Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SPCR PRODISC INS TPS DP TM 6mm

Facility

$1,725.00

Service Code	HCPCS C1889
Hospital Charge Code	270693165
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SPCR PRODISC INS TPS DP TM 6mm

Facility

$1,725.00

Service Code	HCPCS C1889
Hospital Charge Code	270693165
Hospital Revenue Code	278
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) NJ Health	$345.00
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	$417.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Community & State	$41.57
Rate for Payer: Wellpoint Medicaid Managed Care	$45.71

SPEAKING VALVE PURPLE

Facility

$532.05

Hospital Charge Code	270616940
Hospital Revenue Code	270
Min. Negotiated Rate	$79.81
Max. Negotiated Rate	$79.81
Rate for Payer: Qualcare PPO/HMO/WC	$79.81

SPEAKING VALVE PURPLE

Facility

$532.05

Hospital Charge Code	270616940
Hospital Revenue Code	270
Min. Negotiated Rate	$12.82
Max. Negotiated Rate	$266.02
Rate for Payer: Aetna Commercial	$202.18
Rate for Payer: Aetna Medicare Advantage	$159.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.67
Rate for Payer: Cigna Commercial	$266.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.62
Rate for Payer: Oxford Commercial	$106.41
Rate for Payer: Qualcare PPO/HMO/WC	$79.81
Rate for Payer: UnitedHealthcare Commercial	$106.41
Rate for Payer: UnitedHealthcare Community & State	$12.82
Rate for Payer: Wellpoint Medicaid Managed Care	$14.10

SPEAR JUVENILE FLAT BLADE

Facility

$319.50

Hospital Charge Code	270655892
Hospital Revenue Code	271
Min. Negotiated Rate	$47.92
Max. Negotiated Rate	$47.92
Rate for Payer: Qualcare PPO/HMO/WC	$47.92

SPEAR JUVENILE FLAT BLADE

Facility

$319.50

Hospital Charge Code	270655892
Hospital Revenue Code	271
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$159.75
Rate for Payer: Aetna Commercial	$121.41
Rate for Payer: Aetna Medicare Advantage	$95.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.47
Rate for Payer: Cigna Commercial	$159.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.85
Rate for Payer: Oxford Commercial	$63.90
Rate for Payer: Qualcare PPO/HMO/WC	$47.92
Rate for Payer: UnitedHealthcare Commercial	$63.90
Rate for Payer: UnitedHealthcare Community & State	$7.70
Rate for Payer: Wellpoint Medicaid Managed Care	$8.47

SPEAR SURGICAL

Facility

$1.00

Hospital Charge Code	270654191
Hospital Revenue Code	270
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

SPEAR SURGICAL

Facility

$1.00

Hospital Charge Code	270654191
Hospital Revenue Code	270
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.38
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.30
Rate for Payer: Oxford Commercial	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.20
Rate for Payer: UnitedHealthcare Community & State	$0.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.03

SPEAR SURGICAL PVA

Facility

$567.40

Hospital Charge Code	270655872
Hospital Revenue Code	271
Min. Negotiated Rate	$13.67
Max. Negotiated Rate	$283.70
Rate for Payer: Aetna Commercial	$215.61
Rate for Payer: Aetna Medicare Advantage	$170.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.69
Rate for Payer: Cigna Commercial	$283.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.22
Rate for Payer: Oxford Commercial	$113.48
Rate for Payer: Qualcare PPO/HMO/WC	$85.11
Rate for Payer: UnitedHealthcare Commercial	$113.48
Rate for Payer: UnitedHealthcare Community & State	$13.67
Rate for Payer: Wellpoint Medicaid Managed Care	$15.04

SPEAR SURGICAL PVA

Facility

$567.40

Hospital Charge Code	270655872
Hospital Revenue Code	271
Min. Negotiated Rate	$85.11
Max. Negotiated Rate	$85.11
Rate for Payer: Qualcare PPO/HMO/WC	$85.11

SPEAR SURGICAL STER

Facility

$13.65

Hospital Charge Code	270061270
Hospital Revenue Code	272
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

SPEAR SURGICAL STER

Facility

$13.65

Hospital Charge Code	270061270
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$5.19
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.09
Rate for Payer: Oxford Commercial	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$2.73
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

SPEC BOARD FOR SPEC MAMMOGRPHY

Facility

$77.65

Hospital Charge Code	1603588
Hospital Revenue Code	271
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$38.83
Rate for Payer: Aetna Commercial	$29.51
Rate for Payer: Aetna Medicare Advantage	$23.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.80
Rate for Payer: Cigna Commercial	$38.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.30
Rate for Payer: Oxford Commercial	$15.53
Rate for Payer: Qualcare PPO/HMO/WC	$11.65
Rate for Payer: UnitedHealthcare Commercial	$15.53
Rate for Payer: UnitedHealthcare Community & State	$1.87
Rate for Payer: Wellpoint Medicaid Managed Care	$2.06

SPEC BOARD FOR SPEC MAMMOGRPHY

Facility

$77.65

Hospital Charge Code	1603588
Hospital Revenue Code	271
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$11.65
Rate for Payer: Qualcare PPO/HMO/WC	$11.65

SPECEMENT TRAP

Facility

$58.00

Hospital Charge Code	270325604
Hospital Revenue Code	272
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.70

SPECEMENT TRAP

Facility

$58.00

Hospital Charge Code	270325604
Hospital Revenue Code	272
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$29.00
Rate for Payer: Aetna Commercial	$22.04
Rate for Payer: Aetna Medicare Advantage	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.79
Rate for Payer: Cigna Commercial	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.40
Rate for Payer: Oxford Commercial	$11.60
Rate for Payer: Qualcare PPO/HMO/WC	$8.70
Rate for Payer: UnitedHealthcare Commercial	$11.60
Rate for Payer: UnitedHealthcare Community & State	$1.40
Rate for Payer: Wellpoint Medicaid Managed Care	$1.54

SPECIAL ANTIBODY CONFIRMATION

Facility

$514.00

Service Code	HCPCS 86689
Hospital Charge Code	38476135
Hospital Revenue Code	302
Min. Negotiated Rate	$13.62
Max. Negotiated Rate	$257.00
Rate for Payer: Aetna Commercial	$52.63
Rate for Payer: Aetna Medicare Advantage	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.85
Rate for Payer: Cigna Commercial	$257.00
Rate for Payer: Cigna Medicare Advantage	$19.35
Rate for Payer: Clover Medicare Advantage	$18.38
Rate for Payer: EmblemHealth Commercial	$58.05
Rate for Payer: Humana Medicare Advantage	$19.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$77.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.35
Rate for Payer: Wellcare Medicare Advantage	$19.35
Rate for Payer: Wellpoint Medicaid Managed Care	$13.62

SPECIAL ANTIBODY CONFIRMATION

Facility

$514.00

Service Code	HCPCS 86689
Hospital Charge Code	38476135
Hospital Revenue Code	302
Min. Negotiated Rate	$77.10
Max. Negotiated Rate	$77.10
Rate for Payer: Qualcare PPO/HMO/WC	$77.10

SPECIAL ANTIBODY II SCREEN

Facility

$458.00

Service Code	HCPCS 86702
Hospital Charge Code	38476133
Hospital Revenue Code	302
Min. Negotiated Rate	$10.82
Max. Negotiated Rate	$229.00
Rate for Payer: Aetna Commercial	$36.77
Rate for Payer: Aetna Medicare Advantage	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.80
Rate for Payer: Cigna Commercial	$229.00
Rate for Payer: Cigna Medicare Advantage	$13.52
Rate for Payer: Clover Medicare Advantage	$12.84
Rate for Payer: EmblemHealth Commercial	$40.56
Rate for Payer: Humana Medicare Advantage	$13.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.52
Rate for Payer: Wellcare Medicare Advantage	$13.52
Rate for Payer: Wellpoint Medicaid Managed Care	$12.14

SPECIAL ANTIBODY II SCREEN

Facility

$458.00

Service Code	HCPCS 86702
Hospital Charge Code	38476133
Hospital Revenue Code	302
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

SPECIAL ANTIBODY SCREEN

Facility

$522.00

Service Code	HCPCS 86701
Hospital Charge Code	38476132
Hospital Revenue Code	302
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$261.00
Rate for Payer: Aetna Commercial	$24.18
Rate for Payer: Aetna Medicare Advantage	$28.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.09
Rate for Payer: Cigna Commercial	$261.00
Rate for Payer: Cigna Medicare Advantage	$8.89
Rate for Payer: Clover Medicare Advantage	$8.45
Rate for Payer: EmblemHealth Commercial	$26.67
Rate for Payer: Humana Medicare Advantage	$9.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.89
Rate for Payer: Wellcare Medicare Advantage	$8.89
Rate for Payer: Wellpoint Medicaid Managed Care	$13.83

SPECIAL ANTIBODY SCREEN

Facility

$522.00

Service Code	HCPCS 86701
Hospital Charge Code	38476132
Hospital Revenue Code	302
Min. Negotiated Rate	$78.30
Max. Negotiated Rate	$78.30
Rate for Payer: Qualcare PPO/HMO/WC	$78.30

SPECIALIZED TRACHEOST TUBE****

Facility

$340.00

Hospital Charge Code	8004400
Hospital Revenue Code	279
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$129.20
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.00
Rate for Payer: Oxford Commercial	$68.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Commercial	$68.00
Rate for Payer: UnitedHealthcare Community & State	$8.19
Rate for Payer: Wellpoint Medicaid Managed Care	$9.01

SPECIALIZED TRACHEOST TUBE****

Facility

$340.00

Hospital Charge Code	8004400
Hospital Revenue Code	279
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

SPECIAL MED PHYSICS CONSULT

Facility

$515.20

Service Code	HCPCS 77370
Hospital Charge Code	4800546
Hospital Revenue Code	333
Min. Negotiated Rate	$12.42
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$434.33
Rate for Payer: Aetna Medicare Advantage	$517.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$576.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$576.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$159.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$576.40
Rate for Payer: Cigna Commercial	$320.09
Rate for Payer: Cigna Medicare Advantage	$111.78
Rate for Payer: Clover Medicare Advantage	$151.70
Rate for Payer: EmblemHealth Commercial	$479.04
Rate for Payer: Humana Medicare Advantage	$164.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$159.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.56
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$77.28
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$12.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$159.68
Rate for Payer: Wellcare Medicare Advantage	$159.68
Rate for Payer: Wellpoint Medicaid Managed Care	$13.65

Know your out-of-pocket cost for care.

All Charges