Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RADIATION TX AID/S-PC

Facility

$222.95

Service Code	HCPCS 7733326
Hospital Charge Code	85000620
Hospital Revenue Code	333
Min. Negotiated Rate	$33.44
Max. Negotiated Rate	$33.44
Rate for Payer: Qualcare PPO/HMO/WC	$33.44

RADIATION TX AID/S-PC

Facility

$328.10

Service Code	HCPCS 7733426
Hospital Charge Code	85000635
Hospital Revenue Code	333
Min. Negotiated Rate	$7.91
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$124.68
Rate for Payer: Aetna Medicare Advantage	$98.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.67
Rate for Payer: Cigna Commercial	$164.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.43
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.22
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$7.91
Rate for Payer: Wellpoint Medicaid Managed Care	$8.69

RADIATION TX AID/S-PC

Facility

$222.95

Service Code	HCPCS 7733326
Hospital Charge Code	85000620
Hospital Revenue Code	333
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$84.72
Rate for Payer: Aetna Medicare Advantage	$66.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.85
Rate for Payer: Cigna Commercial	$111.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.89
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.44
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$5.37
Rate for Payer: Wellpoint Medicaid Managed Care	$5.91

RADIATION TX AID/S-TC

Facility

$300.50

Service Code	HCPCS 77332TC
Hospital Charge Code	85000600
Hospital Revenue Code	333
Min. Negotiated Rate	$45.08
Max. Negotiated Rate	$45.08
Rate for Payer: Qualcare PPO/HMO/WC	$45.08

RADIATION TX AID/S-TC

Facility

$300.50

Service Code	HCPCS 77332TC
Hospital Charge Code	85000600
Hospital Revenue Code	333
Min. Negotiated Rate	$7.24
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$114.19
Rate for Payer: Aetna Medicare Advantage	$90.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.63
Rate for Payer: Cigna Commercial	$150.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.15
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.08
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$7.24
Rate for Payer: Wellpoint Medicaid Managed Care	$7.96

RADIATION TX AID/S-TC

Facility

$520.50

Service Code	HCPCS 77334TC
Hospital Charge Code	85000630
Hospital Revenue Code	333
Min. Negotiated Rate	$78.08
Max. Negotiated Rate	$78.08
Rate for Payer: Qualcare PPO/HMO/WC	$78.08

RADIATION TX AID/S-TC

Facility

$520.50

Service Code	HCPCS 77334TC
Hospital Charge Code	85000630
Hospital Revenue Code	333
Min. Negotiated Rate	$12.54
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$197.79
Rate for Payer: Aetna Medicare Advantage	$156.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.73
Rate for Payer: Cigna Commercial	$260.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.15
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.08
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$12.54
Rate for Payer: Wellpoint Medicaid Managed Care	$13.79

RADIATION TX AID/S-TC

Facility

$78.50

Service Code	HCPCS 77333TC
Hospital Charge Code	85000615
Hospital Revenue Code	333
Min. Negotiated Rate	$1.89
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$29.83
Rate for Payer: Aetna Medicare Advantage	$23.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.02
Rate for Payer: Cigna Commercial	$39.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.55
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.78
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$1.89
Rate for Payer: Wellpoint Medicaid Managed Care	$2.08

RADIATION TX AID/S-TC

Facility

$78.50

Service Code	HCPCS 77333TC
Hospital Charge Code	85000615
Hospital Revenue Code	333
Min. Negotiated Rate	$11.78
Max. Negotiated Rate	$11.78
Rate for Payer: Qualcare PPO/HMO/WC	$11.78

RADIATION TX COMPLEX

Facility

$887.30

Service Code	HCPCS 77263
Hospital Charge Code	85000372
Hospital Revenue Code	333
Min. Negotiated Rate	$133.09
Max. Negotiated Rate	$133.09
Rate for Payer: Qualcare PPO/HMO/WC	$133.09

RADIATION TX COMPLEX

Facility

$887.30

Service Code	HCPCS 77263
Hospital Charge Code	85000372
Hospital Revenue Code	333
Min. Negotiated Rate	$21.38
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$337.17
Rate for Payer: Aetna Medicare Advantage	$266.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.26
Rate for Payer: Cigna Commercial	$443.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.19
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$133.09
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$21.38
Rate for Payer: Wellpoint Medicaid Managed Care	$23.51

RADIATION TX DELIVERY

Facility

$619.37

Service Code	HCPCS 77407
Hospital Charge Code	85000705
Hospital Revenue Code	333
Min. Negotiated Rate	$14.93
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$1,246.36
Rate for Payer: Aetna Medicare Advantage	$1,484.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,654.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,654.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$458.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,654.04
Rate for Payer: Cigna Commercial	$918.50
Rate for Payer: Cigna Medicare Advantage	$320.75
Rate for Payer: Clover Medicare Advantage	$435.31
Rate for Payer: EmblemHealth Commercial	$1,374.66
Rate for Payer: Humana Medicare Advantage	$471.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$458.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.81
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.91
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$14.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$458.22
Rate for Payer: Wellcare Medicare Advantage	$458.22
Rate for Payer: Wellpoint Medicaid Managed Care	$16.41

RADIATION TX DELIVERY

Facility

$619.37

Service Code	HCPCS 77402
Hospital Charge Code	85000700
Hospital Revenue Code	333
Min. Negotiated Rate	$14.93
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	$185.81
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.91
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$14.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$121.21
Rate for Payer: Wellcare Medicare Advantage	$121.21
Rate for Payer: Wellpoint Medicaid Managed Care	$16.41

RADIATION TX DELIVERY

Facility

$619.37

Service Code	HCPCS 77402
Hospital Charge Code	85000695
Hospital Revenue Code	333
Min. Negotiated Rate	$92.91
Max. Negotiated Rate	$92.91
Rate for Payer: Qualcare PPO/HMO/WC	$92.91

RADIATION TX DELIVERY

Facility

$1,164.28

Service Code	HCPCS 77407
Hospital Charge Code	85000710
Hospital Revenue Code	333
Min. Negotiated Rate	$28.06
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$1,246.36
Rate for Payer: Aetna Medicare Advantage	$1,484.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,654.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,654.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$458.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,654.04
Rate for Payer: Cigna Commercial	$918.50
Rate for Payer: Cigna Medicare Advantage	$320.75
Rate for Payer: Clover Medicare Advantage	$435.31
Rate for Payer: EmblemHealth Commercial	$1,374.66
Rate for Payer: Humana Medicare Advantage	$471.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$458.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$349.28
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$174.64
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$28.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$458.22
Rate for Payer: Wellcare Medicare Advantage	$458.22
Rate for Payer: Wellpoint Medicaid Managed Care	$30.85

RADIATION TX DELIVERY

Facility

$1,164.28

Service Code	HCPCS 77407
Hospital Charge Code	85000710
Hospital Revenue Code	333
Min. Negotiated Rate	$174.64
Max. Negotiated Rate	$174.64
Rate for Payer: Qualcare PPO/HMO/WC	$174.64

RADIATION TX DELIVERY

Facility

$1,548.50

Service Code	HCPCS 77407
Hospital Charge Code	85000715
Hospital Revenue Code	333
Min. Negotiated Rate	$232.28
Max. Negotiated Rate	$232.28
Rate for Payer: Qualcare PPO/HMO/WC	$232.28

RADIATION TX DELIVERY

Facility

$1,164.28

Service Code	HCPCS 77407
Hospital Charge Code	85000720
Hospital Revenue Code	333
Min. Negotiated Rate	$174.64
Max. Negotiated Rate	$174.64
Rate for Payer: Qualcare PPO/HMO/WC	$174.64

RADIATION TX DELIVERY

Facility

$619.37

Service Code	HCPCS 77402
Hospital Charge Code	85000685
Hospital Revenue Code	333
Min. Negotiated Rate	$14.93
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	$185.81
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.91
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$14.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$121.21
Rate for Payer: Wellcare Medicare Advantage	$121.21
Rate for Payer: Wellpoint Medicaid Managed Care	$16.41

RADIATION TX DELIVERY

Facility

$619.37

Service Code	HCPCS 77402
Hospital Charge Code	85000685
Hospital Revenue Code	333
Min. Negotiated Rate	$92.91
Max. Negotiated Rate	$92.91
Rate for Payer: Qualcare PPO/HMO/WC	$92.91

RADIATION TX DELIVERY

Facility

$1,164.28

Service Code	HCPCS 77412
Hospital Charge Code	85000725
Hospital Revenue Code	333
Min. Negotiated Rate	$28.06
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$1,785.49
Rate for Payer: Aetna Medicare Advantage	$2,126.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,369.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,369.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$656.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,369.52
Rate for Payer: Cigna Commercial	$1,315.81
Rate for Payer: Cigna Medicare Advantage	$459.50
Rate for Payer: Clover Medicare Advantage	$623.61
Rate for Payer: EmblemHealth Commercial	$1,969.29
Rate for Payer: Humana Medicare Advantage	$676.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$656.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$349.28
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$174.64
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$28.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$656.43
Rate for Payer: Wellcare Medicare Advantage	$656.43
Rate for Payer: Wellpoint Medicaid Managed Care	$30.85

RADIATION TX DELIVERY

Facility

$1,164.28

Service Code	HCPCS 77412
Hospital Charge Code	85000725
Hospital Revenue Code	333
Min. Negotiated Rate	$174.64
Max. Negotiated Rate	$174.64
Rate for Payer: Qualcare PPO/HMO/WC	$174.64

RADIATION TX DELIVERY

Facility

$1,164.28

Service Code	HCPCS 77407
Hospital Charge Code	85000720
Hospital Revenue Code	333
Min. Negotiated Rate	$28.06
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$1,246.36
Rate for Payer: Aetna Medicare Advantage	$1,484.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,654.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,654.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$458.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,654.04
Rate for Payer: Cigna Commercial	$918.50
Rate for Payer: Cigna Medicare Advantage	$320.75
Rate for Payer: Clover Medicare Advantage	$435.31
Rate for Payer: EmblemHealth Commercial	$1,374.66
Rate for Payer: Humana Medicare Advantage	$471.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$458.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$349.28
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$174.64
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$28.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$458.22
Rate for Payer: Wellcare Medicare Advantage	$458.22
Rate for Payer: Wellpoint Medicaid Managed Care	$30.85

RADIATION TX DELIVERY

Facility

$1,548.50

Service Code	HCPCS 77407
Hospital Charge Code	85000715
Hospital Revenue Code	333
Min. Negotiated Rate	$37.32
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$1,246.36
Rate for Payer: Aetna Medicare Advantage	$1,484.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,654.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,654.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$458.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,654.04
Rate for Payer: Cigna Commercial	$918.50
Rate for Payer: Cigna Medicare Advantage	$320.75
Rate for Payer: Clover Medicare Advantage	$435.31
Rate for Payer: EmblemHealth Commercial	$1,374.66
Rate for Payer: Humana Medicare Advantage	$471.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$458.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.55
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.28
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$37.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$458.22
Rate for Payer: Wellcare Medicare Advantage	$458.22
Rate for Payer: Wellpoint Medicaid Managed Care	$41.04

RADIATION TX DELIVERY

Facility

$1,164.28

Service Code	HCPCS 77412
Hospital Charge Code	85000730
Hospital Revenue Code	333
Min. Negotiated Rate	$28.06
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$1,785.49
Rate for Payer: Aetna Medicare Advantage	$2,126.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,369.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,369.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$656.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,369.52
Rate for Payer: Cigna Commercial	$1,315.81
Rate for Payer: Cigna Medicare Advantage	$459.50
Rate for Payer: Clover Medicare Advantage	$623.61
Rate for Payer: EmblemHealth Commercial	$1,969.29
Rate for Payer: Humana Medicare Advantage	$676.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$656.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$349.28
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$174.64
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$28.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$656.43
Rate for Payer: Wellcare Medicare Advantage	$656.43
Rate for Payer: Wellpoint Medicaid Managed Care	$30.85

Know your out-of-pocket cost for care.

All Charges