Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RENAL ARTERY DUPLEX SCAN LTD

Facility

$17,200.00

Service Code	HCPCS 93976
Hospital Charge Code	421593976
Hospital Revenue Code	921
Min. Negotiated Rate	$117.99
Max. Negotiated Rate	$6,760.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,160.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$414.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$455.80

RENAL ARTERY DUPLEX SCAN LTD

Facility

$789.00

Service Code	HCPCS 93976
Hospital Charge Code	74117051
Hospital Revenue Code	921
Min. Negotiated Rate	$118.35
Max. Negotiated Rate	$118.35
Rate for Payer: Qualcare PPO/HMO/WC	$118.35

RENAL ARTERY DUPLEX SCAN LTD

Facility

$789.00

Service Code	HCPCS 93976
Hospital Charge Code	74116051
Hospital Revenue Code	921
Min. Negotiated Rate	$19.01
Max. Negotiated Rate	$6,760.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.70
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.35
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$19.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$20.91

RENAL ARTERY DUPLEX SCAN LTD

Facility

$17,200.00

Service Code	HCPCS 93976
Hospital Charge Code	2101113
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

RENAL ARTERY DUPLEX SCAN LTD

Facility

$1,555.25

Service Code	HCPCS 93976
Hospital Charge Code	94053265
Hospital Revenue Code	921
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$6,760.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.57
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$233.29
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$37.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$41.21

RENAL ARTERY DUPLEX SCAN LTD

Facility

$789.00

Service Code	HCPCS 93976
Hospital Charge Code	74116051
Hospital Revenue Code	921
Min. Negotiated Rate	$118.35
Max. Negotiated Rate	$118.35
Rate for Payer: Qualcare PPO/HMO/WC	$118.35

RENAL ARTERY DUPLEX SCAN LTD

Facility

$17,200.00

Service Code	HCPCS 93976
Hospital Charge Code	74115051
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

RENAL ARTERY DUPLEX SCAN LTD

Facility

$17,200.00

Service Code	HCPCS 93976
Hospital Charge Code	2692170
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

RENAL ARTERY DUPLEX SCAN LTD

Facility

$17,200.00

Service Code	HCPCS 93976
Hospital Charge Code	2101113
Hospital Revenue Code	921
Min. Negotiated Rate	$117.99
Max. Negotiated Rate	$6,760.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,160.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$414.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$455.80

RENAL BIOPSY PERQ

Facility

$8,404.60

Service Code	HCPCS 50200
Hospital Charge Code	1600000506
Hospital Revenue Code	360
Min. Negotiated Rate	$202.55
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	$862.00
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	$2,521.38
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,260.69
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$202.55
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	$222.72

RENAL BIOPSY PERQ

Facility

$8,404.60

Service Code	HCPCS 50200
Hospital Charge Code	1600000506
Hospital Revenue Code	360
Min. Negotiated Rate	$1,260.69
Max. Negotiated Rate	$1,260.69
Rate for Payer: Qualcare PPO/HMO/WC	$1,260.69

RENAL BLOOD ADMIN/TRANSFUSION

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	8200151
Hospital Revenue Code	391
Min. Negotiated Rate	$33.83
Max. Negotiated Rate	$1,891.95
Rate for Payer: Aetna Commercial	$1,425.63
Rate for Payer: Aetna Medicare Advantage	$1,698.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,891.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,891.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$524.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,891.95
Rate for Payer: Cigna Commercial	$1,050.61
Rate for Payer: Cigna Medicare Advantage	$524.13
Rate for Payer: Clover Medicare Advantage	$497.92
Rate for Payer: EmblemHealth Commercial	$1,572.39
Rate for Payer: Humana Medicare Advantage	$539.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$524.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.12
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.56
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$33.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$524.13
Rate for Payer: Wellcare Medicare Advantage	$524.13
Rate for Payer: Wellpoint Medicaid Managed Care	$37.20

RENAL BLOOD ADMIN/TRANSFUSION

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	8200151
Hospital Revenue Code	391
Min. Negotiated Rate	$210.56
Max. Negotiated Rate	$210.56
Rate for Payer: Qualcare PPO/HMO/WC	$210.56

RENAL CAL

Facility

$21.00

Hospital Charge Code	60635160
Hospital Revenue Code	250
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

RENAL CAL

Facility

$21.00

Hospital Charge Code	60635160
Hospital Revenue Code	250
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$10.50
Rate for Payer: Aetna Commercial	$7.98
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.30
Rate for Payer: Oxford Commercial	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$4.20
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

RENALCAL FLAVOR PKT

Facility

$5.00

Hospital Charge Code	60635268
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

RENALCAL FLAVOR PKT

Facility

$5.00

Hospital Charge Code	60635268
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

RENAL DIALYSIS ACCESS DEVICE PROCEDURES

Facility

$11,203.10

Service Code	APR-DRG 4441
Min. Negotiated Rate	$10,983.43
Max. Negotiated Rate	$11,203.10
Rate for Payer: UnitedHealthcare Community & State	$10,983.43
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,203.10
Rate for Payer: Wellpoint Medicaid Managed Care	$10,983.43

RENAL DIALYSIS ACCESS DEVICE PROCEDURES

Facility

$16,703.17

Service Code	APR-DRG 4442
Min. Negotiated Rate	$16,375.66
Max. Negotiated Rate	$16,703.17
Rate for Payer: UnitedHealthcare Community & State	$16,375.66
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,703.17
Rate for Payer: Wellpoint Medicaid Managed Care	$16,375.66

RENAL DIALYSIS ACCESS DEVICE PROCEDURES

Facility

$24,833.30

Service Code	APR-DRG 4443
Min. Negotiated Rate	$24,346.37
Max. Negotiated Rate	$24,833.30
Rate for Payer: UnitedHealthcare Community & State	$24,346.37
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,833.30
Rate for Payer: Wellpoint Medicaid Managed Care	$24,346.37

RENAL DIALYSIS ACCESS DEVICE PROCEDURES

Facility

$42,385.47

Service Code	APR-DRG 4444
Min. Negotiated Rate	$41,554.38
Max. Negotiated Rate	$42,385.47
Rate for Payer: UnitedHealthcare Community & State	$41,554.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$42,385.47
Rate for Payer: Wellpoint Medicaid Managed Care	$41,554.38

RENAL FAILURE WITH CC

Facility

$30,441.40

Service Code	MSDRG 683
Min. Negotiated Rate	$9,269.02
Max. Negotiated Rate	$30,441.40
Rate for Payer: Aetna Commercial	$21,174.02
Rate for Payer: Aetna Medicare Advantage	$30,441.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,934.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,934.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,756.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20,934.90
Rate for Payer: Cigna Commercial	$16,389.72
Rate for Payer: Cigna Medicare Advantage	$9,756.86
Rate for Payer: Clover Medicare Advantage	$9,269.02
Rate for Payer: EmblemHealth Commercial	$29,270.58
Rate for Payer: Humana Medicare Advantage	$10,049.57
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,756.86
Rate for Payer: Oxford Commercial	$11,779.51
Rate for Payer: UnitedHealthcare Commercial	$20,655.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,756.86
Rate for Payer: Wellcare Medicare Advantage	$9,756.86

RENAL FAILURE WITH MCC

Facility

$50,002.43

Service Code	MSDRG 682
Min. Negotiated Rate	$15,225.10
Max. Negotiated Rate	$50,002.43
Rate for Payer: Aetna Commercial	$34,614.67
Rate for Payer: Aetna Medicare Advantage	$50,002.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34,891.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34,891.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,026.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34,891.50
Rate for Payer: Cigna Commercial	$27,715.43
Rate for Payer: Cigna Medicare Advantage	$16,026.42
Rate for Payer: Clover Medicare Advantage	$15,225.10
Rate for Payer: EmblemHealth Commercial	$48,079.26
Rate for Payer: Humana Medicare Advantage	$16,507.21
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,026.42
Rate for Payer: Oxford Commercial	$19,919.45
Rate for Payer: UnitedHealthcare Commercial	$34,929.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,026.42
Rate for Payer: Wellcare Medicare Advantage	$16,026.42

RENAL FAILURE WITHOUT CC/MCC

Facility

$21,536.80

Service Code	MSDRG 684
Min. Negotiated Rate	$6,557.68
Max. Negotiated Rate	$21,536.80
Rate for Payer: Aetna Commercial	$15,055.56
Rate for Payer: Aetna Medicare Advantage	$21,536.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,902.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,189.21
Rate for Payer: Cigna Commercial	$11,234.01
Rate for Payer: Cigna Medicare Advantage	$6,902.82
Rate for Payer: Clover Medicare Advantage	$6,557.68
Rate for Payer: EmblemHealth Commercial	$20,708.46
Rate for Payer: Humana Medicare Advantage	$7,109.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,902.82
Rate for Payer: Oxford Commercial	$8,074.03
Rate for Payer: UnitedHealthcare Commercial	$14,158.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,902.82
Rate for Payer: Wellcare Medicare Advantage	$6,902.82

RENAL FUNCTION PANEL

Facility

$61.50

Service Code	HCPCS 80069
Hospital Charge Code	38476798
Hospital Revenue Code	301
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$23.61
Rate for Payer: Aetna Medicare Advantage	$28.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.33
Rate for Payer: Cigna Commercial	$30.75
Rate for Payer: Cigna Medicare Advantage	$8.68
Rate for Payer: Clover Medicare Advantage	$8.25
Rate for Payer: EmblemHealth Commercial	$26.04
Rate for Payer: Humana Medicare Advantage	$8.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.22
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.68
Rate for Payer: Wellcare Medicare Advantage	$8.68
Rate for Payer: Wellpoint Medicaid Managed Care	$1.63

Know your out-of-pocket cost for care.

All Charges