer: Cigna Commercial	$663.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$398.36
Rate for Payer: Oxford Commercial	$265.57
Rate for Payer: Qualcare PPO/HMO/WC	$199.18
Rate for Payer: UnitedHealthcare Commercial	$265.57
Rate for Payer: UnitedHealthcare Community & State	$32.00
Rate for Payer: Wellpoint Medicaid Managed Care	$35.19

LASER FIBER LIT PROFLEX 550 M

Facility

$1,805.00

Hospital Charge Code	270682489
Hospital Revenue Code	272
Min. Negotiated Rate	$270.75
Max. Negotiated Rate	$270.75
Rate for Payer: Qualcare PPO/HMO/WC	$270.75

LASER FIBER LIT PROFLEX 550 M

Facility

$1,805.00

Hospital Charge Code	270682489
Hospital Revenue Code	272
Min. Negotiated Rate	$43.50
Max. Negotiated Rate	$902.50
Rate for Payer: Aetna Commercial	$685.90
Rate for Payer: Aetna Medicare Advantage	$541.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$460.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$460.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$460.27
Rate for Payer: Cigna Commercial	$902.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$541.50
Rate for Payer: Oxford Commercial	$361.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.75
Rate for Payer: UnitedHealthcare Commercial	$361.00
Rate for Payer: UnitedHealthcare Community & State	$43.50
Rate for Payer: Wellpoint Medicaid Managed Care	$47.83

LASER FIBER LIT PROFLEX 910 M

Facility

$3,175.00

Hospital Charge Code	270682490
Hospital Revenue Code	272
Min. Negotiated Rate	$76.52
Max. Negotiated Rate	$1,587.50
Rate for Payer: Aetna Commercial	$1,206.50
Rate for Payer: Aetna Medicare Advantage	$952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$809.62
Rate for Payer: Cigna Commercial	$1,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.50
Rate for Payer: Oxford Commercial	$635.00
Rate for Payer: Qualcare PPO/HMO/WC	$476.25
Rate for Payer: UnitedHealthcare Commercial	$635.00
Rate for Payer: UnitedHealthcare Community & State	$76.52
Rate for Payer: Wellpoint Medicaid Managed Care	$84.14

LASER FIBER LIT PROFLEX 910 M

Facility

$3,175.00

Hospital Charge Code	270682490
Hospital Revenue Code	272
Min. Negotiated Rate	$476.25
Max. Negotiated Rate	$476.25
Rate for Payer: Qualcare PPO/HMO/WC	$476.25

LASER FIBER SLIMLINE 550

Facility

$3,215.00

Hospital Charge Code	270670032
Hospital Revenue Code	272
Min. Negotiated Rate	$77.48
Max. Negotiated Rate	$1,607.50
Rate for Payer: Aetna Commercial	$1,221.70
Rate for Payer: Aetna Medicare Advantage	$964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$819.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$819.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$819.83
Rate for Payer: Cigna Commercial	$1,607.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$964.50
Rate for Payer: Oxford Commercial	$643.00
Rate for Payer: Qualcare PPO/HMO/WC	$482.25
Rate for Payer: UnitedHealthcare Commercial	$643.00
Rate for Payer: UnitedHealthcare Community & State	$77.48
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

LASER FIBER SLIMLINE 550

Facility

$3,215.00

Hospital Charge Code	270670032
Hospital Revenue Code	272
Min. Negotiated Rate	$482.25
Max. Negotiated Rate	$482.25
Rate for Payer: Qualcare PPO/HMO/WC	$482.25

LASER FIBR HLM 400 DUR400DBX

Facility

$2,212.25

Hospital Charge Code	270631441
Hospital Revenue Code	272
Min. Negotiated Rate	$53.32
Max. Negotiated Rate	$1,106.12
Rate for Payer: Aetna Commercial	$840.65
Rate for Payer: Aetna Medicare Advantage	$663.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$564.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$564.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$564.12
Rate for Payer: Cigna Commercial	$1,106.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.67
Rate for Payer: Oxford Commercial	$442.45
Rate for Payer: Qualcare PPO/HMO/WC	$331.84
Rate for Payer: UnitedHealthcare Commercial	$442.45
Rate for Payer: UnitedHealthcare Community & State	$53.32
Rate for Payer: Wellpoint Medicaid Managed Care	$58.62

LASER FIBR HLM 400 DUR400DBX

Facility

$2,212.25

Hospital Charge Code	270631441
Hospital Revenue Code	272
Min. Negotiated Rate	$331.84
Max. Negotiated Rate	$331.84
Rate for Payer: Qualcare PPO/HMO/WC	$331.84

LASER FIBR HOL MIC HF0600DSSMS

Facility

$2,524.70

Hospital Charge Code	270631935
Hospital Revenue Code	272
Min. Negotiated Rate	$60.85
Max. Negotiated Rate	$1,262.35
Rate for Payer: Aetna Commercial	$959.39
Rate for Payer: Aetna Medicare Advantage	$757.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$643.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$643.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$643.80
Rate for Payer: Cigna Commercial	$1,262.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$757.41
Rate for Payer: Oxford Commercial	$504.94
Rate for Payer: Qualcare PPO/HMO/WC	$378.70
Rate for Payer: UnitedHealthcare Commercial	$504.94
Rate for Payer: UnitedHealthcare Community & State	$60.85
Rate for Payer: Wellpoint Medicaid Managed Care	$66.90

LASER FIBR HOL MIC HF0600DSSMS

Facility

$2,524.70

Hospital Charge Code	270631935
Hospital Revenue Code	272
Min. Negotiated Rate	$378.70
Max. Negotiated Rate	$378.70
Rate for Payer: Qualcare PPO/HMO/WC	$378.70

LASER FIBR HOLM MC HFO200DSSMS

Facility

$1,000.00

Hospital Charge Code	270632539
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

LASER FIBR HOLM MC HFO200DSSMS

Facility

$1,000.00

Hospital Charge Code	270632539
Hospital Revenue Code	272
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

LASER GREENLIGHT RENTAL

Facility

$4,250.00

Hospital Charge Code	270645490
Hospital Revenue Code	272
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$637.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

LASER GREENLIGHT RENTAL

Facility

$4,250.00

Hospital Charge Code	270645490
Hospital Revenue Code	272
Min. Negotiated Rate	$102.42
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,275.00
Rate for Payer: Oxford Commercial	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Commercial	$850.00
Rate for Payer: UnitedHealthcare Community & State	$102.42
Rate for Payer: Wellpoint Medicaid Managed Care	$112.62

LASER PRO TOUCH

Facility

$4,750.00

Hospital Charge Code	270662160
Hospital Revenue Code	272
Min. Negotiated Rate	$114.47
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,425.00
Rate for Payer: Oxford Commercial	$950.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Commercial	$950.00
Rate for Payer: UnitedHealthcare Community & State	$114.47
Rate for Payer: Wellpoint Medicaid Managed Care	$125.88

LASER PRO TOUCH

Facility

$4,750.00

Hospital Charge Code	270662160
Hospital Revenue Code	272
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$712.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

LASER VAPOZATION OF PROSTATE

Facility

$39,246.20

Service Code	HCPCS 52648
Hospital Charge Code	16000649
Hospital Revenue Code	360
Min. Negotiated Rate	$5,886.93
Max. Negotiated Rate	$5,886.93
Rate for Payer: Qualcare PPO/HMO/WC	$5,886.93

LASER VAPOZATION OF PROSTATE

Facility

$39,246.20

Service Code	HCPCS 52648
Hospital Charge Code	16000649
Hospital Revenue Code	360
Min. Negotiated Rate	$945.83
Max. Negotiated Rate	$22,993.64
Rate for Payer: Aetna Commercial	$17,326.29
Rate for Payer: Aetna Medicare Advantage	$20,638.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,993.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,993.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,369.96
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	$22,993.64
Rate for Payer: Cigna Commercial	$12,768.54
Rate for Payer: Cigna Medicare Advantage	$6,369.96
Rate for Payer: Clover Medicare Advantage	$6,051.46
Rate for Payer: EmblemHealth Commercial	$19,109.88
Rate for Payer: Humana Medicare Advantage	$6,561.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,369.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,773.86
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,886.93
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$945.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,369.96
Rate for Payer: Wellcare Medicare Advantage	$6,369.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1,040.02

LASIX/40MG/TAB

Facility

$3.00

Hospital Charge Code	60633271
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

LASIX/40MG/TAB

Facility

$3.00

Hospital Charge Code	60633271
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

LASIX/80MG/BULK

Facility

$3.00

Hospital Charge Code	60634643
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

Know your out-of-pocket cost for care.

All Charges