Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLMT NEPHROURETERAL CATH

Facility

$8,875.68

Service Code	HCPCS 50433
Hospital Charge Code	2250436
Hospital Revenue Code	361
Min. Negotiated Rate	$213.90
Max. Negotiated Rate	$15,116.59
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,116.59
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.70
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.35
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$213.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$235.21

PLMT NEPHROURETERAL CATH

Facility

$8,875.68

Service Code	HCPCS 50433
Hospital Charge Code	2250436
Hospital Revenue Code	361
Min. Negotiated Rate	$1,331.35
Max. Negotiated Rate	$1,331.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.35

PLMT NEPHROURETERAL CATH

Facility

$8,875.68

Service Code	HCPCS 50433
Hospital Charge Code	366850433
Hospital Revenue Code	361
Min. Negotiated Rate	$1,331.35
Max. Negotiated Rate	$1,331.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.35

PLMT NEPHROURETERAL CATH

Facility

$8,875.68

Service Code	HCPCS 50433
Hospital Charge Code	366850433
Hospital Revenue Code	361
Min. Negotiated Rate	$213.90
Max. Negotiated Rate	$15,116.59
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,116.59
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.70
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.35
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$213.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$235.21

PLMT NEPHROURETERAL CATH

Facility

$8,875.68

Service Code	HCPCS 50433
Hospital Charge Code	2250437
Hospital Revenue Code	361
Min. Negotiated Rate	$1,331.35
Max. Negotiated Rate	$1,331.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.35

PLMT NEPHROURETERAL CATH

Facility

$8,875.68

Service Code	HCPCS 50433
Hospital Charge Code	2250437
Hospital Revenue Code	361
Min. Negotiated Rate	$213.90
Max. Negotiated Rate	$15,116.59
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,116.59
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.70
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.35
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$213.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$235.21

PLMT NEPHROURETERAL CATH

Facility

$10,187.80

Service Code	HCPCS 50433
Hospital Charge Code	2600225
Hospital Revenue Code	361
Min. Negotiated Rate	$245.53
Max. Negotiated Rate	$15,116.59
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,116.59
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,056.34
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$245.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$269.98

PLMT NEPHROURETERAL CATH

Facility

$10,187.80

Service Code	HCPCS 50433
Hospital Charge Code	321050433
Hospital Revenue Code	361
Min. Negotiated Rate	$245.53
Max. Negotiated Rate	$15,116.59
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,116.59
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,056.34
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$245.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$269.98

PLMT NEPHROURETERAL CATH

Facility

$8,875.68

Service Code	HCPCS 50433
Hospital Charge Code	7411609
Hospital Revenue Code	361
Min. Negotiated Rate	$213.90
Max. Negotiated Rate	$15,116.59
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,116.59
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.70
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.35
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$213.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$235.21

PLMT NEPHROURETERAL CATH

Facility

$10,187.80

Service Code	HCPCS 50433
Hospital Charge Code	2600225
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

PLMT NEPHROURETERAL CATH

Facility

$10,187.80

Service Code	HCPCS 50433
Hospital Charge Code	321050433
Hospital Revenue Code	361
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

PLMT NEPHROURETERAL CATH BIL

Facility

$8,875.68

Service Code	HCPCS 5043350
Hospital Charge Code	2011573
Hospital Revenue Code	361
Min. Negotiated Rate	$1,331.35
Max. Negotiated Rate	$1,331.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.35

PLMT NEPHROURETERAL CATH BIL

Facility

$8,875.68

Service Code	HCPCS 5043350
Hospital Charge Code	2011573
Hospital Revenue Code	361
Min. Negotiated Rate	$213.90
Max. Negotiated Rate	$4,437.84
Rate for Payer: Aetna Commercial	$3,372.76
Rate for Payer: Aetna Medicare Advantage	$2,662.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,263.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,263.30
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	$2,263.30
Rate for Payer: Cigna Commercial	$4,437.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.35
Rate for Payer: UnitedHealthcare Community & State	$213.90
Rate for Payer: Wellpoint Medicaid Managed Care	$235.21

PLMT NEPHROURETERAL CATHETER

Facility

$6,782.72

Service Code	HCPCS 50433
Hospital Charge Code	1600000428
Hospital Revenue Code	360
Min. Negotiated Rate	$1,017.41
Max. Negotiated Rate	$1,017.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,017.41

PLMT NEPHROURETERAL CATHETER

Facility

$6,782.72

Service Code	HCPCS 50433
Hospital Charge Code	1600000428
Hospital Revenue Code	360
Min. Negotiated Rate	$163.46
Max. Negotiated Rate	$15,116.59
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,116.59
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,034.82
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,017.41
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$163.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$179.74

PLMT NEPHROURETERAL CATH LT

Facility

$8,875.68

Service Code	HCPCS 50433LT
Hospital Charge Code	2011588
Hospital Revenue Code	361
Min. Negotiated Rate	$1,331.35
Max. Negotiated Rate	$1,331.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.35

PLMT NEPHROURETERAL CATH LT

Facility

$8,875.68

Service Code	HCPCS 50433LT
Hospital Charge Code	2011588
Hospital Revenue Code	361
Min. Negotiated Rate	$213.90
Max. Negotiated Rate	$4,437.84
Rate for Payer: Aetna Commercial	$3,372.76
Rate for Payer: Aetna Medicare Advantage	$2,662.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,263.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,263.30
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	$2,263.30
Rate for Payer: Cigna Commercial	$4,437.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.35
Rate for Payer: UnitedHealthcare Community & State	$213.90
Rate for Payer: Wellpoint Medicaid Managed Care	$235.21

PLMT NEPHROURETERAL CATH RT

Facility

$9,500.00

Service Code	HCPCS 50433RT
Hospital Charge Code	2250435
Hospital Revenue Code	361
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

PLMT NEPHROURETERAL CATH RT

Facility

$9,500.00

Service Code	HCPCS 50433RT
Hospital Charge Code	2250435
Hospital Revenue Code	361
Min. Negotiated Rate	$228.95
Max. Negotiated Rate	$4,750.00
Rate for Payer: Aetna Commercial	$3,610.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
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	$2,422.50
Rate for Payer: Cigna Commercial	$4,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Community & State	$228.95
Rate for Payer: Wellpoint Medicaid Managed Care	$251.75

PLMT URETERL STNT EXISTING

Facility

$13,218.42

Service Code	HCPCS 50693
Hospital Charge Code	7411617
Hospital Revenue Code	361
Min. Negotiated Rate	$1,982.76
Max. Negotiated Rate	$1,982.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,982.76

PLMT URETERL STNT EXISTING

Facility

$13,218.42

Service Code	HCPCS 50693
Hospital Charge Code	2600228
Hospital Revenue Code	361
Min. Negotiated Rate	$318.56
Max. Negotiated Rate	$15,116.59
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,116.59
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,965.53
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,982.76
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$318.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$350.29

PLMT URETERL STNT EXISTING

Facility

$13,482.90

Service Code	HCPCS 50693
Hospital Charge Code	411050693
Hospital Revenue Code	361
Min. Negotiated Rate	$324.94
Max. Negotiated Rate	$15,116.59
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,116.59
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,044.87
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,022.43
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$324.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$357.30

PLMT URETERL STNT EXISTING

Facility

$13,218.42

Service Code	HCPCS 50693
Hospital Charge Code	7411617
Hospital Revenue Code	361
Min. Negotiated Rate	$318.56
Max. Negotiated Rate	$15,116.59
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,116.59
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,965.53
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,982.76
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$318.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$350.29

PLMT URETERL STNT EXISTING

Facility

$13,218.42

Service Code	HCPCS 50693
Hospital Charge Code	321050693
Hospital Revenue Code	361
Min. Negotiated Rate	$318.56
Max. Negotiated Rate	$15,116.59
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
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	$15,116.59
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,965.53
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,982.76
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$318.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$350.29

PLMT URETERL STNT EXISTING

Facility

$13,218.42

Service Code	HCPCS 50693
Hospital Charge Code	321050693
Hospital Revenue Code	361
Min. Negotiated Rate	$1,982.76
Max. Negotiated Rate	$1,982.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,982.76

Know your out-of-pocket cost for care.

All Charges