Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ART BYP FEM-ANT-POST-TIB/PRL

Facility

$32,300.40

Service Code	HCPCS 35566
Hospital Charge Code	1600000873
Hospital Revenue Code	360
Min. Negotiated Rate	$778.44
Max. Negotiated Rate	$16,150.20
Rate for Payer: Aetna Commercial	$12,274.15
Rate for Payer: Aetna Medicare Advantage	$9,690.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,236.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,236.60
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	$8,236.60
Rate for Payer: Cigna Commercial	$16,150.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,690.12
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,845.06
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$778.44
Rate for Payer: Wellpoint Medicaid Managed Care	$855.96

ART BYP FEMORAL- FEMORAL

Facility

$8,481.00

Service Code	HCPCS 35661
Hospital Charge Code	1600000680
Hospital Revenue Code	360
Min. Negotiated Rate	$204.39
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$3,222.78
Rate for Payer: Aetna Medicare Advantage	$2,544.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,162.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,162.66
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	$2,162.66
Rate for Payer: Cigna Commercial	$4,240.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.30
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,272.15
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$204.39
Rate for Payer: Wellpoint Medicaid Managed Care	$224.75

ART BYP FEMORAL- FEMORAL

Facility

$8,481.00

Service Code	HCPCS 35661
Hospital Charge Code	1600000680
Hospital Revenue Code	360
Min. Negotiated Rate	$1,272.15
Max. Negotiated Rate	$1,272.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,272.15

ART BYP FEMORAL- POPLITEAL

Facility

$40,828.00

Service Code	HCPCS 35656
Hospital Charge Code	1600000371
Hospital Revenue Code	360
Min. Negotiated Rate	$6,124.20
Max. Negotiated Rate	$6,124.20
Rate for Payer: Qualcare PPO/HMO/WC	$6,124.20

ART BYP FEMORAL- POPLITEAL

Facility

$40,828.00

Service Code	HCPCS 35656
Hospital Charge Code	1600000371
Hospital Revenue Code	360
Min. Negotiated Rate	$983.95
Max. Negotiated Rate	$20,414.00
Rate for Payer: Aetna Commercial	$15,514.64
Rate for Payer: Aetna Medicare Advantage	$12,248.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,411.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,411.14
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	$10,411.14
Rate for Payer: Cigna Commercial	$20,414.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,248.40
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,124.20
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$983.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1,081.94

ART.COMP,OVOMOTION 46X42MM

Facility

$33,130.00

Service Code	HCPCS C1776
Hospital Charge Code	270687341
Hospital Revenue Code	278
Min. Negotiated Rate	$4,969.50
Max. Negotiated Rate	$8,017.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,626.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,017.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,288.60
Rate for Payer: Qualcare PPO/HMO/WC	$4,969.50

ART.COMP,OVOMOTION 46X42MM

Facility

$33,130.00

Service Code	HCPCS C1776
Hospital Charge Code	270687341
Hospital Revenue Code	278
Min. Negotiated Rate	$798.43
Max. Negotiated Rate	$16,565.00
Rate for Payer: Aetna Commercial	$12,589.40
Rate for Payer: Aetna Medicare Advantage	$9,939.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,448.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,448.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,448.15
Rate for Payer: Cigna Commercial	$16,565.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,017.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,288.60
Rate for Payer: Qualcare PPO/HMO/WC	$4,969.50
Rate for Payer: UnitedHealthcare Community & State	$798.43
Rate for Payer: Wellpoint Medicaid Managed Care	$877.95

ARTEGRAFT 6MM 34C M

Facility

$8,845.00

Service Code	HCPCS C1768
Hospital Charge Code	270686955
Hospital Revenue Code	278
Min. Negotiated Rate	$213.16
Max. Negotiated Rate	$4,422.50
Rate for Payer: Aetna Commercial	$3,361.10
Rate for Payer: Aetna Medicare Advantage	$2,653.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,255.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,255.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,769.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,255.47
Rate for Payer: Cigna Commercial	$4,422.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,140.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,945.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,326.75
Rate for Payer: UnitedHealthcare Community & State	$213.16
Rate for Payer: Wellpoint Medicaid Managed Care	$234.39

ARTEGRAFT 6MM 34C M

Facility

$8,845.00

Service Code	HCPCS C1768
Hospital Charge Code	270686955
Hospital Revenue Code	278
Min. Negotiated Rate	$1,326.75
Max. Negotiated Rate	$2,140.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,769.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,140.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,945.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,326.75

ARTEGRAFT 7MM 42CM

Facility

$6,095.00

Service Code	HCPCS C1768
Hospital Charge Code	270638164
Hospital Revenue Code	278
Min. Negotiated Rate	$914.25
Max. Negotiated Rate	$1,474.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,219.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,474.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,340.90
Rate for Payer: Qualcare PPO/HMO/WC	$914.25

ARTEGRAFT 7MM 42CM

Facility

$6,095.00

Service Code	HCPCS C1768
Hospital Charge Code	270638164
Hospital Revenue Code	278
Min. Negotiated Rate	$146.89
Max. Negotiated Rate	$3,047.50
Rate for Payer: Aetna Commercial	$2,316.10
Rate for Payer: Aetna Medicare Advantage	$1,828.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,554.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,554.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,219.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,554.22
Rate for Payer: Cigna Commercial	$3,047.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,474.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,340.90
Rate for Payer: Qualcare PPO/HMO/WC	$914.25
Rate for Payer: UnitedHealthcare Community & State	$146.89
Rate for Payer: Wellpoint Medicaid Managed Care	$161.52

ARTERIAL BLOOD GAS

Facility

$733.49

Service Code	HCPCS 82803
Hospital Charge Code	397361012
Hospital Revenue Code	300
Min. Negotiated Rate	$19.44
Max. Negotiated Rate	$366.75
Rate for Payer: Aetna Commercial	$70.91
Rate for Payer: Aetna Medicare Advantage	$84.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.10
Rate for Payer: Cigna Commercial	$366.75
Rate for Payer: Cigna Medicare Advantage	$26.07
Rate for Payer: Clover Medicare Advantage	$24.77
Rate for Payer: EmblemHealth Commercial	$78.21
Rate for Payer: Humana Medicare Advantage	$26.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$110.02
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$20.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.07
Rate for Payer: Wellcare Medicare Advantage	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.44

ARTERIAL BLOOD GAS

Facility

$733.49

Service Code	HCPCS 82803
Hospital Charge Code	397361012
Hospital Revenue Code	300
Min. Negotiated Rate	$110.02
Max. Negotiated Rate	$110.02
Rate for Payer: Qualcare PPO/HMO/WC	$110.02

ARTERIAL BLOOD GAS

Professional

Both

$31.40

Service Code	HCPCS 36620
Hospital Charge Code	2500221
Hospital Revenue Code	981
Min. Negotiated Rate	$20.30
Max. Negotiated Rate	$95.96
Rate for Payer: Aetna Commercial	$49.59
Rate for Payer: Aetna Medicare Advantage	$49.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.62
Rate for Payer: Cigna Commercial	$95.96
Rate for Payer: Cigna Medicare Advantage	$95.96
Rate for Payer: Clover Medicare Advantage	$43.91
Rate for Payer: Fidelis All Plans	$20.30
Rate for Payer: Marpai Administrators LLC Commercial	$52.02
Rate for Payer: UnitedHealthcare Commercial	$44.15
Rate for Payer: UnitedHealthcare Community & State	$44.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.15
Rate for Payer: Wellpoint Medicaid Managed Care	$44.33

ARTERIAL BLOOD GASS pH LEVEL**

Facility

$48.00

Service Code	HCPCS 82800
Hospital Charge Code	9500638
Hospital Revenue Code	419
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$29.92
Rate for Payer: Aetna Medicare Advantage	$35.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.71
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: Cigna Medicare Advantage	$11.00
Rate for Payer: Clover Medicare Advantage	$10.45
Rate for Payer: EmblemHealth Commercial	$33.00
Rate for Payer: Humana Medicare Advantage	$11.33
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.40
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.00
Rate for Payer: Wellcare Medicare Advantage	$11.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

ARTERIAL BLOOD GASS pH LEVEL**

Facility

$48.00

Service Code	HCPCS 82800
Hospital Charge Code	9500638
Hospital Revenue Code	419
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

ARTERIAL CANNULATION SUPPORT

Facility

$27.00

Hospital Charge Code	270331605
Hospital Revenue Code	272
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$10.26
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.10
Rate for Payer: Oxford Commercial	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$5.40
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.72

ARTERIAL CANNULATION SUPPORT

Facility

$27.00

Hospital Charge Code	270331605
Hospital Revenue Code	272
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

ARTERIAL DOPPLER-LOWER LTD

Facility

$229.00

Service Code	HCPCS 93922
Hospital Charge Code	74117031
Hospital Revenue Code	921
Min. Negotiated Rate	$34.35
Max. Negotiated Rate	$34.35
Rate for Payer: Qualcare PPO/HMO/WC	$34.35

ARTERIAL DOPPLER-LOWER LTD

Facility

$229.00

Service Code	HCPCS 93922
Hospital Charge Code	74117031
Hospital Revenue Code	921
Min. Negotiated Rate	$5.52
Max. Negotiated Rate	$6,760.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.70
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.35
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$5.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$6.07

ARTERIAL DOPPLER-LOWER LTD

Facility

$17,200.00

Service Code	HCPCS 93922
Hospital Charge Code	74115031
Hospital Revenue Code	921
Min. Negotiated Rate	$150.16
Max. Negotiated Rate	$6,760.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,160.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$414.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$455.80

ARTERIAL DOPPLER-LOWER LTD

Facility

$229.00

Service Code	HCPCS 93922
Hospital Charge Code	74116031
Hospital Revenue Code	921
Min. Negotiated Rate	$34.35
Max. Negotiated Rate	$34.35
Rate for Payer: Qualcare PPO/HMO/WC	$34.35

ARTERIAL DOPPLER-LOWER LTD

Facility

$229.00

Service Code	HCPCS 93922
Hospital Charge Code	74116031
Hospital Revenue Code	921
Min. Negotiated Rate	$5.52
Max. Negotiated Rate	$6,760.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.70
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.35
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$5.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$6.07

ARTERIAL DOPPLER-LOWER LTD

Facility

$17,200.00

Service Code	HCPCS 93922
Hospital Charge Code	94053175
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

ARTERIAL DOPPLER-LOWER LTD

Facility

$17,200.00

Service Code	HCPCS 93922
Hospital Charge Code	74115031
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

Know your out-of-pocket cost for care.

All Charges