Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

REMOVAL BLADDER LESION

Facility

$16,842.20

Service Code	HCPCS 51525
Hospital Charge Code	1600000812
Hospital Revenue Code	360
Min. Negotiated Rate	$2,526.33
Max. Negotiated Rate	$2,526.33
Rate for Payer: Qualcare PPO/HMO/WC	$2,526.33

REMOVAL DUCT/GB CALCULI

Facility

$4,222.25

Service Code	HCPCS 47544
Hospital Charge Code	7411571
Hospital Revenue Code	361
Min. Negotiated Rate	$633.34
Max. Negotiated Rate	$633.34
Rate for Payer: Qualcare PPO/HMO/WC	$633.34

REMOVAL DUCT/GB CALCULI

Facility

$4,222.25

Service Code	HCPCS 47544
Hospital Charge Code	2600240
Hospital Revenue Code	361
Min. Negotiated Rate	$633.34
Max. Negotiated Rate	$633.34
Rate for Payer: Qualcare PPO/HMO/WC	$633.34

REMOVAL DUCT/GB CALCULI

Facility

$4,222.25

Service Code	HCPCS 47544
Hospital Charge Code	7411571
Hospital Revenue Code	361
Min. Negotiated Rate	$101.76
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,604.45
Rate for Payer: Aetna Medicare Advantage	$1,266.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,076.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,076.67
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	$1,076.67
Rate for Payer: Cigna Commercial	$2,111.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,266.67
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$633.34
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$101.76
Rate for Payer: Wellpoint Medicaid Managed Care	$111.89

REMOVAL DUCT/GB CALCULI

Facility

$4,222.25

Service Code	HCPCS 47544
Hospital Charge Code	2600240
Hospital Revenue Code	361
Min. Negotiated Rate	$101.76
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,604.45
Rate for Payer: Aetna Medicare Advantage	$1,266.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,076.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,076.67
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	$1,076.67
Rate for Payer: Cigna Commercial	$2,111.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,266.67
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$633.34
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$101.76
Rate for Payer: Wellpoint Medicaid Managed Care	$111.89

REMOVAL EVENT RECORDER

Facility

$2,457.00

Service Code	HCPCS 33284
Hospital Charge Code	7411035
Hospital Revenue Code	361
Min. Negotiated Rate	$59.21
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$933.66
Rate for Payer: Aetna Medicare Advantage	$737.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.53
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	$626.53
Rate for Payer: Cigna Commercial	$1,228.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$737.10
Rate for Payer: Qualcare PPO/HMO/WC	$368.55
Rate for Payer: UnitedHealthcare Community & State	$59.21
Rate for Payer: Wellpoint Medicaid Managed Care	$65.11

REMOVAL EVENT RECORDER

Facility

$2,457.00

Service Code	HCPCS 33284
Hospital Charge Code	7411035
Hospital Revenue Code	361
Min. Negotiated Rate	$368.55
Max. Negotiated Rate	$368.55
Rate for Payer: Qualcare PPO/HMO/WC	$368.55

REMOVAL FB DEEP/COMP

Facility

$13,630.25

Service Code	HCPCS 20525
Hospital Charge Code	412320525
Hospital Revenue Code	361
Min. Negotiated Rate	$2,044.54
Max. Negotiated Rate	$2,044.54
Rate for Payer: Qualcare PPO/HMO/WC	$2,044.54

REMOVAL FB DEEP/COMP

Facility

$13,630.25

Service Code	HCPCS 20525
Hospital Charge Code	412320525
Hospital Revenue Code	361
Min. Negotiated Rate	$328.49
Max. Negotiated Rate	$12,456.64
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,456.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,456.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,456.64
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,089.07
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,044.54
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$328.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$361.20

REMOVAL FB SIMPLE

Facility

$7,903.25

Service Code	HCPCS 20520
Hospital Charge Code	412320520
Hospital Revenue Code	361
Min. Negotiated Rate	$1,185.49
Max. Negotiated Rate	$1,185.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,185.49

REMOVAL FB SIMPLE

Facility

$7,903.25

Service Code	HCPCS 20520
Hospital Charge Code	412320520
Hospital Revenue Code	361
Min. Negotiated Rate	$190.47
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,370.97
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,185.49
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$190.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$209.44

REMOVAL FOREIGN BODY MUSCLE,SM

Facility

$6,322.68

Service Code	HCPCS 20520
Hospital Charge Code	16000792
Hospital Revenue Code	360
Min. Negotiated Rate	$152.38
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,896.80
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$948.40
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$152.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$167.55

REMOVAL FOREIGN BODY MUSCLE,SM

Facility

$6,322.68

Service Code	HCPCS 20520
Hospital Charge Code	16000792
Hospital Revenue Code	360
Min. Negotiated Rate	$948.40
Max. Negotiated Rate	$948.40
Rate for Payer: Qualcare PPO/HMO/WC	$948.40

REMOVAL FOREIGN BODY-VAGINA

Facility

$8,582.36

Service Code	HCPCS 57415
Hospital Charge Code	5770010
Hospital Revenue Code	450
Min. Negotiated Rate	$1,287.35
Max. Negotiated Rate	$1,287.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,287.35

REMOVAL FOREIGN BODY-VAGINA

Facility

$8,582.36

Service Code	HCPCS 57415
Hospital Charge Code	5770010
Hospital Revenue Code	450
Min. Negotiated Rate	$67.76
Max. Negotiated Rate	$13,882.15
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,882.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,882.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,882.15
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,574.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,287.35
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$227.43

REMOVAL IMPACTED CERUMEN EAR

Facility

$261.00

Service Code	HCPCS 69510
Hospital Charge Code	2500367
Hospital Revenue Code	761
Min. Negotiated Rate	$6.29
Max. Negotiated Rate	$130.50
Rate for Payer: Aetna Commercial	$99.18
Rate for Payer: Aetna Medicare Advantage	$78.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.56
Rate for Payer: Cigna Commercial	$130.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.30
Rate for Payer: Oxford Commercial	$52.20
Rate for Payer: Qualcare PPO/HMO/WC	$39.15
Rate for Payer: UnitedHealthcare Commercial	$52.20
Rate for Payer: UnitedHealthcare Community & State	$6.29
Rate for Payer: Wellpoint Medicaid Managed Care	$6.92

REMOVAL IMPACTED CERUMEN EAR

Facility

$261.00

Service Code	HCPCS 69510
Hospital Charge Code	2500367
Hospital Revenue Code	761
Min. Negotiated Rate	$39.15
Max. Negotiated Rate	$39.15
Rate for Payer: Qualcare PPO/HMO/WC	$39.15

REMOVAL IUD

Facility

$669.00

Service Code	HCPCS 58301
Hospital Charge Code	5770035
Hospital Revenue Code	450
Min. Negotiated Rate	$17.73
Max. Negotiated Rate	$1,306.82
Rate for Payer: Aetna Commercial	$984.72
Rate for Payer: Aetna Medicare Advantage	$1,172.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,306.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,306.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$362.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,306.82
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: Cigna Medicare Advantage	$362.03
Rate for Payer: Clover Medicare Advantage	$343.93
Rate for Payer: EmblemHealth Commercial	$1,086.09
Rate for Payer: Humana Medicare Advantage	$372.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$362.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.35
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$362.03
Rate for Payer: Wellcare Medicare Advantage	$362.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.73

REMOVAL IUD

Facility

$669.00

Service Code	HCPCS 58301
Hospital Charge Code	5770035
Hospital Revenue Code	450
Min. Negotiated Rate	$100.35
Max. Negotiated Rate	$100.35
Rate for Payer: Qualcare PPO/HMO/WC	$100.35

REMOVAL KIDNEY OPEN RADICAL

Facility

$27,043.80

Service Code	HCPCS 50230
Hospital Charge Code	1600000686
Hospital Revenue Code	360
Min. Negotiated Rate	$4,056.57
Max. Negotiated Rate	$4,056.57
Rate for Payer: Qualcare PPO/HMO/WC	$4,056.57

REMOVAL KIDNEY OPEN RADICAL

Facility

$27,043.80

Service Code	HCPCS 50230
Hospital Charge Code	1600000686
Hospital Revenue Code	360
Min. Negotiated Rate	$651.76
Max. Negotiated Rate	$13,521.90
Rate for Payer: Aetna Commercial	$10,276.64
Rate for Payer: Aetna Medicare Advantage	$8,113.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,896.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,896.17
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	$6,896.17
Rate for Payer: Cigna Commercial	$13,521.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,113.14
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,056.57
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$651.76
Rate for Payer: Wellpoint Medicaid Managed Care	$716.66

REMOVAL NONBIODEG RX DELIV IMP

Facility

$2,130.55

Service Code	HCPCS 11982
Hospital Charge Code	412311982
Hospital Revenue Code	761
Min. Negotiated Rate	$319.58
Max. Negotiated Rate	$319.58
Rate for Payer: Qualcare PPO/HMO/WC	$319.58

REMOVAL NONBIODEG RX DELIV IMP

Facility

$2,130.55

Service Code	HCPCS 11982
Hospital Charge Code	412311982
Hospital Revenue Code	761
Min. Negotiated Rate	$51.35
Max. Negotiated Rate	$1,915.74
Rate for Payer: Aetna Commercial	$1,443.56
Rate for Payer: Aetna Medicare Advantage	$1,719.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,915.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,915.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$530.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,915.74
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: Cigna Medicare Advantage	$530.72
Rate for Payer: Clover Medicare Advantage	$504.18
Rate for Payer: EmblemHealth Commercial	$1,592.16
Rate for Payer: Humana Medicare Advantage	$546.64
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$530.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$639.16
Rate for Payer: Oxford Commercial	$426.11
Rate for Payer: Qualcare PPO/HMO/WC	$319.58
Rate for Payer: UnitedHealthcare Commercial	$426.11
Rate for Payer: UnitedHealthcare Community & State	$51.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$530.72
Rate for Payer: Wellcare Medicare Advantage	$530.72
Rate for Payer: Wellpoint Medicaid Managed Care	$56.46

REMOVAL OF ADENOIDS 1< 12YRS

Facility

$42,339.20

Service Code	HCPCS 42830
Hospital Charge Code	1600000385
Hospital Revenue Code	360
Min. Negotiated Rate	$6,350.88
Max. Negotiated Rate	$6,350.88
Rate for Payer: Qualcare PPO/HMO/WC	$6,350.88

REMOVAL OF ADENOIDS 1< 12YRS

Facility

$42,339.20

Service Code	HCPCS 42830
Hospital Charge Code	1600000385
Hospital Revenue Code	360
Min. Negotiated Rate	$1,020.37
Max. Negotiated Rate	$14,218.07
Rate for Payer: Aetna Commercial	$10,713.67
Rate for Payer: Aetna Medicare Advantage	$12,761.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,218.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,218.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,938.85
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	$14,218.07
Rate for Payer: Cigna Commercial	$7,895.42
Rate for Payer: Cigna Medicare Advantage	$3,938.85
Rate for Payer: Clover Medicare Advantage	$3,741.91
Rate for Payer: EmblemHealth Commercial	$11,816.55
Rate for Payer: Humana Medicare Advantage	$4,057.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,938.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,701.76
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,350.88
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$1,020.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,938.85
Rate for Payer: Wellcare Medicare Advantage	$3,938.85
Rate for Payer: Wellpoint Medicaid Managed Care	$1,121.99

Know your out-of-pocket cost for care.

All Charges