Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

R&L HRT CATH CHD NML NT CNJ

Facility

$25,737.16

Service Code	HCPCS 93596
Hospital Charge Code	411093596
Hospital Revenue Code	481
Min. Negotiated Rate	$620.27
Max. Negotiated Rate	$13,902.76
Rate for Payer: Aetna Commercial	$10,476.08
Rate for Payer: Aetna Medicare Advantage	$12,478.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,851.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,902.76
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: Cigna Medicare Advantage	$3,851.50
Rate for Payer: Clover Medicare Advantage	$3,658.93
Rate for Payer: EmblemHealth Commercial	$11,554.50
Rate for Payer: Humana Medicare Advantage	$3,967.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,851.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,721.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$620.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,851.50
Rate for Payer: Wellcare Medicare Advantage	$3,851.50
Rate for Payer: Wellpoint Medicaid Managed Care	$682.03

R&L HRT CATH CHD NML NT CNJ

Facility

$25,737.16

Service Code	HCPCS 93596
Hospital Charge Code	411093596
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

RMVL DEVITALIZED TISSUE NON-SE

Facility

$623.14

Service Code	HCPCS 97598
Hospital Charge Code	75190165
Hospital Revenue Code	761
Min. Negotiated Rate	$15.02
Max. Negotiated Rate	$774.40
Rate for Payer: Aetna Commercial	$236.79
Rate for Payer: Aetna Medicare Advantage	$186.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$774.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.90
Rate for Payer: Cigna Commercial	$311.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.94
Rate for Payer: Oxford Commercial	$124.63
Rate for Payer: Qualcare PPO/HMO/WC	$93.47
Rate for Payer: UnitedHealthcare Commercial	$124.63
Rate for Payer: UnitedHealthcare Community & State	$15.02
Rate for Payer: Wellpoint Medicaid Managed Care	$16.51

RMVL DEVITALIZED TISSUE NON-SE

Facility

$623.14

Service Code	HCPCS 97598
Hospital Charge Code	75190165
Hospital Revenue Code	761
Min. Negotiated Rate	$93.47
Max. Negotiated Rate	$93.47
Rate for Payer: Qualcare PPO/HMO/WC	$93.47

RMVL NINFCT MESH HERNIA RPR

Facility

$13,461.00

Service Code	HCPCS 49623
Hospital Charge Code	1600000389
Hospital Revenue Code	360
Min. Negotiated Rate	$2,019.15
Max. Negotiated Rate	$2,019.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,019.15

RMVL NINFCT MESH HERNIA RPR

Facility

$13,461.00

Service Code	HCPCS 49623
Hospital Charge Code	1600000389
Hospital Revenue Code	360
Min. Negotiated Rate	$324.41
Max. Negotiated Rate	$6,730.50
Rate for Payer: Aetna Commercial	$5,115.18
Rate for Payer: Aetna Medicare Advantage	$4,038.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,432.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,432.55
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	$3,432.55
Rate for Payer: Cigna Commercial	$6,730.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,038.30
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,019.15
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$324.41
Rate for Payer: Wellpoint Medicaid Managed Care	$356.72

RMVL OF SPINAL LAMINA SGL CERV

Facility

$47,548.90

Service Code	HCPCS 63045
Hospital Charge Code	16000652
Hospital Revenue Code	360
Min. Negotiated Rate	$1,145.93
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,264.67
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,145.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,260.05

RMVL OF SPINAL LAMINA SGL CERV

Facility

$47,548.90

Service Code	HCPCS 63045
Hospital Charge Code	16000652
Hospital Revenue Code	360
Min. Negotiated Rate	$7,132.34
Max. Negotiated Rate	$7,132.34
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34

RMVL OF SPINL LAMINA SGL THRCC

Facility

$47,548.90

Service Code	HCPCS 63046
Hospital Charge Code	16001021
Hospital Revenue Code	360
Min. Negotiated Rate	$1,145.93
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,264.67
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,145.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,260.05

RMVL OF SPINL LAMINA SGL THRCC

Facility

$47,548.90

Service Code	HCPCS 63046
Hospital Charge Code	16001021
Hospital Revenue Code	360
Min. Negotiated Rate	$7,132.34
Max. Negotiated Rate	$7,132.34
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34

RMVL OF SPNL LMNA LMBR,1-2VERT

Facility

$47,548.90

Service Code	HCPCS 63005
Hospital Charge Code	16000769
Hospital Revenue Code	360
Min. Negotiated Rate	$1,145.93
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,264.67
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,145.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,260.05

RMVL OF SPNL LMNA LMBR,1-2VERT

Facility

$47,548.90

Service Code	HCPCS 63005
Hospital Charge Code	16000769
Hospital Revenue Code	360
Min. Negotiated Rate	$7,132.34
Max. Negotiated Rate	$7,132.34
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34

RMVL TIS XPNDR WO INSJ IMPLT

Facility

$11,452.64

Service Code	HCPCS 11971
Hospital Charge Code	16000595
Hospital Revenue Code	360
Min. Negotiated Rate	$1,717.90
Max. Negotiated Rate	$1,717.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,717.90

RMVL TIS XPNDR WO INSJ IMPLT

Facility

$11,452.64

Service Code	HCPCS 11971
Hospital Charge Code	16000595
Hospital Revenue Code	360
Min. Negotiated Rate	$276.01
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	$862.00
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	$3,435.79
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,717.90
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$276.01
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	$303.49

RMVL W REINSERT DRUG IMPL DEL

Facility

$1,670.85

Service Code	HCPCS 11983
Hospital Charge Code	412311983
Hospital Revenue Code	361
Min. Negotiated Rate	$40.27
Max. Negotiated Rate	$2,220.00
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	$1,626.00
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	$501.25
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.63
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$40.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$530.72
Rate for Payer: Wellcare Medicare Advantage	$530.72
Rate for Payer: Wellpoint Medicaid Managed Care	$44.28

RMVL W REINSERT DRUG IMPL DEL

Facility

$1,670.85

Service Code	HCPCS 11983
Hospital Charge Code	412311983
Hospital Revenue Code	361
Min. Negotiated Rate	$250.63
Max. Negotiated Rate	$250.63
Rate for Payer: Qualcare PPO/HMO/WC	$250.63

RMV OR BIVLVNG GNTLT BT

Facility

$288.00

Service Code	HCPCS 29700
Hospital Charge Code	94186080
Hospital Revenue Code	361
Min. Negotiated Rate	$43.20
Max. Negotiated Rate	$43.20
Rate for Payer: Qualcare PPO/HMO/WC	$43.20

RMV OR BIVLVNG GNTLT BT

Facility

$288.00

Service Code	HCPCS 29700
Hospital Charge Code	94186080
Hospital Revenue Code	361
Min. Negotiated Rate	$6.94
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$903.80
Rate for Payer: Aetna Medicare Advantage	$1,076.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,199.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,199.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$332.28
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	$1,199.43
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: Cigna Medicare Advantage	$332.28
Rate for Payer: Clover Medicare Advantage	$315.67
Rate for Payer: EmblemHealth Commercial	$996.84
Rate for Payer: Humana Medicare Advantage	$342.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$332.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.40
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.20
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$6.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.28
Rate for Payer: Wellcare Medicare Advantage	$332.28
Rate for Payer: Wellpoint Medicaid Managed Care	$7.63

[RMYPCOGU;;OMR 400MG TABS****

Facility

$1.30

Hospital Charge Code	6027031
Hospital Revenue Code	251
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.20

[RMYPCOGU;;OMR 400MG TABS****

Facility

$1.30

Hospital Charge Code	6027031
Hospital Revenue Code	251
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.65
Rate for Payer: Aetna Commercial	$0.49
Rate for Payer: Aetna Medicare Advantage	$0.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.33
Rate for Payer: Cigna Commercial	$0.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$0.26
Rate for Payer: Qualcare PPO/HMO/WC	$0.20
Rate for Payer: UnitedHealthcare Commercial	$0.26
Rate for Payer: UnitedHealthcare Community & State	$0.03
Rate for Payer: Wellpoint Medicaid Managed Care	$0.03

RNA POLYMERASE III ANTIBODY

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	401183520
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RNA POLYMERASE III ANTIBODY

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	401183520
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.34
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

RNGD STC 18MCROCATH .018 150cm

Facility

$2,240.00

Hospital Charge Code	2709003623
Hospital Revenue Code	272
Min. Negotiated Rate	$336.00
Max. Negotiated Rate	$336.00
Rate for Payer: Qualcare PPO/HMO/WC	$336.00

RNGD STC 18MCROCATH .018 150cm

Facility

$2,240.00

Hospital Charge Code	2709003623
Hospital Revenue Code	272
Min. Negotiated Rate	$53.98
Max. Negotiated Rate	$1,120.00
Rate for Payer: Aetna Commercial	$851.20
Rate for Payer: Aetna Medicare Advantage	$672.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$571.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$571.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$571.20
Rate for Payer: Cigna Commercial	$1,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$672.00
Rate for Payer: Oxford Commercial	$448.00
Rate for Payer: Qualcare PPO/HMO/WC	$336.00
Rate for Payer: UnitedHealthcare Commercial	$448.00
Rate for Payer: UnitedHealthcare Community & State	$53.98
Rate for Payer: Wellpoint Medicaid Managed Care	$59.36

RNL NEUROLYSIS W USE OF OP MIC

Facility

$7,922.15

Service Code	HCPCS 64727
Hospital Charge Code	16000462
Hospital Revenue Code	360
Min. Negotiated Rate	$1,188.32
Max. Negotiated Rate	$1,188.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,188.32

Know your out-of-pocket cost for care.

All Charges