Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MRI BIOPSY LIVER

Facility

$1,808.25

Service Code	HCPCS 77021
Hospital Charge Code	2400560
Hospital Revenue Code	610
Min. Negotiated Rate	$43.58
Max. Negotiated Rate	$6,162.00
Rate for Payer: Aetna Commercial	$687.13
Rate for Payer: Aetna Medicare Advantage	$542.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.10
Rate for Payer: Cigna Commercial	$904.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$542.48
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$271.24
Rate for Payer: UnitedHealthcare Commercial	$6,162.00
Rate for Payer: UnitedHealthcare Community & State	$43.58
Rate for Payer: Wellpoint Medicaid Managed Care	$47.92

MRI BIOPSY LIVER

Facility

$1,808.25

Service Code	HCPCS 77021
Hospital Charge Code	2400560
Hospital Revenue Code	610
Min. Negotiated Rate	$271.24
Max. Negotiated Rate	$271.24
Rate for Payer: Qualcare PPO/HMO/WC	$271.24

MRI BIOPSY LUNG LEFT

Facility

$1,808.25

Service Code	HCPCS 77021
Hospital Charge Code	2400561
Hospital Revenue Code	610
Min. Negotiated Rate	$271.24
Max. Negotiated Rate	$271.24
Rate for Payer: Qualcare PPO/HMO/WC	$271.24

MRI BIOPSY LUNG LEFT

Facility

$1,808.25

Service Code	HCPCS 77021
Hospital Charge Code	2400561
Hospital Revenue Code	610
Min. Negotiated Rate	$43.58
Max. Negotiated Rate	$6,162.00
Rate for Payer: Aetna Commercial	$687.13
Rate for Payer: Aetna Medicare Advantage	$542.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.10
Rate for Payer: Cigna Commercial	$904.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$542.48
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$271.24
Rate for Payer: UnitedHealthcare Commercial	$6,162.00
Rate for Payer: UnitedHealthcare Community & State	$43.58
Rate for Payer: Wellpoint Medicaid Managed Care	$47.92

MRI BIOPSY LUNG RIGHT

Facility

$1,808.25

Service Code	HCPCS 77021
Hospital Charge Code	2400562
Hospital Revenue Code	610
Min. Negotiated Rate	$271.24
Max. Negotiated Rate	$271.24
Rate for Payer: Qualcare PPO/HMO/WC	$271.24

MRI BIOPSY LUNG RIGHT

Facility

$1,808.25

Service Code	HCPCS 77021
Hospital Charge Code	2400562
Hospital Revenue Code	610
Min. Negotiated Rate	$43.58
Max. Negotiated Rate	$6,162.00
Rate for Payer: Aetna Commercial	$687.13
Rate for Payer: Aetna Medicare Advantage	$542.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.10
Rate for Payer: Cigna Commercial	$904.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$542.48
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$271.24
Rate for Payer: UnitedHealthcare Commercial	$6,162.00
Rate for Payer: UnitedHealthcare Community & State	$43.58
Rate for Payer: Wellpoint Medicaid Managed Care	$47.92

MRI BIOPSY PANCREAS

Facility

$1,808.25

Service Code	HCPCS 77021
Hospital Charge Code	2400563
Hospital Revenue Code	610
Min. Negotiated Rate	$271.24
Max. Negotiated Rate	$271.24
Rate for Payer: Qualcare PPO/HMO/WC	$271.24

MRI BIOPSY PANCREAS

Facility

$1,808.25

Service Code	HCPCS 77021
Hospital Charge Code	2400563
Hospital Revenue Code	610
Min. Negotiated Rate	$43.58
Max. Negotiated Rate	$6,162.00
Rate for Payer: Aetna Commercial	$687.13
Rate for Payer: Aetna Medicare Advantage	$542.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.10
Rate for Payer: Cigna Commercial	$904.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$542.48
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$271.24
Rate for Payer: UnitedHealthcare Commercial	$6,162.00
Rate for Payer: UnitedHealthcare Community & State	$43.58
Rate for Payer: Wellpoint Medicaid Managed Care	$47.92

MRI BIOPSY PLEURA LEFT

Facility

$1,808.25

Service Code	HCPCS 77021
Hospital Charge Code	2400564
Hospital Revenue Code	610
Min. Negotiated Rate	$271.24
Max. Negotiated Rate	$271.24
Rate for Payer: Qualcare PPO/HMO/WC	$271.24

MRI BIOPSY PLEURA LEFT

Facility

$1,808.25

Service Code	HCPCS 77021
Hospital Charge Code	2400564
Hospital Revenue Code	610
Min. Negotiated Rate	$43.58
Max. Negotiated Rate	$6,162.00
Rate for Payer: Aetna Commercial	$687.13
Rate for Payer: Aetna Medicare Advantage	$542.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.10
Rate for Payer: Cigna Commercial	$904.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$542.48
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$271.24
Rate for Payer: UnitedHealthcare Commercial	$6,162.00
Rate for Payer: UnitedHealthcare Community & State	$43.58
Rate for Payer: Wellpoint Medicaid Managed Care	$47.92

MRI BIOPSY PLEURA RIGHT

Facility

$1,808.25

Service Code	HCPCS 77021
Hospital Charge Code	2400565
Hospital Revenue Code	610
Min. Negotiated Rate	$271.24
Max. Negotiated Rate	$271.24
Rate for Payer: Qualcare PPO/HMO/WC	$271.24

MRI BIOPSY PLEURA RIGHT

Facility

$1,808.25

Service Code	HCPCS 77021
Hospital Charge Code	2400565
Hospital Revenue Code	610
Min. Negotiated Rate	$43.58
Max. Negotiated Rate	$6,162.00
Rate for Payer: Aetna Commercial	$687.13
Rate for Payer: Aetna Medicare Advantage	$542.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.10
Rate for Payer: Cigna Commercial	$904.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$542.48
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$271.24
Rate for Payer: UnitedHealthcare Commercial	$6,162.00
Rate for Payer: UnitedHealthcare Community & State	$43.58
Rate for Payer: Wellpoint Medicaid Managed Care	$47.92

MRI BIOPSY RENAL LEFT

Facility

$1,808.25

Service Code	HCPCS 77021
Hospital Charge Code	2400566
Hospital Revenue Code	610
Min. Negotiated Rate	$43.58
Max. Negotiated Rate	$6,162.00
Rate for Payer: Aetna Commercial	$687.13
Rate for Payer: Aetna Medicare Advantage	$542.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.10
Rate for Payer: Cigna Commercial	$904.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$542.48
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$271.24
Rate for Payer: UnitedHealthcare Commercial	$6,162.00
Rate for Payer: UnitedHealthcare Community & State	$43.58
Rate for Payer: Wellpoint Medicaid Managed Care	$47.92

MRI BIOPSY RENAL LEFT

Facility

$1,808.25

Service Code	HCPCS 77021
Hospital Charge Code	2400566
Hospital Revenue Code	610
Min. Negotiated Rate	$271.24
Max. Negotiated Rate	$271.24
Rate for Payer: Qualcare PPO/HMO/WC	$271.24

MRI BIOPSY RENAL RIGHT

Facility

$1,808.25

Service Code	HCPCS 77021
Hospital Charge Code	2400567
Hospital Revenue Code	610
Min. Negotiated Rate	$271.24
Max. Negotiated Rate	$271.24
Rate for Payer: Qualcare PPO/HMO/WC	$271.24

MRI BIOPSY RENAL RIGHT

Facility

$1,808.25

Service Code	HCPCS 77021
Hospital Charge Code	2400567
Hospital Revenue Code	610
Min. Negotiated Rate	$43.58
Max. Negotiated Rate	$6,162.00
Rate for Payer: Aetna Commercial	$687.13
Rate for Payer: Aetna Medicare Advantage	$542.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.10
Rate for Payer: Cigna Commercial	$904.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$542.48
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$271.24
Rate for Payer: UnitedHealthcare Commercial	$6,162.00
Rate for Payer: UnitedHealthcare Community & State	$43.58
Rate for Payer: Wellpoint Medicaid Managed Care	$47.92

MRI BONE MARROW BLOOD SUPPLY

Facility

$2,588.75

Service Code	HCPCS 77084
Hospital Charge Code	2400364
Hospital Revenue Code	614
Min. Negotiated Rate	$62.39
Max. Negotiated Rate	$6,162.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$776.62
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$388.31
Rate for Payer: UnitedHealthcare Commercial	$6,162.00
Rate for Payer: UnitedHealthcare Community & State	$62.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$68.60

MRI BONE MARROW BLOOD SUPPLY

Facility

$2,588.75

Service Code	HCPCS 77084
Hospital Charge Code	2400364
Hospital Revenue Code	614
Min. Negotiated Rate	$388.31
Max. Negotiated Rate	$388.31
Rate for Payer: Qualcare PPO/HMO/WC	$388.31

MRI BRAIN IAC WITH CONTRAST

Facility

$13,500.00

Service Code	HCPCS 70558
Hospital Charge Code	2400587
Hospital Revenue Code	611
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$2,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

MRI BRAIN IAC WITH CONTRAST

Facility

$13,500.00

Service Code	HCPCS 70558
Hospital Charge Code	2400587
Hospital Revenue Code	611
Min. Negotiated Rate	$197.96
Max. Negotiated Rate	$6,162.00
Rate for Payer: Aetna Commercial	$566.79
Rate for Payer: Aetna Medicare Advantage	$675.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$208.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$883.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.19
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: Cigna Medicare Advantage	$208.38
Rate for Payer: Clover Medicare Advantage	$197.96
Rate for Payer: EmblemHealth Commercial	$625.14
Rate for Payer: Humana Medicare Advantage	$214.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$208.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,050.00
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: UnitedHealthcare Commercial	$6,162.00
Rate for Payer: UnitedHealthcare Community & State	$325.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellpoint Medicaid Managed Care	$357.75

MRI BRAIN IAC WITHOUT CONTRAST

Facility

$2,080.60

Service Code	HCPCS 70557
Hospital Charge Code	2400588
Hospital Revenue Code	611
Min. Negotiated Rate	$50.14
Max. Negotiated Rate	$6,162.00
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$799.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$649.16
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.18
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$312.09
Rate for Payer: UnitedHealthcare Commercial	$6,162.00
Rate for Payer: UnitedHealthcare Community & State	$50.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$55.14

MRI BRAIN IAC WITHOUT CONTRAST

Facility

$2,080.60

Service Code	HCPCS 70557
Hospital Charge Code	2400588
Hospital Revenue Code	611
Min. Negotiated Rate	$312.09
Max. Negotiated Rate	$312.09
Rate for Payer: Qualcare PPO/HMO/WC	$312.09

MRI BRAIN IAC W & W/O CONTRAST

Facility

$3,155.25

Service Code	HCPCS 70559
Hospital Charge Code	2400589
Hospital Revenue Code	611
Min. Negotiated Rate	$76.04
Max. Negotiated Rate	$6,162.00
Rate for Payer: Aetna Commercial	$566.79
Rate for Payer: Aetna Medicare Advantage	$675.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$208.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$887.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.19
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: Cigna Medicare Advantage	$208.38
Rate for Payer: Clover Medicare Advantage	$197.96
Rate for Payer: EmblemHealth Commercial	$625.14
Rate for Payer: Humana Medicare Advantage	$214.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$208.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$946.58
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$473.29
Rate for Payer: UnitedHealthcare Commercial	$6,162.00
Rate for Payer: UnitedHealthcare Community & State	$76.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellpoint Medicaid Managed Care	$83.61

MRI BRAIN IAC W & W/O CONTRAST

Facility

$3,155.25

Service Code	HCPCS 70559
Hospital Charge Code	2400589
Hospital Revenue Code	611
Min. Negotiated Rate	$473.29
Max. Negotiated Rate	$473.29
Rate for Payer: Qualcare PPO/HMO/WC	$473.29

MRI BRAIN NEUROQUANT

Facility

$1,145.00

Service Code	HCPCS 0865T
Hospital Charge Code	40610865T
Hospital Revenue Code	614
Min. Negotiated Rate	$27.59
Max. Negotiated Rate	$6,162.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.50
Rate for Payer: Oxford Commercial	$3,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.75
Rate for Payer: UnitedHealthcare Commercial	$6,162.00
Rate for Payer: UnitedHealthcare Community & State	$27.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$30.34

Know your out-of-pocket cost for care.

All Charges