Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BILIARY DILATOR

Facility

$146.00

Hospital Charge Code	270325606
Hospital Revenue Code	272
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$73.00
Rate for Payer: Aetna Commercial	$55.48
Rate for Payer: Aetna Medicare Advantage	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.23
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.80
Rate for Payer: Oxford Commercial	$29.20
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$29.20
Rate for Payer: UnitedHealthcare Community & State	$3.52
Rate for Payer: Wellpoint Medicaid Managed Care	$3.87

BILIARY ENDOSCOPY THRU SKIN

Facility

$17,259.20

Service Code	HCPCS 47555
Hospital Charge Code	321047555
Hospital Revenue Code	361
Min. Negotiated Rate	$415.95
Max. Negotiated Rate	$27,762.46
Rate for Payer: Aetna Commercial	$20,919.71
Rate for Payer: Aetna Medicare Advantage	$24,919.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,762.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,762.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,691.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,762.46
Rate for Payer: Cigna Commercial	$15,416.72
Rate for Payer: Cigna Medicare Advantage	$7,691.07
Rate for Payer: Clover Medicare Advantage	$7,306.52
Rate for Payer: EmblemHealth Commercial	$23,073.21
Rate for Payer: Humana Medicare Advantage	$7,921.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,691.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,177.76
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$415.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,691.07
Rate for Payer: Wellcare Medicare Advantage	$7,691.07
Rate for Payer: Wellpoint Medicaid Managed Care	$457.37

BILIARY ENDOSCOPY THRU SKIN

Facility

$10,885.55

Service Code	HCPCS 47555
Hospital Charge Code	5100831
Hospital Revenue Code	361
Min. Negotiated Rate	$262.34
Max. Negotiated Rate	$27,762.46
Rate for Payer: Aetna Commercial	$20,919.71
Rate for Payer: Aetna Medicare Advantage	$24,919.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,762.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,762.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,691.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,762.46
Rate for Payer: Cigna Commercial	$15,416.72
Rate for Payer: Cigna Medicare Advantage	$7,691.07
Rate for Payer: Clover Medicare Advantage	$7,306.52
Rate for Payer: EmblemHealth Commercial	$23,073.21
Rate for Payer: Humana Medicare Advantage	$7,921.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,691.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,265.66
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,632.83
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$262.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,691.07
Rate for Payer: Wellcare Medicare Advantage	$7,691.07
Rate for Payer: Wellpoint Medicaid Managed Care	$288.47

BILIARY ENDOSCOPY THRU SKIN

Facility

$17,259.20

Service Code	HCPCS 47555
Hospital Charge Code	321047555
Hospital Revenue Code	361
Min. Negotiated Rate	$2,588.88
Max. Negotiated Rate	$2,588.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

BILIARY ENDOSCOPY THRU SKIN

Facility

$10,885.55

Service Code	HCPCS 47555
Hospital Charge Code	5100831
Hospital Revenue Code	361
Min. Negotiated Rate	$1,632.83
Max. Negotiated Rate	$1,632.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,632.83

BILIARY FELXIMA SYSTEM W/LOCKI

Facility

$440.90

Hospital Charge Code	2706000545
Hospital Revenue Code	272
Min. Negotiated Rate	$10.63
Max. Negotiated Rate	$220.45
Rate for Payer: Aetna Commercial	$167.54
Rate for Payer: Aetna Medicare Advantage	$132.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.43
Rate for Payer: Cigna Commercial	$220.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.27
Rate for Payer: Oxford Commercial	$88.18
Rate for Payer: Qualcare PPO/HMO/WC	$66.14
Rate for Payer: UnitedHealthcare Commercial	$88.18
Rate for Payer: UnitedHealthcare Community & State	$10.63
Rate for Payer: Wellpoint Medicaid Managed Care	$11.68

BILIARY FELXIMA SYSTEM W/LOCKI

Facility

$440.90

Hospital Charge Code	2706000545
Hospital Revenue Code	272
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$66.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.14

BILIARY FLEXIMA SYSTEM W/LOCKI

Facility

$440.90

Hospital Charge Code	2706000546
Hospital Revenue Code	272
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$66.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.14

BILIARY FLEXIMA SYSTEM W/LOCKI

Facility

$440.90

Hospital Charge Code	2706000544
Hospital Revenue Code	272
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$66.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.14

BILIARY FLEXIMA SYSTEM W/LOCKI

Facility

$440.90

Hospital Charge Code	2706000544
Hospital Revenue Code	272
Min. Negotiated Rate	$10.63
Max. Negotiated Rate	$220.45
Rate for Payer: Aetna Commercial	$167.54
Rate for Payer: Aetna Medicare Advantage	$132.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.43
Rate for Payer: Cigna Commercial	$220.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.27
Rate for Payer: Oxford Commercial	$88.18
Rate for Payer: Qualcare PPO/HMO/WC	$66.14
Rate for Payer: UnitedHealthcare Commercial	$88.18
Rate for Payer: UnitedHealthcare Community & State	$10.63
Rate for Payer: Wellpoint Medicaid Managed Care	$11.68

BILIARY FLEXIMA SYSTEM W/LOCKI

Facility

$440.90

Hospital Charge Code	2706000546
Hospital Revenue Code	272
Min. Negotiated Rate	$10.63
Max. Negotiated Rate	$220.45
Rate for Payer: Aetna Commercial	$167.54
Rate for Payer: Aetna Medicare Advantage	$132.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.43
Rate for Payer: Cigna Commercial	$220.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.27
Rate for Payer: Oxford Commercial	$88.18
Rate for Payer: Qualcare PPO/HMO/WC	$66.14
Rate for Payer: UnitedHealthcare Commercial	$88.18
Rate for Payer: UnitedHealthcare Community & State	$10.63
Rate for Payer: Wellpoint Medicaid Managed Care	$11.68

BILIARY FLEXIMA SYS. W/LOCKING

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270655396
Hospital Revenue Code	272
Min. Negotiated Rate	$9.67
Max. Negotiated Rate	$200.62
Rate for Payer: Aetna Commercial	$152.47
Rate for Payer: Aetna Medicare Advantage	$120.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.32
Rate for Payer: Cigna Commercial	$200.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.38
Rate for Payer: Oxford Commercial	$80.25
Rate for Payer: Qualcare PPO/HMO/WC	$60.19
Rate for Payer: UnitedHealthcare Commercial	$80.25
Rate for Payer: UnitedHealthcare Community & State	$9.67
Rate for Payer: Wellpoint Medicaid Managed Care	$10.63

BILIARY FLEXIMA SYS. W/LOCKING

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270655396N
Hospital Revenue Code	272
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$60.19
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

BILIARY FLEXIMA SYS. W/LOCKING

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270655396N
Hospital Revenue Code	272
Min. Negotiated Rate	$9.67
Max. Negotiated Rate	$200.62
Rate for Payer: Aetna Commercial	$152.47
Rate for Payer: Aetna Medicare Advantage	$120.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.32
Rate for Payer: Cigna Commercial	$200.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.38
Rate for Payer: Oxford Commercial	$80.25
Rate for Payer: Qualcare PPO/HMO/WC	$60.19
Rate for Payer: UnitedHealthcare Commercial	$80.25
Rate for Payer: UnitedHealthcare Community & State	$9.67
Rate for Payer: Wellpoint Medicaid Managed Care	$10.63

BILIARY FLEXIMA SYS. W/LOCKING

Facility

$401.25

Service Code	HCPCS C1729
Hospital Charge Code	270655396
Hospital Revenue Code	272
Min. Negotiated Rate	$60.19
Max. Negotiated Rate	$60.19
Rate for Payer: Qualcare PPO/HMO/WC	$60.19

BILIARY STENT 7FR-11CM

Facility

$642.00

Hospital Charge Code	270332260
Hospital Revenue Code	278
Min. Negotiated Rate	$96.30
Max. Negotiated Rate	$155.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.24
Rate for Payer: Qualcare PPO/HMO/WC	$96.30

BILIARY STENT 7FR-11CM

Facility

$642.00

Hospital Charge Code	270332260
Hospital Revenue Code	278
Min. Negotiated Rate	$15.47
Max. Negotiated Rate	$321.00
Rate for Payer: Aetna Commercial	$243.96
Rate for Payer: Aetna Medicare Advantage	$192.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.71
Rate for Payer: Cigna Commercial	$321.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.24
Rate for Payer: Qualcare PPO/HMO/WC	$96.30
Rate for Payer: UnitedHealthcare Community & State	$15.47
Rate for Payer: Wellpoint Medicaid Managed Care	$17.01

BILIARY STENT 7FR-6CM

Facility

$642.00

Hospital Charge Code	270332258
Hospital Revenue Code	278
Min. Negotiated Rate	$15.47
Max. Negotiated Rate	$321.00
Rate for Payer: Aetna Commercial	$243.96
Rate for Payer: Aetna Medicare Advantage	$192.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.71
Rate for Payer: Cigna Commercial	$321.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.24
Rate for Payer: Qualcare PPO/HMO/WC	$96.30
Rate for Payer: UnitedHealthcare Community & State	$15.47
Rate for Payer: Wellpoint Medicaid Managed Care	$17.01

BILIARY STENT 7FR-6CM

Facility

$642.00

Hospital Charge Code	270332258
Hospital Revenue Code	278
Min. Negotiated Rate	$96.30
Max. Negotiated Rate	$155.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.24
Rate for Payer: Qualcare PPO/HMO/WC	$96.30

BILIARY STENT SET 8.5FR-5CM

Facility

$642.00

Hospital Charge Code	270332255
Hospital Revenue Code	278
Min. Negotiated Rate	$96.30
Max. Negotiated Rate	$155.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.24
Rate for Payer: Qualcare PPO/HMO/WC	$96.30

BILIARY STENT SET 8.5FR-5CM

Facility

$642.00

Hospital Charge Code	270332255
Hospital Revenue Code	278
Min. Negotiated Rate	$15.47
Max. Negotiated Rate	$321.00
Rate for Payer: Aetna Commercial	$243.96
Rate for Payer: Aetna Medicare Advantage	$192.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.71
Rate for Payer: Cigna Commercial	$321.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$141.24
Rate for Payer: Qualcare PPO/HMO/WC	$96.30
Rate for Payer: UnitedHealthcare Community & State	$15.47
Rate for Payer: Wellpoint Medicaid Managed Care	$17.01

BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC

Facility

$72,508.05

Service Code	MSDRG 409
Min. Negotiated Rate	$22,077.77
Max. Negotiated Rate	$72,508.05
Rate for Payer: Aetna Commercial	$50,078.62
Rate for Payer: Aetna Medicare Advantage	$72,508.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,591.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,591.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,239.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45,591.56
Rate for Payer: Cigna Commercial	$40,745.99
Rate for Payer: Cigna Medicare Advantage	$23,239.76
Rate for Payer: Clover Medicare Advantage	$22,077.77
Rate for Payer: EmblemHealth Commercial	$69,719.28
Rate for Payer: Humana Medicare Advantage	$23,936.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23,239.76
Rate for Payer: Oxford Commercial	$29,284.69
Rate for Payer: UnitedHealthcare Commercial	$51,351.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,239.76
Rate for Payer: Wellcare Medicare Advantage	$23,239.76

BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC

Facility

$117,380.14

Service Code	MSDRG 408
Min. Negotiated Rate	$35,740.75
Max. Negotiated Rate	$117,380.14
Rate for Payer: Aetna Commercial	$80,910.87
Rate for Payer: Aetna Medicare Advantage	$117,380.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86,530.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86,530.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37,621.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86,530.92
Rate for Payer: Cigna Commercial	$66,726.64
Rate for Payer: Cigna Medicare Advantage	$37,621.84
Rate for Payer: Clover Medicare Advantage	$35,740.75
Rate for Payer: EmblemHealth Commercial	$112,865.52
Rate for Payer: Humana Medicare Advantage	$38,750.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$37,621.84
Rate for Payer: Oxford Commercial	$47,957.32
Rate for Payer: UnitedHealthcare Commercial	$84,094.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$37,621.84
Rate for Payer: Wellcare Medicare Advantage	$37,621.84

BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC

Facility

$53,451.18

Service Code	MSDRG 410
Min. Negotiated Rate	$16,275.20
Max. Negotiated Rate	$53,451.18
Rate for Payer: Aetna Commercial	$36,984.40
Rate for Payer: Aetna Medicare Advantage	$53,451.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36,519.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36,519.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,131.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36,519.77
Rate for Payer: Cigna Commercial	$29,712.22
Rate for Payer: Cigna Medicare Advantage	$17,131.79
Rate for Payer: Clover Medicare Advantage	$16,275.20
Rate for Payer: EmblemHealth Commercial	$51,395.37
Rate for Payer: Humana Medicare Advantage	$17,645.74
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17,131.79
Rate for Payer: Oxford Commercial	$21,354.56
Rate for Payer: UnitedHealthcare Commercial	$37,445.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,131.79
Rate for Payer: Wellcare Medicare Advantage	$17,131.79

BILIRUBIN, AMNIOTIC FLUID

Facility

$54.45

Service Code	HCPCS 82143
Hospital Charge Code	3030970
Hospital Revenue Code	301
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$8.17

Know your out-of-pocket cost for care.

All Charges