Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PUDDLE-VAC LVT 9321

Facility

$75.00

Hospital Charge Code	270600358
Hospital Revenue Code	270
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

PUDDLE-VAC LVT 9321

Facility

$75.00

Hospital Charge Code	270600358
Hospital Revenue Code	270
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

PUL ART BALLOON REPR PERCUT

Facility

$35,998.44

Service Code	HCPCS 92998
Hospital Charge Code	411092998
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PUL ART BALLOON REPR PERCUT

Facility

$35,998.40

Service Code	HCPCS 92997
Hospital Charge Code	411092997
Hospital Revenue Code	481
Min. Negotiated Rate	$867.56
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	$3,194.00
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	$10,799.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.76
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$867.56
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	$953.96

PUL ART BALLOON REPR PERCUT

Facility

$35,998.44

Service Code	HCPCS 92998
Hospital Charge Code	411092998
Hospital Revenue Code	481
Min. Negotiated Rate	$867.56
Max. Negotiated Rate	$17,999.22
Rate for Payer: Aetna Commercial	$13,679.41
Rate for Payer: Aetna Medicare Advantage	$10,799.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,179.60
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	$9,179.60
Rate for Payer: Cigna Commercial	$17,999.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,799.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$867.56
Rate for Payer: Wellpoint Medicaid Managed Care	$953.96

PUL ART BALLOON REPR PERCUT

Facility

$35,998.40

Service Code	HCPCS 92997
Hospital Charge Code	411092997
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.76
Max. Negotiated Rate	$5,399.76
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.76

PULLER BMT PLUG 6MM 423868

Facility

$1,556.85

Hospital Charge Code	270615809
Hospital Revenue Code	272
Min. Negotiated Rate	$233.53
Max. Negotiated Rate	$233.53
Rate for Payer: Qualcare PPO/HMO/WC	$233.53

PULLER BMT PLUG 6MM 423868

Facility

$1,556.85

Hospital Charge Code	270615809
Hospital Revenue Code	272
Min. Negotiated Rate	$37.52
Max. Negotiated Rate	$778.42
Rate for Payer: Aetna Commercial	$591.60
Rate for Payer: Aetna Medicare Advantage	$467.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$397.00
Rate for Payer: Cigna Commercial	$778.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.06
Rate for Payer: Oxford Commercial	$311.37
Rate for Payer: Qualcare PPO/HMO/WC	$233.53
Rate for Payer: UnitedHealthcare Commercial	$311.37
Rate for Payer: UnitedHealthcare Community & State	$37.52
Rate for Payer: Wellpoint Medicaid Managed Care	$41.26

PULM FUNC PRE/POST BRONCHDL

Facility

$6,100.00

Service Code	HCPCS 94060
Hospital Charge Code	9500034
Hospital Revenue Code	460
Min. Negotiated Rate	$147.01
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$1,205.83
Rate for Payer: Aetna Medicare Advantage	$1,436.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$443.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,600.25
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: Cigna Medicare Advantage	$443.32
Rate for Payer: Clover Medicare Advantage	$421.15
Rate for Payer: EmblemHealth Commercial	$1,329.96
Rate for Payer: Humana Medicare Advantage	$456.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$443.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,830.00
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$147.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$443.32
Rate for Payer: Wellcare Medicare Advantage	$443.32
Rate for Payer: Wellpoint Medicaid Managed Care	$161.65

PULM FUNC PRE/POST BRONCHDL

Facility

$6,100.00

Service Code	HCPCS 94060
Hospital Charge Code	9500034
Hospital Revenue Code	460
Min. Negotiated Rate	$915.00
Max. Negotiated Rate	$915.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00

PULMO-AIDE DEVILBISS

Facility

$760.00

Hospital Charge Code	270600617
Hospital Revenue Code	272
Min. Negotiated Rate	$18.32
Max. Negotiated Rate	$380.00
Rate for Payer: Aetna Commercial	$288.80
Rate for Payer: Aetna Medicare Advantage	$228.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$193.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$193.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$193.80
Rate for Payer: Cigna Commercial	$380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.00
Rate for Payer: Oxford Commercial	$152.00
Rate for Payer: Qualcare PPO/HMO/WC	$114.00
Rate for Payer: UnitedHealthcare Commercial	$152.00
Rate for Payer: UnitedHealthcare Community & State	$18.32
Rate for Payer: Wellpoint Medicaid Managed Care	$20.14

PULMO-AIDE DEVILBISS

Facility

$760.00

Hospital Charge Code	270600617
Hospital Revenue Code	272
Min. Negotiated Rate	$114.00
Max. Negotiated Rate	$114.00
Rate for Payer: Qualcare PPO/HMO/WC	$114.00

PULMOCARE

Facility

$7.00

Hospital Charge Code	60635159
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

PULMOCARE

Facility

$7.00

Hospital Charge Code	60635159
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.66
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.40
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

PULMONARY EDEMA AND RESPIRATORY FAILURE

Facility

$42,064.25

Service Code	MSDRG 189
Min. Negotiated Rate	$12,808.02
Max. Negotiated Rate	$42,064.25
Rate for Payer: Aetna Commercial	$29,160.26
Rate for Payer: Aetna Medicare Advantage	$42,064.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,611.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,611.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,482.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28,611.03
Rate for Payer: Cigna Commercial	$23,119.28
Rate for Payer: Cigna Medicare Advantage	$13,482.13
Rate for Payer: Clover Medicare Advantage	$12,808.02
Rate for Payer: EmblemHealth Commercial	$40,446.39
Rate for Payer: Humana Medicare Advantage	$13,886.59
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,482.13
Rate for Payer: Oxford Commercial	$16,616.13
Rate for Payer: UnitedHealthcare Commercial	$29,136.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,482.13
Rate for Payer: Wellcare Medicare Advantage	$13,482.13

PULMONARY EMBOLISM

Facility

$7,120.17

Service Code	APR-DRG 1341
Min. Negotiated Rate	$6,980.56
Max. Negotiated Rate	$7,120.17
Rate for Payer: UnitedHealthcare Community & State	$6,980.56
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,120.17
Rate for Payer: Wellpoint Medicaid Managed Care	$6,980.56

PULMONARY EMBOLISM

Facility

$9,090.17

Service Code	APR-DRG 1342
Min. Negotiated Rate	$8,911.93
Max. Negotiated Rate	$9,090.17
Rate for Payer: UnitedHealthcare Community & State	$8,911.93
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,090.17
Rate for Payer: Wellpoint Medicaid Managed Care	$8,911.93

PULMONARY EMBOLISM

Facility

$22,253.07

Service Code	APR-DRG 1344
Min. Negotiated Rate	$21,816.74
Max. Negotiated Rate	$22,253.07
Rate for Payer: UnitedHealthcare Community & State	$21,816.74
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,253.07
Rate for Payer: Wellpoint Medicaid Managed Care	$21,816.74

PULMONARY EMBOLISM

Facility

$13,456.54

Service Code	APR-DRG 1343
Min. Negotiated Rate	$13,192.69
Max. Negotiated Rate	$13,456.54
Rate for Payer: UnitedHealthcare Community & State	$13,192.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,456.54
Rate for Payer: Wellpoint Medicaid Managed Care	$13,192.69

PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE

Facility

$46,531.15

Service Code	MSDRG 175
Min. Negotiated Rate	$14,168.14
Max. Negotiated Rate	$46,531.15
Rate for Payer: Aetna Commercial	$32,229.51
Rate for Payer: Aetna Medicare Advantage	$46,531.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32,565.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32,565.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,913.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32,565.40
Rate for Payer: Cigna Commercial	$25,705.55
Rate for Payer: Cigna Medicare Advantage	$14,913.83
Rate for Payer: Clover Medicare Advantage	$14,168.14
Rate for Payer: EmblemHealth Commercial	$44,741.49
Rate for Payer: Humana Medicare Advantage	$15,361.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,913.83
Rate for Payer: Oxford Commercial	$18,474.92
Rate for Payer: UnitedHealthcare Commercial	$32,396.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,913.83
Rate for Payer: Wellcare Medicare Advantage	$14,913.83

PULMONARY EMBOLISM WITHOUT MCC

Facility

$28,153.01

Service Code	MSDRG 176
Min. Negotiated Rate	$8,572.23
Max. Negotiated Rate	$28,153.01
Rate for Payer: Aetna Commercial	$19,601.64
Rate for Payer: Aetna Medicare Advantage	$28,153.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,074.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,074.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,023.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19,074.02
Rate for Payer: Cigna Commercial	$15,064.77
Rate for Payer: Cigna Medicare Advantage	$9,023.40
Rate for Payer: Clover Medicare Advantage	$8,572.23
Rate for Payer: EmblemHealth Commercial	$27,070.20
Rate for Payer: Humana Medicare Advantage	$9,294.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,023.40
Rate for Payer: Oxford Commercial	$10,827.25
Rate for Payer: UnitedHealthcare Commercial	$18,985.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,023.40
Rate for Payer: Wellcare Medicare Advantage	$9,023.40

PULMONARY FUNC DIFFUSION

Facility

$6,100.00

Service Code	HCPCS 94729
Hospital Charge Code	9500042
Hospital Revenue Code	460
Min. Negotiated Rate	$915.00
Max. Negotiated Rate	$915.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00

PULMONARY FUNC DIFFUSION

Facility

$6,100.00

Service Code	HCPCS 94729
Hospital Charge Code	9500042
Hospital Revenue Code	460
Min. Negotiated Rate	$60.46
Max. Negotiated Rate	$3,050.00
Rate for Payer: Aetna Commercial	$2,318.00
Rate for Payer: Aetna Medicare Advantage	$1,830.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,555.50
Rate for Payer: Cigna Commercial	$3,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,830.00
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$147.01
Rate for Payer: Wellpoint Medicaid Managed Care	$161.65

PULMONARY FUNC LUNG VOLUME

Facility

$6,100.00

Service Code	HCPCS 94727
Hospital Charge Code	9500043
Hospital Revenue Code	460
Min. Negotiated Rate	$915.00
Max. Negotiated Rate	$915.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00

PULMONARY FUNC LUNG VOLUME

Facility

$6,100.00

Service Code	HCPCS 94727
Hospital Charge Code	9500043
Hospital Revenue Code	460
Min. Negotiated Rate	$47.14
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$925.96
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,830.00
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$147.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$161.65

Know your out-of-pocket cost for care.

All Charges