Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RADIAL STYLOID PLT SID RAD 5H

Facility

$4,605.00

Hospital Charge Code	270702937
Hospital Revenue Code	278
Min. Negotiated Rate	$110.98
Max. Negotiated Rate	$2,302.50
Rate for Payer: Aetna Commercial	$1,749.90
Rate for Payer: Aetna Medicare Advantage	$1,381.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,174.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,174.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$921.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,174.28
Rate for Payer: Cigna Commercial	$2,302.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,114.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,013.10
Rate for Payer: Qualcare PPO/HMO/WC	$690.75
Rate for Payer: UnitedHealthcare Community & State	$110.98
Rate for Payer: Wellpoint Medicaid Managed Care	$122.03

RADIAL STYLOID PLT SID RAD 5H

Facility

$4,605.00

Hospital Charge Code	270702937
Hospital Revenue Code	278
Min. Negotiated Rate	$690.75
Max. Negotiated Rate	$1,114.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$921.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,114.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,013.10
Rate for Payer: Qualcare PPO/HMO/WC	$690.75

RADIALUCENT DILATOR ABBOT SPN

Facility

$295.00

Hospital Charge Code	270339026
Hospital Revenue Code	272
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.50
Rate for Payer: Oxford Commercial	$59.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: UnitedHealthcare Commercial	$59.00
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$7.82

RADIALUCENT DILATOR ABBOT SPN

Facility

$295.00

Hospital Charge Code	270339026
Hospital Revenue Code	272
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$44.25
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

RADIATION PHYSICS CONSULT

Facility

$711.65

Service Code	HCPCS 77370
Hospital Charge Code	85000660
Hospital Revenue Code	333
Min. Negotiated Rate	$17.15
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$434.33
Rate for Payer: Aetna Medicare Advantage	$517.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$576.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$576.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$159.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$576.40
Rate for Payer: Cigna Commercial	$320.09
Rate for Payer: Cigna Medicare Advantage	$111.78
Rate for Payer: Clover Medicare Advantage	$151.70
Rate for Payer: EmblemHealth Commercial	$479.04
Rate for Payer: Humana Medicare Advantage	$164.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$159.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.50
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$106.75
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$17.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$159.68
Rate for Payer: Wellcare Medicare Advantage	$159.68
Rate for Payer: Wellpoint Medicaid Managed Care	$18.86

RADIATION PHYSICS CONSULT

Facility

$711.65

Service Code	HCPCS 77336
Hospital Charge Code	85000640
Hospital Revenue Code	333
Min. Negotiated Rate	$106.75
Max. Negotiated Rate	$106.75
Rate for Payer: Qualcare PPO/HMO/WC	$106.75

RADIATION PHYSICS CONSULT

Facility

$711.65

Service Code	HCPCS 77370
Hospital Charge Code	85000660
Hospital Revenue Code	333
Min. Negotiated Rate	$106.75
Max. Negotiated Rate	$106.75
Rate for Payer: Qualcare PPO/HMO/WC	$106.75

RADIATION PHYSICS CONSULT

Facility

$711.65

Service Code	HCPCS 77336
Hospital Charge Code	85000640M
Hospital Revenue Code	333
Min. Negotiated Rate	$17.15
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$434.33
Rate for Payer: Aetna Medicare Advantage	$517.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$576.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$576.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$159.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$576.40
Rate for Payer: Cigna Commercial	$320.09
Rate for Payer: Cigna Medicare Advantage	$111.78
Rate for Payer: Clover Medicare Advantage	$151.70
Rate for Payer: EmblemHealth Commercial	$479.04
Rate for Payer: Humana Medicare Advantage	$164.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$159.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.50
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$106.75
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$17.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$159.68
Rate for Payer: Wellcare Medicare Advantage	$159.68
Rate for Payer: Wellpoint Medicaid Managed Care	$18.86

RADIATION PHYSICS CONSULT

Facility

$711.65

Service Code	HCPCS 77336
Hospital Charge Code	85000640M
Hospital Revenue Code	333
Min. Negotiated Rate	$106.75
Max. Negotiated Rate	$106.75
Rate for Payer: Qualcare PPO/HMO/WC	$106.75

RADIATION PHYSICS CONSULT

Facility

$711.65

Service Code	HCPCS 77336
Hospital Charge Code	85000640
Hospital Revenue Code	333
Min. Negotiated Rate	$17.15
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$434.33
Rate for Payer: Aetna Medicare Advantage	$517.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$576.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$576.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$159.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$576.40
Rate for Payer: Cigna Commercial	$320.09
Rate for Payer: Cigna Medicare Advantage	$111.78
Rate for Payer: Clover Medicare Advantage	$151.70
Rate for Payer: EmblemHealth Commercial	$479.04
Rate for Payer: Humana Medicare Advantage	$164.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$159.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.50
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$106.75
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$17.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$159.68
Rate for Payer: Wellcare Medicare Advantage	$159.68
Rate for Payer: Wellpoint Medicaid Managed Care	$18.86

RADIATION RESISTANT GLOVES SZ8

Facility

$190.00

Hospital Charge Code	270655376
Hospital Revenue Code	270
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

RADIATION RESISTANT GLOVES SZ8

Facility

$190.00

Hospital Charge Code	270655376
Hospital Revenue Code	270
Min. Negotiated Rate	$4.58
Max. Negotiated Rate	$95.00
Rate for Payer: Aetna Commercial	$72.20
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.00
Rate for Payer: Oxford Commercial	$38.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$38.00
Rate for Payer: UnitedHealthcare Community & State	$4.58
Rate for Payer: Wellpoint Medicaid Managed Care	$5.04

RADIATION TREATMENT DELIVERY>=

Facility

$644.75

Service Code	HCPCS 77402
Hospital Charge Code	85000899
Hospital Revenue Code	333
Min. Negotiated Rate	$96.71
Max. Negotiated Rate	$96.71
Rate for Payer: Qualcare PPO/HMO/WC	$96.71

RADIATION TREATMENT DELIVERY>=

Facility

$644.75

Service Code	HCPCS 77402
Hospital Charge Code	85000899
Hospital Revenue Code	333
Min. Negotiated Rate	$15.54
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$329.69
Rate for Payer: Aetna Medicare Advantage	$392.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$437.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$437.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$121.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$437.53
Rate for Payer: Cigna Commercial	$242.98
Rate for Payer: Cigna Medicare Advantage	$84.85
Rate for Payer: Clover Medicare Advantage	$115.15
Rate for Payer: EmblemHealth Commercial	$363.63
Rate for Payer: Humana Medicare Advantage	$124.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$121.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.43
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.71
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$15.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$121.21
Rate for Payer: Wellcare Medicare Advantage	$121.21
Rate for Payer: Wellpoint Medicaid Managed Care	$17.09

RADIATION TX AID/S-GL

Facility

$1,308.51

Service Code	HCPCS 77333
Hospital Charge Code	85000610
Hospital Revenue Code	333
Min. Negotiated Rate	$31.54
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$434.33
Rate for Payer: Aetna Medicare Advantage	$517.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$576.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$576.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$159.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$576.40
Rate for Payer: Cigna Commercial	$320.09
Rate for Payer: Cigna Medicare Advantage	$111.78
Rate for Payer: Clover Medicare Advantage	$151.70
Rate for Payer: EmblemHealth Commercial	$479.04
Rate for Payer: Humana Medicare Advantage	$164.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$159.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.55
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$196.28
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$31.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$159.68
Rate for Payer: Wellcare Medicare Advantage	$159.68
Rate for Payer: Wellpoint Medicaid Managed Care	$34.68

RADIATION TX AID/S-GL

Facility

$1,308.51

Service Code	HCPCS 77334
Hospital Charge Code	85000625M
Hospital Revenue Code	333
Min. Negotiated Rate	$196.28
Max. Negotiated Rate	$196.28
Rate for Payer: Qualcare PPO/HMO/WC	$196.28

RADIATION TX AID/S-GL

Facility

$1,308.51

Service Code	HCPCS 77334
Hospital Charge Code	85000625M
Hospital Revenue Code	333
Min. Negotiated Rate	$31.54
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$1,209.94
Rate for Payer: Aetna Medicare Advantage	$1,441.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,605.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,605.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$444.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,605.70
Rate for Payer: Cigna Commercial	$891.65
Rate for Payer: Cigna Medicare Advantage	$311.38
Rate for Payer: Clover Medicare Advantage	$422.59
Rate for Payer: EmblemHealth Commercial	$1,334.49
Rate for Payer: Humana Medicare Advantage	$458.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$444.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.55
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$196.28
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$31.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$444.83
Rate for Payer: Wellcare Medicare Advantage	$444.83
Rate for Payer: Wellpoint Medicaid Managed Care	$34.68

RADIATION TX AID/S-GL

Facility

$1,308.51

Service Code	HCPCS 77333
Hospital Charge Code	85000610
Hospital Revenue Code	333
Min. Negotiated Rate	$196.28
Max. Negotiated Rate	$196.28
Rate for Payer: Qualcare PPO/HMO/WC	$196.28

RADIATION TX AID/S-GL

Facility

$1,308.51

Service Code	HCPCS 77332
Hospital Charge Code	85000595
Hospital Revenue Code	333
Min. Negotiated Rate	$196.28
Max. Negotiated Rate	$196.28
Rate for Payer: Qualcare PPO/HMO/WC	$196.28

RADIATION TX AID/S-GL

Facility

$1,308.51

Service Code	HCPCS 77334
Hospital Charge Code	85000625
Hospital Revenue Code	333
Min. Negotiated Rate	$31.54
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$1,209.94
Rate for Payer: Aetna Medicare Advantage	$1,441.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,605.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,605.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$444.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,605.70
Rate for Payer: Cigna Commercial	$891.65
Rate for Payer: Cigna Medicare Advantage	$311.38
Rate for Payer: Clover Medicare Advantage	$422.59
Rate for Payer: EmblemHealth Commercial	$1,334.49
Rate for Payer: Humana Medicare Advantage	$458.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$444.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.55
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$196.28
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$31.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$444.83
Rate for Payer: Wellcare Medicare Advantage	$444.83
Rate for Payer: Wellpoint Medicaid Managed Care	$34.68

RADIATION TX AID/S-GL

Facility

$1,308.51

Service Code	HCPCS 77334
Hospital Charge Code	85000625
Hospital Revenue Code	333
Min. Negotiated Rate	$196.28
Max. Negotiated Rate	$196.28
Rate for Payer: Qualcare PPO/HMO/WC	$196.28

RADIATION TX AID/S-GL

Facility

$1,308.51

Service Code	HCPCS 77332
Hospital Charge Code	85000595
Hospital Revenue Code	333
Min. Negotiated Rate	$31.54
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$434.33
Rate for Payer: Aetna Medicare Advantage	$517.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$576.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$576.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$159.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$576.40
Rate for Payer: Cigna Commercial	$320.09
Rate for Payer: Cigna Medicare Advantage	$111.78
Rate for Payer: Clover Medicare Advantage	$151.70
Rate for Payer: EmblemHealth Commercial	$479.04
Rate for Payer: Humana Medicare Advantage	$164.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$159.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.55
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$196.28
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$31.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$159.68
Rate for Payer: Wellcare Medicare Advantage	$159.68
Rate for Payer: Wellpoint Medicaid Managed Care	$34.68

RADIATION TX AID/S-PC

Facility

$143.65

Service Code	HCPCS 7733226
Hospital Charge Code	85000605
Hospital Revenue Code	333
Min. Negotiated Rate	$3.46
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$54.59
Rate for Payer: Aetna Medicare Advantage	$43.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.63
Rate for Payer: Cigna Commercial	$71.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.09
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.55
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$3.46
Rate for Payer: Wellpoint Medicaid Managed Care	$3.81

RADIATION TX AID/S-PC

Facility

$143.65

Service Code	HCPCS 7733226
Hospital Charge Code	85000605
Hospital Revenue Code	333
Min. Negotiated Rate	$21.55
Max. Negotiated Rate	$21.55
Rate for Payer: Qualcare PPO/HMO/WC	$21.55

RADIATION TX AID/S-PC

Facility

$328.10

Service Code	HCPCS 7733426
Hospital Charge Code	85000635
Hospital Revenue Code	333
Min. Negotiated Rate	$49.22
Max. Negotiated Rate	$49.22
Rate for Payer: Qualcare PPO/HMO/WC	$49.22

Know your out-of-pocket cost for care.

All Charges