Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

THORACENTESIS *******

Facility

$270.00

Service Code	HCPCS 32000
Hospital Charge Code	1001140
Hospital Revenue Code	361
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

THORACENTESIS *******

Facility

$270.00

Service Code	HCPCS 32000
Hospital Charge Code	1001140
Hospital Revenue Code	361
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
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	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Community & State	$6.51
Rate for Payer: Wellpoint Medicaid Managed Care	$7.16

THORACENTESIS-BILAT

Facility

$985.00

Service Code	HCPCS 3255450
Hospital Charge Code	93500133
Hospital Revenue Code	361
Min. Negotiated Rate	$23.74
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$374.30
Rate for Payer: Aetna Medicare Advantage	$295.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.18
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	$251.18
Rate for Payer: Cigna Commercial	$492.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.50
Rate for Payer: Qualcare PPO/HMO/WC	$147.75
Rate for Payer: UnitedHealthcare Community & State	$23.74
Rate for Payer: Wellpoint Medicaid Managed Care	$26.10

THORACENTESIS-BILAT

Facility

$985.00

Service Code	HCPCS 3255450
Hospital Charge Code	93500133
Hospital Revenue Code	361
Min. Negotiated Rate	$147.75
Max. Negotiated Rate	$147.75
Rate for Payer: Qualcare PPO/HMO/WC	$147.75

THORACENTESIS-BILAT

Facility

$985.00

Service Code	HCPCS 3255450
Hospital Charge Code	3409005
Hospital Revenue Code	361
Min. Negotiated Rate	$147.75
Max. Negotiated Rate	$147.75
Rate for Payer: Qualcare PPO/HMO/WC	$147.75

THORACENTESIS-BILAT

Facility

$985.00

Service Code	HCPCS 3255450
Hospital Charge Code	3409005
Hospital Revenue Code	361
Min. Negotiated Rate	$23.74
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$374.30
Rate for Payer: Aetna Medicare Advantage	$295.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.18
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	$251.18
Rate for Payer: Cigna Commercial	$492.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.50
Rate for Payer: Qualcare PPO/HMO/WC	$147.75
Rate for Payer: UnitedHealthcare Community & State	$23.74
Rate for Payer: Wellpoint Medicaid Managed Care	$26.10

THORACENTESIS FLUID CYTOLOGY

Facility

$264.85

Service Code	HCPCS 88104
Hospital Charge Code	3005354
Hospital Revenue Code	311
Min. Negotiated Rate	$7.02
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$120.69
Rate for Payer: Aetna Medicare Advantage	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.16
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$44.37
Rate for Payer: Clover Medicare Advantage	$42.15
Rate for Payer: EmblemHealth Commercial	$133.11
Rate for Payer: Humana Medicare Advantage	$45.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.73
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$61.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.37
Rate for Payer: Wellcare Medicare Advantage	$44.37
Rate for Payer: Wellpoint Medicaid Managed Care	$7.02

THORACENTESIS FLUID CYTOLOGY

Facility

$264.85

Service Code	HCPCS 88104
Hospital Charge Code	3005354
Hospital Revenue Code	311
Min. Negotiated Rate	$39.73
Max. Negotiated Rate	$39.73
Rate for Payer: Qualcare PPO/HMO/WC	$39.73

THORACENTESIS-LT

Facility

$985.00

Service Code	HCPCS 32554LT
Hospital Charge Code	3409040
Hospital Revenue Code	361
Min. Negotiated Rate	$23.74
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$374.30
Rate for Payer: Aetna Medicare Advantage	$295.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.18
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	$251.18
Rate for Payer: Cigna Commercial	$492.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.50
Rate for Payer: Qualcare PPO/HMO/WC	$147.75
Rate for Payer: UnitedHealthcare Community & State	$23.74
Rate for Payer: Wellpoint Medicaid Managed Care	$26.10

THORACENTESIS-LT

Facility

$985.00

Service Code	HCPCS 32554LT
Hospital Charge Code	3409040
Hospital Revenue Code	361
Min. Negotiated Rate	$147.75
Max. Negotiated Rate	$147.75
Rate for Payer: Qualcare PPO/HMO/WC	$147.75

THORACENTESIS-LT

Facility

$985.00

Service Code	HCPCS 32554LT
Hospital Charge Code	93500135
Hospital Revenue Code	361
Min. Negotiated Rate	$147.75
Max. Negotiated Rate	$147.75
Rate for Payer: Qualcare PPO/HMO/WC	$147.75

THORACENTESIS-LT

Facility

$985.00

Service Code	HCPCS 32554LT
Hospital Charge Code	93500135
Hospital Revenue Code	361
Min. Negotiated Rate	$23.74
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$374.30
Rate for Payer: Aetna Medicare Advantage	$295.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.18
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	$251.18
Rate for Payer: Cigna Commercial	$492.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.50
Rate for Payer: Qualcare PPO/HMO/WC	$147.75
Rate for Payer: UnitedHealthcare Community & State	$23.74
Rate for Payer: Wellpoint Medicaid Managed Care	$26.10

THORACENTESIS OR NEEDLE CHEST

Facility

$2,289.68

Service Code	HCPCS 32421
Hospital Charge Code	5780170
Hospital Revenue Code	450
Min. Negotiated Rate	$60.68
Max. Negotiated Rate	$1,144.84
Rate for Payer: Aetna Commercial	$870.08
Rate for Payer: Aetna Medicare Advantage	$686.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$583.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$583.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$583.87
Rate for Payer: Cigna Commercial	$1,144.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$686.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$343.45
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$60.68

THORACENTESIS OR NEEDLE CHEST

Facility

$2,289.68

Service Code	HCPCS 32421
Hospital Charge Code	5780170
Hospital Revenue Code	450
Min. Negotiated Rate	$343.45
Max. Negotiated Rate	$343.45
Rate for Payer: Qualcare PPO/HMO/WC	$343.45

THORACENTESIS PUNCT PLEURL CAV

Facility

$4,709.90

Service Code	HCPCS 32405
Hospital Charge Code	2008001
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

THORACENTESIS PUNCT PLEURL CAV

Facility

$4,709.90

Service Code	HCPCS 32405
Hospital Charge Code	2008001
Hospital Revenue Code	361
Min. Negotiated Rate	$113.51
Max. Negotiated Rate	$2,354.95
Rate for Payer: Aetna Commercial	$1,789.76
Rate for Payer: Aetna Medicare Advantage	$1,412.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,201.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,201.02
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	$1,201.02
Rate for Payer: Cigna Commercial	$2,354.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,412.97
Rate for Payer: Qualcare PPO/HMO/WC	$706.49
Rate for Payer: UnitedHealthcare Community & State	$113.51
Rate for Payer: Wellpoint Medicaid Managed Care	$124.81

THORACENTESIS-RT

Facility

$985.00

Service Code	HCPCS 32554RT
Hospital Charge Code	3409045
Hospital Revenue Code	361
Min. Negotiated Rate	$147.75
Max. Negotiated Rate	$147.75
Rate for Payer: Qualcare PPO/HMO/WC	$147.75

THORACENTESIS-RT

Facility

$985.00

Service Code	HCPCS 32554RT
Hospital Charge Code	93500137
Hospital Revenue Code	361
Min. Negotiated Rate	$147.75
Max. Negotiated Rate	$147.75
Rate for Payer: Qualcare PPO/HMO/WC	$147.75

THORACENTESIS-RT

Facility

$985.00

Service Code	HCPCS 32554RT
Hospital Charge Code	93500137
Hospital Revenue Code	361
Min. Negotiated Rate	$23.74
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$374.30
Rate for Payer: Aetna Medicare Advantage	$295.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.18
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	$251.18
Rate for Payer: Cigna Commercial	$492.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.50
Rate for Payer: Qualcare PPO/HMO/WC	$147.75
Rate for Payer: UnitedHealthcare Community & State	$23.74
Rate for Payer: Wellpoint Medicaid Managed Care	$26.10

THORACENTESIS-RT

Facility

$985.00

Service Code	HCPCS 32554RT
Hospital Charge Code	3409045
Hospital Revenue Code	361
Min. Negotiated Rate	$23.74
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$374.30
Rate for Payer: Aetna Medicare Advantage	$295.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.18
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	$251.18
Rate for Payer: Cigna Commercial	$492.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.50
Rate for Payer: Qualcare PPO/HMO/WC	$147.75
Rate for Payer: UnitedHealthcare Community & State	$23.74
Rate for Payer: Wellpoint Medicaid Managed Care	$26.10

THORACENTESIS SET48/CS 4653-48

Facility

$14.25

Hospital Charge Code	270100961
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$7.12
Rate for Payer: Aetna Commercial	$5.42
Rate for Payer: Aetna Medicare Advantage	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.63
Rate for Payer: Cigna Commercial	$7.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.28
Rate for Payer: Oxford Commercial	$2.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.14
Rate for Payer: UnitedHealthcare Commercial	$2.85
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.38

THORACENTESIS SET48/CS 4653-48

Facility

$14.25

Hospital Charge Code	270100961
Hospital Revenue Code	272
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$2.14
Rate for Payer: Qualcare PPO/HMO/WC	$2.14

THORACIC AORTOGRAM

Facility

$6,122.00

Hospital Charge Code	2009040
Hospital Revenue Code	323
Min. Negotiated Rate	$147.54
Max. Negotiated Rate	$3,061.00
Rate for Payer: Aetna Commercial	$2,326.36
Rate for Payer: Aetna Medicare Advantage	$1,836.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,561.11
Rate for Payer: Cigna Commercial	$3,061.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.60
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$918.30
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$147.54
Rate for Payer: Wellpoint Medicaid Managed Care	$162.23

THORACIC AORTOGRAM

Facility

$6,122.00

Hospital Charge Code	2009040
Hospital Revenue Code	323
Min. Negotiated Rate	$918.30
Max. Negotiated Rate	$918.30
Rate for Payer: Qualcare PPO/HMO/WC	$918.30

THORACIC CATH RT. ANGLE 36FR

Facility

$42.00

Hospital Charge Code	270331012
Hospital Revenue Code	272
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$21.00
Rate for Payer: Aetna Commercial	$15.96
Rate for Payer: Aetna Medicare Advantage	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.71
Rate for Payer: Cigna Commercial	$21.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.60
Rate for Payer: Oxford Commercial	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Commercial	$8.40
Rate for Payer: UnitedHealthcare Community & State	$1.01
Rate for Payer: Wellpoint Medicaid Managed Care	$1.11

Know your out-of-pocket cost for care.

All Charges