Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PERQ PLMT BILE DUCT STENT(S)

Facility

$26,912.85

Service Code	HCPCS 47540
Hospital Charge Code	321047540
Hospital Revenue Code	361
Min. Negotiated Rate	$4,036.93
Max. Negotiated Rate	$4,036.93
Rate for Payer: Qualcare PPO/HMO/WC	$4,036.93

PERQ PLMT BILE DUCT STENT(S)

Facility

$26,912.85

Service Code	HCPCS 47539
Hospital Charge Code	2600233
Hospital Revenue Code	361
Min. Negotiated Rate	$648.60
Max. Negotiated Rate	$25,925.77
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$25,925.77
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,073.85
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,036.93
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$648.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$713.19

PERQ PLMT BILE DUCT STENT(S)

Facility

$26,912.85

Service Code	HCPCS 47539
Hospital Charge Code	321047539
Hospital Revenue Code	361
Min. Negotiated Rate	$648.60
Max. Negotiated Rate	$25,925.77
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$25,925.77
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,073.85
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,036.93
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$648.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$713.19

PERQ PLMT BILE DUCT STENT(S)

Facility

$26,912.85

Service Code	HCPCS 47540
Hospital Charge Code	321047540
Hospital Revenue Code	361
Min. Negotiated Rate	$648.60
Max. Negotiated Rate	$25,925.77
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$25,925.77
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,073.85
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,036.93
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$648.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$713.19

PERQ PLMT BILE DUCT STENT(S)

Facility

$24,264.20

Service Code	HCPCS 47538
Hospital Charge Code	7411567
Hospital Revenue Code	361
Min. Negotiated Rate	$3,639.63
Max. Negotiated Rate	$3,639.63
Rate for Payer: Qualcare PPO/HMO/WC	$3,639.63

PERQ PLMT BILE DUCT STENT(S)

Facility

$24,264.20

Service Code	HCPCS 47540
Hospital Charge Code	2011571
Hospital Revenue Code	361
Min. Negotiated Rate	$3,639.63
Max. Negotiated Rate	$3,639.63
Rate for Payer: Qualcare PPO/HMO/WC	$3,639.63

PERQ PLMT BILE DUCT STENT(S)

Facility

$24,264.20

Service Code	HCPCS 47539
Hospital Charge Code	366847539
Hospital Revenue Code	361
Min. Negotiated Rate	$3,639.63
Max. Negotiated Rate	$3,639.63
Rate for Payer: Qualcare PPO/HMO/WC	$3,639.63

PERQ PLMT BILE DUCT STENT(S)

Facility

$24,264.20

Service Code	HCPCS 47538
Hospital Charge Code	366847538
Hospital Revenue Code	361
Min. Negotiated Rate	$584.77
Max. Negotiated Rate	$25,925.77
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$25,925.77
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,279.26
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,639.63
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$584.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$643.00

PERQ PLMT BILE DUCT STENT(S)

Facility

$26,912.85

Service Code	HCPCS 47538
Hospital Charge Code	321047538
Hospital Revenue Code	361
Min. Negotiated Rate	$4,036.93
Max. Negotiated Rate	$4,036.93
Rate for Payer: Qualcare PPO/HMO/WC	$4,036.93

PERQ PLMT BILE DUCT STENT(S)

Facility

$24,264.20

Service Code	HCPCS 47540
Hospital Charge Code	411047540
Hospital Revenue Code	361
Min. Negotiated Rate	$3,639.63
Max. Negotiated Rate	$3,639.63
Rate for Payer: Qualcare PPO/HMO/WC	$3,639.63

PERQ PLMT BILE DUCT STENT(S)

Facility

$26,912.85

Service Code	HCPCS 47540
Hospital Charge Code	2600234
Hospital Revenue Code	361
Min. Negotiated Rate	$4,036.93
Max. Negotiated Rate	$4,036.93
Rate for Payer: Qualcare PPO/HMO/WC	$4,036.93

PERQ PLMT BILE DUCT STENT(S)

Facility

$24,264.20

Service Code	HCPCS 47539
Hospital Charge Code	411047539
Hospital Revenue Code	361
Min. Negotiated Rate	$3,639.63
Max. Negotiated Rate	$3,639.63
Rate for Payer: Qualcare PPO/HMO/WC	$3,639.63

PERQ REMOVAL OF KIDNEY STONE

Facility

$49,882.40

Service Code	HCPCS 50080
Hospital Charge Code	404650080
Hospital Revenue Code	360
Min. Negotiated Rate	$1,202.17
Max. Negotiated Rate	$40,596.17
Rate for Payer: Aetna Commercial	$30,590.24
Rate for Payer: Aetna Medicare Advantage	$36,438.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40,596.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40,596.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,246.41
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	$40,596.17
Rate for Payer: Cigna Commercial	$22,543.37
Rate for Payer: Cigna Medicare Advantage	$11,246.41
Rate for Payer: Clover Medicare Advantage	$10,684.09
Rate for Payer: EmblemHealth Commercial	$33,739.23
Rate for Payer: Humana Medicare Advantage	$11,583.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11,246.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,964.72
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,482.36
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$1,202.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,246.41
Rate for Payer: Wellcare Medicare Advantage	$11,246.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1,321.88

PERQ REMOVAL OF KIDNEY STONE

Facility

$49,882.40

Service Code	HCPCS 50080
Hospital Charge Code	404650080
Hospital Revenue Code	360
Min. Negotiated Rate	$7,482.36
Max. Negotiated Rate	$7,482.36
Rate for Payer: Qualcare PPO/HMO/WC	$7,482.36

PERQ TRLUML CORONRY LITHOTRP

Facility

$13,012.00

Service Code	HCPCS 92972
Hospital Charge Code	74110108
Hospital Revenue Code	481
Min. Negotiated Rate	$1,951.80
Max. Negotiated Rate	$1,951.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,951.80

PERQ TRLUML CORONRY LITHOTRP

Facility

$13,012.00

Service Code	HCPCS 92972
Hospital Charge Code	74110108
Hospital Revenue Code	481
Min. Negotiated Rate	$313.59
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$4,944.56
Rate for Payer: Aetna Medicare Advantage	$3,903.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,318.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,318.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,318.06
Rate for Payer: Cigna Commercial	$6,506.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,903.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,951.80
Rate for Payer: UnitedHealthcare Community & State	$313.59
Rate for Payer: Wellpoint Medicaid Managed Care	$344.82

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22513
Hospital Charge Code	7411355
Hospital Revenue Code	320
Min. Negotiated Rate	$5,630.17
Max. Negotiated Rate	$5,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22514
Hospital Charge Code	411022514
Hospital Revenue Code	320
Min. Negotiated Rate	$5,630.17
Max. Negotiated Rate	$5,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22514
Hospital Charge Code	7411356
Hospital Revenue Code	320
Min. Negotiated Rate	$904.58
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	$8,443.42
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	$6,034.40
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	$11,260.34
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$904.58
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	$994.66

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22514
Hospital Charge Code	366822514
Hospital Revenue Code	320
Min. Negotiated Rate	$5,630.17
Max. Negotiated Rate	$5,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22513
Hospital Charge Code	411022513
Hospital Revenue Code	320
Min. Negotiated Rate	$5,630.17
Max. Negotiated Rate	$5,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22514
Hospital Charge Code	411022514
Hospital Revenue Code	320
Min. Negotiated Rate	$904.58
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	$8,443.42
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	$6,034.40
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	$11,260.34
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$904.58
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	$994.66

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	366822515
Hospital Revenue Code	320
Min. Negotiated Rate	$372.20
Max. Negotiated Rate	$7,721.93
Rate for Payer: Aetna Commercial	$5,868.66
Rate for Payer: Aetna Medicare Advantage	$4,633.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,128.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,938.18
Rate for Payer: Cigna Commercial	$7,721.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,633.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$372.20
Rate for Payer: Wellpoint Medicaid Managed Care	$409.26

PERQ VERTEBRAL AUGMENTATION

Facility

$37,534.48

Service Code	HCPCS 22514
Hospital Charge Code	7411356
Hospital Revenue Code	320
Min. Negotiated Rate	$5,630.17
Max. Negotiated Rate	$5,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,630.17

PERQ VERTEBRAL AUGMENTATION

Facility

$15,443.85

Service Code	HCPCS 22515
Hospital Charge Code	411022515
Hospital Revenue Code	320
Min. Negotiated Rate	$372.20
Max. Negotiated Rate	$7,721.93
Rate for Payer: Aetna Commercial	$5,868.66
Rate for Payer: Aetna Medicare Advantage	$4,633.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,128.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,938.18
Rate for Payer: Cigna Commercial	$7,721.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,633.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$372.20
Rate for Payer: Wellpoint Medicaid Managed Care	$409.26

Know your out-of-pocket cost for care.

All Charges