Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

REP ARTEIRL BLK OPEN BRAC/BRAN

Facility

$7,917.57

Service Code	HCPCS 35458
Hospital Charge Code	5100597
Hospital Revenue Code	361
Min. Negotiated Rate	$190.81
Max. Negotiated Rate	$3,958.78
Rate for Payer: Aetna Commercial	$3,008.68
Rate for Payer: Aetna Medicare Advantage	$2,375.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,018.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,018.98
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	$2,018.98
Rate for Payer: Cigna Commercial	$3,958.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,375.27
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.64
Rate for Payer: UnitedHealthcare Community & State	$190.81
Rate for Payer: Wellpoint Medicaid Managed Care	$209.82

REP ARTEIRL BLK OPEN BRAC/BRAN

Facility

$7,917.57

Service Code	HCPCS 35458
Hospital Charge Code	5100597
Hospital Revenue Code	361
Min. Negotiated Rate	$1,187.64
Max. Negotiated Rate	$1,187.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.64

REP ARTERIAL BLCK OPEN FEM-POP

Facility

$9,003.10

Service Code	HCPCS 35456
Hospital Charge Code	5100595
Hospital Revenue Code	361
Min. Negotiated Rate	$1,350.46
Max. Negotiated Rate	$1,350.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.46

REP ARTERIAL BLCK OPEN FEM-POP

Facility

$9,003.10

Service Code	HCPCS 35456
Hospital Charge Code	5100595
Hospital Revenue Code	361
Min. Negotiated Rate	$216.97
Max. Negotiated Rate	$4,501.55
Rate for Payer: Aetna Commercial	$3,421.18
Rate for Payer: Aetna Medicare Advantage	$2,700.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.79
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	$2,295.79
Rate for Payer: Cigna Commercial	$4,501.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,700.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.46
Rate for Payer: UnitedHealthcare Community & State	$216.97
Rate for Payer: Wellpoint Medicaid Managed Care	$238.58

REP ARTERIAL BLOCK OPEN AORTIC

Facility

$9,002.90

Service Code	HCPCS 35452
Hospital Charge Code	5100601
Hospital Revenue Code	361
Min. Negotiated Rate	$216.97
Max. Negotiated Rate	$4,501.45
Rate for Payer: Aetna Commercial	$3,421.10
Rate for Payer: Aetna Medicare Advantage	$2,700.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.74
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	$2,295.74
Rate for Payer: Cigna Commercial	$4,501.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,700.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.43
Rate for Payer: UnitedHealthcare Community & State	$216.97
Rate for Payer: Wellpoint Medicaid Managed Care	$238.58

REP ARTERIAL BLOCK OPEN AORTIC

Facility

$9,002.90

Service Code	HCPCS 35452
Hospital Charge Code	5100601
Hospital Revenue Code	361
Min. Negotiated Rate	$1,350.43
Max. Negotiated Rate	$1,350.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.43

REP ARTERIAL BLOCK OPEN ILIAC

Facility

$9,003.10

Service Code	HCPCS 35454
Hospital Charge Code	5100599
Hospital Revenue Code	361
Min. Negotiated Rate	$216.97
Max. Negotiated Rate	$4,501.55
Rate for Payer: Aetna Commercial	$3,421.18
Rate for Payer: Aetna Medicare Advantage	$2,700.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.79
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	$2,295.79
Rate for Payer: Cigna Commercial	$4,501.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,700.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.46
Rate for Payer: UnitedHealthcare Community & State	$216.97
Rate for Payer: Wellpoint Medicaid Managed Care	$238.58

REP ARTERIAL BLOCK OPEN ILIAC

Facility

$9,003.10

Service Code	HCPCS 35454
Hospital Charge Code	5100599
Hospital Revenue Code	361
Min. Negotiated Rate	$1,350.46
Max. Negotiated Rate	$1,350.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.46

REP ARTIAL BLK OPN RENAL/OTHER

Facility

$9,003.10

Service Code	HCPCS 35450
Hospital Charge Code	5100605
Hospital Revenue Code	361
Min. Negotiated Rate	$1,350.46
Max. Negotiated Rate	$1,350.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.46

REP ARTIAL BLK OPN RENAL/OTHER

Facility

$9,003.10

Service Code	HCPCS 35450
Hospital Charge Code	5100605
Hospital Revenue Code	361
Min. Negotiated Rate	$216.97
Max. Negotiated Rate	$4,501.55
Rate for Payer: Aetna Commercial	$3,421.18
Rate for Payer: Aetna Medicare Advantage	$2,700.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.79
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	$2,295.79
Rate for Payer: Cigna Commercial	$4,501.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,700.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.46
Rate for Payer: UnitedHealthcare Community & State	$216.97
Rate for Payer: Wellpoint Medicaid Managed Care	$238.58

REP COMP TUN CV DEV W SQ PORT

Facility

$14,614.45

Service Code	HCPCS 36582
Hospital Charge Code	404336582
Hospital Revenue Code	361
Min. Negotiated Rate	$2,192.17
Max. Negotiated Rate	$2,192.17
Rate for Payer: Qualcare PPO/HMO/WC	$2,192.17

REP COMP TUN CV DEV W SQ PORT

Facility

$14,614.45

Service Code	HCPCS 36582
Hospital Charge Code	404336582
Hospital Revenue Code	361
Min. Negotiated Rate	$352.21
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	$1,355.00
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	$4,384.34
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,192.17
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$352.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$387.28

REP DURL/CSF LEAK WO LAMINCTMY

Facility

$10,338.30

Service Code	HCPCS 63707
Hospital Charge Code	16000770
Hospital Revenue Code	360
Min. Negotiated Rate	$249.15
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$3,928.55
Rate for Payer: Aetna Medicare Advantage	$3,101.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,636.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,636.27
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	$2,636.27
Rate for Payer: Cigna Commercial	$5,169.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,101.49
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,550.74
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$249.15
Rate for Payer: Wellpoint Medicaid Managed Care	$273.96

REP DURL/CSF LEAK WO LAMINCTMY

Facility

$10,338.30

Service Code	HCPCS 63707
Hospital Charge Code	16000770
Hospital Revenue Code	360
Min. Negotiated Rate	$1,550.74
Max. Negotiated Rate	$1,550.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,550.74

REPERFUSIONCATHKITRED43 138CM

Facility

$13,750.00

Service Code	HCPCS C1887
Hospital Charge Code	270700367S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

REPERFUSIONCATHKITRED43 138CM

Facility

$13,750.00

Service Code	HCPCS C1887
Hospital Charge Code	270700367S
Hospital Revenue Code	278
Min. Negotiated Rate	$331.38
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$5,225.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50
Rate for Payer: UnitedHealthcare Community & State	$331.38
Rate for Payer: Wellpoint Medicaid Managed Care	$364.38

REPERFUSION CATH RED43 138CM

Facility

$11,950.00

Service Code	HCPCS C1725
Hospital Charge Code	270700366S
Hospital Revenue Code	278
Min. Negotiated Rate	$288.00
Max. Negotiated Rate	$5,975.00
Rate for Payer: Aetna Commercial	$4,541.00
Rate for Payer: Aetna Medicare Advantage	$3,585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,047.25
Rate for Payer: Cigna Commercial	$5,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,629.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50
Rate for Payer: UnitedHealthcare Community & State	$288.00
Rate for Payer: Wellpoint Medicaid Managed Care	$316.68

REPERFUSION CATH RED43 138CM

Facility

$11,950.00

Service Code	HCPCS C1725
Hospital Charge Code	270700366S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,792.50
Max. Negotiated Rate	$2,891.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,629.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50

REP FLXR TNDN NT Z2 WO GRFT EA

Facility

$26,471.80

Service Code	HCPCS 26350
Hospital Charge Code	16000338
Hospital Revenue Code	360
Min. Negotiated Rate	$3,970.77
Max. Negotiated Rate	$3,970.77
Rate for Payer: Qualcare PPO/HMO/WC	$3,970.77

REP FLXR TNDN NT Z2 WO GRFT EA

Facility

$26,471.80

Service Code	HCPCS 26350
Hospital Charge Code	16000338
Hospital Revenue Code	360
Min. Negotiated Rate	$637.97
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,941.54
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,970.77
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$637.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$701.50

REP INCOMPL CIRCUMCIS

Facility

$19,343.80

Service Code	HCPCS 54163
Hospital Charge Code	1600000505
Hospital Revenue Code	360
Min. Negotiated Rate	$2,901.57
Max. Negotiated Rate	$2,901.57
Rate for Payer: Qualcare PPO/HMO/WC	$2,901.57

REP INCOMPL CIRCUMCIS

Facility

$19,343.80

Service Code	HCPCS 54163
Hospital Charge Code	1600000505
Hospital Revenue Code	360
Min. Negotiated Rate	$466.19
Max. Negotiated Rate	$8,964.44
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,964.44
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,803.14
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,901.57
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$466.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$512.61

REP INIT FEM HRN RDCBL,INCARCE

Facility

$30,877.00

Service Code	HCPCS 49553
Hospital Charge Code	1600000308
Hospital Revenue Code	360
Min. Negotiated Rate	$744.14
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,263.10
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$744.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$818.24

REP INIT FEM HRN RDCBL,INCARCE

Facility

$30,877.00

Service Code	HCPCS 49553
Hospital Charge Code	1600000308
Hospital Revenue Code	360
Min. Negotiated Rate	$4,631.55
Max. Negotiated Rate	$4,631.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55

REP INIT INCI/ VENTRAL HERNIA

Facility

$30,877.00

Service Code	HCPCS 49560
Hospital Charge Code	16000989
Hospital Revenue Code	360
Min. Negotiated Rate	$4,631.55
Max. Negotiated Rate	$4,631.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55

Know your out-of-pocket cost for care.

All Charges