Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PERC PORTAL VEIN CATHETEZATION

Facility

$3,987.20

Service Code	HCPCS 36481
Hospital Charge Code	16000734
Hospital Revenue Code	360
Min. Negotiated Rate	$598.08
Max. Negotiated Rate	$598.08
Rate for Payer: Qualcare PPO/HMO/WC	$598.08

PERC PORTAL VEIN CATHETEZATION

Facility

$3,987.20

Service Code	HCPCS 36481
Hospital Charge Code	16000734
Hospital Revenue Code	360
Min. Negotiated Rate	$96.09
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,515.14
Rate for Payer: Aetna Medicare Advantage	$1,196.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,016.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,016.74
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	$1,016.74
Rate for Payer: Cigna Commercial	$1,993.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,196.16
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$598.08
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$96.09
Rate for Payer: Wellpoint Medicaid Managed Care	$105.66

PERC PRE-BENT ROD 70MM

Facility

$1,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270703858
Hospital Revenue Code	278
Min. Negotiated Rate	$31.93
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$31.93
Rate for Payer: Wellpoint Medicaid Managed Care	$35.11

PERC PRE-BENT ROD 70MM

Facility

$1,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270703858
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

PERC PRE-BENT ROD 70MM

Facility

$1,325.00

Service Code	HCPCS C1889
Hospital Charge Code	2707038583
Hospital Revenue Code	278
Min. Negotiated Rate	$31.93
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$31.93
Rate for Payer: Wellpoint Medicaid Managed Care	$35.11

PERC PRE-BENT ROD 70MM

Facility

$1,325.00

Service Code	HCPCS C1889
Hospital Charge Code	2707038583
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

PERC ROD 150MM

Facility

$1,541.05

Hospital Charge Code	270703338
Hospital Revenue Code	279
Min. Negotiated Rate	$231.16
Max. Negotiated Rate	$231.16
Rate for Payer: Qualcare PPO/HMO/WC	$231.16

PERC ROD 150MM

Facility

$1,541.05

Hospital Charge Code	270703338
Hospital Revenue Code	279
Min. Negotiated Rate	$37.14
Max. Negotiated Rate	$770.52
Rate for Payer: Aetna Commercial	$585.60
Rate for Payer: Aetna Medicare Advantage	$462.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$392.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$392.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$392.97
Rate for Payer: Cigna Commercial	$770.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$462.31
Rate for Payer: Oxford Commercial	$308.21
Rate for Payer: Qualcare PPO/HMO/WC	$231.16
Rate for Payer: UnitedHealthcare Commercial	$308.21
Rate for Payer: UnitedHealthcare Community & State	$37.14
Rate for Payer: Wellpoint Medicaid Managed Care	$40.84

PERC ROD PRE-BENT 5.5X50MM

Facility

$1,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270704528
Hospital Revenue Code	278
Min. Negotiated Rate	$31.93
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$31.93
Rate for Payer: Wellpoint Medicaid Managed Care	$35.11

PERC ROD PRE-BENT 5.5X50MM

Facility

$1,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270704528
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

PERC SK FIXATION MC FX,EA BONE

Facility

$23,899.60

Service Code	HCPCS 26608
Hospital Charge Code	16000292
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 SK FIXATION MC FX,EA BONE

Facility

$23,899.60

Service Code	HCPCS 26608
Hospital Charge Code	16000292
Hospital Revenue Code	360
Min. Negotiated Rate	$575.98
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
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	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$633.34

PERC SK FIX METATARSAL FX W MA

Facility

$28,255.00

Service Code	HCPCS 28476
Hospital Charge Code	16000725
Hospital Revenue Code	360
Min. Negotiated Rate	$680.95
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,476.50
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,238.25
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$680.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$748.76

PERC SK FIX METATARSAL FX W MA

Facility

$28,255.00

Service Code	HCPCS 28476
Hospital Charge Code	16000725
Hospital Revenue Code	360
Min. Negotiated Rate	$4,238.25
Max. Negotiated Rate	$4,238.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,238.25

PERC SK FIX UNST PHAL SHFT F1

Facility

$23,899.60

Service Code	HCPCS 26727
Hospital Charge Code	16000293
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 SK FIX UNST PHAL SHFT F1

Facility

$23,899.60

Service Code	HCPCS 26727
Hospital Charge Code	16000293
Hospital Revenue Code	360
Min. Negotiated Rate	$575.98
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
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	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$633.34

PERC SKTL FX D PHA FX FNGR/THM

Facility

$23,899.60

Service Code	HCPCS 26756
Hospital Charge Code	16000476
Hospital Revenue Code	360
Min. Negotiated Rate	$575.98
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
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	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$633.34

PERC SKTL FX D PHA FX FNGR/THM

Facility

$23,899.60

Service Code	HCPCS 26756
Hospital Charge Code	16000476
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

PERCUCUT BIOPSY NEEDLE 21G X 1

Facility

$180.00

Hospital Charge Code	270331868
Hospital Revenue Code	272
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$90.00
Rate for Payer: Aetna Commercial	$68.40
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.00
Rate for Payer: Oxford Commercial	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$36.00
Rate for Payer: UnitedHealthcare Community & State	$4.34
Rate for Payer: Wellpoint Medicaid Managed Care	$4.77

PERCUCUT BIOPSY NEEDLE 21G X 1

Facility

$180.00

Hospital Charge Code	270331868
Hospital Revenue Code	272
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

PERCUIGUIDE 20Gx10CM LESION MA

Facility

$108.15

Hospital Charge Code	270664731
Hospital Revenue Code	270
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$54.08
Rate for Payer: Aetna Commercial	$41.10
Rate for Payer: Aetna Medicare Advantage	$32.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.58
Rate for Payer: Cigna Commercial	$54.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.45
Rate for Payer: Oxford Commercial	$21.63
Rate for Payer: Qualcare PPO/HMO/WC	$16.22
Rate for Payer: UnitedHealthcare Commercial	$21.63
Rate for Payer: UnitedHealthcare Community & State	$2.61
Rate for Payer: Wellpoint Medicaid Managed Care	$2.87

PERCUIGUIDE 20Gx10CM LESION MA

Facility

$108.15

Hospital Charge Code	270664731
Hospital Revenue Code	270
Min. Negotiated Rate	$16.22
Max. Negotiated Rate	$16.22
Rate for Payer: Qualcare PPO/HMO/WC	$16.22

PERCUIGUIDE 20Gx5CM LESIONMARK

Facility

$108.15

Hospital Charge Code	270664052
Hospital Revenue Code	270
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$54.08
Rate for Payer: Aetna Commercial	$41.10
Rate for Payer: Aetna Medicare Advantage	$32.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.58
Rate for Payer: Cigna Commercial	$54.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.45
Rate for Payer: Oxford Commercial	$21.63
Rate for Payer: Qualcare PPO/HMO/WC	$16.22
Rate for Payer: UnitedHealthcare Commercial	$21.63
Rate for Payer: UnitedHealthcare Community & State	$2.61
Rate for Payer: Wellpoint Medicaid Managed Care	$2.87

PERCUIGUIDE 20Gx5CM LESIONMARK

Facility

$108.15

Hospital Charge Code	270664052
Hospital Revenue Code	270
Min. Negotiated Rate	$16.22
Max. Negotiated Rate	$16.22
Rate for Payer: Qualcare PPO/HMO/WC	$16.22

PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC

Facility

$135,477.08

Service Code	MSDRG 273
Min. Negotiated Rate	$41,251.03
Max. Negotiated Rate	$135,477.08
Rate for Payer: Aetna Commercial	$93,345.54
Rate for Payer: Aetna Medicare Advantage	$135,477.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90,717.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90,717.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$43,422.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90,717.90
Rate for Payer: Cigna Commercial	$77,204.61
Rate for Payer: Cigna Medicare Advantage	$43,422.14
Rate for Payer: Clover Medicare Advantage	$41,251.03
Rate for Payer: EmblemHealth Commercial	$130,266.42
Rate for Payer: Humana Medicare Advantage	$44,724.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$43,422.14
Rate for Payer: Oxford Commercial	$55,487.97
Rate for Payer: UnitedHealthcare Commercial	$97,299.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$43,422.14
Rate for Payer: Wellcare Medicare Advantage	$43,422.14

Know your out-of-pocket cost for care.

All Charges