Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MICROPUNCTURE PEDAL 4.0 FRx7cm

Facility

$346.80

Hospital Charge Code	270680365
Hospital Revenue Code	272
Min. Negotiated Rate	$52.02
Max. Negotiated Rate	$52.02
Rate for Payer: Qualcare PPO/HMO/WC	$52.02

MICROPUNCTURE PEDAL 4.0 FRx7cm

Facility

$346.80

Hospital Charge Code	270680365
Hospital Revenue Code	272
Min. Negotiated Rate	$8.36
Max. Negotiated Rate	$173.40
Rate for Payer: Aetna Commercial	$131.78
Rate for Payer: Aetna Medicare Advantage	$104.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.43
Rate for Payer: Cigna Commercial	$173.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.04
Rate for Payer: Oxford Commercial	$69.36
Rate for Payer: Qualcare PPO/HMO/WC	$52.02
Rate for Payer: UnitedHealthcare Commercial	$69.36
Rate for Payer: UnitedHealthcare Community & State	$8.36
Rate for Payer: Wellpoint Medicaid Managed Care	$9.19

MICROPUNCTURE PEDAL INTR 2.9/5

Facility

$340.00

Service Code	HCPCS C1894
Hospital Charge Code	270671135S
Hospital Revenue Code	278
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$129.20
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.80
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Community & State	$8.19
Rate for Payer: Wellpoint Medicaid Managed Care	$9.01

MICROPUNCTURE PEDAL INTR 2.9/5

Facility

$340.00

Service Code	HCPCS C1894
Hospital Charge Code	270671135
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$82.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.80
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

MICROPUNCTURE PEDAL INTR 2.9/5

Facility

$340.00

Service Code	HCPCS C1894
Hospital Charge Code	270671135
Hospital Revenue Code	278
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$129.20
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.80
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Community & State	$8.19
Rate for Payer: Wellpoint Medicaid Managed Care	$9.01

MICROPUNCTURE PEDAL INTR 2.9/5

Facility

$340.00

Service Code	HCPCS C1894
Hospital Charge Code	270671135N
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$82.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.80
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

MICROPUNCTURE PEDAL INTR 2.9/5

Facility

$340.00

Service Code	HCPCS C1894
Hospital Charge Code	270671135N
Hospital Revenue Code	278
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$129.20
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.80
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Community & State	$8.19
Rate for Payer: Wellpoint Medicaid Managed Care	$9.01

MICROPUNCTURE PEDAL INTR 2.9/5

Facility

$340.00

Service Code	HCPCS C1894
Hospital Charge Code	270671135S
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$82.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.80
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

MICROPUNCTURE SET 5FR SS

Facility

$87.55

Hospital Charge Code	270654224N
Hospital Revenue Code	272
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$13.13
Rate for Payer: Qualcare PPO/HMO/WC	$13.13

MICROPUNCTURE SET 5FR SS

Facility

$87.55

Hospital Charge Code	270654224N
Hospital Revenue Code	272
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$43.77
Rate for Payer: Aetna Commercial	$33.27
Rate for Payer: Aetna Medicare Advantage	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.33
Rate for Payer: Cigna Commercial	$43.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.27
Rate for Payer: Oxford Commercial	$17.51
Rate for Payer: Qualcare PPO/HMO/WC	$13.13
Rate for Payer: UnitedHealthcare Commercial	$17.51
Rate for Payer: UnitedHealthcare Community & State	$2.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.32

MICROPUNCTURE SET 5FR SS

Facility

$87.55

Hospital Charge Code	270654224S
Hospital Revenue Code	272
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$13.13
Rate for Payer: Qualcare PPO/HMO/WC	$13.13

MICROPUNCTURE SET 5FR SS

Facility

$87.55

Hospital Charge Code	270654224S
Hospital Revenue Code	272
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$43.77
Rate for Payer: Aetna Commercial	$33.27
Rate for Payer: Aetna Medicare Advantage	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.33
Rate for Payer: Cigna Commercial	$43.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.27
Rate for Payer: Oxford Commercial	$17.51
Rate for Payer: Qualcare PPO/HMO/WC	$13.13
Rate for Payer: UnitedHealthcare Commercial	$17.51
Rate for Payer: UnitedHealthcare Community & State	$2.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.32

MICROPUNCTURE SET 5FR SS

Facility

$87.55

Hospital Charge Code	270654224
Hospital Revenue Code	272
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$43.77
Rate for Payer: Aetna Commercial	$33.27
Rate for Payer: Aetna Medicare Advantage	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.33
Rate for Payer: Cigna Commercial	$43.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.27
Rate for Payer: Oxford Commercial	$17.51
Rate for Payer: Qualcare PPO/HMO/WC	$13.13
Rate for Payer: UnitedHealthcare Commercial	$17.51
Rate for Payer: UnitedHealthcare Community & State	$2.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.32

MICROPUNCTURE SET 5FR SS

Facility

$87.55

Hospital Charge Code	270654224
Hospital Revenue Code	272
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$13.13
Rate for Payer: Qualcare PPO/HMO/WC	$13.13

MICROPUNCTURE SET 5FR SS ECHOG

Facility

$122.50

Hospital Charge Code	2709000384
Hospital Revenue Code	272
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$61.25
Rate for Payer: Aetna Commercial	$46.55
Rate for Payer: Aetna Medicare Advantage	$36.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.24
Rate for Payer: Cigna Commercial	$61.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.75
Rate for Payer: Oxford Commercial	$24.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.38
Rate for Payer: UnitedHealthcare Commercial	$24.50
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.25

MICROPUNCTURE SET 5FR SS ECHOG

Facility

$122.50

Hospital Charge Code	2709000384
Hospital Revenue Code	272
Min. Negotiated Rate	$18.38
Max. Negotiated Rate	$18.38
Rate for Payer: Qualcare PPO/HMO/WC	$18.38

MICROPUNCTURE SHEATH 5FRX10CM

Facility

$3,550.00

Hospital Charge Code	270665132
Hospital Revenue Code	279
Min. Negotiated Rate	$532.50
Max. Negotiated Rate	$532.50
Rate for Payer: Qualcare PPO/HMO/WC	$532.50

MICROPUNCTURE SHEATH 5FRX10CM

Facility

$3,550.00

Hospital Charge Code	270665132
Hospital Revenue Code	279
Min. Negotiated Rate	$85.56
Max. Negotiated Rate	$1,775.00
Rate for Payer: Aetna Commercial	$1,349.00
Rate for Payer: Aetna Medicare Advantage	$1,065.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$905.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$905.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$905.25
Rate for Payer: Cigna Commercial	$1,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,065.00
Rate for Payer: Oxford Commercial	$710.00
Rate for Payer: Qualcare PPO/HMO/WC	$532.50
Rate for Payer: UnitedHealthcare Commercial	$710.00
Rate for Payer: UnitedHealthcare Community & State	$85.56
Rate for Payer: Wellpoint Medicaid Managed Care	$94.08

MICRO SAGITTAL BLADE

Facility

$30.80

Hospital Charge Code	270654639
Hospital Revenue Code	270
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$4.62
Rate for Payer: Qualcare PPO/HMO/WC	$4.62

MICRO SAGITTAL BLADE

Facility

$30.80

Hospital Charge Code	270654638
Hospital Revenue Code	272
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$4.62
Rate for Payer: Qualcare PPO/HMO/WC	$4.62

MICRO SAGITTAL BLADE

Facility

$30.80

Hospital Charge Code	270654639
Hospital Revenue Code	270
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$15.40
Rate for Payer: Aetna Commercial	$11.70
Rate for Payer: Aetna Medicare Advantage	$9.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.85
Rate for Payer: Cigna Commercial	$15.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.24
Rate for Payer: Oxford Commercial	$6.16
Rate for Payer: Qualcare PPO/HMO/WC	$4.62
Rate for Payer: UnitedHealthcare Commercial	$6.16
Rate for Payer: UnitedHealthcare Community & State	$0.74
Rate for Payer: Wellpoint Medicaid Managed Care	$0.82

MICRO SAGITTAL BLADE

Facility

$30.80

Hospital Charge Code	270654638
Hospital Revenue Code	272
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$15.40
Rate for Payer: Aetna Commercial	$11.70
Rate for Payer: Aetna Medicare Advantage	$9.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.85
Rate for Payer: Cigna Commercial	$15.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.24
Rate for Payer: Oxford Commercial	$6.16
Rate for Payer: Qualcare PPO/HMO/WC	$4.62
Rate for Payer: UnitedHealthcare Commercial	$6.16
Rate for Payer: UnitedHealthcare Community & State	$0.74
Rate for Payer: Wellpoint Medicaid Managed Care	$0.82

MICROSCOPIC EXAM, URINE

Facility

$390.00

Service Code	HCPCS 81015
Hospital Charge Code	3032711
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MICROSCOPIC EXAM, URINE

Facility

$390.00

Service Code	HCPCS 81015
Hospital Charge Code	3032711
Hospital Revenue Code	307
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$8.30
Rate for Payer: Aetna Medicare Advantage	$9.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.01
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$3.05
Rate for Payer: Clover Medicare Advantage	$2.90
Rate for Payer: EmblemHealth Commercial	$9.15
Rate for Payer: Humana Medicare Advantage	$3.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.05
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	$2.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.05
Rate for Payer: Wellcare Medicare Advantage	$3.05
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

MICROSCOPIC NEURO LASER

Facility

$258.00

Hospital Charge Code	270335115
Hospital Revenue Code	272
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$129.00
Rate for Payer: Aetna Commercial	$98.04
Rate for Payer: Aetna Medicare Advantage	$77.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.79
Rate for Payer: Cigna Commercial	$129.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.40
Rate for Payer: Oxford Commercial	$51.60
Rate for Payer: Qualcare PPO/HMO/WC	$38.70
Rate for Payer: UnitedHealthcare Commercial	$51.60
Rate for Payer: UnitedHealthcare Community & State	$6.22
Rate for Payer: Wellpoint Medicaid Managed Care	$6.84

Know your out-of-pocket cost for care.

All Charges