Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LEFT HEART CATH PERC RETRO

Facility

$25,737.16

Service Code	HCPCS 93452
Hospital Charge Code	366893452
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	74110021
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	74110021
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	5100193
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 LPS-FLEX SIZE D

Facility

$12,166.15

Hospital Charge Code	270657031
Hospital Revenue Code	278
Min. Negotiated Rate	$293.20
Max. Negotiated Rate	$6,083.07
Rate for Payer: Aetna Commercial	$4,623.14
Rate for Payer: Aetna Medicare Advantage	$3,649.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,102.37
Rate for Payer: Cigna Commercial	$6,083.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,676.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92
Rate for Payer: UnitedHealthcare Community & State	$293.20
Rate for Payer: Wellpoint Medicaid Managed Care	$322.40

LEFT LPS-FLEX SIZE D

Facility

$12,166.15

Hospital Charge Code	270657031
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.92
Max. Negotiated Rate	$2,944.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,676.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92

LEFT STANDARD VDR PLATE

Facility

$5,920.00

Hospital Charge Code	270665465
Hospital Revenue Code	278
Min. Negotiated Rate	$142.67
Max. Negotiated Rate	$2,960.00
Rate for Payer: Aetna Commercial	$2,249.60
Rate for Payer: Aetna Medicare Advantage	$1,776.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,509.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,509.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,184.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,509.60
Rate for Payer: Cigna Commercial	$2,960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,432.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,302.40
Rate for Payer: Qualcare PPO/HMO/WC	$888.00
Rate for Payer: UnitedHealthcare Community & State	$142.67
Rate for Payer: Wellpoint Medicaid Managed Care	$156.88

LEFT STANDARD VDR PLATE

Facility

$5,920.00

Hospital Charge Code	270665465
Hospital Revenue Code	278
Min. Negotiated Rate	$888.00
Max. Negotiated Rate	$1,432.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,184.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,432.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,302.40
Rate for Payer: Qualcare PPO/HMO/WC	$888.00

LEGATO PROBE MONO BALL TIP

Facility

$1,310.00

Hospital Charge Code	270694697
Hospital Revenue Code	272
Min. Negotiated Rate	$31.57
Max. Negotiated Rate	$655.00
Rate for Payer: Aetna Commercial	$497.80
Rate for Payer: Aetna Medicare Advantage	$393.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$334.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$334.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$334.05
Rate for Payer: Cigna Commercial	$655.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.00
Rate for Payer: Oxford Commercial	$262.00
Rate for Payer: Qualcare PPO/HMO/WC	$196.50
Rate for Payer: UnitedHealthcare Commercial	$262.00
Rate for Payer: UnitedHealthcare Community & State	$31.57
Rate for Payer: Wellpoint Medicaid Managed Care	$34.72

LEGATO PROBE MONO BALL TIP

Facility

$1,310.00

Hospital Charge Code	270694697
Hospital Revenue Code	272
Min. Negotiated Rate	$196.50
Max. Negotiated Rate	$196.50
Rate for Payer: Qualcare PPO/HMO/WC	$196.50

LEG CUFF SET

Facility

$1,499.70

Hospital Charge Code	270656306
Hospital Revenue Code	272
Min. Negotiated Rate	$36.14
Max. Negotiated Rate	$749.85
Rate for Payer: Aetna Commercial	$569.89
Rate for Payer: Aetna Medicare Advantage	$449.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.42
Rate for Payer: Cigna Commercial	$749.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$449.91
Rate for Payer: Oxford Commercial	$299.94
Rate for Payer: Qualcare PPO/HMO/WC	$224.96
Rate for Payer: UnitedHealthcare Commercial	$299.94
Rate for Payer: UnitedHealthcare Community & State	$36.14
Rate for Payer: Wellpoint Medicaid Managed Care	$39.74

LEG CUFF SET

Facility

$1,499.70

Hospital Charge Code	270656306
Hospital Revenue Code	272
Min. Negotiated Rate	$224.96
Max. Negotiated Rate	$224.96
Rate for Payer: Qualcare PPO/HMO/WC	$224.96

LEGEND 14CM, 5MM BALL DIAMO

Facility

$878.85

Hospital Charge Code	270658945
Hospital Revenue Code	272
Min. Negotiated Rate	$21.18
Max. Negotiated Rate	$439.43
Rate for Payer: Aetna Commercial	$333.96
Rate for Payer: Aetna Medicare Advantage	$263.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.11
Rate for Payer: Cigna Commercial	$439.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$263.65
Rate for Payer: Oxford Commercial	$175.77
Rate for Payer: Qualcare PPO/HMO/WC	$131.83
Rate for Payer: UnitedHealthcare Commercial	$175.77
Rate for Payer: UnitedHealthcare Community & State	$21.18
Rate for Payer: Wellpoint Medicaid Managed Care	$23.29

LEGEND 14CM, 5MM BALL DIAMO

Facility

$878.85

Hospital Charge Code	270658945
Hospital Revenue Code	272
Min. Negotiated Rate	$131.83
Max. Negotiated Rate	$131.83
Rate for Payer: Qualcare PPO/HMO/WC	$131.83

LEGGINGS DISP 89408

Facility

$22.45

Hospital Charge Code	270600163
Hospital Revenue Code	270
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$8.53
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.74
Rate for Payer: Oxford Commercial	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$4.49
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

LEGGINGS DISP 89408

Facility

$22.45

Hospital Charge Code	270600163
Hospital Revenue Code	270
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

LEGIONELLA AB

Facility

$168.00

Service Code	HCPCS 86713
Hospital Charge Code	38476020
Hospital Revenue Code	302
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$41.62
Rate for Payer: Aetna Medicare Advantage	$49.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.23
Rate for Payer: Cigna Commercial	$84.00
Rate for Payer: Cigna Medicare Advantage	$15.30
Rate for Payer: Clover Medicare Advantage	$14.54
Rate for Payer: EmblemHealth Commercial	$45.90
Rate for Payer: Humana Medicare Advantage	$15.76
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.30
Rate for Payer: Wellcare Medicare Advantage	$15.30
Rate for Payer: Wellpoint Medicaid Managed Care	$4.45

LEGIONELLA AB

Facility

$168.00

Service Code	HCPCS 86713
Hospital Charge Code	38476020
Hospital Revenue Code	302
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$25.20
Rate for Payer: Qualcare PPO/HMO/WC	$25.20

LEGIONELLA AB PANEL IFA, I

Facility

$390.00

Service Code	HCPCS 8671391
Hospital Charge Code	39990045A
Hospital Revenue Code	302
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

LEGIONELLA AB PANEL IFA, I

Facility

$390.00

Service Code	HCPCS 8671391
Hospital Charge Code	39990045A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LEGIONELLA AB PANEL IFA, II

Facility

$390.00

Service Code	HCPCS 8671391
Hospital Charge Code	39990045B
Hospital Revenue Code	302
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

LEGIONELLA AB PANEL IFA, II

Facility

$390.00

Service Code	HCPCS 8671391
Hospital Charge Code	39990045B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LEGIONELLA AG DETECT DFA STOOL

Facility

$390.00

Service Code	HCPCS 87278
Hospital Charge Code	397071539
Hospital Revenue Code	306
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$42.43
Rate for Payer: Aetna Medicare Advantage	$50.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.31
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$15.60
Rate for Payer: Clover Medicare Advantage	$14.82
Rate for Payer: EmblemHealth Commercial	$46.80
Rate for Payer: Humana Medicare Advantage	$16.07
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.60
Rate for Payer: Wellcare Medicare Advantage	$15.60
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

LEGIONELLA AG DETECT DFA STOOL

Facility

$390.00

Service Code	HCPCS 87278
Hospital Charge Code	401387278
Hospital Revenue Code	306
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$42.43
Rate for Payer: Aetna Medicare Advantage	$50.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.31
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$15.60
Rate for Payer: Clover Medicare Advantage	$14.82
Rate for Payer: EmblemHealth Commercial	$46.80
Rate for Payer: Humana Medicare Advantage	$16.07
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.60
Rate for Payer: Wellcare Medicare Advantage	$15.60
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

LEGIONELLA AG DETECT DFA STOOL

Facility

$390.00

Service Code	HCPCS 87278
Hospital Charge Code	397071539
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges