Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

OBS CATH INSERT-STRAIGHT

Facility

$221.00

Hospital Charge Code	910955
Hospital Revenue Code	761
Min. Negotiated Rate	$33.15
Max. Negotiated Rate	$33.15
Rate for Payer: Qualcare PPO/HMO/WC	$33.15

OBS CHANGE GASTROSTOMY TUBE

Facility

$717.00

Hospital Charge Code	910945
Hospital Revenue Code	750
Min. Negotiated Rate	$17.28
Max. Negotiated Rate	$358.50
Rate for Payer: Aetna Commercial	$272.46
Rate for Payer: Aetna Medicare Advantage	$215.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.84
Rate for Payer: Cigna Commercial	$358.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.10
Rate for Payer: Qualcare PPO/HMO/WC	$107.55
Rate for Payer: UnitedHealthcare Community & State	$17.28
Rate for Payer: Wellpoint Medicaid Managed Care	$19.00

OBS CHANGE GASTROSTOMY TUBE

Facility

$717.00

Hospital Charge Code	910945
Hospital Revenue Code	750
Min. Negotiated Rate	$107.55
Max. Negotiated Rate	$107.55
Rate for Payer: Qualcare PPO/HMO/WC	$107.55

OBS ENDOTRACHEAL INTUBATION

Facility

$662.00

Hospital Charge Code	910901
Hospital Revenue Code	761
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$99.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

OBS ENDOTRACHEAL INTUBATION

Facility

$662.00

Hospital Charge Code	910901
Hospital Revenue Code	761
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$331.00
Rate for Payer: Aetna Commercial	$251.56
Rate for Payer: Aetna Medicare Advantage	$198.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.81
Rate for Payer: Cigna Commercial	$331.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.60
Rate for Payer: Oxford Commercial	$132.40
Rate for Payer: Qualcare PPO/HMO/WC	$99.30
Rate for Payer: UnitedHealthcare Commercial	$132.40
Rate for Payer: UnitedHealthcare Community & State	$15.95
Rate for Payer: Wellpoint Medicaid Managed Care	$17.54

OBSER ASTHMA HOURLY RATE

Facility

$434.00

Service Code	HCPCS 99218
Hospital Charge Code	5250003
Hospital Revenue Code	762
Min. Negotiated Rate	$65.10
Max. Negotiated Rate	$65.10
Rate for Payer: Qualcare PPO/HMO/WC	$65.10

OBSER ASTHMA HOURLY RATE

Facility

$434.00

Service Code	HCPCS 99218
Hospital Charge Code	5250003
Hospital Revenue Code	762
Min. Negotiated Rate	$10.46
Max. Negotiated Rate	$10,384.00
Rate for Payer: Aetna Commercial	$164.92
Rate for Payer: Aetna Medicare Advantage	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.67
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	$110.67
Rate for Payer: Cigna Commercial	$217.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.20
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$65.10
Rate for Payer: UnitedHealthcare Commercial	$10,384.00
Rate for Payer: UnitedHealthcare Community & State	$10.46
Rate for Payer: Wellpoint Medicaid Managed Care	$50.00

OBSER CHEST PAIN HOURLY RATE

Facility

$434.00

Service Code	HCPCS 99218
Hospital Charge Code	5250002
Hospital Revenue Code	762
Min. Negotiated Rate	$65.10
Max. Negotiated Rate	$65.10
Rate for Payer: Qualcare PPO/HMO/WC	$65.10

OBSER CHEST PAIN HOURLY RATE

Facility

$434.00

Service Code	HCPCS 99218
Hospital Charge Code	5250002
Hospital Revenue Code	762
Min. Negotiated Rate	$10.46
Max. Negotiated Rate	$10,384.00
Rate for Payer: Aetna Commercial	$164.92
Rate for Payer: Aetna Medicare Advantage	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.67
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	$110.67
Rate for Payer: Cigna Commercial	$217.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.20
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$65.10
Rate for Payer: UnitedHealthcare Commercial	$10,384.00
Rate for Payer: UnitedHealthcare Community & State	$10.46
Rate for Payer: Wellpoint Medicaid Managed Care	$50.00

OBSER CONGEST HEART FAILURE HR

Facility

$434.00

Service Code	HCPCS 99218
Hospital Charge Code	5250001
Hospital Revenue Code	762
Min. Negotiated Rate	$65.10
Max. Negotiated Rate	$65.10
Rate for Payer: Qualcare PPO/HMO/WC	$65.10

OBSER CONGEST HEART FAILURE HR

Facility

$434.00

Service Code	HCPCS 99218
Hospital Charge Code	5250001
Hospital Revenue Code	762
Min. Negotiated Rate	$10.46
Max. Negotiated Rate	$10,384.00
Rate for Payer: Aetna Commercial	$164.92
Rate for Payer: Aetna Medicare Advantage	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.67
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	$110.67
Rate for Payer: Cigna Commercial	$217.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.20
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$65.10
Rate for Payer: UnitedHealthcare Commercial	$10,384.00
Rate for Payer: UnitedHealthcare Community & State	$10.46
Rate for Payer: Wellpoint Medicaid Managed Care	$50.00

OBSERVATION CARE

Facility

$2,302.00

Service Code	HCPCS G0244
Hospital Charge Code	60629221
Hospital Revenue Code	636
Min. Negotiated Rate	$345.30
Max. Negotiated Rate	$557.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$557.08
Rate for Payer: Qualcare PPO/HMO/WC	$345.30

OBSERVATION CARE

Facility

$2,302.00

Service Code	HCPCS G0244
Hospital Charge Code	60629221
Hospital Revenue Code	636
Min. Negotiated Rate	$55.48
Max. Negotiated Rate	$1,151.00
Rate for Payer: Aetna Commercial	$874.76
Rate for Payer: Aetna Medicare Advantage	$690.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$587.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$587.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$587.01
Rate for Payer: Cigna Commercial	$1,151.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$557.08
Rate for Payer: Qualcare PPO/HMO/WC	$345.30
Rate for Payer: UnitedHealthcare Community & State	$55.48
Rate for Payer: Wellpoint Medicaid Managed Care	$61.00

OBSERVATION DIRECT ADMIT

Facility

$1,303.50

Service Code	HCPCS G0379
Hospital Charge Code	100510
Hospital Revenue Code	762
Min. Negotiated Rate	$31.41
Max. Negotiated Rate	$10,384.00
Rate for Payer: Aetna Commercial	$1,924.43
Rate for Payer: Aetna Medicare Advantage	$2,292.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,553.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,553.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$707.51
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	$2,553.90
Rate for Payer: Cigna Commercial	$1,418.20
Rate for Payer: Cigna Medicare Advantage	$707.51
Rate for Payer: Clover Medicare Advantage	$672.13
Rate for Payer: EmblemHealth Commercial	$2,122.53
Rate for Payer: Humana Medicare Advantage	$728.74
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$707.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$391.05
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.53
Rate for Payer: UnitedHealthcare Commercial	$10,384.00
Rate for Payer: UnitedHealthcare Community & State	$31.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$707.51
Rate for Payer: Wellcare Medicare Advantage	$707.51
Rate for Payer: Wellpoint Medicaid Managed Care	$50.00

OBSERVATION DIRECT ADMIT

Facility

$1,303.50

Service Code	HCPCS G0379
Hospital Charge Code	100510
Hospital Revenue Code	762
Min. Negotiated Rate	$195.53
Max. Negotiated Rate	$195.53
Rate for Payer: Qualcare PPO/HMO/WC	$195.53

OBSERVATION PER HOUR

Facility

$3,582.00

Service Code	HCPCS G0378
Hospital Charge Code	100110
Hospital Revenue Code	762
Min. Negotiated Rate	$50.00
Max. Negotiated Rate	$10,384.00
Rate for Payer: Aetna Commercial	$1,361.16
Rate for Payer: Aetna Medicare Advantage	$1,074.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$913.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$913.41
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	$913.41
Rate for Payer: Cigna Commercial	$1,791.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,074.60
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$537.30
Rate for Payer: UnitedHealthcare Commercial	$10,384.00
Rate for Payer: UnitedHealthcare Community & State	$86.33
Rate for Payer: Wellpoint Medicaid Managed Care	$50.00

OBSERVATION PER HOUR

Facility

$3,582.00

Service Code	HCPCS G0378
Hospital Charge Code	100110
Hospital Revenue Code	762
Min. Negotiated Rate	$537.30
Max. Negotiated Rate	$537.30
Rate for Payer: Qualcare PPO/HMO/WC	$537.30

OBS GASTRIC LAVAGE

Facility

$441.00

Hospital Charge Code	910940
Hospital Revenue Code	750
Min. Negotiated Rate	$10.63
Max. Negotiated Rate	$220.50
Rate for Payer: Aetna Commercial	$167.58
Rate for Payer: Aetna Medicare Advantage	$132.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.45
Rate for Payer: Cigna Commercial	$220.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.30
Rate for Payer: Qualcare PPO/HMO/WC	$66.15
Rate for Payer: UnitedHealthcare Community & State	$10.63
Rate for Payer: Wellpoint Medicaid Managed Care	$11.69

OBS GASTRIC LAVAGE

Facility

$441.00

Hospital Charge Code	910940
Hospital Revenue Code	750
Min. Negotiated Rate	$66.15
Max. Negotiated Rate	$66.15
Rate for Payer: Qualcare PPO/HMO/WC	$66.15

OBS INJECT IM/SQ ANTIBIOT

Facility

$343.00

Hospital Charge Code	911010
Hospital Revenue Code	260
Min. Negotiated Rate	$51.45
Max. Negotiated Rate	$51.45
Rate for Payer: Qualcare PPO/HMO/WC	$51.45

OBS INJECT IM/SQ ANTIBIOT

Facility

$343.00

Hospital Charge Code	911010
Hospital Revenue Code	260
Min. Negotiated Rate	$8.27
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$130.34
Rate for Payer: Aetna Medicare Advantage	$102.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.47
Rate for Payer: Cigna Commercial	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.90
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.45
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$8.27
Rate for Payer: Wellpoint Medicaid Managed Care	$9.09

OBS INJECTION INTRA-ARTERIAL

Facility

$250.00

Service Code	HCPCS 96373
Hospital Charge Code	100112
Hospital Revenue Code	260
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

OBS INJECTION INTRA-ARTERIAL

Facility

$250.00

Service Code	HCPCS 96373
Hospital Charge Code	100112
Hospital Revenue Code	260
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$912.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$912.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$912.17
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

OBS INJECTION INTRADERMAL

Facility

$110.00

Hospital Charge Code	911005
Hospital Revenue Code	924
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$1,041.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.00
Rate for Payer: Oxford Commercial	$594.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$1,041.00
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

OBS INJECTION INTRADERMAL

Facility

$110.00

Hospital Charge Code	911005
Hospital Revenue Code	924
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

Know your out-of-pocket cost for care.

All Charges