Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STEREO BREAST LOCAL EA ADD LES

Facility

$1,184.85

Service Code	HCPCS 19284
Hospital Charge Code	2700027
Hospital Revenue Code	361
Min. Negotiated Rate	$28.55
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$450.24
Rate for Payer: Aetna Medicare Advantage	$355.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$302.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$302.14
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	$302.14
Rate for Payer: Cigna Commercial	$592.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.45
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$177.73
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$28.55
Rate for Payer: Wellpoint Medicaid Managed Care	$31.40

STEREOSCOPIC XRAY GUIDANCE-PC

Facility

$101.35

Service Code	HCPCS 7742126
Hospital Charge Code	85000765
Hospital Revenue Code	333
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$38.51
Rate for Payer: Aetna Medicare Advantage	$30.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.84
Rate for Payer: Cigna Commercial	$50.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.41
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.20
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$2.44
Rate for Payer: Wellpoint Medicaid Managed Care	$2.69

STEREOSCOPIC XRAY GUIDANCE-PC

Facility

$101.35

Service Code	HCPCS 7742126
Hospital Charge Code	85000765
Hospital Revenue Code	333
Min. Negotiated Rate	$15.20
Max. Negotiated Rate	$15.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.20

STEREOSCOPIC XRAY GUIDANCE-TC

Facility

$401.45

Service Code	HCPCS 77421TC
Hospital Charge Code	85000760
Hospital Revenue Code	333
Min. Negotiated Rate	$9.67
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$152.55
Rate for Payer: Aetna Medicare Advantage	$120.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.37
Rate for Payer: Cigna Commercial	$200.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.44
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.22
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$9.67
Rate for Payer: Wellpoint Medicaid Managed Care	$10.64

STEREOSCOPIC XRAY GUIDANCE-TC

Facility

$401.45

Service Code	HCPCS 77421TC
Hospital Charge Code	85000760
Hospital Revenue Code	333
Min. Negotiated Rate	$60.22
Max. Negotiated Rate	$60.22
Rate for Payer: Qualcare PPO/HMO/WC	$60.22

STEREOTACGUIDEBRSTBIOP1STLESLT

Facility

$4,169.44

Service Code	HCPCS 19081
Hospital Charge Code	94064001L
Hospital Revenue Code	361
Min. Negotiated Rate	$100.48
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	$1,626.00
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	$1,250.83
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$625.42
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$100.48
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	$110.49

STEREOTACGUIDEBRSTBIOP1STLESLT

Facility

$4,169.44

Service Code	HCPCS 19081
Hospital Charge Code	94064001L
Hospital Revenue Code	361
Min. Negotiated Rate	$625.42
Max. Negotiated Rate	$625.42
Rate for Payer: Qualcare PPO/HMO/WC	$625.42

STEREOTACGUIDEBRSTBIOP1STLESRT

Facility

$4,169.44

Service Code	HCPCS 19081
Hospital Charge Code	94064001R
Hospital Revenue Code	361
Min. Negotiated Rate	$100.48
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	$1,626.00
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	$1,250.83
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$625.42
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$100.48
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	$110.49

STEREOTACGUIDEBRSTBIOP1STLESRT

Facility

$4,169.44

Service Code	HCPCS 19081
Hospital Charge Code	94064001R
Hospital Revenue Code	361
Min. Negotiated Rate	$625.42
Max. Negotiated Rate	$625.42
Rate for Payer: Qualcare PPO/HMO/WC	$625.42

STEREOTACGUIDEBRSTBIOPADDLESLT

Facility

$3,214.70

Service Code	HCPCS 19082
Hospital Charge Code	94064003L
Hospital Revenue Code	361
Min. Negotiated Rate	$77.47
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,221.59
Rate for Payer: Aetna Medicare Advantage	$964.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$819.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$819.75
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	$819.75
Rate for Payer: Cigna Commercial	$1,607.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$964.41
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$482.20
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$77.47
Rate for Payer: Wellpoint Medicaid Managed Care	$85.19

STEREOTACGUIDEBRSTBIOPADDLESLT

Facility

$3,214.70

Service Code	HCPCS 19082
Hospital Charge Code	94064003L
Hospital Revenue Code	361
Min. Negotiated Rate	$482.20
Max. Negotiated Rate	$482.20
Rate for Payer: Qualcare PPO/HMO/WC	$482.20

STEREOTACGUIDEBRSTBIOPADDLESRT

Facility

$3,214.70

Service Code	HCPCS 19082
Hospital Charge Code	94064003R
Hospital Revenue Code	361
Min. Negotiated Rate	$77.47
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,221.59
Rate for Payer: Aetna Medicare Advantage	$964.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$819.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$819.75
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	$819.75
Rate for Payer: Cigna Commercial	$1,607.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$964.41
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$482.20
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$77.47
Rate for Payer: Wellpoint Medicaid Managed Care	$85.19

STEREOTACGUIDEBRSTBIOPADDLESRT

Facility

$3,214.70

Service Code	HCPCS 19082
Hospital Charge Code	94064003R
Hospital Revenue Code	361
Min. Negotiated Rate	$482.20
Max. Negotiated Rate	$482.20
Rate for Payer: Qualcare PPO/HMO/WC	$482.20

STEREOTACGUIDEBRSTBIOPSY1STLES

Facility

$8,338.88

Service Code	HCPCS 19081
Hospital Charge Code	94064001
Hospital Revenue Code	361
Min. Negotiated Rate	$200.97
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	$1,626.00
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	$2,501.66
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,250.83
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$200.97
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	$220.98

STEREOTACGUIDEBRSTBIOPSY1STLES

Facility

$8,338.88

Service Code	HCPCS 19081
Hospital Charge Code	94064001
Hospital Revenue Code	361
Min. Negotiated Rate	$1,250.83
Max. Negotiated Rate	$1,250.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,250.83

STEREOTACGUIDEBRSTBIOPSYADDLES

Facility

$6,429.40

Service Code	HCPCS 19082
Hospital Charge Code	94064003
Hospital Revenue Code	361
Min. Negotiated Rate	$964.41
Max. Negotiated Rate	$964.41
Rate for Payer: Qualcare PPO/HMO/WC	$964.41

STEREOTACGUIDEBRSTBIOPSYADDLES

Facility

$6,429.40

Service Code	HCPCS 19082
Hospital Charge Code	94064003
Hospital Revenue Code	361
Min. Negotiated Rate	$154.95
Max. Negotiated Rate	$3,214.70
Rate for Payer: Aetna Commercial	$2,443.17
Rate for Payer: Aetna Medicare Advantage	$1,928.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,639.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,639.50
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	$1,639.50
Rate for Payer: Cigna Commercial	$3,214.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,928.82
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$964.41
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$154.95
Rate for Payer: Wellpoint Medicaid Managed Care	$170.38

STEREOTACT GUIDE BRST BX-GL

Facility

$824.35

Hospital Charge Code	85000035
Hospital Revenue Code	320
Min. Negotiated Rate	$19.87
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$313.25
Rate for Payer: Aetna Medicare Advantage	$247.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.21
Rate for Payer: Cigna Commercial	$412.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.31
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.65
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$19.87
Rate for Payer: Wellpoint Medicaid Managed Care	$21.85

STEREOTACT GUIDE BRST BX-GL

Facility

$824.35

Hospital Charge Code	85000035
Hospital Revenue Code	320
Min. Negotiated Rate	$123.65
Max. Negotiated Rate	$123.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.65

STEREOTACT GUIDE BRST BX-PC

Facility

$424.95

Service Code	HCPCS 7703126
Hospital Charge Code	85000045
Hospital Revenue Code	320
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$161.48
Rate for Payer: Aetna Medicare Advantage	$127.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.36
Rate for Payer: Cigna Commercial	$212.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.48
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.74
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

STEREOTACT GUIDE BRST BX-PC

Facility

$424.95

Service Code	HCPCS 7703126
Hospital Charge Code	85000045
Hospital Revenue Code	320
Min. Negotiated Rate	$63.74
Max. Negotiated Rate	$63.74
Rate for Payer: Qualcare PPO/HMO/WC	$63.74

STEREOTACT GUIDE BRST BX-TC

Facility

$399.40

Service Code	HCPCS 77031TC
Hospital Charge Code	85000040
Hospital Revenue Code	320
Min. Negotiated Rate	$59.91
Max. Negotiated Rate	$59.91
Rate for Payer: Qualcare PPO/HMO/WC	$59.91

STEREOTACT GUIDE BRST BX-TC

Facility

$399.40

Service Code	HCPCS 77031TC
Hospital Charge Code	85000040
Hospital Revenue Code	320
Min. Negotiated Rate	$9.63
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$151.77
Rate for Payer: Aetna Medicare Advantage	$119.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.85
Rate for Payer: Cigna Commercial	$199.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.82
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.91
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$9.63
Rate for Payer: Wellpoint Medicaid Managed Care	$10.58

STEREOTACTIC BREAST BIOPSY

Facility

$2,669.00

Service Code	HCPCS 19081
Hospital Charge Code	87502806
Hospital Revenue Code	361
Min. Negotiated Rate	$400.35
Max. Negotiated Rate	$400.35
Rate for Payer: Qualcare PPO/HMO/WC	$400.35

STEREOTACTIC BREAST BIOPSY

Facility

$2,669.00

Service Code	HCPCS 19081
Hospital Charge Code	87502806
Hospital Revenue Code	361
Min. Negotiated Rate	$64.32
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	$1,626.00
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	$800.70
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$400.35
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$64.32
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	$70.73

Know your out-of-pocket cost for care.

All Charges