Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

AV FUSION FOREARM VEIN

Facility

$31,830.40

Service Code	HCPCS 36280
Hospital Charge Code	1600000645
Hospital Revenue Code	360
Min. Negotiated Rate	$767.11
Max. Negotiated Rate	$15,915.20
Rate for Payer: Aetna Commercial	$12,095.55
Rate for Payer: Aetna Medicare Advantage	$9,549.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,116.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,116.75
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	$8,116.75
Rate for Payer: Cigna Commercial	$15,915.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,549.12
Rate for Payer: Qualcare PPO/HMO/WC	$4,774.56
Rate for Payer: UnitedHealthcare Community & State	$767.11
Rate for Payer: Wellpoint Medicaid Managed Care	$843.51

AV FUSION FOREARM VEIN

Facility

$31,830.40

Service Code	HCPCS 36280
Hospital Charge Code	1600000645
Hospital Revenue Code	360
Min. Negotiated Rate	$4,774.56
Max. Negotiated Rate	$4,774.56
Rate for Payer: Qualcare PPO/HMO/WC	$4,774.56

AVIATOR BALLOON 6X20

Facility

$1,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270631631S
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

AVIATOR BALLOON 6X20

Facility

$1,050.00

Service Code	HCPCS C1725
Hospital Charge Code	270631631S
Hospital Revenue Code	278
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Community & State	$25.30
Rate for Payer: Wellpoint Medicaid Managed Care	$27.82

AV IMPULSE REGULAR

Facility

$350.00

Hospital Charge Code	270654501
Hospital Revenue Code	272
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

AV IMPULSE REGULAR

Facility

$350.00

Hospital Charge Code	270654501
Hospital Revenue Code	272
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.00
Rate for Payer: Oxford Commercial	$70.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Commercial	$70.00
Rate for Payer: UnitedHealthcare Community & State	$8.44
Rate for Payer: Wellpoint Medicaid Managed Care	$9.28

AVISTA MRI 74CM 8 CON LEAD KIT

Facility

$12,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270702948
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

AVISTA MRI 74CM 8 CON LEAD KIT

Facility

$12,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270702948
Hospital Revenue Code	278
Min. Negotiated Rate	$301.25
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Community & State	$301.25
Rate for Payer: Wellpoint Medicaid Managed Care	$331.25

AVITENE/1GM

Facility

$43.00

Hospital Charge Code	60632516
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

AVITENE/1GM

Facility

$43.00

Hospital Charge Code	60632516
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

AVITENE ENDOSCOPIC 1010150

Facility

$693.00

Hospital Charge Code	270608018
Hospital Revenue Code	272
Min. Negotiated Rate	$103.95
Max. Negotiated Rate	$103.95
Rate for Payer: Qualcare PPO/HMO/WC	$103.95

AVITENE ENDOSCOPIC 1010150

Facility

$693.00

Hospital Charge Code	270608018
Hospital Revenue Code	272
Min. Negotiated Rate	$16.70
Max. Negotiated Rate	$346.50
Rate for Payer: Aetna Commercial	$263.34
Rate for Payer: Aetna Medicare Advantage	$207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.72
Rate for Payer: Cigna Commercial	$346.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.90
Rate for Payer: Oxford Commercial	$138.60
Rate for Payer: Qualcare PPO/HMO/WC	$103.95
Rate for Payer: UnitedHealthcare Commercial	$138.60
Rate for Payer: UnitedHealthcare Community & State	$16.70
Rate for Payer: Wellpoint Medicaid Managed Care	$18.36

AVITENE PADS

Facility

$776.00

Hospital Charge Code	270335092
Hospital Revenue Code	272
Min. Negotiated Rate	$116.40
Max. Negotiated Rate	$116.40
Rate for Payer: Qualcare PPO/HMO/WC	$116.40

AVITENE PADS

Facility

$776.00

Hospital Charge Code	270335092
Hospital Revenue Code	272
Min. Negotiated Rate	$18.70
Max. Negotiated Rate	$388.00
Rate for Payer: Aetna Commercial	$294.88
Rate for Payer: Aetna Medicare Advantage	$232.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.88
Rate for Payer: Cigna Commercial	$388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.80
Rate for Payer: Oxford Commercial	$155.20
Rate for Payer: Qualcare PPO/HMO/WC	$116.40
Rate for Payer: UnitedHealthcare Commercial	$155.20
Rate for Payer: UnitedHealthcare Community & State	$18.70
Rate for Payer: Wellpoint Medicaid Managed Care	$20.56

AV LINE (REDY)

Facility

$32.00

Hospital Charge Code	8200339
Hospital Revenue Code	272
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$6.40
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

AV LINE (REDY)

Facility

$32.00

Hospital Charge Code	8200339
Hospital Revenue Code	272
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

AVN DELIVERY NEEDLE

Facility

$1,475.00

Hospital Charge Code	270671805
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

AVN DELIVERY NEEDLE

Facility

$1,475.00

Hospital Charge Code	270671805
Hospital Revenue Code	272
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.50
Rate for Payer: Oxford Commercial	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$295.00
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

AVULS NAIL PL PART/COMP/SIMP

Facility

$372.00

Service Code	HCPCS 11732
Hospital Charge Code	84208070
Hospital Revenue Code	361
Min. Negotiated Rate	$8.97
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$141.36
Rate for Payer: Aetna Medicare Advantage	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.86
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	$94.86
Rate for Payer: Cigna Commercial	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.60
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$8.97
Rate for Payer: Wellpoint Medicaid Managed Care	$9.86

AVULS NAIL PL PART/COMP/SIMP

Facility

$372.00

Service Code	HCPCS 11732
Hospital Charge Code	84208070
Hospital Revenue Code	361
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

AWL 5.5

Facility

$1,860.00

Hospital Charge Code	270687187
Hospital Revenue Code	272
Min. Negotiated Rate	$279.00
Max. Negotiated Rate	$279.00
Rate for Payer: Qualcare PPO/HMO/WC	$279.00

AWL 5.5

Facility

$1,860.00

Hospital Charge Code	270687187
Hospital Revenue Code	272
Min. Negotiated Rate	$44.83
Max. Negotiated Rate	$930.00
Rate for Payer: Aetna Commercial	$706.80
Rate for Payer: Aetna Medicare Advantage	$558.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$474.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$474.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$474.30
Rate for Payer: Cigna Commercial	$930.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$558.00
Rate for Payer: Oxford Commercial	$372.00
Rate for Payer: Qualcare PPO/HMO/WC	$279.00
Rate for Payer: UnitedHealthcare Commercial	$372.00
Rate for Payer: UnitedHealthcare Community & State	$44.83
Rate for Payer: Wellpoint Medicaid Managed Care	$49.29

AXID/150MG

Facility

$12.00

Hospital Charge Code	60634998
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

AXID/150MG

Facility

$12.00

Hospital Charge Code	60634998
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

AXILLARY BLOCK NEEDLE 22GX1

Facility

$26.00

Hospital Charge Code	270332389
Hospital Revenue Code	272
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.90

Know your out-of-pocket cost for care.

All Charges