Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PERC CHOLECYSTOSTOMY

Facility

$17,067.55

Service Code	HCPCS 47490
Hospital Charge Code	2250452
Hospital Revenue Code	361
Min. Negotiated Rate	$411.33
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,120.27
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,560.13
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$411.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$452.29

PERC CRYO ABL RENALTUM-LT

Facility

$16,368.00

Service Code	HCPCS 50593LT
Hospital Charge Code	7411974
Hospital Revenue Code	361
Min. Negotiated Rate	$394.47
Max. Negotiated Rate	$8,184.00
Rate for Payer: Aetna Commercial	$6,219.84
Rate for Payer: Aetna Medicare Advantage	$4,910.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,173.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,173.84
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	$4,173.84
Rate for Payer: Cigna Commercial	$8,184.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,910.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,455.20
Rate for Payer: UnitedHealthcare Community & State	$394.47
Rate for Payer: Wellpoint Medicaid Managed Care	$433.75

PERC CRYO ABL RENALTUM-LT

Facility

$16,368.00

Service Code	HCPCS 50593LT
Hospital Charge Code	2691670
Hospital Revenue Code	361
Min. Negotiated Rate	$2,455.20
Max. Negotiated Rate	$2,455.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,455.20

PERC CRYO ABL RENALTUM-LT

Facility

$16,368.00

Service Code	HCPCS 50593LT
Hospital Charge Code	7411974
Hospital Revenue Code	361
Min. Negotiated Rate	$2,455.20
Max. Negotiated Rate	$2,455.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,455.20

PERC CRYO ABL RENALTUM-LT

Facility

$16,368.00

Service Code	HCPCS 50593LT
Hospital Charge Code	2691670
Hospital Revenue Code	361
Min. Negotiated Rate	$394.47
Max. Negotiated Rate	$8,184.00
Rate for Payer: Aetna Commercial	$6,219.84
Rate for Payer: Aetna Medicare Advantage	$4,910.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,173.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,173.84
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	$4,173.84
Rate for Payer: Cigna Commercial	$8,184.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,910.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,455.20
Rate for Payer: UnitedHealthcare Community & State	$394.47
Rate for Payer: Wellpoint Medicaid Managed Care	$433.75

PERC CRYO ABL RENALTUM-RT

Facility

$16,368.00

Service Code	HCPCS 50593RT
Hospital Charge Code	2691675
Hospital Revenue Code	361
Min. Negotiated Rate	$2,455.20
Max. Negotiated Rate	$2,455.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,455.20

PERC CRYO ABL RENALTUM-RT

Facility

$16,368.00

Service Code	HCPCS 50593RT
Hospital Charge Code	7411975
Hospital Revenue Code	361
Min. Negotiated Rate	$2,455.20
Max. Negotiated Rate	$2,455.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,455.20

PERC CRYO ABL RENALTUM-RT

Facility

$16,368.00

Service Code	HCPCS 50593RT
Hospital Charge Code	7411975
Hospital Revenue Code	361
Min. Negotiated Rate	$394.47
Max. Negotiated Rate	$8,184.00
Rate for Payer: Aetna Commercial	$6,219.84
Rate for Payer: Aetna Medicare Advantage	$4,910.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,173.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,173.84
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	$4,173.84
Rate for Payer: Cigna Commercial	$8,184.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,910.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,455.20
Rate for Payer: UnitedHealthcare Community & State	$394.47
Rate for Payer: Wellpoint Medicaid Managed Care	$433.75

PERC CRYO ABL RENALTUM-RT

Facility

$16,368.00

Service Code	HCPCS 50593RT
Hospital Charge Code	2691675
Hospital Revenue Code	361
Min. Negotiated Rate	$394.47
Max. Negotiated Rate	$8,184.00
Rate for Payer: Aetna Commercial	$6,219.84
Rate for Payer: Aetna Medicare Advantage	$4,910.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,173.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,173.84
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	$4,173.84
Rate for Payer: Cigna Commercial	$8,184.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,910.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,455.20
Rate for Payer: UnitedHealthcare Community & State	$394.47
Rate for Payer: Wellpoint Medicaid Managed Care	$433.75

PERC D-E COR STENT ATHER BR

Facility

$47,735.22

Service Code	HCPCS C9603
Hospital Charge Code	4110C9603
Hospital Revenue Code	480
Min. Negotiated Rate	$1,150.42
Max. Negotiated Rate	$23,867.61
Rate for Payer: Aetna Commercial	$18,139.38
Rate for Payer: Aetna Medicare Advantage	$14,320.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,172.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,172.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,172.48
Rate for Payer: Cigna Commercial	$23,867.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,320.57
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,160.28
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$1,150.42
Rate for Payer: Wellpoint Medicaid Managed Care	$1,264.98

PERC D-E COR STENT ATHER BR

Facility

$47,735.22

Service Code	HCPCS C9603
Hospital Charge Code	4110C9603
Hospital Revenue Code	480
Min. Negotiated Rate	$7,160.28
Max. Negotiated Rate	$7,160.28
Rate for Payer: Qualcare PPO/HMO/WC	$7,160.28

PERC D-E COR STENT ATHER S

Facility

$98,874.75

Service Code	HCPCS C9602
Hospital Charge Code	4110C9602
Hospital Revenue Code	480
Min. Negotiated Rate	$1,580.00
Max. Negotiated Rate	$78,613.74
Rate for Payer: Aetna Commercial	$59,237.44
Rate for Payer: Aetna Medicare Advantage	$70,562.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78,613.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78,613.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,778.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78,613.74
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: Cigna Medicare Advantage	$21,778.47
Rate for Payer: Clover Medicare Advantage	$20,689.55
Rate for Payer: EmblemHealth Commercial	$65,335.41
Rate for Payer: Humana Medicare Advantage	$22,431.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,778.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29,662.42
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$14,831.21
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$2,382.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,778.47
Rate for Payer: Wellcare Medicare Advantage	$21,778.47
Rate for Payer: Wellpoint Medicaid Managed Care	$2,620.18

PERC D-E COR STENT ATHER S

Facility

$98,874.75

Service Code	HCPCS C9602
Hospital Charge Code	4110C9602
Hospital Revenue Code	480
Min. Negotiated Rate	$14,831.21
Max. Negotiated Rate	$14,831.21
Rate for Payer: Qualcare PPO/HMO/WC	$14,831.21

PERC FIX FEM PROX NK FX

Facility

$30,595.00

Service Code	HCPCS 27235
Hospital Charge Code	1600000365
Hospital Revenue Code	360
Min. Negotiated Rate	$4,589.25
Max. Negotiated Rate	$4,589.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25

PERC FIX FEM PROX NK FX

Facility

$30,595.00

Service Code	HCPCS 27235
Hospital Charge Code	1600000365
Hospital Revenue Code	360
Min. Negotiated Rate	$737.34
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,178.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$737.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$810.77

PERC FIX SC/TC HUMERUS FX

Facility

$23,899.60

Service Code	HCPCS 24538
Hospital Charge Code	16000825
Hospital Revenue Code	360
Min. Negotiated Rate	$3,584.94
Max. Negotiated Rate	$3,584.94
Rate for Payer: Qualcare PPO/HMO/WC	$3,584.94

PERC FIX SC/TC HUMERUS FX

Facility

$23,899.60

Service Code	HCPCS 24538
Hospital Charge Code	16000825
Hospital Revenue Code	360
Min. Negotiated Rate	$575.98
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,169.88
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,584.94
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$575.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$633.34

PERC FNA PLEURA-BIL

Facility

$3,604.80

Service Code	HCPCS 1002250
Hospital Charge Code	2250445
Hospital Revenue Code	361
Min. Negotiated Rate	$86.88
Max. Negotiated Rate	$1,802.40
Rate for Payer: Aetna Commercial	$1,369.82
Rate for Payer: Aetna Medicare Advantage	$1,081.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.22
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	$919.22
Rate for Payer: Cigna Commercial	$1,802.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,081.44
Rate for Payer: Qualcare PPO/HMO/WC	$540.72
Rate for Payer: UnitedHealthcare Community & State	$86.88
Rate for Payer: Wellpoint Medicaid Managed Care	$95.53

PERC FNA PLEURA-BIL

Facility

$3,604.80

Service Code	HCPCS 1002250
Hospital Charge Code	2250445
Hospital Revenue Code	361
Min. Negotiated Rate	$540.72
Max. Negotiated Rate	$540.72
Rate for Payer: Qualcare PPO/HMO/WC	$540.72

PERC FNA PLEURA-BIL

Facility

$3,604.80

Service Code	HCPCS 1002250
Hospital Charge Code	7412050
Hospital Revenue Code	361
Min. Negotiated Rate	$86.88
Max. Negotiated Rate	$1,802.40
Rate for Payer: Aetna Commercial	$1,369.82
Rate for Payer: Aetna Medicare Advantage	$1,081.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.22
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	$919.22
Rate for Payer: Cigna Commercial	$1,802.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,081.44
Rate for Payer: Qualcare PPO/HMO/WC	$540.72
Rate for Payer: UnitedHealthcare Community & State	$86.88
Rate for Payer: Wellpoint Medicaid Managed Care	$95.53

PERC FNA PLEURA-BIL

Facility

$3,604.80

Service Code	HCPCS 1002250
Hospital Charge Code	7412050
Hospital Revenue Code	361
Min. Negotiated Rate	$540.72
Max. Negotiated Rate	$540.72
Rate for Payer: Qualcare PPO/HMO/WC	$540.72

PERC FNA PLEURA=BIL

Facility

$3,604.80

Service Code	HCPCS 1002250
Hospital Charge Code	2101195
Hospital Revenue Code	361
Min. Negotiated Rate	$86.88
Max. Negotiated Rate	$1,802.40
Rate for Payer: Aetna Commercial	$1,369.82
Rate for Payer: Aetna Medicare Advantage	$1,081.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.22
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	$919.22
Rate for Payer: Cigna Commercial	$1,802.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,081.44
Rate for Payer: Qualcare PPO/HMO/WC	$540.72
Rate for Payer: UnitedHealthcare Community & State	$86.88
Rate for Payer: Wellpoint Medicaid Managed Care	$95.53

PERC FNA PLEURA=BIL

Facility

$3,604.80

Service Code	HCPCS 1002250
Hospital Charge Code	2101195
Hospital Revenue Code	361
Min. Negotiated Rate	$540.72
Max. Negotiated Rate	$540.72
Rate for Payer: Qualcare PPO/HMO/WC	$540.72

PERC FNA PLEURA-LT

Facility

$2,403.20

Service Code	HCPCS 10022LT
Hospital Charge Code	2250446
Hospital Revenue Code	361
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

PERC FNA PLEURA-LT

Facility

$2,403.20

Service Code	HCPCS 10022LT
Hospital Charge Code	2250446
Hospital Revenue Code	361
Min. Negotiated Rate	$57.92
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$913.22
Rate for Payer: Aetna Medicare Advantage	$720.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.82
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	$612.82
Rate for Payer: Cigna Commercial	$1,201.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.96
Rate for Payer: Qualcare PPO/HMO/WC	$360.48
Rate for Payer: UnitedHealthcare Community & State	$57.92
Rate for Payer: Wellpoint Medicaid Managed Care	$63.68

Know your out-of-pocket cost for care.

All Charges