Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NASAL ENDOSCOPY-DX

Facility

$1,644.90

Service Code	HCPCS 31231
Hospital Charge Code	1600000347
Hospital Revenue Code	360
Min. Negotiated Rate	$246.74
Max. Negotiated Rate	$246.74
Rate for Payer: Qualcare PPO/HMO/WC	$246.74

NASAL ENDO W BLD CNTRL

Facility

$14,446.50

Service Code	HCPCS 31238
Hospital Charge Code	1600000319
Hospital Revenue Code	360
Min. Negotiated Rate	$2,166.97
Max. Negotiated Rate	$2,166.97
Rate for Payer: Qualcare PPO/HMO/WC	$2,166.97

NASAL ENDO W BLD CNTRL

Facility

$14,446.50

Service Code	HCPCS 31238
Hospital Charge Code	1600000319
Hospital Revenue Code	360
Min. Negotiated Rate	$348.16
Max. Negotiated Rate	$7,632.96
Rate for Payer: Aetna Commercial	$5,751.63
Rate for Payer: Aetna Medicare Advantage	$6,851.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,114.57
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	$7,632.96
Rate for Payer: Cigna Commercial	$4,238.63
Rate for Payer: Cigna Medicare Advantage	$2,114.57
Rate for Payer: Clover Medicare Advantage	$2,008.84
Rate for Payer: EmblemHealth Commercial	$6,343.71
Rate for Payer: Humana Medicare Advantage	$2,178.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,114.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,333.95
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,166.97
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$348.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare Medicare Advantage	$2,114.57
Rate for Payer: Wellpoint Medicaid Managed Care	$382.83

NASAL ENDO,W BX POLYPECT/DEBD

Facility

$14,446.50

Service Code	HCPCS 31237
Hospital Charge Code	16000924
Hospital Revenue Code	360
Min. Negotiated Rate	$2,166.97
Max. Negotiated Rate	$2,166.97
Rate for Payer: Qualcare PPO/HMO/WC	$2,166.97

NASAL ENDO,W BX POLYPECT/DEBD

Facility

$14,446.50

Service Code	HCPCS 31237
Hospital Charge Code	16000924
Hospital Revenue Code	360
Min. Negotiated Rate	$348.16
Max. Negotiated Rate	$7,632.96
Rate for Payer: Aetna Commercial	$5,751.63
Rate for Payer: Aetna Medicare Advantage	$6,851.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,114.57
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	$7,632.96
Rate for Payer: Cigna Commercial	$4,238.63
Rate for Payer: Cigna Medicare Advantage	$2,114.57
Rate for Payer: Clover Medicare Advantage	$2,008.84
Rate for Payer: EmblemHealth Commercial	$6,343.71
Rate for Payer: Humana Medicare Advantage	$2,178.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,114.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,333.95
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,166.97
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$348.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare Medicare Advantage	$2,114.57
Rate for Payer: Wellpoint Medicaid Managed Care	$382.83

NASAL ENDO,W CONCHA BULLA RES

Facility

$22,334.60

Service Code	HCPCS 31240
Hospital Charge Code	1600000708
Hospital Revenue Code	360
Min. Negotiated Rate	$3,350.19
Max. Negotiated Rate	$3,350.19
Rate for Payer: Qualcare PPO/HMO/WC	$3,350.19

NASAL ENDO,W CONCHA BULLA RES

Facility

$22,334.60

Service Code	HCPCS 31240
Hospital Charge Code	1600000708
Hospital Revenue Code	360
Min. Negotiated Rate	$538.26
Max. Negotiated Rate	$8,157.00
Rate for Payer: Aetna Commercial	$5,751.63
Rate for Payer: Aetna Medicare Advantage	$6,851.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,632.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,114.57
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	$7,632.96
Rate for Payer: Cigna Commercial	$4,238.63
Rate for Payer: Cigna Medicare Advantage	$2,114.57
Rate for Payer: Clover Medicare Advantage	$2,008.84
Rate for Payer: EmblemHealth Commercial	$6,343.71
Rate for Payer: Humana Medicare Advantage	$2,178.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,114.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,700.38
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,350.19
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$538.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,114.57
Rate for Payer: Wellcare Medicare Advantage	$2,114.57
Rate for Payer: Wellpoint Medicaid Managed Care	$591.87

NASAL ENDOW ETHMOIDEC BL

Facility

$36,247.00

Service Code	HCPCS 31255
Hospital Charge Code	1600000478
Hospital Revenue Code	360
Min. Negotiated Rate	$873.55
Max. Negotiated Rate	$30,265.35
Rate for Payer: Aetna Commercial	$22,805.70
Rate for Payer: Aetna Medicare Advantage	$27,165.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,265.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,265.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,384.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,742.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30,265.35
Rate for Payer: Cigna Commercial	$16,806.60
Rate for Payer: Cigna Medicare Advantage	$8,384.45
Rate for Payer: Clover Medicare Advantage	$7,965.23
Rate for Payer: EmblemHealth Commercial	$25,153.35
Rate for Payer: Humana Medicare Advantage	$8,635.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,384.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,874.10
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,437.05
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$873.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,384.45
Rate for Payer: Wellcare Medicare Advantage	$8,384.45
Rate for Payer: Wellpoint Medicaid Managed Care	$960.55

NASAL ENDOW ETHMOIDEC BL

Facility

$36,247.00

Service Code	HCPCS 31255
Hospital Charge Code	1600000478
Hospital Revenue Code	360
Min. Negotiated Rate	$5,437.05
Max. Negotiated Rate	$5,437.05
Rate for Payer: Qualcare PPO/HMO/WC	$5,437.05

NASAL ENDO W MAXILL ANTROSTMY

Facility

$43,275.35

Service Code	HCPCS 31256
Hospital Charge Code	1600000312
Hospital Revenue Code	360
Min. Negotiated Rate	$855.69
Max. Negotiated Rate	$15,988.70
Rate for Payer: Aetna Commercial	$12,047.89
Rate for Payer: Aetna Medicare Advantage	$14,351.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,988.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,988.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,429.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,988.70
Rate for Payer: Cigna Commercial	$8,878.66
Rate for Payer: Cigna Medicare Advantage	$4,429.37
Rate for Payer: Clover Medicare Advantage	$4,207.90
Rate for Payer: EmblemHealth Commercial	$13,288.11
Rate for Payer: Humana Medicare Advantage	$4,562.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,429.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,982.60
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,491.30
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$1,042.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,429.37
Rate for Payer: Wellcare Medicare Advantage	$4,429.37
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$872.80
Rate for Payer: Wellpoint Medicaid Managed Care	$855.69

NASAL ENDO W MAXILL ANTROSTMY

Facility

$43,275.35

Service Code	HCPCS 31256
Hospital Charge Code	1600000312
Hospital Revenue Code	360
Min. Negotiated Rate	$6,491.30
Max. Negotiated Rate	$6,491.30
Rate for Payer: Qualcare PPO/HMO/WC	$6,491.30

NASAL END W MA,W RM TISS MS RT

Facility

$28,850.55

Service Code	HCPCS 31267
Hospital Charge Code	1600000492
Hospital Revenue Code	360
Min. Negotiated Rate	$695.30
Max. Negotiated Rate	$30,265.35
Rate for Payer: Aetna Commercial	$22,805.70
Rate for Payer: Aetna Medicare Advantage	$27,165.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,265.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,265.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,384.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30,265.35
Rate for Payer: Cigna Commercial	$16,806.60
Rate for Payer: Cigna Medicare Advantage	$8,384.45
Rate for Payer: Clover Medicare Advantage	$7,965.23
Rate for Payer: EmblemHealth Commercial	$25,153.35
Rate for Payer: Humana Medicare Advantage	$8,635.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,384.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,655.17
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,327.58
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$695.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,384.45
Rate for Payer: Wellcare Medicare Advantage	$8,384.45
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,355.84
Rate for Payer: Wellpoint Medicaid Managed Care	$14,074.35

NASAL END W MA,W RM TISS MS RT

Facility

$28,850.55

Service Code	HCPCS 31267
Hospital Charge Code	1600000492
Hospital Revenue Code	360
Min. Negotiated Rate	$4,327.58
Max. Negotiated Rate	$4,327.58
Rate for Payer: Qualcare PPO/HMO/WC	$4,327.58

NASALIDE 0.025% NASAL/25M

Facility

$135.00

Hospital Charge Code	60633504
Hospital Revenue Code	250
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$20.25
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

NASALIDE 0.025% NASAL/25M

Facility

$135.00

Hospital Charge Code	60633504
Hospital Revenue Code	250
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.50
Rate for Payer: Oxford Commercial	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Commercial	$27.00
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

NASAL PILLOW SWIFT FX

Facility

$550.00

Hospital Charge Code	270648553
Hospital Revenue Code	271
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.00
Rate for Payer: Oxford Commercial	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$110.00
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

NASAL PILLOW SWIFT FX

Facility

$550.00

Hospital Charge Code	270648553
Hospital Revenue Code	271
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

NASAL/S ENDO W FRNTAL SINUS B

Facility

$43,275.35

Service Code	HCPCS 31276
Hospital Charge Code	1600000484
Hospital Revenue Code	360
Min. Negotiated Rate	$6,491.30
Max. Negotiated Rate	$6,491.30
Rate for Payer: Qualcare PPO/HMO/WC	$6,491.30

NASAL/S ENDO W FRNTAL SINUS B

Facility

$43,275.35

Service Code	HCPCS 31276
Hospital Charge Code	1600000484
Hospital Revenue Code	360
Min. Negotiated Rate	$1,042.94
Max. Negotiated Rate	$30,265.35
Rate for Payer: Aetna Commercial	$22,805.70
Rate for Payer: Aetna Medicare Advantage	$27,165.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,265.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,265.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,384.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30,265.35
Rate for Payer: Cigna Commercial	$16,806.60
Rate for Payer: Cigna Medicare Advantage	$8,384.45
Rate for Payer: Clover Medicare Advantage	$7,965.23
Rate for Payer: EmblemHealth Commercial	$25,153.35
Rate for Payer: Humana Medicare Advantage	$8,635.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,384.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,982.60
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,491.30
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$1,042.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,384.45
Rate for Payer: Wellcare Medicare Advantage	$8,384.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1,146.80

NASAL SEPTAL BUTTON 3.2CM

Facility

$204.00

Hospital Charge Code	270335719
Hospital Revenue Code	272
Min. Negotiated Rate	$4.92
Max. Negotiated Rate	$102.00
Rate for Payer: Aetna Commercial	$77.52
Rate for Payer: Aetna Medicare Advantage	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.02
Rate for Payer: Cigna Commercial	$102.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.20
Rate for Payer: Oxford Commercial	$40.80
Rate for Payer: Qualcare PPO/HMO/WC	$30.60
Rate for Payer: UnitedHealthcare Commercial	$40.80
Rate for Payer: UnitedHealthcare Community & State	$4.92
Rate for Payer: Wellpoint Medicaid Managed Care	$5.41

NASAL SEPTAL BUTTON 3.2CM

Facility

$204.00

Hospital Charge Code	270335719
Hospital Revenue Code	272
Min. Negotiated Rate	$30.60
Max. Negotiated Rate	$30.60
Rate for Payer: Qualcare PPO/HMO/WC	$30.60

NASAL SEPTAL BUTTON 5.0CM

Facility

$255.00

Hospital Charge Code	270335718
Hospital Revenue Code	272
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$96.90
Rate for Payer: Aetna Medicare Advantage	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.03
Rate for Payer: Cigna Commercial	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.50
Rate for Payer: Oxford Commercial	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.25
Rate for Payer: UnitedHealthcare Commercial	$51.00
Rate for Payer: UnitedHealthcare Community & State	$6.15
Rate for Payer: Wellpoint Medicaid Managed Care	$6.76

NASAL SEPTAL BUTTON 5.0CM

Facility

$255.00

Hospital Charge Code	270335718
Hospital Revenue Code	272
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$38.25
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

NASAL/SINUS ENDOSCOPY SURG

Facility

$40,761.60

Service Code	HCPCS 31287
Hospital Charge Code	1600000722
Hospital Revenue Code	360
Min. Negotiated Rate	$6,114.24
Max. Negotiated Rate	$6,114.24
Rate for Payer: Qualcare PPO/HMO/WC	$6,114.24

NASAL/SINUS ENDOSCOPY SURG

Facility

$13,338.00

Service Code	HCPCS 31291
Hospital Charge Code	1600000662
Hospital Revenue Code	360
Min. Negotiated Rate	$321.45
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,068.44
Rate for Payer: Aetna Medicare Advantage	$4,001.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,401.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,401.19
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	$3,401.19
Rate for Payer: Cigna Commercial	$6,669.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,001.40
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,000.70
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$321.45
Rate for Payer: Wellpoint Medicaid Managed Care	$353.46

Know your out-of-pocket cost for care.

All Charges