Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LIGATION ARTIERIES AND VEIN

Facility

$19,137.00

Service Code	HCPCS 37600
Hospital Charge Code	160003431
Hospital Revenue Code	450
Min. Negotiated Rate	$2,870.55
Max. Negotiated Rate	$2,870.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,870.55

LIGATION / BIOPSY TEMPORAL ART

Facility

$16,853.95

Service Code	HCPCS 37609
Hospital Charge Code	16000343
Hospital Revenue Code	360
Min. Negotiated Rate	$2,528.09
Max. Negotiated Rate	$2,528.09
Rate for Payer: Qualcare PPO/HMO/WC	$2,528.09

LIGATION / BIOPSY TEMPORAL ART

Facility

$16,853.95

Service Code	HCPCS 37609
Hospital Charge Code	16000343
Hospital Revenue Code	360
Min. Negotiated Rate	$406.18
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,056.19
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,528.09
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$406.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$446.63

LIGATION MAJOR ARTERY; EXTREMI

Facility

$7,452.59

Service Code	HCPCS 37618
Hospital Charge Code	16000955
Hospital Revenue Code	360
Min. Negotiated Rate	$1,117.89
Max. Negotiated Rate	$1,117.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,117.89

LIGATION MAJOR ARTERY; EXTREMI

Facility

$7,452.59

Service Code	HCPCS 37618
Hospital Charge Code	16000955
Hospital Revenue Code	360
Min. Negotiated Rate	$179.61
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$2,831.98
Rate for Payer: Aetna Medicare Advantage	$2,235.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,900.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,900.41
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	$1,900.41
Rate for Payer: Cigna Commercial	$3,726.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,235.78
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,117.89
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$179.61
Rate for Payer: Wellpoint Medicaid Managed Care	$197.49

LIGATION MAJOR ARTERY; EXTREMI

Facility

$7,452.59

Service Code	HCPCS 37618
Hospital Charge Code	5792298
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$3,726.30
Rate for Payer: Aetna Commercial	$2,831.98
Rate for Payer: Aetna Medicare Advantage	$2,235.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,900.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,900.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$396.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,900.41
Rate for Payer: Cigna Commercial	$3,726.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,235.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,117.89
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$197.49

LIGATION MAJOR ARTERY; EXTREMI

Facility

$7,452.59

Service Code	HCPCS 37618
Hospital Charge Code	5792298
Hospital Revenue Code	450
Min. Negotiated Rate	$1,117.89
Max. Negotiated Rate	$1,117.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,117.89

LIGATION MAJOR ARTERY NECK

Facility

$17,869.95

Service Code	HCPCS 37615
Hospital Charge Code	323037615
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$396.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,360.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,680.49
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$473.55

LIGATION MAJOR ARTERY NECK

Facility

$17,869.95

Service Code	HCPCS 37615
Hospital Charge Code	323037615
Hospital Revenue Code	450
Min. Negotiated Rate	$2,680.49
Max. Negotiated Rate	$2,680.49
Rate for Payer: Qualcare PPO/HMO/WC	$2,680.49

LIGATION OF HEMORRHOID(S)

Facility

$5,616.30

Service Code	HCPCS 46221
Hospital Charge Code	1600000281
Hospital Revenue Code	360
Min. Negotiated Rate	$842.45
Max. Negotiated Rate	$842.45
Rate for Payer: Qualcare PPO/HMO/WC	$842.45

LIGATION OF HEMORRHOID(S)

Facility

$5,616.30

Service Code	HCPCS 46221
Hospital Charge Code	1600000281
Hospital Revenue Code	360
Min. Negotiated Rate	$135.35
Max. Negotiated Rate	$3,988.03
Rate for Payer: Aetna Commercial	$3,005.08
Rate for Payer: Aetna Medicare Advantage	$3,579.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,988.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,988.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,104.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,988.03
Rate for Payer: Cigna Commercial	$2,214.60
Rate for Payer: Cigna Medicare Advantage	$1,104.81
Rate for Payer: Clover Medicare Advantage	$1,049.57
Rate for Payer: EmblemHealth Commercial	$3,314.43
Rate for Payer: Humana Medicare Advantage	$1,137.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,104.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,684.89
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$842.45
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$135.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,104.81
Rate for Payer: Wellcare Medicare Advantage	$1,104.81
Rate for Payer: Wellpoint Medicaid Managed Care	$148.83

LIGATOR BAND SUPERVIEW SUPE

Facility

$731.39

Hospital Charge Code	270631111
Hospital Revenue Code	272
Min. Negotiated Rate	$109.71
Max. Negotiated Rate	$109.71
Rate for Payer: Qualcare PPO/HMO/WC	$109.71

LIGATOR BAND SUPERVIEW SUPE

Facility

$731.39

Hospital Charge Code	270631111
Hospital Revenue Code	272
Min. Negotiated Rate	$17.63
Max. Negotiated Rate	$365.69
Rate for Payer: Aetna Commercial	$277.93
Rate for Payer: Aetna Medicare Advantage	$219.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.50
Rate for Payer: Cigna Commercial	$365.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.42
Rate for Payer: Oxford Commercial	$146.28
Rate for Payer: Qualcare PPO/HMO/WC	$109.71
Rate for Payer: UnitedHealthcare Commercial	$146.28
Rate for Payer: UnitedHealthcare Community & State	$17.63
Rate for Payer: Wellpoint Medicaid Managed Care	$19.38

LIGATOR BAND SUPERVIW 7 422540

Facility

$731.39

Hospital Charge Code	270633712
Hospital Revenue Code	272
Min. Negotiated Rate	$17.63
Max. Negotiated Rate	$365.69
Rate for Payer: Aetna Commercial	$277.93
Rate for Payer: Aetna Medicare Advantage	$219.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.50
Rate for Payer: Cigna Commercial	$365.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.42
Rate for Payer: Oxford Commercial	$146.28
Rate for Payer: Qualcare PPO/HMO/WC	$109.71
Rate for Payer: UnitedHealthcare Commercial	$146.28
Rate for Payer: UnitedHealthcare Community & State	$17.63
Rate for Payer: Wellpoint Medicaid Managed Care	$19.38

LIGATOR BAND SUPERVIW 7 422540

Facility

$731.39

Hospital Charge Code	270633712
Hospital Revenue Code	272
Min. Negotiated Rate	$109.71
Max. Negotiated Rate	$109.71
Rate for Payer: Qualcare PPO/HMO/WC	$109.71

LIGATOR MCV SPEEDBAND 4225

Facility

$2,222.45

Hospital Charge Code	270611764
Hospital Revenue Code	272
Min. Negotiated Rate	$333.37
Max. Negotiated Rate	$333.37
Rate for Payer: Qualcare PPO/HMO/WC	$333.37

LIGATOR MCV SPEEDBAND 4225

Facility

$2,222.45

Hospital Charge Code	270611764
Hospital Revenue Code	272
Min. Negotiated Rate	$53.56
Max. Negotiated Rate	$1,111.22
Rate for Payer: Aetna Commercial	$844.53
Rate for Payer: Aetna Medicare Advantage	$666.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$566.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$566.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$566.72
Rate for Payer: Cigna Commercial	$1,111.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$666.74
Rate for Payer: Oxford Commercial	$444.49
Rate for Payer: Qualcare PPO/HMO/WC	$333.37
Rate for Payer: UnitedHealthcare Commercial	$444.49
Rate for Payer: UnitedHealthcare Community & State	$53.56
Rate for Payer: Wellpoint Medicaid Managed Care	$58.89

LIGATOR WV MULTIBAND MBL-6-0V

Facility

$693.65

Hospital Charge Code	270623620
Hospital Revenue Code	272
Min. Negotiated Rate	$16.72
Max. Negotiated Rate	$346.82
Rate for Payer: Aetna Commercial	$263.59
Rate for Payer: Aetna Medicare Advantage	$208.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.88
Rate for Payer: Cigna Commercial	$346.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.09
Rate for Payer: Oxford Commercial	$138.73
Rate for Payer: Qualcare PPO/HMO/WC	$104.05
Rate for Payer: UnitedHealthcare Commercial	$138.73
Rate for Payer: UnitedHealthcare Community & State	$16.72
Rate for Payer: Wellpoint Medicaid Managed Care	$18.38

LIGATOR WV MULTIBAND MBL-6-0V

Facility

$693.65

Hospital Charge Code	270623620
Hospital Revenue Code	272
Min. Negotiated Rate	$104.05
Max. Negotiated Rate	$104.05
Rate for Payer: Qualcare PPO/HMO/WC	$104.05

LIGHT CLIP STERILE

Facility

$1,550.00

Hospital Charge Code	270656685
Hospital Revenue Code	272
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$232.50
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

LIGHT CLIP STERILE

Facility

$1,550.00

Hospital Charge Code	270656685
Hospital Revenue Code	272
Min. Negotiated Rate	$37.35
Max. Negotiated Rate	$775.00
Rate for Payer: Aetna Commercial	$589.00
Rate for Payer: Aetna Medicare Advantage	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.25
Rate for Payer: Cigna Commercial	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$465.00
Rate for Payer: Oxford Commercial	$310.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.50
Rate for Payer: UnitedHealthcare Commercial	$310.00
Rate for Payer: UnitedHealthcare Community & State	$37.35
Rate for Payer: Wellpoint Medicaid Managed Care	$41.08

LIGHT CORD.

Facility

$1,861.40

Hospital Charge Code	270656371
Hospital Revenue Code	272
Min. Negotiated Rate	$44.86
Max. Negotiated Rate	$930.70
Rate for Payer: Aetna Commercial	$707.33
Rate for Payer: Aetna Medicare Advantage	$558.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$474.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$474.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$474.66
Rate for Payer: Cigna Commercial	$930.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$558.42
Rate for Payer: Oxford Commercial	$372.28
Rate for Payer: Qualcare PPO/HMO/WC	$279.21
Rate for Payer: UnitedHealthcare Commercial	$372.28
Rate for Payer: UnitedHealthcare Community & State	$44.86
Rate for Payer: Wellpoint Medicaid Managed Care	$49.33

LIGHT CORD.

Facility

$1,861.40

Hospital Charge Code	270656371
Hospital Revenue Code	272
Min. Negotiated Rate	$279.21
Max. Negotiated Rate	$279.21
Rate for Payer: Qualcare PPO/HMO/WC	$279.21

LIGHTENING BOLT 6XTX ASP CATH

Facility

$38,600.00

Hospital Charge Code	270703465
Hospital Revenue Code	272
Min. Negotiated Rate	$5,790.00
Max. Negotiated Rate	$5,790.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,790.00

LIGHTENING BOLT 6XTX ASP CATH

Facility

$38,600.00

Hospital Charge Code	270703465
Hospital Revenue Code	272
Min. Negotiated Rate	$930.26
Max. Negotiated Rate	$19,300.00
Rate for Payer: Aetna Commercial	$14,668.00
Rate for Payer: Aetna Medicare Advantage	$11,580.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,843.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,843.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,843.00
Rate for Payer: Cigna Commercial	$19,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,580.00
Rate for Payer: Oxford Commercial	$7,720.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,790.00
Rate for Payer: UnitedHealthcare Commercial	$7,720.00
Rate for Payer: UnitedHealthcare Community & State	$930.26
Rate for Payer: Wellpoint Medicaid Managed Care	$1,022.90

Know your out-of-pocket cost for care.

All Charges