Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SKYLITE BASKET 2.4F

Facility

$850.00

Hospital Charge Code	270682480
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.00
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$170.00
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

SKYLITE BASKET 2.4F

Facility

$850.00

Hospital Charge Code	270682480
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SLAP RASP

Facility

$1,725.00

Hospital Charge Code	270656573
Hospital Revenue Code	272
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$258.75
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SLAP RASP

Facility

$1,725.00

Hospital Charge Code	270656573
Hospital Revenue Code	272
Min. Negotiated Rate	$41.57
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$517.50
Rate for Payer: Oxford Commercial	$345.00
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Commercial	$345.00
Rate for Payer: UnitedHealthcare Community & State	$41.57
Rate for Payer: Wellpoint Medicaid Managed Care	$45.71

SLCTIV CATH VEIN,2ND ORDR FAM

Facility

$1,980.80

Service Code	HCPCS 36012
Hospital Charge Code	16000944
Hospital Revenue Code	360
Min. Negotiated Rate	$47.74
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$752.70
Rate for Payer: Aetna Medicare Advantage	$594.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$505.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$505.10
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	$505.10
Rate for Payer: Cigna Commercial	$990.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.24
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$297.12
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$47.74
Rate for Payer: Wellpoint Medicaid Managed Care	$52.49

SLCTIV CATH VEIN,2ND ORDR FAM

Facility

$1,980.80

Service Code	HCPCS 36012
Hospital Charge Code	16000944
Hospital Revenue Code	360
Min. Negotiated Rate	$297.12
Max. Negotiated Rate	$297.12
Rate for Payer: Qualcare PPO/HMO/WC	$297.12

SLCTV WND DEBRIDEM 20 CM OR <

Facility

$630.15

Service Code	HCPCS 97597
Hospital Charge Code	160000220
Hospital Revenue Code	360
Min. Negotiated Rate	$15.19
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
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	$860.41
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.04
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.52
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$15.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$16.70

SLCTV WND DEBRIDEM 20 CM OR <

Facility

$630.15

Service Code	HCPCS 97597
Hospital Charge Code	160000220
Hospital Revenue Code	360
Min. Negotiated Rate	$94.52
Max. Negotiated Rate	$94.52
Rate for Payer: Qualcare PPO/HMO/WC	$94.52

SLCTV WND DEBRIDEM ADDL 20C

Facility

$361.65

Service Code	HCPCS 97598
Hospital Charge Code	1600000377
Hospital Revenue Code	360
Min. Negotiated Rate	$54.25
Max. Negotiated Rate	$54.25
Rate for Payer: Qualcare PPO/HMO/WC	$54.25

SLCTV WND DEBRIDEM ADDL 20C

Facility

$361.65

Service Code	HCPCS 97598
Hospital Charge Code	1600000377
Hospital Revenue Code	360
Min. Negotiated Rate	$8.72
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$137.43
Rate for Payer: Aetna Medicare Advantage	$108.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.22
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	$92.22
Rate for Payer: Cigna Commercial	$180.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.50
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.25
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$8.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.58

SLEEP STUDY ATTENDED

Facility

$40,000.00

Service Code	HCPCS 95807
Hospital Charge Code	405295807
Hospital Revenue Code	920
Min. Negotiated Rate	$421.15
Max. Negotiated Rate	$18,046.00
Rate for Payer: Aetna Commercial	$1,205.83
Rate for Payer: Aetna Medicare Advantage	$1,436.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$443.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,600.25
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: Cigna Medicare Advantage	$443.32
Rate for Payer: Clover Medicare Advantage	$421.15
Rate for Payer: EmblemHealth Commercial	$1,329.96
Rate for Payer: Humana Medicare Advantage	$456.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$443.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,000.00
Rate for Payer: Oxford Commercial	$10,292.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00
Rate for Payer: UnitedHealthcare Commercial	$18,046.00
Rate for Payer: UnitedHealthcare Community & State	$964.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$443.32
Rate for Payer: Wellcare Medicare Advantage	$443.32
Rate for Payer: Wellpoint Medicaid Managed Care	$1,060.00

SLEEP STUDY ATTENDED

Facility

$40,000.00

Service Code	HCPCS 95807
Hospital Charge Code	405295807
Hospital Revenue Code	920
Min. Negotiated Rate	$6,000.00
Max. Negotiated Rate	$6,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00

SLEEP STUDY ATTENDED PAP-NAP

Facility

$4,688.00

Service Code	HCPCS 9580752
Hospital Charge Code	90000025
Hospital Revenue Code	740
Min. Negotiated Rate	$703.20
Max. Negotiated Rate	$703.20
Rate for Payer: Qualcare PPO/HMO/WC	$703.20

SLEEP STUDY ATTENDED PAP-NAP

Facility

$4,688.00

Service Code	HCPCS 9580752
Hospital Charge Code	90000025
Hospital Revenue Code	740
Min. Negotiated Rate	$112.98
Max. Negotiated Rate	$18,046.00
Rate for Payer: Aetna Commercial	$1,781.44
Rate for Payer: Aetna Medicare Advantage	$1,406.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,195.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,195.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,195.44
Rate for Payer: Cigna Commercial	$2,344.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,406.40
Rate for Payer: Oxford Commercial	$10,292.00
Rate for Payer: Qualcare PPO/HMO/WC	$703.20
Rate for Payer: UnitedHealthcare Commercial	$18,046.00
Rate for Payer: UnitedHealthcare Community & State	$112.98
Rate for Payer: Wellpoint Medicaid Managed Care	$124.23

SLEEP STUDY UNATTENDED

Facility

$1,004.00

Service Code	HCPCS 95800
Hospital Charge Code	90000001
Hospital Revenue Code	920
Min. Negotiated Rate	$150.60
Max. Negotiated Rate	$150.60
Rate for Payer: Qualcare PPO/HMO/WC	$150.60

SLEEP STUDY UNATTENDED

Facility

$1,004.00

Service Code	HCPCS 95800
Hospital Charge Code	90000001
Hospital Revenue Code	920
Min. Negotiated Rate	$24.20
Max. Negotiated Rate	$13,534.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$925.96
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.20
Rate for Payer: Oxford Commercial	$7,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.60
Rate for Payer: UnitedHealthcare Commercial	$13,534.00
Rate for Payer: UnitedHealthcare Community & State	$24.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$26.61

SLEEP STUDY UNATT & RESP EFFOR

Facility

$40,000.00

Service Code	HCPCS 95806
Hospital Charge Code	90000020
Hospital Revenue Code	920
Min. Negotiated Rate	$243.69
Max. Negotiated Rate	$13,534.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$925.96
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,000.00
Rate for Payer: Oxford Commercial	$7,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00
Rate for Payer: UnitedHealthcare Commercial	$13,534.00
Rate for Payer: UnitedHealthcare Community & State	$964.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1,060.00

SLEEP STUDY UNATT & RESP EFFOR

Facility

$40,000.00

Service Code	HCPCS 95806
Hospital Charge Code	90000020
Hospital Revenue Code	920
Min. Negotiated Rate	$6,000.00
Max. Negotiated Rate	$6,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00

SLEEP STUDY UNATT W/RESP ANAL

Facility

$1,004.00

Service Code	HCPCS 95801
Hospital Charge Code	90000005
Hospital Revenue Code	740
Min. Negotiated Rate	$150.60
Max. Negotiated Rate	$150.60
Rate for Payer: Qualcare PPO/HMO/WC	$150.60

SLEEP STUDY UNATT W/RESP ANAL

Facility

$1,004.00

Service Code	HCPCS 95801
Hospital Charge Code	90000005
Hospital Revenue Code	740
Min. Negotiated Rate	$24.20
Max. Negotiated Rate	$13,534.00
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.97
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.20
Rate for Payer: Oxford Commercial	$7,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.60
Rate for Payer: UnitedHealthcare Commercial	$13,534.00
Rate for Payer: UnitedHealthcare Community & State	$24.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$26.61

SLEEVE 2MM MINIPORT 171312

Facility

$220.85

Hospital Charge Code	270612743
Hospital Revenue Code	272
Min. Negotiated Rate	$5.32
Max. Negotiated Rate	$110.42
Rate for Payer: Aetna Commercial	$83.92
Rate for Payer: Aetna Medicare Advantage	$66.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.32
Rate for Payer: Cigna Commercial	$110.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.25
Rate for Payer: Oxford Commercial	$44.17
Rate for Payer: Qualcare PPO/HMO/WC	$33.13
Rate for Payer: UnitedHealthcare Commercial	$44.17
Rate for Payer: UnitedHealthcare Community & State	$5.32
Rate for Payer: Wellpoint Medicaid Managed Care	$5.85

SLEEVE 2MM MINIPORT 171312

Facility

$220.85

Hospital Charge Code	270612743
Hospital Revenue Code	272
Min. Negotiated Rate	$33.13
Max. Negotiated Rate	$33.13
Rate for Payer: Qualcare PPO/HMO/WC	$33.13

SLEEVE 5 X 100 STABILITY OPT

Facility

$90.00

Hospital Charge Code	270669196
Hospital Revenue Code	272
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.00
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

SLEEVE 5 X 100 STABILITY OPT

Facility

$90.00

Hospital Charge Code	270669196
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

SLEEVE ADAPTER FEMORAL 5MM

Facility

$2,015.00

Service Code	HCPCS C1776
Hospital Charge Code	270696296
Hospital Revenue Code	278
Min. Negotiated Rate	$48.56
Max. Negotiated Rate	$1,007.50
Rate for Payer: Aetna Commercial	$765.70
Rate for Payer: Aetna Medicare Advantage	$604.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$513.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$513.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$403.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$513.83
Rate for Payer: Cigna Commercial	$1,007.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$443.30
Rate for Payer: Qualcare PPO/HMO/WC	$302.25
Rate for Payer: UnitedHealthcare Community & State	$48.56
Rate for Payer: Wellpoint Medicaid Managed Care	$53.40

Know your out-of-pocket cost for care.

All Charges