Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PERCUTANEOUS INSERTION KIT

Facility

$1,395.00

Hospital Charge Code	270675965
Hospital Revenue Code	272
Min. Negotiated Rate	$33.62
Max. Negotiated Rate	$697.50
Rate for Payer: Aetna Commercial	$530.10
Rate for Payer: Aetna Medicare Advantage	$418.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.73
Rate for Payer: Cigna Commercial	$697.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$418.50
Rate for Payer: Oxford Commercial	$279.00
Rate for Payer: Qualcare PPO/HMO/WC	$209.25
Rate for Payer: UnitedHealthcare Commercial	$279.00
Rate for Payer: UnitedHealthcare Community & State	$33.62
Rate for Payer: Wellpoint Medicaid Managed Care	$36.97

PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$30,369.10

Service Code	APR-DRG 0302
Min. Negotiated Rate	$29,773.63
Max. Negotiated Rate	$30,369.10
Rate for Payer: UnitedHealthcare Community & State	$29,773.63
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$30,369.10
Rate for Payer: Wellpoint Medicaid Managed Care	$29,773.63

PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$22,946.29

Service Code	APR-DRG 0301
Min. Negotiated Rate	$22,496.36
Max. Negotiated Rate	$22,946.29
Rate for Payer: UnitedHealthcare Community & State	$22,496.36
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,946.29
Rate for Payer: Wellpoint Medicaid Managed Care	$22,496.36

PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$41,472.61

Service Code	APR-DRG 0303
Min. Negotiated Rate	$40,659.42
Max. Negotiated Rate	$41,472.61
Rate for Payer: UnitedHealthcare Community & State	$40,659.42
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$41,472.61
Rate for Payer: Wellpoint Medicaid Managed Care	$40,659.42

PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES

Facility

$55,150.04

Service Code	APR-DRG 0304
Min. Negotiated Rate	$54,068.67
Max. Negotiated Rate	$55,150.04
Rate for Payer: UnitedHealthcare Community & State	$54,068.67
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$55,150.04
Rate for Payer: Wellpoint Medicaid Managed Care	$54,068.67

PERCUTANEOUS LAMINOTOMY/LAMINECTOMY (INTERLAMINAR APPROACH) FOR DECOMPRESSION OF NEURAL ELEMENTS, (WITH OR WITHOUT LIGAMENTOUS RESECTION, DISCECTOMY, FACETECTOMY AND/OR FORAMINOTOMY), ANY METHOD, UNDER INDIRECT IMAGE GUIDANCE (EG, FLUOROSCOPIC, CT), SINGLE OR MULTIPLE LEVELS, UNILATERAL OR BILATERAL; LUMBAR

Facility

$14,834.00

Service Code	CPT 0275T
Hospital Revenue Code	360
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$14,834.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: UnitedHealthcare Commercial	$14,834.00

PERCUTANEOUS LMBR DECOMPR

Facility

$18,840.10

Service Code	HCPCS 22533
Hospital Charge Code	1600000821
Hospital Revenue Code	360
Min. Negotiated Rate	$2,826.01
Max. Negotiated Rate	$2,826.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,826.01

PERCUTANEOUS LMBR DECOMPR

Facility

$18,840.10

Service Code	HCPCS 22533
Hospital Charge Code	1600000821
Hospital Revenue Code	360
Min. Negotiated Rate	$454.05
Max. Negotiated Rate	$75,192.36
Rate for Payer: Aetna Commercial	$56,659.34
Rate for Payer: Aetna Medicare Advantage	$67,491.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75,192.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75,192.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,830.64
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	$75,192.36
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: Cigna Medicare Advantage	$20,830.64
Rate for Payer: Clover Medicare Advantage	$19,789.11
Rate for Payer: EmblemHealth Commercial	$62,491.92
Rate for Payer: Humana Medicare Advantage	$21,455.56
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,830.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,652.03
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,826.01
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$454.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,830.64
Rate for Payer: Wellcare Medicare Advantage	$20,830.64
Rate for Payer: Wellpoint Medicaid Managed Care	$499.26

PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES

Facility

$49,732.97

Service Code	APR-DRG 1832
Min. Negotiated Rate	$48,757.81
Max. Negotiated Rate	$49,732.97
Rate for Payer: UnitedHealthcare Community & State	$48,757.81
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$49,732.97
Rate for Payer: Wellpoint Medicaid Managed Care	$48,757.81

PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES

Facility

$48,674.58

Service Code	APR-DRG 1831
Min. Negotiated Rate	$47,720.18
Max. Negotiated Rate	$48,674.58
Rate for Payer: UnitedHealthcare Community & State	$47,720.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$48,674.58
Rate for Payer: Wellpoint Medicaid Managed Care	$47,720.18

PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES

Facility

$86,403.88

Service Code	APR-DRG 1834
Min. Negotiated Rate	$84,709.69
Max. Negotiated Rate	$86,403.88
Rate for Payer: UnitedHealthcare Community & State	$84,709.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$86,403.88
Rate for Payer: Wellpoint Medicaid Managed Care	$84,709.69

PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES

Facility

$57,713.66

Service Code	APR-DRG 1833
Min. Negotiated Rate	$56,582.02
Max. Negotiated Rate	$57,713.66
Rate for Payer: UnitedHealthcare Community & State	$56,582.02
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$57,713.66
Rate for Payer: Wellpoint Medicaid Managed Care	$56,582.02

PERCUTAN INSERT KIT ARTERIAL

Facility

$284.75

Hospital Charge Code	2703110S
Hospital Revenue Code	272
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$142.38
Rate for Payer: Aetna Commercial	$108.20
Rate for Payer: Aetna Medicare Advantage	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.61
Rate for Payer: Cigna Commercial	$142.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.42
Rate for Payer: Oxford Commercial	$56.95
Rate for Payer: Qualcare PPO/HMO/WC	$42.71
Rate for Payer: UnitedHealthcare Commercial	$56.95
Rate for Payer: UnitedHealthcare Community & State	$6.86
Rate for Payer: Wellpoint Medicaid Managed Care	$7.55

PERCUTAN INSERT KIT ARTERIAL

Facility

$284.75

Hospital Charge Code	2703110S
Hospital Revenue Code	272
Min. Negotiated Rate	$42.71
Max. Negotiated Rate	$42.71
Rate for Payer: Qualcare PPO/HMO/WC	$42.71

PERCUTAN INSERT KIT VENOUS

Facility

$284.75

Hospital Charge Code	2703110T
Hospital Revenue Code	272
Min. Negotiated Rate	$42.71
Max. Negotiated Rate	$42.71
Rate for Payer: Qualcare PPO/HMO/WC	$42.71

PERCUTAN INSERT KIT VENOUS

Facility

$284.75

Hospital Charge Code	2703110T
Hospital Revenue Code	272
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$142.38
Rate for Payer: Aetna Commercial	$108.20
Rate for Payer: Aetna Medicare Advantage	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.61
Rate for Payer: Cigna Commercial	$142.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.42
Rate for Payer: Oxford Commercial	$56.95
Rate for Payer: Qualcare PPO/HMO/WC	$42.71
Rate for Payer: UnitedHealthcare Commercial	$56.95
Rate for Payer: UnitedHealthcare Community & State	$6.86
Rate for Payer: Wellpoint Medicaid Managed Care	$7.55

PERCUT BX LUNG/MEDIASTINUM

Facility

$8,407.60

Service Code	HCPCS 32408
Hospital Charge Code	16000183
Hospital Revenue Code	360
Min. Negotiated Rate	$1,261.14
Max. Negotiated Rate	$1,261.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,261.14

PERCUT BX LUNG/MEDIASTINUM

Facility

$8,407.60

Service Code	HCPCS 32408
Hospital Charge Code	16000183
Hospital Revenue Code	360
Min. Negotiated Rate	$202.62
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,522.28
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,261.14
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$202.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$222.80

PERDIEM GRANULES

Facility

$23.00

Hospital Charge Code	60634871
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

PERDIEM GRANULES

Facility

$23.00

Hospital Charge Code	60634871
Hospital Revenue Code	250
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$8.74
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.90
Rate for Payer: Oxford Commercial	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$4.60
Rate for Payer: UnitedHealthcare Community & State	$0.55
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

PERFECT SCALPEL

Facility

$825.00

Hospital Charge Code	270704788
Hospital Revenue Code	279
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.50
Rate for Payer: Oxford Commercial	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Commercial	$165.00
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

PERFECT SCALPEL

Facility

$825.00

Hospital Charge Code	270704788
Hospital Revenue Code	279
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$123.75
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

PERFLUTREN LIPD MICRO SUSP 2ML

Facility

$1,045.20

Service Code	NDC 11994001104
Hospital Charge Code	6063943158
Hospital Revenue Code	250
Min. Negotiated Rate	$156.78
Max. Negotiated Rate	$156.78
Rate for Payer: Qualcare PPO/HMO/WC	$156.78

PERFLUTREN LIPD MICRO SUSP 2ML

Facility

$1,045.20

Service Code	NDC 11994001104
Hospital Charge Code	6063943158
Hospital Revenue Code	250
Min. Negotiated Rate	$25.19
Max. Negotiated Rate	$522.60
Rate for Payer: Aetna Commercial	$397.18
Rate for Payer: Aetna Medicare Advantage	$313.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$266.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$266.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$266.53
Rate for Payer: Cigna Commercial	$522.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.56
Rate for Payer: Oxford Commercial	$209.04
Rate for Payer: Qualcare PPO/HMO/WC	$156.78
Rate for Payer: UnitedHealthcare Commercial	$209.04
Rate for Payer: UnitedHealthcare Community & State	$25.19
Rate for Payer: Wellpoint Medicaid Managed Care	$27.70

PERFORATOR AMNIHOOK

Facility

$16.85

Hospital Charge Code	270130010
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

Know your out-of-pocket cost for care.

All Charges