Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MCROPUNCTRE SET 5FR SS ECHOGEN

Facility

$24.50

Hospital Charge Code	270650009
Hospital Revenue Code	272
Min. Negotiated Rate	$3.67
Max. Negotiated Rate	$3.67
Rate for Payer: Qualcare PPO/HMO/WC	$3.67

MCV TOPNOTCH CORE 510-110****

Facility

$76.00

Hospital Charge Code	1810084
Hospital Revenue Code	272
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$38.00
Rate for Payer: Aetna Commercial	$28.88
Rate for Payer: Aetna Medicare Advantage	$22.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.38
Rate for Payer: Cigna Commercial	$38.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.80
Rate for Payer: Oxford Commercial	$15.20
Rate for Payer: Qualcare PPO/HMO/WC	$11.40
Rate for Payer: UnitedHealthcare Commercial	$15.20
Rate for Payer: UnitedHealthcare Community & State	$1.83
Rate for Payer: Wellpoint Medicaid Managed Care	$2.01

MCV TOPNOTCH CORE 510-110****

Facility

$76.00

Hospital Charge Code	1810084
Hospital Revenue Code	272
Min. Negotiated Rate	$11.40
Max. Negotiated Rate	$11.40
Rate for Payer: Qualcare PPO/HMO/WC	$11.40

MCYTOGEN CHROM IN SITU HYBRID

Facility

$204.95

Service Code	HCPCS 88273
Hospital Charge Code	38477180
Hospital Revenue Code	311
Min. Negotiated Rate	$5.43
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$94.68
Rate for Payer: Aetna Medicare Advantage	$112.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.65
Rate for Payer: Cigna Commercial	$102.47
Rate for Payer: Cigna Medicare Advantage	$34.81
Rate for Payer: Clover Medicare Advantage	$33.07
Rate for Payer: EmblemHealth Commercial	$104.43
Rate for Payer: Humana Medicare Advantage	$35.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.74
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$27.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.81
Rate for Payer: Wellcare Medicare Advantage	$34.81
Rate for Payer: Wellpoint Medicaid Managed Care	$5.43

MCYTOGEN CHROM IN SITU HYBRID

Facility

$204.95

Service Code	HCPCS 88273
Hospital Charge Code	38477180
Hospital Revenue Code	311
Min. Negotiated Rate	$30.74
Max. Negotiated Rate	$30.74
Rate for Payer: Qualcare PPO/HMO/WC	$30.74

M CYTOGEN CHROMO IN SITU HYBRI

Facility

$153.75

Service Code	HCPCS 88272
Hospital Charge Code	38477169
Hospital Revenue Code	311
Min. Negotiated Rate	$23.06
Max. Negotiated Rate	$23.06
Rate for Payer: Qualcare PPO/HMO/WC	$23.06

M CYTOGEN CHROMO IN SITU HYBRI

Facility

$153.75

Service Code	HCPCS 88272
Hospital Charge Code	38477169
Hospital Revenue Code	311
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$110.70
Rate for Payer: Aetna Medicare Advantage	$131.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$40.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.91
Rate for Payer: Cigna Commercial	$76.88
Rate for Payer: Cigna Medicare Advantage	$40.70
Rate for Payer: Clover Medicare Advantage	$38.66
Rate for Payer: EmblemHealth Commercial	$122.10
Rate for Payer: Humana Medicare Advantage	$41.92
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$40.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.06
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$3.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$40.70
Rate for Payer: Wellcare Medicare Advantage	$40.70
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

M CYTOGEN CHROMO IN SITU HYBRI

Facility

$246.55

Service Code	HCPCS 88274
Hospital Charge Code	38477192
Hospital Revenue Code	311
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$115.27
Rate for Payer: Aetna Medicare Advantage	$137.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$152.98
Rate for Payer: Cigna Commercial	$123.28
Rate for Payer: Cigna Medicare Advantage	$42.38
Rate for Payer: Clover Medicare Advantage	$40.26
Rate for Payer: EmblemHealth Commercial	$127.14
Rate for Payer: Humana Medicare Advantage	$43.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.98
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$33.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.38
Rate for Payer: Wellcare Medicare Advantage	$42.38
Rate for Payer: Wellpoint Medicaid Managed Care	$6.53

M CYTOGEN CHROMO IN SITU HYBRI

Facility

$246.55

Service Code	HCPCS 88274
Hospital Charge Code	38477192
Hospital Revenue Code	311
Min. Negotiated Rate	$36.98
Max. Negotiated Rate	$36.98
Rate for Payer: Qualcare PPO/HMO/WC	$36.98

M CYTOGEN/CHROMO IN SITU HYBRI

Facility

$284.40

Service Code	HCPCS 88275
Hospital Charge Code	38477202
Hospital Revenue Code	311
Min. Negotiated Rate	$42.66
Max. Negotiated Rate	$42.66
Rate for Payer: Qualcare PPO/HMO/WC	$42.66

M CYTOGEN/CHROMO IN SITU HYBRI

Facility

$284.40

Service Code	HCPCS 88275
Hospital Charge Code	38477202
Hospital Revenue Code	311
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$184.78
Rate for Payer: Aetna Commercial	$139.24
Rate for Payer: Aetna Medicare Advantage	$165.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$51.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.78
Rate for Payer: Cigna Commercial	$142.20
Rate for Payer: Cigna Medicare Advantage	$51.19
Rate for Payer: Clover Medicare Advantage	$48.63
Rate for Payer: EmblemHealth Commercial	$153.57
Rate for Payer: Humana Medicare Advantage	$52.73
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$51.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.66
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$40.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$51.19
Rate for Payer: Wellcare Medicare Advantage	$51.19
Rate for Payer: Wellpoint Medicaid Managed Care	$7.54

M CYTOGENETICS DNA PROBE EA

Facility

$128.19

Service Code	HCPCS 88271
Hospital Charge Code	38477151
Hospital Revenue Code	311
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$58.26
Rate for Payer: Aetna Medicare Advantage	$69.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.32
Rate for Payer: Cigna Commercial	$64.09
Rate for Payer: Cigna Medicare Advantage	$21.42
Rate for Payer: Clover Medicare Advantage	$20.35
Rate for Payer: EmblemHealth Commercial	$64.26
Rate for Payer: Humana Medicare Advantage	$22.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.23
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$17.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.42
Rate for Payer: Wellcare Medicare Advantage	$21.42
Rate for Payer: Wellpoint Medicaid Managed Care	$3.40

M CYTOGENETICS DNA PROBE EA

Facility

$128.19

Service Code	HCPCS 88271
Hospital Charge Code	38477151
Hospital Revenue Code	311
Min. Negotiated Rate	$19.23
Max. Negotiated Rate	$19.23
Rate for Payer: Qualcare PPO/HMO/WC	$19.23

MD-60 CONTRAST MEDIA

Facility

$28.00

Hospital Charge Code	270331611
Hospital Revenue Code	272
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

MD-60 CONTRAST MEDIA

Facility

$28.00

Hospital Charge Code	270331611
Hospital Revenue Code	272
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

MD GASTROVIEW 30ML

Facility

$132.66

Service Code	NDC 19481604
Hospital Charge Code	60635832
Hospital Revenue Code	255
Min. Negotiated Rate	$19.90
Max. Negotiated Rate	$19.90
Rate for Payer: Qualcare PPO/HMO/WC	$19.90

MD GASTROVIEW 30ML

Facility

$132.66

Service Code	NDC 19481604
Hospital Charge Code	60635832
Hospital Revenue Code	255
Min. Negotiated Rate	$3.20
Max. Negotiated Rate	$66.33
Rate for Payer: Aetna Commercial	$50.41
Rate for Payer: Aetna Medicare Advantage	$39.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.83
Rate for Payer: Cigna Commercial	$66.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.80
Rate for Payer: Oxford Commercial	$26.53
Rate for Payer: Qualcare PPO/HMO/WC	$19.90
Rate for Payer: UnitedHealthcare Commercial	$26.53
Rate for Payer: UnitedHealthcare Community & State	$3.20
Rate for Payer: Wellpoint Medicaid Managed Care	$3.52

MD GASTROVIEW SOL.BULK

Facility

$50.00

Hospital Charge Code	60635833
Hospital Revenue Code	255
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$10.00
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

MD GASTROVIEW SOL.BULK

Facility

$50.00

Hospital Charge Code	60635833
Hospital Revenue Code	255
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

MD HYBRID GLENOID BASE 4MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270687429
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

MD HYBRID GLENOID BASE 4MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270687429
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

MDI SIZE 3

Facility

$18,625.00

Hospital Charge Code	270656321
Hospital Revenue Code	278
Min. Negotiated Rate	$448.86
Max. Negotiated Rate	$9,312.50
Rate for Payer: Aetna Commercial	$7,077.50
Rate for Payer: Aetna Medicare Advantage	$5,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,749.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,749.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,749.38
Rate for Payer: Cigna Commercial	$9,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,507.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,097.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,793.75
Rate for Payer: UnitedHealthcare Community & State	$448.86
Rate for Payer: Wellpoint Medicaid Managed Care	$493.56

MDI SIZE 3

Facility

$18,625.00

Hospital Charge Code	270656321
Hospital Revenue Code	278
Min. Negotiated Rate	$2,793.75
Max. Negotiated Rate	$4,507.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,507.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,097.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,793.75

MDLR CP 10 DEG NEU 50/52/54X32

Facility

$4,454.05

Hospital Charge Code	270663144
Hospital Revenue Code	278
Min. Negotiated Rate	$107.34
Max. Negotiated Rate	$2,227.03
Rate for Payer: Aetna Commercial	$1,692.54
Rate for Payer: Aetna Medicare Advantage	$1,336.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,135.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,135.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$890.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,135.78
Rate for Payer: Cigna Commercial	$2,227.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,077.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$979.89
Rate for Payer: Qualcare PPO/HMO/WC	$668.11
Rate for Payer: UnitedHealthcare Community & State	$107.34
Rate for Payer: Wellpoint Medicaid Managed Care	$118.03

MDLR CP 10 DEG NEU 50/52/54X32

Facility

$4,454.05

Hospital Charge Code	270663144
Hospital Revenue Code	278
Min. Negotiated Rate	$668.11
Max. Negotiated Rate	$1,077.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$890.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,077.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$979.89
Rate for Payer: Qualcare PPO/HMO/WC	$668.11

Know your out-of-pocket cost for care.

All Charges