Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LEAD WIRE PACEMAKER

Facility

$3,080.00

Hospital Charge Code	270657307
Hospital Revenue Code	278
Min. Negotiated Rate	$74.23
Max. Negotiated Rate	$1,540.00
Rate for Payer: Aetna Commercial	$1,170.40
Rate for Payer: Aetna Medicare Advantage	$924.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$785.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$785.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$616.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$785.40
Rate for Payer: Cigna Commercial	$1,540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$745.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$677.60
Rate for Payer: Qualcare PPO/HMO/WC	$462.00
Rate for Payer: UnitedHealthcare Community & State	$74.23
Rate for Payer: Wellpoint Medicaid Managed Care	$81.62

LEAD WIRE PACEMAKER

Facility

$3,080.00

Hospital Charge Code	270657307
Hospital Revenue Code	278
Min. Negotiated Rate	$462.00
Max. Negotiated Rate	$745.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$616.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$745.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$677.60
Rate for Payer: Qualcare PPO/HMO/WC	$462.00

LEAVE OF ABSENCE

Facility

$0.01

Hospital Charge Code	10008
Hospital Revenue Code	180
Max. Negotiated Rate	$6,764.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,764.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

LECITHIN/SPHINGO RATIO,AMN FLD

Facility

$137.50

Service Code	HCPCS 84081
Hospital Charge Code	3002310B
Hospital Revenue Code	301
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$44.93
Rate for Payer: Aetna Medicare Advantage	$53.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.63
Rate for Payer: Cigna Commercial	$68.75
Rate for Payer: Cigna Medicare Advantage	$16.52
Rate for Payer: Clover Medicare Advantage	$15.69
Rate for Payer: EmblemHealth Commercial	$49.56
Rate for Payer: Humana Medicare Advantage	$17.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.62
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.52
Rate for Payer: Wellcare Medicare Advantage	$16.52
Rate for Payer: Wellpoint Medicaid Managed Care	$3.64

LECITHIN/SPHINGO RATIO,AMN FLD

Facility

$137.50

Service Code	HCPCS 84081
Hospital Charge Code	3002310B
Hospital Revenue Code	301
Min. Negotiated Rate	$20.62
Max. Negotiated Rate	$20.62
Rate for Payer: Qualcare PPO/HMO/WC	$20.62

LECITHIN/SPHINGO RATIO,AMN FLD

Facility

$228.75

Service Code	HCPCS 83661
Hospital Charge Code	3002310A
Hospital Revenue Code	301
Min. Negotiated Rate	$6.06
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$59.81
Rate for Payer: Aetna Medicare Advantage	$71.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.38
Rate for Payer: Cigna Commercial	$114.38
Rate for Payer: Cigna Medicare Advantage	$21.99
Rate for Payer: Clover Medicare Advantage	$20.89
Rate for Payer: EmblemHealth Commercial	$65.97
Rate for Payer: Humana Medicare Advantage	$22.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.31
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$17.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.99
Rate for Payer: Wellcare Medicare Advantage	$21.99
Rate for Payer: Wellpoint Medicaid Managed Care	$6.06

LECITHIN/SPHINGO RATIO,AMN FLD

Facility

$228.75

Service Code	HCPCS 83661
Hospital Charge Code	3002310A
Hospital Revenue Code	301
Min. Negotiated Rate	$34.31
Max. Negotiated Rate	$34.31
Rate for Payer: Qualcare PPO/HMO/WC	$34.31

LECT STIM-UNATTENDED NOT WC

Facility

$206.00

Service Code	HCPCS 97014GO
Hospital Charge Code	74203027
Hospital Revenue Code	430
Min. Negotiated Rate	$30.90
Max. Negotiated Rate	$30.90
Rate for Payer: Qualcare PPO/HMO/WC	$30.90

LECT STIM-UNATTENDED NOT WC

Facility

$206.00

Service Code	HCPCS 97014GO
Hospital Charge Code	74203027
Hospital Revenue Code	430
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$78.28
Rate for Payer: Aetna Medicare Advantage	$61.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.53
Rate for Payer: Cigna Commercial	$103.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.80
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$4.96
Rate for Payer: Wellpoint Medicaid Managed Care	$5.46

LED BULD LARYNGOSCOPE LAMP

Facility

$62.50

Hospital Charge Code	270664904
Hospital Revenue Code	270
Min. Negotiated Rate	$9.38
Max. Negotiated Rate	$9.38
Rate for Payer: Qualcare PPO/HMO/WC	$9.38

LED BULD LARYNGOSCOPE LAMP

Facility

$62.50

Hospital Charge Code	270664904
Hospital Revenue Code	270
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$31.25
Rate for Payer: Aetna Commercial	$23.75
Rate for Payer: Aetna Medicare Advantage	$18.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.94
Rate for Payer: Cigna Commercial	$31.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.75
Rate for Payer: Oxford Commercial	$12.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.38
Rate for Payer: UnitedHealthcare Commercial	$12.50
Rate for Payer: UnitedHealthcare Community & State	$1.51
Rate for Payer: Wellpoint Medicaid Managed Care	$1.66

LEDERCILLIN VK/250MG/TAB

Facility

$4.00

Hospital Charge Code	60633273
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

LEDERCILLIN VK/250MG/TAB

Facility

$4.00

Hospital Charge Code	60633273
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

LEDERCILLIN VK/500MG/TAB

Facility

$3.00

Hospital Charge Code	60633274
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

LEDERCILLIN VK/500MG/TAB

Facility

$3.00

Hospital Charge Code	60633274
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

LEFT FIBULA PLATE

Facility

$17,952.90

Service Code	HCPCS C1713
Hospital Charge Code	270704756
Hospital Revenue Code	278
Min. Negotiated Rate	$2,692.93
Max. Negotiated Rate	$4,344.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,590.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,344.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,949.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,692.93

LEFT FIBULA PLATE

Facility

$17,952.90

Service Code	HCPCS C1713
Hospital Charge Code	270704756
Hospital Revenue Code	278
Min. Negotiated Rate	$432.66
Max. Negotiated Rate	$8,976.45
Rate for Payer: Aetna Commercial	$6,822.10
Rate for Payer: Aetna Medicare Advantage	$5,385.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,577.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,577.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,590.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,577.99
Rate for Payer: Cigna Commercial	$8,976.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,344.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,949.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,692.93
Rate for Payer: UnitedHealthcare Community & State	$432.66
Rate for Payer: Wellpoint Medicaid Managed Care	$475.75

LEFT HEART CATH

Facility

$25,737.16

Service Code	HCPCS 93458
Hospital Charge Code	366893458
Hospital Revenue Code	481
Min. Negotiated Rate	$620.27
Max. Negotiated Rate	$13,902.76
Rate for Payer: Aetna Commercial	$10,476.08
Rate for Payer: Aetna Medicare Advantage	$12,478.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,851.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,902.76
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: Cigna Medicare Advantage	$3,851.50
Rate for Payer: Clover Medicare Advantage	$3,658.93
Rate for Payer: EmblemHealth Commercial	$11,554.50
Rate for Payer: Humana Medicare Advantage	$3,967.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,851.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,721.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$620.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,851.50
Rate for Payer: Wellcare Medicare Advantage	$3,851.50
Rate for Payer: Wellpoint Medicaid Managed Care	$682.03

LEFT HEART CATH

Facility

$25,737.16

Service Code	HCPCS 93458
Hospital Charge Code	366893458
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

LEFT HEART CATH

Facility

$25,737.16

Service Code	HCPCS 93458
Hospital Charge Code	7411235
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

LEFT HEART CATH

Facility

$25,737.16

Service Code	HCPCS 93458
Hospital Charge Code	7411235
Hospital Revenue Code	481
Min. Negotiated Rate	$620.27
Max. Negotiated Rate	$13,902.76
Rate for Payer: Aetna Commercial	$10,476.08
Rate for Payer: Aetna Medicare Advantage	$12,478.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,851.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,902.76
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: Cigna Medicare Advantage	$3,851.50
Rate for Payer: Clover Medicare Advantage	$3,658.93
Rate for Payer: EmblemHealth Commercial	$11,554.50
Rate for Payer: Humana Medicare Advantage	$3,967.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,851.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,721.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$620.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,851.50
Rate for Payer: Wellcare Medicare Advantage	$3,851.50
Rate for Payer: Wellpoint Medicaid Managed Care	$682.03

LEFT HEART CATH ABORT

Facility

$25,737.16

Service Code	HCPCS 93458
Hospital Charge Code	7411237
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

LEFT HEART CATH ABORT

Facility

$25,737.16

Service Code	HCPCS 93458
Hospital Charge Code	7411237
Hospital Revenue Code	481
Min. Negotiated Rate	$620.27
Max. Negotiated Rate	$13,902.76
Rate for Payer: Aetna Commercial	$10,476.08
Rate for Payer: Aetna Medicare Advantage	$12,478.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,851.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,902.76
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: Cigna Medicare Advantage	$3,851.50
Rate for Payer: Clover Medicare Advantage	$3,658.93
Rate for Payer: EmblemHealth Commercial	$11,554.50
Rate for Payer: Humana Medicare Advantage	$3,967.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,851.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,721.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$620.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,851.50
Rate for Payer: Wellcare Medicare Advantage	$3,851.50
Rate for Payer: Wellpoint Medicaid Managed Care	$682.03

LEFT HEART CATH PERC RETRO

Facility

$25,737.16

Service Code	HCPCS 93452
Hospital Charge Code	5100193
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

LEFT HEART CATH PERC RETRO

Facility

$25,737.16

Service Code	HCPCS 93452
Hospital Charge Code	366893452
Hospital Revenue Code	481
Min. Negotiated Rate	$620.27
Max. Negotiated Rate	$13,902.76
Rate for Payer: Aetna Commercial	$10,476.08
Rate for Payer: Aetna Medicare Advantage	$12,478.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,851.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,902.76
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: Cigna Medicare Advantage	$3,851.50
Rate for Payer: Clover Medicare Advantage	$3,658.93
Rate for Payer: EmblemHealth Commercial	$11,554.50
Rate for Payer: Humana Medicare Advantage	$3,967.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,851.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,721.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$620.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,851.50
Rate for Payer: Wellcare Medicare Advantage	$3,851.50
Rate for Payer: Wellpoint Medicaid Managed Care	$682.03

Know your out-of-pocket cost for care.

All Charges