Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

OBS INSERT CENTRAL LINE VEIN

Facility

$2,756.00

Hospital Charge Code	910930
Hospital Revenue Code	761
Min. Negotiated Rate	$66.42
Max. Negotiated Rate	$1,378.00
Rate for Payer: Aetna Commercial	$1,047.28
Rate for Payer: Aetna Medicare Advantage	$826.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$702.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$702.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$702.78
Rate for Payer: Cigna Commercial	$1,378.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$826.80
Rate for Payer: Oxford Commercial	$551.20
Rate for Payer: Qualcare PPO/HMO/WC	$413.40
Rate for Payer: UnitedHealthcare Commercial	$551.20
Rate for Payer: UnitedHealthcare Community & State	$66.42
Rate for Payer: Wellpoint Medicaid Managed Care	$73.03

OBS INSERT CENTRAL LINE VEIN

Facility

$2,756.00

Hospital Charge Code	910930
Hospital Revenue Code	761
Min. Negotiated Rate	$413.40
Max. Negotiated Rate	$413.40
Rate for Payer: Qualcare PPO/HMO/WC	$413.40

OBS INSERT CHEST TUBE WO IMAGE

Facility

$1,103.00

Service Code	HCPCS 32556
Hospital Charge Code	910915
Hospital Revenue Code	361
Min. Negotiated Rate	$165.45
Max. Negotiated Rate	$165.45
Rate for Payer: Qualcare PPO/HMO/WC	$165.45

OBS INSERT CHEST TUBE WO IMAGE

Facility

$1,103.00

Service Code	HCPCS 32556
Hospital Charge Code	910915
Hospital Revenue Code	361
Min. Negotiated Rate	$26.58
Max. Negotiated Rate	$8,229.07
Rate for Payer: Aetna Commercial	$6,200.81
Rate for Payer: Aetna Medicare Advantage	$7,386.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,229.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,229.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,279.71
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	$8,229.07
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: Cigna Medicare Advantage	$2,279.71
Rate for Payer: Clover Medicare Advantage	$2,165.72
Rate for Payer: EmblemHealth Commercial	$6,839.13
Rate for Payer: Humana Medicare Advantage	$2,348.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,279.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.90
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.45
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$26.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,279.71
Rate for Payer: Wellcare Medicare Advantage	$2,279.71
Rate for Payer: Wellpoint Medicaid Managed Care	$29.23

OBS IV INFUSION PUMP > 8 HRS

Facility

$772.00

Hospital Charge Code	911020
Hospital Revenue Code	260
Min. Negotiated Rate	$115.80
Max. Negotiated Rate	$115.80
Rate for Payer: Qualcare PPO/HMO/WC	$115.80

OBS IV INFUSION PUMP > 8 HRS

Facility

$772.00

Hospital Charge Code	911020
Hospital Revenue Code	260
Min. Negotiated Rate	$18.61
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$293.36
Rate for Payer: Aetna Medicare Advantage	$231.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.86
Rate for Payer: Cigna Commercial	$386.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.60
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$115.80
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$18.61
Rate for Payer: Wellpoint Medicaid Managed Care	$20.46

OBS IV PUSH-1STMED INITAL AVS

Facility

$394.88

Hospital Charge Code	911015
Hospital Revenue Code	260
Min. Negotiated Rate	$59.23
Max. Negotiated Rate	$59.23
Rate for Payer: Qualcare PPO/HMO/WC	$59.23

OBS IV PUSH-1STMED INITAL AVS

Facility

$394.88

Hospital Charge Code	911015
Hospital Revenue Code	260
Min. Negotiated Rate	$9.52
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$150.05
Rate for Payer: Aetna Medicare Advantage	$118.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.69
Rate for Payer: Cigna Commercial	$197.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.46
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.23
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$9.52
Rate for Payer: Wellpoint Medicaid Managed Care	$10.46

OBS LUMBAR PUNCTURE

Facility

$662.00

Hospital Charge Code	910970
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

OBS LUMBAR PUNCTURE

Facility

$662.00

Hospital Charge Code	910970
Hospital Revenue Code	761
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$99.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

OBS NG TUBE INSERT

Facility

$386.00

Hospital Charge Code	910935
Hospital Revenue Code	750
Min. Negotiated Rate	$57.90
Max. Negotiated Rate	$57.90
Rate for Payer: Qualcare PPO/HMO/WC	$57.90

OBS NG TUBE INSERT

Facility

$386.00

Hospital Charge Code	910935
Hospital Revenue Code	750
Min. Negotiated Rate	$9.30
Max. Negotiated Rate	$193.00
Rate for Payer: Aetna Commercial	$146.68
Rate for Payer: Aetna Medicare Advantage	$115.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.43
Rate for Payer: Cigna Commercial	$193.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.80
Rate for Payer: Qualcare PPO/HMO/WC	$57.90
Rate for Payer: UnitedHealthcare Community & State	$9.30
Rate for Payer: Wellpoint Medicaid Managed Care	$10.23

OBS OBSERVATION

Facility

$497.00

Service Code	HCPCS G0379
Hospital Charge Code	911035
Hospital Revenue Code	762
Min. Negotiated Rate	$74.55
Max. Negotiated Rate	$74.55
Rate for Payer: Qualcare PPO/HMO/WC	$74.55

OBS OBSERVATION

Facility

$497.00

Service Code	HCPCS G0379
Hospital Charge Code	911035
Hospital Revenue Code	762
Min. Negotiated Rate	$11.98
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	$149.10
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.55
Rate for Payer: UnitedHealthcare Commercial	$10,384.00
Rate for Payer: UnitedHealthcare Community & State	$11.98
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

OBS PARACENTESIS W/IMAGE

Facility

$1,103.00

Hospital Charge Code	910950
Hospital Revenue Code	761
Min. Negotiated Rate	$26.58
Max. Negotiated Rate	$551.50
Rate for Payer: Aetna Commercial	$419.14
Rate for Payer: Aetna Medicare Advantage	$330.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$281.26
Rate for Payer: Cigna Commercial	$551.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.90
Rate for Payer: Oxford Commercial	$220.60
Rate for Payer: Qualcare PPO/HMO/WC	$165.45
Rate for Payer: UnitedHealthcare Commercial	$220.60
Rate for Payer: UnitedHealthcare Community & State	$26.58
Rate for Payer: Wellpoint Medicaid Managed Care	$29.23

OBS PARACENTESIS W/IMAGE

Facility

$1,103.00

Hospital Charge Code	910950
Hospital Revenue Code	761
Min. Negotiated Rate	$165.45
Max. Negotiated Rate	$165.45
Rate for Payer: Qualcare PPO/HMO/WC	$165.45

OBS PERIPHERAL NERVE BLOCK

Facility

$662.00

Hospital Charge Code	910975
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

OBS PERIPHERAL NERVE BLOCK

Facility

$662.00

Hospital Charge Code	910975
Hospital Revenue Code	761
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$99.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

OBS PULSE OX-CONTINUOUS(1 PD)

Facility

$303.00

Hospital Charge Code	911000
Hospital Revenue Code	460
Min. Negotiated Rate	$45.45
Max. Negotiated Rate	$45.45
Rate for Payer: Qualcare PPO/HMO/WC	$45.45

OBS PULSE OX-CONTINUOUS(1 PD)

Facility

$303.00

Hospital Charge Code	911000
Hospital Revenue Code	460
Min. Negotiated Rate	$7.30
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$115.14
Rate for Payer: Aetna Medicare Advantage	$90.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.27
Rate for Payer: Cigna Commercial	$151.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.90
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.45
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$7.30
Rate for Payer: Wellpoint Medicaid Managed Care	$8.03

OBS SUCTIONING NASOTRACHEAL

Facility

$282.00

Hospital Charge Code	910905
Hospital Revenue Code	761
Min. Negotiated Rate	$42.30
Max. Negotiated Rate	$42.30
Rate for Payer: Qualcare PPO/HMO/WC	$42.30

OBS SUCTIONING NASOTRACHEAL

Facility

$282.00

Hospital Charge Code	910905
Hospital Revenue Code	761
Min. Negotiated Rate	$6.80
Max. Negotiated Rate	$141.00
Rate for Payer: Aetna Commercial	$107.16
Rate for Payer: Aetna Medicare Advantage	$84.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.91
Rate for Payer: Cigna Commercial	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.60
Rate for Payer: Oxford Commercial	$56.40
Rate for Payer: Qualcare PPO/HMO/WC	$42.30
Rate for Payer: UnitedHealthcare Commercial	$56.40
Rate for Payer: UnitedHealthcare Community & State	$6.80
Rate for Payer: Wellpoint Medicaid Managed Care	$7.47

OBS TELEMETRY ( 1 PER DAY )

Facility

$551.00

Hospital Charge Code	910995
Hospital Revenue Code	480
Min. Negotiated Rate	$13.28
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$209.38
Rate for Payer: Aetna Medicare Advantage	$165.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.50
Rate for Payer: Cigna Commercial	$275.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.30
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.65
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$13.28
Rate for Payer: Wellpoint Medicaid Managed Care	$14.60

OBS TELEMETRY ( 1 PER DAY )

Facility

$551.00

Hospital Charge Code	910995
Hospital Revenue Code	480
Min. Negotiated Rate	$82.65
Max. Negotiated Rate	$82.65
Rate for Payer: Qualcare PPO/HMO/WC	$82.65

OBS TEMP TRANSCUT PACING

Facility

$772.00

Hospital Charge Code	910985
Hospital Revenue Code	480
Min. Negotiated Rate	$18.61
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$293.36
Rate for Payer: Aetna Medicare Advantage	$231.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.86
Rate for Payer: Cigna Commercial	$386.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.60
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$115.80
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$18.61
Rate for Payer: Wellpoint Medicaid Managed Care	$20.46

Know your out-of-pocket cost for care.

All Charges