Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RENAL ANGIO-BIL

Facility

$5,072.00

Service Code	HCPCS 36252
Hospital Charge Code	7411121
Hospital Revenue Code	361
Min. Negotiated Rate	$122.24
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,521.60
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$760.80
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$122.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,216.80
Rate for Payer: Wellpoint Medicaid Managed Care	$7,075.29

RENAL ANGIO-LT

Facility

$5,072.00

Service Code	HCPCS 36251
Hospital Charge Code	7411117
Hospital Revenue Code	361
Min. Negotiated Rate	$760.80
Max. Negotiated Rate	$760.80
Rate for Payer: Qualcare PPO/HMO/WC	$760.80

RENAL ANGIO-LT

Facility

$5,072.00

Service Code	HCPCS 36251
Hospital Charge Code	7411117
Hospital Revenue Code	361
Min. Negotiated Rate	$122.24
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,521.60
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$760.80
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$122.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,216.80
Rate for Payer: Wellpoint Medicaid Managed Care	$7,075.29

RENAL ANGIO-RT

Facility

$5,072.00

Service Code	HCPCS 36251
Hospital Charge Code	7411119
Hospital Revenue Code	361
Min. Negotiated Rate	$122.24
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,521.60
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$760.80
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$122.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,216.80
Rate for Payer: Wellpoint Medicaid Managed Care	$7,075.29

RENAL ANGIO-RT

Facility

$5,072.00

Service Code	HCPCS 36251
Hospital Charge Code	7411119
Hospital Revenue Code	361
Min. Negotiated Rate	$760.80
Max. Negotiated Rate	$760.80
Rate for Payer: Qualcare PPO/HMO/WC	$760.80

RENAL ANGIO-W/AORTA-LT

Facility

$15,468.50

Service Code	HCPCS 36251LT
Hospital Charge Code	2691280
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

RENAL ANGIO-W/AORTA-LT

Facility

$8,741.00

Service Code	HCPCS 36251LT
Hospital Charge Code	7411912
Hospital Revenue Code	361
Min. Negotiated Rate	$210.66
Max. Negotiated Rate	$4,370.50
Rate for Payer: Aetna Commercial	$3,321.58
Rate for Payer: Aetna Medicare Advantage	$2,622.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,228.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,228.95
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	$2,228.95
Rate for Payer: Cigna Commercial	$4,370.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,622.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,311.15
Rate for Payer: UnitedHealthcare Community & State	$210.66
Rate for Payer: Wellpoint Medicaid Managed Care	$231.64

RENAL ANGIO-W/AORTA-LT

Facility

$15,468.50

Service Code	HCPCS 36251LT
Hospital Charge Code	2691280
Hospital Revenue Code	361
Min. Negotiated Rate	$372.79
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$5,878.03
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
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	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Community & State	$372.79
Rate for Payer: Wellpoint Medicaid Managed Care	$409.92

RENAL ANGIO-W/AORTA-LT

Facility

$8,741.00

Service Code	HCPCS 36251LT
Hospital Charge Code	7411912
Hospital Revenue Code	361
Min. Negotiated Rate	$1,311.15
Max. Negotiated Rate	$1,311.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,311.15

RENAL ANGIO-W/AORTA-LT

Facility

$15,468.50

Service Code	HCPCS 36251LT
Hospital Charge Code	366836251
Hospital Revenue Code	361
Min. Negotiated Rate	$372.79
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$5,878.03
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
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	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Community & State	$372.79
Rate for Payer: Wellpoint Medicaid Managed Care	$409.92

RENAL ANGIO-W/AORTA-LT

Facility

$15,468.50

Service Code	HCPCS 36251LT
Hospital Charge Code	366836251
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

RENAL ANGIO-W/AORTA-RT

Facility

$15,468.50

Service Code	HCPCS 36251RT
Hospital Charge Code	321036251R
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

RENAL ANGIO-W/AORTA-RT

Facility

$8,741.00

Service Code	HCPCS 36251RT
Hospital Charge Code	7411913
Hospital Revenue Code	361
Min. Negotiated Rate	$1,311.15
Max. Negotiated Rate	$1,311.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,311.15

RENAL ANGIO-W/AORTA-RT

Facility

$15,468.50

Service Code	HCPCS 36251RT
Hospital Charge Code	321036251R
Hospital Revenue Code	361
Min. Negotiated Rate	$372.79
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$5,878.03
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
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	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Community & State	$372.79
Rate for Payer: Wellpoint Medicaid Managed Care	$409.92

RENAL ANGIO-W/AORTA-RT

Facility

$15,468.50

Service Code	HCPCS 36251RT
Hospital Charge Code	2691285
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

RENAL ANGIO-W/AORTA-RT

Facility

$15,468.50

Service Code	HCPCS 36251RT
Hospital Charge Code	2691285
Hospital Revenue Code	361
Min. Negotiated Rate	$372.79
Max. Negotiated Rate	$7,734.25
Rate for Payer: Aetna Commercial	$5,878.03
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
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	$3,944.47
Rate for Payer: Cigna Commercial	$7,734.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Community & State	$372.79
Rate for Payer: Wellpoint Medicaid Managed Care	$409.92

RENAL ANGIO-W/AORTA-RT

Facility

$8,741.00

Service Code	HCPCS 36251RT
Hospital Charge Code	7411913
Hospital Revenue Code	361
Min. Negotiated Rate	$210.66
Max. Negotiated Rate	$4,370.50
Rate for Payer: Aetna Commercial	$3,321.58
Rate for Payer: Aetna Medicare Advantage	$2,622.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,228.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,228.95
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	$2,228.95
Rate for Payer: Cigna Commercial	$4,370.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,622.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,311.15
Rate for Payer: UnitedHealthcare Community & State	$210.66
Rate for Payer: Wellpoint Medicaid Managed Care	$231.64

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	321036253L
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	7411914
Hospital Revenue Code	361
Min. Negotiated Rate	$617.65
Max. Negotiated Rate	$12,814.23
Rate for Payer: Aetna Commercial	$9,738.81
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$12,814.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,688.53
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Community & State	$617.65
Rate for Payer: Wellpoint Medicaid Managed Care	$679.15

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	2691290
Hospital Revenue Code	361
Min. Negotiated Rate	$617.65
Max. Negotiated Rate	$12,814.23
Rate for Payer: Aetna Commercial	$9,738.81
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$12,814.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,688.53
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Community & State	$617.65
Rate for Payer: Wellpoint Medicaid Managed Care	$679.15

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	2691290
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	7411914
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	366836253L
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	366836253L
Hospital Revenue Code	361
Min. Negotiated Rate	$617.65
Max. Negotiated Rate	$12,814.23
Rate for Payer: Aetna Commercial	$9,738.81
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$12,814.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,688.53
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Community & State	$617.65
Rate for Payer: Wellpoint Medicaid Managed Care	$679.15

RENAL ANG-SUPSEL W/AOR-LT

Facility

$25,628.45

Service Code	HCPCS 36253LT
Hospital Charge Code	321036253L
Hospital Revenue Code	361
Min. Negotiated Rate	$617.65
Max. Negotiated Rate	$12,814.23
Rate for Payer: Aetna Commercial	$9,738.81
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
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	$6,535.25
Rate for Payer: Cigna Commercial	$12,814.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,688.53
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Community & State	$617.65
Rate for Payer: Wellpoint Medicaid Managed Care	$679.15

Know your out-of-pocket cost for care.

All Charges