Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NAVIGATION LANTERN ASSIST DEV

Facility

$6,000.00

Hospital Charge Code	270694804
Hospital Revenue Code	271
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) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,800.00
Rate for Payer: Oxford Commercial	$1,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Commercial	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

NAVIGATOR CANNULA LEFT MID

Facility

$1,075.00

Hospital Charge Code	270691762
Hospital Revenue Code	272
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$161.25
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

NAVIGATOR CANNULA LEFT MID

Facility

$1,075.00

Hospital Charge Code	270691762
Hospital Revenue Code	272
Min. Negotiated Rate	$25.91
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.50
Rate for Payer: Oxford Commercial	$215.00
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Commercial	$215.00
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$28.49

NAVIGATOR POST RIGHT

Facility

$1,075.00

Hospital Charge Code	270691763
Hospital Revenue Code	272
Min. Negotiated Rate	$25.91
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.50
Rate for Payer: Oxford Commercial	$215.00
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Commercial	$215.00
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$28.49

NAVIGATOR POST RIGHT

Facility

$1,075.00

Hospital Charge Code	270691763
Hospital Revenue Code	272
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$161.25
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

NAV-X BLADE

Facility

$3,540.00

Hospital Charge Code	270679505
Hospital Revenue Code	272
Min. Negotiated Rate	$531.00
Max. Negotiated Rate	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$531.00

NAV-X BLADE

Facility

$3,540.00

Hospital Charge Code	270679505
Hospital Revenue Code	272
Min. Negotiated Rate	$85.31
Max. Negotiated Rate	$1,770.00
Rate for Payer: Aetna Commercial	$1,345.20
Rate for Payer: Aetna Medicare Advantage	$1,062.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$902.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$902.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$902.70
Rate for Payer: Cigna Commercial	$1,770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,062.00
Rate for Payer: Oxford Commercial	$708.00
Rate for Payer: Qualcare PPO/HMO/WC	$531.00
Rate for Payer: UnitedHealthcare Commercial	$708.00
Rate for Payer: UnitedHealthcare Community & State	$85.31
Rate for Payer: Wellpoint Medicaid Managed Care	$93.81

N BLOCK INJ CELIAC PELUS

Facility

$3,583.05

Service Code	HCPCS 64530
Hospital Charge Code	16001042
Hospital Revenue Code	360
Min. Negotiated Rate	$537.46
Max. Negotiated Rate	$537.46
Rate for Payer: Qualcare PPO/HMO/WC	$537.46

N BLOCK INJ CELIAC PELUS

Facility

$3,583.05

Service Code	HCPCS 64530
Hospital Charge Code	16001042
Hospital Revenue Code	360
Min. Negotiated Rate	$86.35
Max. Negotiated Rate	$3,793.00
Rate for Payer: Aetna Commercial	$2,858.12
Rate for Payer: Aetna Medicare Advantage	$3,404.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,050.78
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	$3,793.00
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: Cigna Medicare Advantage	$1,050.78
Rate for Payer: Clover Medicare Advantage	$998.24
Rate for Payer: EmblemHealth Commercial	$3,152.34
Rate for Payer: Humana Medicare Advantage	$1,082.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,050.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,074.91
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$537.46
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$86.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,050.78
Rate for Payer: Wellcare Medicare Advantage	$1,050.78
Rate for Payer: Wellpoint Medicaid Managed Care	$94.95

N BLOCK INJ FACIAL

Facility

$615.85

Service Code	HCPCS 64402
Hospital Charge Code	412364402
Hospital Revenue Code	510
Min. Negotiated Rate	$92.38
Max. Negotiated Rate	$92.38
Rate for Payer: Qualcare PPO/HMO/WC	$92.38

N BLOCK INJ FACIAL

Facility

$615.85

Service Code	HCPCS 64402
Hospital Charge Code	412364402
Hospital Revenue Code	510
Min. Negotiated Rate	$14.84
Max. Negotiated Rate	$307.93
Rate for Payer: Aetna Commercial	$234.02
Rate for Payer: Aetna Medicare Advantage	$184.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.04
Rate for Payer: Cigna Commercial	$307.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.75
Rate for Payer: Qualcare PPO/HMO/WC	$92.38
Rate for Payer: UnitedHealthcare Community & State	$14.84
Rate for Payer: Wellpoint Medicaid Managed Care	$16.32

N BLOCK INJ HYPOGAS PLXS

Facility

$5,242.30

Service Code	HCPCS 64517
Hospital Charge Code	1600000410
Hospital Revenue Code	360
Min. Negotiated Rate	$126.34
Max. Negotiated Rate	$3,793.00
Rate for Payer: Aetna Commercial	$2,858.12
Rate for Payer: Aetna Medicare Advantage	$3,404.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,050.78
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	$3,793.00
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: Cigna Medicare Advantage	$1,050.78
Rate for Payer: Clover Medicare Advantage	$998.24
Rate for Payer: EmblemHealth Commercial	$3,152.34
Rate for Payer: Humana Medicare Advantage	$1,082.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,050.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,572.69
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$786.35
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$126.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,050.78
Rate for Payer: Wellcare Medicare Advantage	$1,050.78
Rate for Payer: Wellpoint Medicaid Managed Care	$138.92

N BLOCK INJ HYPOGAS PLXS

Facility

$5,242.30

Service Code	HCPCS 64517
Hospital Charge Code	1600000410
Hospital Revenue Code	360
Min. Negotiated Rate	$786.35
Max. Negotiated Rate	$786.35
Rate for Payer: Qualcare PPO/HMO/WC	$786.35

N BLOCK INJ INTERCOST SNG

Facility

$4,204.50

Service Code	HCPCS 64420
Hospital Charge Code	1600000850
Hospital Revenue Code	360
Min. Negotiated Rate	$630.67
Max. Negotiated Rate	$630.67
Rate for Payer: Qualcare PPO/HMO/WC	$630.67

N BLOCK INJ INTERCOST SNG

Facility

$4,204.50

Service Code	HCPCS 64420
Hospital Charge Code	1600000850
Hospital Revenue Code	360
Min. Negotiated Rate	$101.33
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,281.02
Rate for Payer: Aetna Medicare Advantage	$2,717.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$838.61
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	$3,027.13
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: Cigna Medicare Advantage	$838.61
Rate for Payer: Clover Medicare Advantage	$796.68
Rate for Payer: EmblemHealth Commercial	$2,515.83
Rate for Payer: Humana Medicare Advantage	$863.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$838.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,261.35
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$630.67
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$101.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$111.42

N BLOCK INJ OCCIPITAL

Facility

$717.30

Service Code	HCPCS 64405
Hospital Charge Code	412364405
Hospital Revenue Code	510
Min. Negotiated Rate	$107.59
Max. Negotiated Rate	$107.59
Rate for Payer: Qualcare PPO/HMO/WC	$107.59

N BLOCK INJ OCCIPITAL

Facility

$717.30

Service Code	HCPCS 64405
Hospital Charge Code	412364405
Hospital Revenue Code	510
Min. Negotiated Rate	$17.29
Max. Negotiated Rate	$1,316.35
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.19
Rate for Payer: Qualcare PPO/HMO/WC	$107.59
Rate for Payer: UnitedHealthcare Community & State	$17.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$19.01

N BLOCK INJ PLANTAR DIGIT

Facility

$1,434.65

Service Code	HCPCS 64455
Hospital Charge Code	412364455
Hospital Revenue Code	361
Min. Negotiated Rate	$215.20
Max. Negotiated Rate	$215.20
Rate for Payer: Qualcare PPO/HMO/WC	$215.20

N BLOCK INJ PLANTAR DIGIT

Facility

$1,434.65

Service Code	HCPCS 64455
Hospital Charge Code	412364455
Hospital Revenue Code	361
Min. Negotiated Rate	$34.58
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
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	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$430.39
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$215.20
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$34.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$835.79
Rate for Payer: Wellpoint Medicaid Managed Care	$819.40

N BLOCK INJ,SCIATIC,SNG-RT

Facility

$7,956.80

Service Code	HCPCS 64445
Hospital Charge Code	16000387
Hospital Revenue Code	360
Min. Negotiated Rate	$1,193.52
Max. Negotiated Rate	$1,193.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,193.52

N BLOCK INJ,SCIATIC,SNG-RT

Facility

$7,956.80

Service Code	HCPCS 64445
Hospital Charge Code	16000387
Hospital Revenue Code	360
Min. Negotiated Rate	$191.76
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,281.02
Rate for Payer: Aetna Medicare Advantage	$2,717.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$838.61
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	$3,027.13
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: Cigna Medicare Advantage	$838.61
Rate for Payer: Clover Medicare Advantage	$796.68
Rate for Payer: EmblemHealth Commercial	$2,515.83
Rate for Payer: Humana Medicare Advantage	$863.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$838.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,387.04
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,193.52
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$191.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$210.86

N BLOCK OTHER PERIPHERAL

Facility

$3,185.75

Service Code	HCPCS 64450
Hospital Charge Code	412364450
Hospital Revenue Code	510
Min. Negotiated Rate	$73.18
Max. Negotiated Rate	$3,027.13
Rate for Payer: Aetna Commercial	$2,281.02
Rate for Payer: Aetna Medicare Advantage	$2,717.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$838.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,027.13
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: Cigna Medicare Advantage	$838.61
Rate for Payer: Clover Medicare Advantage	$796.68
Rate for Payer: EmblemHealth Commercial	$2,515.83
Rate for Payer: Humana Medicare Advantage	$863.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$838.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$955.73
Rate for Payer: Qualcare PPO/HMO/WC	$477.86
Rate for Payer: UnitedHealthcare Community & State	$76.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$84.42

N BLOCK OTHER PERIPHERAL

Facility

$3,185.75

Service Code	HCPCS 64450
Hospital Charge Code	412364450
Hospital Revenue Code	510
Min. Negotiated Rate	$477.86
Max. Negotiated Rate	$477.86
Rate for Payer: Qualcare PPO/HMO/WC	$477.86

NCAL BX SKN SINGLE LES

Facility

$1,278.04

Service Code	HCPCS 11106
Hospital Charge Code	16000164
Hospital Revenue Code	360
Min. Negotiated Rate	$191.71
Max. Negotiated Rate	$191.71
Rate for Payer: Qualcare PPO/HMO/WC	$191.71

NCAL BX SKN SINGLE LES

Facility

$1,278.04

Service Code	HCPCS 11106
Hospital Charge Code	1600000335
Hospital Revenue Code	360
Min. Negotiated Rate	$191.71
Max. Negotiated Rate	$191.71
Rate for Payer: Qualcare PPO/HMO/WC	$191.71

Know your out-of-pocket cost for care.

All Charges