Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PUNCH BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11104
Hospital Charge Code	303511104
Hospital Revenue Code	510
Min. Negotiated Rate	$24.93
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.35
Rate for Payer: Qualcare PPO/HMO/WC	$155.17
Rate for Payer: UnitedHealthcare Community & State	$24.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$27.41

PUNCH BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11104
Hospital Charge Code	303511104
Hospital Revenue Code	510
Min. Negotiated Rate	$155.17
Max. Negotiated Rate	$155.17
Rate for Payer: Qualcare PPO/HMO/WC	$155.17

PUNCH BX SKIN EA ADD LESION

Facility

$517.25

Service Code	HCPCS 11105
Hospital Charge Code	303511105
Hospital Revenue Code	510
Min. Negotiated Rate	$77.59
Max. Negotiated Rate	$77.59
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

PUNCH BX SKIN EA ADD LESION

Facility

$517.25

Service Code	HCPCS 11105
Hospital Charge Code	303511105
Hospital Revenue Code	510
Min. Negotiated Rate	$12.47
Max. Negotiated Rate	$258.62
Rate for Payer: Aetna Commercial	$196.56
Rate for Payer: Aetna Medicare Advantage	$155.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.90
Rate for Payer: Cigna Commercial	$258.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.18
Rate for Payer: Qualcare PPO/HMO/WC	$77.59
Rate for Payer: UnitedHealthcare Community & State	$12.47
Rate for Payer: Wellpoint Medicaid Managed Care	$13.71

PUNCH BX SKIN EA ADD LESION

Facility

$517.25

Service Code	HCPCS 11105
Hospital Charge Code	395011105
Hospital Revenue Code	761
Min. Negotiated Rate	$77.59
Max. Negotiated Rate	$77.59
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

PUNCH BX SKIN EA ADD LESION

Facility

$517.25

Service Code	HCPCS 11105
Hospital Charge Code	395011105
Hospital Revenue Code	761
Min. Negotiated Rate	$12.47
Max. Negotiated Rate	$258.62
Rate for Payer: Aetna Commercial	$196.56
Rate for Payer: Aetna Medicare Advantage	$155.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.90
Rate for Payer: Cigna Commercial	$258.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.18
Rate for Payer: Oxford Commercial	$103.45
Rate for Payer: Qualcare PPO/HMO/WC	$77.59
Rate for Payer: UnitedHealthcare Commercial	$103.45
Rate for Payer: UnitedHealthcare Community & State	$12.47
Rate for Payer: Wellpoint Medicaid Managed Care	$13.71

PUNCH BX SKIN EA ADD LESION

Facility

$517.25

Service Code	HCPCS 11105
Hospital Charge Code	450211105
Hospital Revenue Code	761
Min. Negotiated Rate	$77.59
Max. Negotiated Rate	$77.59
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

PUNCH BX SKIN EA ADD LESION

Facility

$517.25

Service Code	HCPCS 11105
Hospital Charge Code	412311105
Hospital Revenue Code	361
Min. Negotiated Rate	$77.59
Max. Negotiated Rate	$77.59
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

PUNCH BX SKIN EA ADD LESION

Facility

$517.25

Service Code	HCPCS 11105
Hospital Charge Code	412311105
Hospital Revenue Code	361
Min. Negotiated Rate	$12.47
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$196.56
Rate for Payer: Aetna Medicare Advantage	$155.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.90
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	$131.90
Rate for Payer: Cigna Commercial	$258.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.18
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$77.59
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$12.47
Rate for Payer: Wellpoint Medicaid Managed Care	$13.71

PUNCH BX SKIN EA ADD LESION

Facility

$517.25

Service Code	HCPCS 11105
Hospital Charge Code	450211105
Hospital Revenue Code	761
Min. Negotiated Rate	$12.47
Max. Negotiated Rate	$258.62
Rate for Payer: Aetna Commercial	$196.56
Rate for Payer: Aetna Medicare Advantage	$155.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.90
Rate for Payer: Cigna Commercial	$258.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.18
Rate for Payer: Oxford Commercial	$103.45
Rate for Payer: Qualcare PPO/HMO/WC	$77.59
Rate for Payer: UnitedHealthcare Commercial	$103.45
Rate for Payer: UnitedHealthcare Community & State	$12.47
Rate for Payer: Wellpoint Medicaid Managed Care	$13.71

PUNCH BX SKIN EA SEP/ADDL

Facility

$368.14

Service Code	HCPCS 11105
Hospital Charge Code	1600000510
Hospital Revenue Code	360
Min. Negotiated Rate	$55.22
Max. Negotiated Rate	$55.22
Rate for Payer: Qualcare PPO/HMO/WC	$55.22

PUNCH BX SKIN EA SEP/ADDL

Facility

$368.14

Service Code	HCPCS 11105
Hospital Charge Code	160000201
Hospital Revenue Code	360
Min. Negotiated Rate	$8.87
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$139.89
Rate for Payer: Aetna Medicare Advantage	$110.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.88
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	$93.88
Rate for Payer: Cigna Commercial	$184.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.44
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.22
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$8.87
Rate for Payer: Wellpoint Medicaid Managed Care	$9.76

PUNCH BX SKIN EA SEP/ADDL

Facility

$368.14

Service Code	HCPCS 11105
Hospital Charge Code	160000201
Hospital Revenue Code	360
Min. Negotiated Rate	$55.22
Max. Negotiated Rate	$55.22
Rate for Payer: Qualcare PPO/HMO/WC	$55.22

PUNCH BX SKIN EA SEP/ADDL

Facility

$368.14

Service Code	HCPCS 11105
Hospital Charge Code	1600000510
Hospital Revenue Code	360
Min. Negotiated Rate	$8.87
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$139.89
Rate for Payer: Aetna Medicare Advantage	$110.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.88
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	$93.88
Rate for Payer: Cigna Commercial	$184.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.44
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.22
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$8.87
Rate for Payer: Wellpoint Medicaid Managed Care	$9.76

PUNCH BX SKIN SINGLE LESION

Facility

$2,160.92

Service Code	HCPCS 11104
Hospital Charge Code	16000346
Hospital Revenue Code	360
Min. Negotiated Rate	$52.08
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
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	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.28
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.14
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$52.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$57.26

PUNCH BX SKIN SINGLE LESION

Facility

$2,160.92

Service Code	HCPCS 11104
Hospital Charge Code	16000346
Hospital Revenue Code	360
Min. Negotiated Rate	$324.14
Max. Negotiated Rate	$324.14
Rate for Payer: Qualcare PPO/HMO/WC	$324.14

PUNCH CORNEA 8.5 MM

Facility

$315.00

Hospital Charge Code	270657589
Hospital Revenue Code	270
Min. Negotiated Rate	$47.25
Max. Negotiated Rate	$47.25
Rate for Payer: Qualcare PPO/HMO/WC	$47.25

PUNCH CORNEA 8.5 MM

Facility

$315.00

Hospital Charge Code	270657589
Hospital Revenue Code	270
Min. Negotiated Rate	$7.59
Max. Negotiated Rate	$157.50
Rate for Payer: Aetna Commercial	$119.70
Rate for Payer: Aetna Medicare Advantage	$94.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.33
Rate for Payer: Cigna Commercial	$157.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.50
Rate for Payer: Oxford Commercial	$63.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.25
Rate for Payer: UnitedHealthcare Commercial	$63.00
Rate for Payer: UnitedHealthcare Community & State	$7.59
Rate for Payer: Wellpoint Medicaid Managed Care	$8.35

PUNCH CORNEA DON 7.25MM

Facility

$430.45

Hospital Charge Code	270600214
Hospital Revenue Code	272
Min. Negotiated Rate	$10.37
Max. Negotiated Rate	$215.22
Rate for Payer: Aetna Commercial	$163.57
Rate for Payer: Aetna Medicare Advantage	$129.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.76
Rate for Payer: Cigna Commercial	$215.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.13
Rate for Payer: Oxford Commercial	$86.09
Rate for Payer: Qualcare PPO/HMO/WC	$64.57
Rate for Payer: UnitedHealthcare Commercial	$86.09
Rate for Payer: UnitedHealthcare Community & State	$10.37
Rate for Payer: Wellpoint Medicaid Managed Care	$11.41

PUNCH CORNEA DON 7.25MM

Facility

$430.45

Hospital Charge Code	270600214
Hospital Revenue Code	272
Min. Negotiated Rate	$64.57
Max. Negotiated Rate	$64.57
Rate for Payer: Qualcare PPO/HMO/WC	$64.57

PUNCH CORNEA DON 8.0MM

Facility

$345.00

Hospital Charge Code	270600223
Hospital Revenue Code	272
Min. Negotiated Rate	$8.31
Max. Negotiated Rate	$172.50
Rate for Payer: Aetna Commercial	$131.10
Rate for Payer: Aetna Medicare Advantage	$103.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.97
Rate for Payer: Cigna Commercial	$172.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.50
Rate for Payer: Oxford Commercial	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.75
Rate for Payer: UnitedHealthcare Commercial	$69.00
Rate for Payer: UnitedHealthcare Community & State	$8.31
Rate for Payer: Wellpoint Medicaid Managed Care	$9.14

PUNCH CORNEA DON 8.0MM

Facility

$345.00

Hospital Charge Code	270600223
Hospital Revenue Code	272
Min. Negotiated Rate	$51.75
Max. Negotiated Rate	$51.75
Rate for Payer: Qualcare PPO/HMO/WC	$51.75

PUNCH CORNEA DONO 7.5MM

Facility

$360.00

Hospital Charge Code	270600215
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

PUNCH CORNEA DONO 7.5MM

Facility

$360.00

Hospital Charge Code	270600215
Hospital Revenue Code	272
Min. Negotiated Rate	$8.68
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$136.80
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.00
Rate for Payer: Oxford Commercial	$72.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$72.00
Rate for Payer: UnitedHealthcare Community & State	$8.68
Rate for Payer: Wellpoint Medicaid Managed Care	$9.54

PUNCH CORNEA DONO 7.7MM

Facility

$430.45

Hospital Charge Code	270600222
Hospital Revenue Code	272
Min. Negotiated Rate	$10.37
Max. Negotiated Rate	$215.22
Rate for Payer: Aetna Commercial	$163.57
Rate for Payer: Aetna Medicare Advantage	$129.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.76
Rate for Payer: Cigna Commercial	$215.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.13
Rate for Payer: Oxford Commercial	$86.09
Rate for Payer: Qualcare PPO/HMO/WC	$64.57
Rate for Payer: UnitedHealthcare Commercial	$86.09
Rate for Payer: UnitedHealthcare Community & State	$10.37
Rate for Payer: Wellpoint Medicaid Managed Care	$11.41

Know your out-of-pocket cost for care.

All Charges