Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MAS PLIF FIXATION ROD, 40MM

Facility

$2,980.00

Hospital Charge Code	270667571
Hospital Revenue Code	278
Min. Negotiated Rate	$71.82
Max. Negotiated Rate	$1,490.00
Rate for Payer: Aetna Commercial	$1,132.40
Rate for Payer: Aetna Medicare Advantage	$894.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$759.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$759.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$596.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$759.90
Rate for Payer: Cigna Commercial	$1,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$721.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$655.60
Rate for Payer: Qualcare PPO/HMO/WC	$447.00
Rate for Payer: UnitedHealthcare Community & State	$71.82
Rate for Payer: Wellpoint Medicaid Managed Care	$78.97

MAS PLIF MODULE

Facility

$15,495.00

Service Code	HCPCS C1713
Hospital Charge Code	270667569
Hospital Revenue Code	278
Min. Negotiated Rate	$2,324.25
Max. Negotiated Rate	$3,749.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,099.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,749.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,408.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,324.25

MAS PLIF MODULE

Facility

$15,495.00

Service Code	HCPCS C1713
Hospital Charge Code	270667569
Hospital Revenue Code	278
Min. Negotiated Rate	$373.43
Max. Negotiated Rate	$7,747.50
Rate for Payer: Aetna Commercial	$5,888.10
Rate for Payer: Aetna Medicare Advantage	$4,648.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,951.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,951.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,099.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,951.22
Rate for Payer: Cigna Commercial	$7,747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,749.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,408.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,324.25
Rate for Payer: UnitedHealthcare Community & State	$373.43
Rate for Payer: Wellpoint Medicaid Managed Care	$410.62

MASSAGE 10 MIN

Facility

$328.00

Service Code	HCPCS 97124
Hospital Charge Code	409297124
Hospital Revenue Code	420
Min. Negotiated Rate	$7.90
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$124.64
Rate for Payer: Aetna Medicare Advantage	$98.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.64
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	$83.64
Rate for Payer: Cigna Commercial	$164.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.40
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.20
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$7.90
Rate for Payer: Wellpoint Medicaid Managed Care	$8.69

MASSAGE 10 MIN

Facility

$328.00

Service Code	HCPCS 97124
Hospital Charge Code	409297124
Hospital Revenue Code	420
Min. Negotiated Rate	$49.20
Max. Negotiated Rate	$49.20
Rate for Payer: Qualcare PPO/HMO/WC	$49.20

MASSAGE EA 15 MIN CQ

Facility

$116.85

Service Code	HCPCS 97124GP
Hospital Charge Code	409197124Q
Hospital Revenue Code	420
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$17.53
Rate for Payer: Qualcare PPO/HMO/WC	$17.53

MASSAGE EA 15 MIN CQ

Facility

$116.85

Service Code	HCPCS 97124GP
Hospital Charge Code	409197124Q
Hospital Revenue Code	420
Min. Negotiated Rate	$2.82
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$44.40
Rate for Payer: Aetna Medicare Advantage	$35.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.80
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	$29.80
Rate for Payer: Cigna Commercial	$58.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.05
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.53
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.82
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

MASSE BREAST CREAM/60GM

Facility

$28.00

Hospital Charge Code	60633355
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

MASSE BREAST CREAM/60GM

Facility

$28.00

Hospital Charge Code	60633355
Hospital Revenue Code	250
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$10.64
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.40
Rate for Payer: Oxford Commercial	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

MASSON TRICHROME STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005332
Hospital Revenue Code	310
Min. Negotiated Rate	$17.81
Max. Negotiated Rate	$570.55
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) 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	$201.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.80
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$68.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$17.81

MASSON TRICHROME STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005332
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

MASTECTOMY FOR MALIGNANCY WITH CC/MCC

Facility

$64,404.94

Service Code	MSDRG 582
Min. Negotiated Rate	$19,610.48
Max. Negotiated Rate	$64,404.94
Rate for Payer: Aetna Commercial	$44,510.86
Rate for Payer: Aetna Medicare Advantage	$64,404.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40,474.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40,474.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,642.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40,474.14
Rate for Payer: Cigna Commercial	$36,054.39
Rate for Payer: Cigna Medicare Advantage	$20,642.61
Rate for Payer: Clover Medicare Advantage	$19,610.48
Rate for Payer: EmblemHealth Commercial	$61,927.83
Rate for Payer: Humana Medicare Advantage	$21,261.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,642.61
Rate for Payer: Oxford Commercial	$25,912.77
Rate for Payer: UnitedHealthcare Commercial	$45,438.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,642.61
Rate for Payer: Wellcare Medicare Advantage	$20,642.61

MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC

Facility

$57,869.57

Service Code	MSDRG 583
Min. Negotiated Rate	$17,620.54
Max. Negotiated Rate	$57,869.57
Rate for Payer: Aetna Commercial	$40,020.35
Rate for Payer: Aetna Medicare Advantage	$57,869.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,356.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,356.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,547.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,356.72
Rate for Payer: Cigna Commercial	$32,270.42
Rate for Payer: Cigna Medicare Advantage	$18,547.94
Rate for Payer: Clover Medicare Advantage	$17,620.54
Rate for Payer: EmblemHealth Commercial	$55,643.82
Rate for Payer: Humana Medicare Advantage	$19,104.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,547.94
Rate for Payer: Oxford Commercial	$23,193.18
Rate for Payer: UnitedHealthcare Commercial	$40,669.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,547.94
Rate for Payer: Wellcare Medicare Advantage	$18,547.94

MASTECTOMY PROCEDURES

Facility

$26,995.99

Service Code	APR-DRG 3623
Min. Negotiated Rate	$26,466.66
Max. Negotiated Rate	$26,995.99
Rate for Payer: UnitedHealthcare Community & State	$26,466.66
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,995.99
Rate for Payer: Wellpoint Medicaid Managed Care	$26,466.66

MASTECTOMY PROCEDURES

Facility

$23,939.55

Service Code	APR-DRG 3622
Min. Negotiated Rate	$23,470.15
Max. Negotiated Rate	$23,939.55
Rate for Payer: UnitedHealthcare Community & State	$23,470.15
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,939.55
Rate for Payer: Wellpoint Medicaid Managed Care	$23,470.15

MASTECTOMY PROCEDURES

Facility

$44,351.62

Service Code	APR-DRG 3624
Min. Negotiated Rate	$43,481.98
Max. Negotiated Rate	$44,351.62
Rate for Payer: UnitedHealthcare Community & State	$43,481.98
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$44,351.62
Rate for Payer: Wellpoint Medicaid Managed Care	$43,481.98

MASTECTOMY PROCEDURES

Facility

$15,771.19

Service Code	APR-DRG 3621
Min. Negotiated Rate	$15,461.95
Max. Negotiated Rate	$15,771.19
Rate for Payer: UnitedHealthcare Community & State	$15,461.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,771.19
Rate for Payer: Wellpoint Medicaid Managed Care	$15,461.95

MA STEREOTACTIC LOC BILAT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700013
Hospital Revenue Code	361
Min. Negotiated Rate	$45.13
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	$1,626.00
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	$561.75
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$280.88
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$45.13
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	$49.62

MA STEREOTACTIC LOC BILAT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700013
Hospital Revenue Code	361
Min. Negotiated Rate	$280.88
Max. Negotiated Rate	$280.88
Rate for Payer: Qualcare PPO/HMO/WC	$280.88

MA STEREOTACTIC LOC LEFT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700014
Hospital Revenue Code	361
Min. Negotiated Rate	$280.88
Max. Negotiated Rate	$280.88
Rate for Payer: Qualcare PPO/HMO/WC	$280.88

MA STEREOTACTIC LOC LEFT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700014
Hospital Revenue Code	361
Min. Negotiated Rate	$45.13
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	$1,626.00
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	$561.75
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$280.88
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$45.13
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	$49.62

MA STEREOTACTIC LOC RIGHT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700015
Hospital Revenue Code	361
Min. Negotiated Rate	$45.13
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	$1,626.00
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	$561.75
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$280.88
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$45.13
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	$49.62

MA STEREOTACTIC LOC RIGHT

Facility

$1,872.50

Service Code	HCPCS 19083
Hospital Charge Code	2700015
Hospital Revenue Code	361
Min. Negotiated Rate	$280.88
Max. Negotiated Rate	$280.88
Rate for Payer: Qualcare PPO/HMO/WC	$280.88

MASTIC SOL 0.666ML

Facility

$3.85

Hospital Charge Code	60628642
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

MASTIC SOL 0.666ML

Facility

$3.85

Hospital Charge Code	60628642
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.46
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.16
Rate for Payer: Oxford Commercial	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$0.77
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

Know your out-of-pocket cost for care.

All Charges