Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PTCA UNSUCESSFUL

Facility

$34,486.68

Hospital Charge Code	1
Hospital Revenue Code	481
Min. Negotiated Rate	$5,173.00
Max. Negotiated Rate	$5,173.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,173.00

PTCA UNSUCESSFUL

Facility

$61,620.70

Service Code	HCPCS C9600
Hospital Charge Code	411039600
Hospital Revenue Code	361
Min. Negotiated Rate	$1,485.06
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18,486.21
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,243.10
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,485.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,632.95

PTCA W/RX STENT/POBA

Facility

$34,486.68

Hospital Charge Code	74110055
Hospital Revenue Code	481
Min. Negotiated Rate	$5,173.00
Max. Negotiated Rate	$5,173.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,173.00

PTCA W/RX STENT/POBA

Facility

$34,486.68

Hospital Charge Code	5100615
Hospital Revenue Code	481
Min. Negotiated Rate	$5,173.00
Max. Negotiated Rate	$5,173.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,173.00

PTCA W/RX STENT/POBA

Facility

$34,486.68

Hospital Charge Code	74110055
Hospital Revenue Code	481
Min. Negotiated Rate	$831.13
Max. Negotiated Rate	$17,243.34
Rate for Payer: Aetna Commercial	$13,104.94
Rate for Payer: Aetna Medicare Advantage	$10,346.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,794.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,794.10
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	$8,794.10
Rate for Payer: Cigna Commercial	$17,243.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,346.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,173.00
Rate for Payer: UnitedHealthcare Community & State	$831.13
Rate for Payer: Wellpoint Medicaid Managed Care	$913.90

PTCA W/RX STENT/POBA

Facility

$34,486.68

Hospital Charge Code	5100615
Hospital Revenue Code	481
Min. Negotiated Rate	$831.13
Max. Negotiated Rate	$17,243.34
Rate for Payer: Aetna Commercial	$13,104.94
Rate for Payer: Aetna Medicare Advantage	$10,346.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,794.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,794.10
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	$8,794.10
Rate for Payer: Cigna Commercial	$17,243.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,346.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,173.00
Rate for Payer: UnitedHealthcare Community & State	$831.13
Rate for Payer: Wellpoint Medicaid Managed Care	$913.90

PT CHEST PHYSICAL THERAPY INIT

Facility

$102.40

Service Code	HCPCS 94667GP
Hospital Charge Code	9000068
Hospital Revenue Code	410
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$38.91
Rate for Payer: Aetna Medicare Advantage	$30.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.11
Rate for Payer: Cigna Commercial	$51.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.72
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.36
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$2.47
Rate for Payer: Wellpoint Medicaid Managed Care	$2.71

PT CHEST PHYSICAL THERAPY INIT

Facility

$102.40

Service Code	HCPCS 94667GP
Hospital Charge Code	9000068
Hospital Revenue Code	410
Min. Negotiated Rate	$15.36
Max. Negotiated Rate	$15.36
Rate for Payer: Qualcare PPO/HMO/WC	$15.36

PT CHEST PHYSICAL THERAPY SUBS

Facility

$62.10

Service Code	HCPCS 94668GP
Hospital Charge Code	9000076
Hospital Revenue Code	410
Min. Negotiated Rate	$9.31
Max. Negotiated Rate	$9.31
Rate for Payer: Qualcare PPO/HMO/WC	$9.31

PT CHEST PHYSICAL THERAPY SUBS

Facility

$62.10

Service Code	HCPCS 94668GP
Hospital Charge Code	9000076
Hospital Revenue Code	410
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$23.60
Rate for Payer: Aetna Medicare Advantage	$18.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.84
Rate for Payer: Cigna Commercial	$31.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.63
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.31
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$1.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1.65

PT CHILD STUDY*****

Facility

$125.00

Service Code	HCPCS 97001
Hospital Charge Code	9000407
Hospital Revenue Code	424
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

PT CHILD STUDY*****

Facility

$125.00

Service Code	HCPCS 97001
Hospital Charge Code	9000407
Hospital Revenue Code	424
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.50
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

PT CHKOUT ORTH/PROS USE EA 15M

Facility

$92.60

Service Code	HCPCS 97763GP
Hospital Charge Code	9100140
Hospital Revenue Code	420
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$35.19
Rate for Payer: Aetna Medicare Advantage	$27.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.61
Rate for Payer: Cigna Commercial	$46.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.78
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.89
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.23
Rate for Payer: Wellpoint Medicaid Managed Care	$2.45

PT CHKOUT ORTH/PROS USE EA 15M

Facility

$92.60

Service Code	HCPCS 97763GP
Hospital Charge Code	9100140
Hospital Revenue Code	420
Min. Negotiated Rate	$13.89
Max. Negotiated Rate	$13.89
Rate for Payer: Qualcare PPO/HMO/WC	$13.89

PT COGNITIV FUNC DIR PT 1ST 15

Facility

$141.00

Service Code	HCPCS 97129GP
Hospital Charge Code	422597129
Hospital Revenue Code	420
Min. Negotiated Rate	$21.15
Max. Negotiated Rate	$21.15
Rate for Payer: Qualcare PPO/HMO/WC	$21.15

PT COGNITIV FUNC DIR PT 1ST 15

Facility

$141.00

Service Code	HCPCS 97129GP
Hospital Charge Code	422597129
Hospital Revenue Code	420
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$53.58
Rate for Payer: Aetna Medicare Advantage	$42.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.95
Rate for Payer: Cigna Commercial	$70.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.30
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.15
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.40
Rate for Payer: Wellpoint Medicaid Managed Care	$3.74

PT COGNITIV FUNC DIR PT ADD 15

Facility

$117.30

Service Code	HCPCS 97130GP
Hospital Charge Code	422597130
Hospital Revenue Code	420
Min. Negotiated Rate	$17.59
Max. Negotiated Rate	$17.59
Rate for Payer: Qualcare PPO/HMO/WC	$17.59

PT COGNITIV FUNC DIR PT ADD 15

Facility

$117.30

Service Code	HCPCS 97130GP
Hospital Charge Code	422597130
Hospital Revenue Code	420
Min. Negotiated Rate	$2.83
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$44.57
Rate for Payer: Aetna Medicare Advantage	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.91
Rate for Payer: Cigna Commercial	$58.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.19
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.59
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.83
Rate for Payer: Wellpoint Medicaid Managed Care	$3.11

PT COMMUNITY/WORK REINTERGRA

Facility

$126.00

Service Code	HCPCS 97537
Hospital Charge Code	1008040
Hospital Revenue Code	420
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$47.88
Rate for Payer: Aetna Medicare Advantage	$37.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.13
Rate for Payer: Cigna Commercial	$63.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.80
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.90
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.04
Rate for Payer: Wellpoint Medicaid Managed Care	$3.34

PT COMMUNITY/WORK REINTERGRA

Facility

$126.00

Service Code	HCPCS 97537
Hospital Charge Code	1008040
Hospital Revenue Code	420
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

PT COMMUNITY/WORK REINTERGRATI

Facility

$161.00

Service Code	HCPCS 97537GP
Hospital Charge Code	9107001
Hospital Revenue Code	420
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$61.18
Rate for Payer: Aetna Medicare Advantage	$48.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.05
Rate for Payer: Cigna Commercial	$80.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.30
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.15
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.88
Rate for Payer: Wellpoint Medicaid Managed Care	$4.27

PT COMMUNITY/WORK REINTERGRATI

Facility

$161.00

Service Code	HCPCS 97537GP
Hospital Charge Code	9107001
Hospital Revenue Code	420
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$24.15
Rate for Payer: Qualcare PPO/HMO/WC	$24.15

PT COMMUNITY/WORK TRAINING

Facility

$102.40

Service Code	HCPCS 97537GP
Hospital Charge Code	9100190
Hospital Revenue Code	420
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$38.91
Rate for Payer: Aetna Medicare Advantage	$30.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.11
Rate for Payer: Cigna Commercial	$51.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.72
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.36
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$2.47
Rate for Payer: Wellpoint Medicaid Managed Care	$2.71

PT COMMUNITY/WORK TRAINING

Facility

$102.40

Service Code	HCPCS 97537GP
Hospital Charge Code	9100190
Hospital Revenue Code	420
Min. Negotiated Rate	$15.36
Max. Negotiated Rate	$15.36
Rate for Payer: Qualcare PPO/HMO/WC	$15.36

PT COMM/WORK REINTEG EA 15 MIN

Facility

$161.00

Service Code	HCPCS 97537GP
Hospital Charge Code	422597537
Hospital Revenue Code	420
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$24.15
Rate for Payer: Qualcare PPO/HMO/WC	$24.15

Know your out-of-pocket cost for care.

All Charges