Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

OBS TEMP TRANSCUT PACING

Facility

$772.00

Hospital Charge Code	910985
Hospital Revenue Code	480
Min. Negotiated Rate	$115.80
Max. Negotiated Rate	$115.80
Rate for Payer: Qualcare PPO/HMO/WC	$115.80

OBSTETRICAL CARE

Facility

$12,676.20

Service Code	HCPCS 59409
Hospital Charge Code	16001012
Hospital Revenue Code	360
Min. Negotiated Rate	$1,901.43
Max. Negotiated Rate	$1,901.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,901.43

OBSTETRICAL CARE

Facility

$12,676.20

Service Code	HCPCS 59409
Hospital Charge Code	16001012
Hospital Revenue Code	360
Min. Negotiated Rate	$305.50
Max. Negotiated Rate	$13,882.15
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,882.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,882.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
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	$13,882.15
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,802.86
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,901.43
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$305.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$335.92

OBSTETRIC PANEL

Facility

$105.00

Service Code	HCPCS 80055
Hospital Charge Code	38476799
Hospital Revenue Code	301
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$172.58
Rate for Payer: Aetna Commercial	$130.04
Rate for Payer: Aetna Medicare Advantage	$154.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$47.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.58
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: Cigna Medicare Advantage	$47.81
Rate for Payer: Clover Medicare Advantage	$45.42
Rate for Payer: EmblemHealth Commercial	$143.43
Rate for Payer: Humana Medicare Advantage	$49.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$47.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$38.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$47.81
Rate for Payer: Wellcare Medicare Advantage	$47.81
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

OBSTETRIC PANEL

Facility

$105.00

Service Code	HCPCS 80055
Hospital Charge Code	38476799
Hospital Revenue Code	301
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

OBS THORACENTESIS WO IMAGING

Facility

$1,103.00

Service Code	HCPCS 32554
Hospital Charge Code	910910
Hospital Revenue Code	361
Min. Negotiated Rate	$26.58
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,027.08
Rate for Payer: Aetna Medicare Advantage	$2,414.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$745.25
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	$2,690.13
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: Cigna Medicare Advantage	$745.25
Rate for Payer: Clover Medicare Advantage	$707.99
Rate for Payer: EmblemHealth Commercial	$2,235.75
Rate for Payer: Humana Medicare Advantage	$767.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.90
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.45
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$26.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$745.25
Rate for Payer: Wellcare Medicare Advantage	$745.25
Rate for Payer: Wellpoint Medicaid Managed Care	$29.23

OBS THORACENTESIS WO IMAGING

Facility

$1,103.00

Service Code	HCPCS 32554
Hospital Charge Code	910910
Hospital Revenue Code	361
Min. Negotiated Rate	$165.45
Max. Negotiated Rate	$165.45
Rate for Payer: Qualcare PPO/HMO/WC	$165.45

OBS VENIPUNCTURE

Facility

$64.00

Service Code	HCPCS 36415
Hospital Charge Code	910920
Hospital Revenue Code	300
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

OBS VENIPUNCTURE

Facility

$64.00

Service Code	HCPCS 36415
Hospital Charge Code	910920
Hospital Revenue Code	300
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$25.40
Rate for Payer: Aetna Medicare Advantage	$30.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.71
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: Cigna Medicare Advantage	$9.34
Rate for Payer: Clover Medicare Advantage	$8.87
Rate for Payer: EmblemHealth Commercial	$28.02
Rate for Payer: Humana Medicare Advantage	$9.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.34
Rate for Payer: Wellcare Medicare Advantage	$9.34
Rate for Payer: Wellpoint Medicaid Managed Care	$1.70

OBTAPE 93-4000

Facility

$4,960.00

Hospital Charge Code	270631182
Hospital Revenue Code	272
Min. Negotiated Rate	$119.54
Max. Negotiated Rate	$2,480.00
Rate for Payer: Aetna Commercial	$1,884.80
Rate for Payer: Aetna Medicare Advantage	$1,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,264.80
Rate for Payer: Cigna Commercial	$2,480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,488.00
Rate for Payer: Oxford Commercial	$992.00
Rate for Payer: Qualcare PPO/HMO/WC	$744.00
Rate for Payer: UnitedHealthcare Commercial	$992.00
Rate for Payer: UnitedHealthcare Community & State	$119.54
Rate for Payer: Wellpoint Medicaid Managed Care	$131.44

OBTAPE 93-4000

Facility

$4,960.00

Hospital Charge Code	270631182
Hospital Revenue Code	272
Min. Negotiated Rate	$744.00
Max. Negotiated Rate	$744.00
Rate for Payer: Qualcare PPO/HMO/WC	$744.00

OB TRANSAB AMNIOINFUSION,US IN

Facility

$669.00

Service Code	HCPCS 59070
Hospital Charge Code	73190023
Hospital Revenue Code	361
Min. Negotiated Rate	$16.12
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$984.72
Rate for Payer: Aetna Medicare Advantage	$1,172.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,306.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,306.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$362.03
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	$1,306.82
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: Cigna Medicare Advantage	$362.03
Rate for Payer: Clover Medicare Advantage	$343.93
Rate for Payer: EmblemHealth Commercial	$1,086.09
Rate for Payer: Humana Medicare Advantage	$372.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$362.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.70
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.35
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$16.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$362.03
Rate for Payer: Wellcare Medicare Advantage	$362.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.73

OB TRANSAB AMNIOINFUSION,US IN

Facility

$669.00

Service Code	HCPCS 59070
Hospital Charge Code	73190023
Hospital Revenue Code	361
Min. Negotiated Rate	$100.35
Max. Negotiated Rate	$100.35
Rate for Payer: Qualcare PPO/HMO/WC	$100.35

OBTURATOR 8MM BLDELESS LONG

Facility

$3,000.00

Hospital Charge Code	270664218
Hospital Revenue Code	270
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

OBTURATOR 8MM BLDELESS LONG

Facility

$3,000.00

Hospital Charge Code	270664218
Hospital Revenue Code	270
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$900.00
Rate for Payer: Oxford Commercial	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Commercial	$600.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

OBTURATOR BLADELESS 8MM

Facility

$125.00

Hospital Charge Code	270663999
Hospital Revenue Code	272
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

OBTURATOR BLADELESS 8MM

Facility

$125.00

Hospital Charge Code	270663999
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

OBTURATOR PENCIL 4.0MM SHARP

Facility

$814.30

Hospital Charge Code	270688983
Hospital Revenue Code	272
Min. Negotiated Rate	$19.62
Max. Negotiated Rate	$407.15
Rate for Payer: Aetna Commercial	$309.43
Rate for Payer: Aetna Medicare Advantage	$244.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.65
Rate for Payer: Cigna Commercial	$407.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.29
Rate for Payer: Oxford Commercial	$162.86
Rate for Payer: Qualcare PPO/HMO/WC	$122.14
Rate for Payer: UnitedHealthcare Commercial	$162.86
Rate for Payer: UnitedHealthcare Community & State	$19.62
Rate for Payer: Wellpoint Medicaid Managed Care	$21.58

OBTURATOR PENCIL 4.0MM SHARP

Facility

$814.30

Hospital Charge Code	270688983
Hospital Revenue Code	272
Min. Negotiated Rate	$122.14
Max. Negotiated Rate	$122.14
Rate for Payer: Qualcare PPO/HMO/WC	$122.14

OBTURATOR PENCIL PKG

Facility

$587.10

Hospital Charge Code	270688258
Hospital Revenue Code	272
Min. Negotiated Rate	$14.15
Max. Negotiated Rate	$293.55
Rate for Payer: Aetna Commercial	$223.10
Rate for Payer: Aetna Medicare Advantage	$176.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.71
Rate for Payer: Cigna Commercial	$293.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.13
Rate for Payer: Oxford Commercial	$117.42
Rate for Payer: Qualcare PPO/HMO/WC	$88.06
Rate for Payer: UnitedHealthcare Commercial	$117.42
Rate for Payer: UnitedHealthcare Community & State	$14.15
Rate for Payer: Wellpoint Medicaid Managed Care	$15.56

OBTURATOR PENCIL PKG

Facility

$587.10

Hospital Charge Code	270688258
Hospital Revenue Code	272
Min. Negotiated Rate	$88.06
Max. Negotiated Rate	$88.06
Rate for Payer: Qualcare PPO/HMO/WC	$88.06

OBTURATOR VERSAPRT RT 5 179769

Facility

$159.45

Hospital Charge Code	270635090
Hospital Revenue Code	272
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$79.72
Rate for Payer: Aetna Commercial	$60.59
Rate for Payer: Aetna Medicare Advantage	$47.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.66
Rate for Payer: Cigna Commercial	$79.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.84
Rate for Payer: Oxford Commercial	$31.89
Rate for Payer: Qualcare PPO/HMO/WC	$23.92
Rate for Payer: UnitedHealthcare Commercial	$31.89
Rate for Payer: UnitedHealthcare Community & State	$3.84
Rate for Payer: Wellpoint Medicaid Managed Care	$4.23

OBTURATOR VERSAPRT RT 5 179769

Facility

$159.45

Hospital Charge Code	270635090
Hospital Revenue Code	272
Min. Negotiated Rate	$23.92
Max. Negotiated Rate	$23.92
Rate for Payer: Qualcare PPO/HMO/WC	$23.92

OBTURATOR XI 8MM BLADELESS XLN

Facility

$150.00

Service Code	HCPCS C1776
Hospital Charge Code	270678879
Hospital Revenue Code	278
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Community & State	$3.62
Rate for Payer: Wellpoint Medicaid Managed Care	$3.98

OBTURATOR XI 8MM BLADELESS XLN

Facility

$150.00

Service Code	HCPCS C1776
Hospital Charge Code	270678879
Hospital Revenue Code	278
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

Know your out-of-pocket cost for care.

All Charges