Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ULTRASLING III BLK SMALL

Facility

$258.70

Hospital Charge Code	270669814
Hospital Revenue Code	270
Min. Negotiated Rate	$6.23
Max. Negotiated Rate	$129.35
Rate for Payer: Aetna Commercial	$98.31
Rate for Payer: Aetna Medicare Advantage	$77.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.97
Rate for Payer: Cigna Commercial	$129.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.61
Rate for Payer: Oxford Commercial	$51.74
Rate for Payer: Qualcare PPO/HMO/WC	$38.80
Rate for Payer: UnitedHealthcare Commercial	$51.74
Rate for Payer: UnitedHealthcare Community & State	$6.23
Rate for Payer: Wellpoint Medicaid Managed Care	$6.86

ULTRASLING III BLK SMALL

Facility

$258.70

Hospital Charge Code	270669814
Hospital Revenue Code	270
Min. Negotiated Rate	$38.80
Max. Negotiated Rate	$38.80
Rate for Payer: Qualcare PPO/HMO/WC	$38.80

ULTRASLING III BLK XTRA PAD LG

Facility

$241.90

Hospital Charge Code	270669812
Hospital Revenue Code	270
Min. Negotiated Rate	$36.28
Max. Negotiated Rate	$36.28
Rate for Payer: Qualcare PPO/HMO/WC	$36.28

ULTRASLING III BLK XTRA PAD LG

Facility

$241.90

Hospital Charge Code	270669812
Hospital Revenue Code	270
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$120.95
Rate for Payer: Aetna Commercial	$91.92
Rate for Payer: Aetna Medicare Advantage	$72.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.68
Rate for Payer: Cigna Commercial	$120.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.57
Rate for Payer: Oxford Commercial	$48.38
Rate for Payer: Qualcare PPO/HMO/WC	$36.28
Rate for Payer: UnitedHealthcare Commercial	$48.38
Rate for Payer: UnitedHealthcare Community & State	$5.83
Rate for Payer: Wellpoint Medicaid Managed Care	$6.41

ULTRASLING II SAD LG 110449LG

Facility

$267.90

Hospital Charge Code	270636282
Hospital Revenue Code	270
Min. Negotiated Rate	$40.19
Max. Negotiated Rate	$40.19
Rate for Payer: Qualcare PPO/HMO/WC	$40.19

ULTRASLING II SAD LG 110449LG

Facility

$267.90

Hospital Charge Code	270636282
Hospital Revenue Code	270
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$133.95
Rate for Payer: Aetna Commercial	$101.80
Rate for Payer: Aetna Medicare Advantage	$80.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.31
Rate for Payer: Cigna Commercial	$133.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.37
Rate for Payer: Oxford Commercial	$53.58
Rate for Payer: Qualcare PPO/HMO/WC	$40.19
Rate for Payer: UnitedHealthcare Commercial	$53.58
Rate for Payer: UnitedHealthcare Community & State	$6.46
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

ULTRASLING MEDIUM

Facility

$249.15

Hospital Charge Code	270666408
Hospital Revenue Code	270
Min. Negotiated Rate	$37.37
Max. Negotiated Rate	$37.37
Rate for Payer: Qualcare PPO/HMO/WC	$37.37

ULTRASLING MEDIUM

Facility

$249.15

Hospital Charge Code	270666408
Hospital Revenue Code	270
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$124.58
Rate for Payer: Aetna Commercial	$94.68
Rate for Payer: Aetna Medicare Advantage	$74.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.53
Rate for Payer: Cigna Commercial	$124.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.75
Rate for Payer: Oxford Commercial	$49.83
Rate for Payer: Qualcare PPO/HMO/WC	$37.37
Rate for Payer: UnitedHealthcare Commercial	$49.83
Rate for Payer: UnitedHealthcare Community & State	$6.00
Rate for Payer: Wellpoint Medicaid Managed Care	$6.60

ULTRASLING SMALL

Facility

$249.15

Hospital Charge Code	270666407
Hospital Revenue Code	270
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$124.58
Rate for Payer: Aetna Commercial	$94.68
Rate for Payer: Aetna Medicare Advantage	$74.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.53
Rate for Payer: Cigna Commercial	$124.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.75
Rate for Payer: Oxford Commercial	$49.83
Rate for Payer: Qualcare PPO/HMO/WC	$37.37
Rate for Payer: UnitedHealthcare Commercial	$49.83
Rate for Payer: UnitedHealthcare Community & State	$6.00
Rate for Payer: Wellpoint Medicaid Managed Care	$6.60

ULTRASLING SMALL

Facility

$249.15

Hospital Charge Code	270666407
Hospital Revenue Code	270
Min. Negotiated Rate	$37.37
Max. Negotiated Rate	$37.37
Rate for Payer: Qualcare PPO/HMO/WC	$37.37

ULTRA SONIC PROBE TRAY

Facility

$1,380.85

Hospital Charge Code	270665601
Hospital Revenue Code	270
Min. Negotiated Rate	$207.13
Max. Negotiated Rate	$207.13
Rate for Payer: Qualcare PPO/HMO/WC	$207.13

ULTRA SONIC PROBE TRAY

Facility

$1,380.85

Hospital Charge Code	270665601
Hospital Revenue Code	270
Min. Negotiated Rate	$33.28
Max. Negotiated Rate	$690.42
Rate for Payer: Aetna Commercial	$524.72
Rate for Payer: Aetna Medicare Advantage	$414.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$352.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$352.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$352.12
Rate for Payer: Cigna Commercial	$690.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$414.25
Rate for Payer: Oxford Commercial	$276.17
Rate for Payer: Qualcare PPO/HMO/WC	$207.13
Rate for Payer: UnitedHealthcare Commercial	$276.17
Rate for Payer: UnitedHealthcare Community & State	$33.28
Rate for Payer: Wellpoint Medicaid Managed Care	$36.59

ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC

Facility

$182,042.92

Service Code	MSDRG 278
Min. Negotiated Rate	$55,429.74
Max. Negotiated Rate	$182,042.92
Rate for Payer: Aetna Commercial	$125,341.57
Rate for Payer: Aetna Medicare Advantage	$182,042.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$58,347.09
Rate for Payer: Cigna Commercial	$104,165.87
Rate for Payer: Cigna Medicare Advantage	$58,347.09
Rate for Payer: Clover Medicare Advantage	$55,429.74
Rate for Payer: EmblemHealth Commercial	$175,041.27
Rate for Payer: Humana Medicare Advantage	$60,097.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$58,347.09
Rate for Payer: Oxford Commercial	$74,865.39
Rate for Payer: UnitedHealthcare Commercial	$131,278.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$58,347.09
Rate for Payer: Wellcare Medicare Advantage	$58,347.09

ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC

Facility

$118,698.90

Service Code	MSDRG 279
Min. Negotiated Rate	$36,142.29
Max. Negotiated Rate	$118,698.90
Rate for Payer: Aetna Commercial	$81,816.99
Rate for Payer: Aetna Medicare Advantage	$118,698.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$38,044.52
Rate for Payer: Cigna Commercial	$67,490.17
Rate for Payer: Cigna Medicare Advantage	$38,044.52
Rate for Payer: Clover Medicare Advantage	$36,142.29
Rate for Payer: EmblemHealth Commercial	$114,133.56
Rate for Payer: Humana Medicare Advantage	$39,185.86
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$38,044.52
Rate for Payer: Oxford Commercial	$48,506.08
Rate for Payer: UnitedHealthcare Commercial	$85,056.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$38,044.52
Rate for Payer: Wellcare Medicare Advantage	$38,044.52

ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM

Facility

$98,336.22

Service Code	MSDRG 173
Min. Negotiated Rate	$29,942.12
Max. Negotiated Rate	$98,336.22
Rate for Payer: Aetna Commercial	$67,825.52
Rate for Payer: Aetna Medicare Advantage	$98,336.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$31,518.02
Rate for Payer: Cigna Commercial	$55,700.35
Rate for Payer: Cigna Medicare Advantage	$31,518.02
Rate for Payer: Clover Medicare Advantage	$29,942.12
Rate for Payer: EmblemHealth Commercial	$94,554.06
Rate for Payer: Humana Medicare Advantage	$32,463.56
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$31,518.02
Rate for Payer: Oxford Commercial	$40,032.58
Rate for Payer: UnitedHealthcare Commercial	$70,198.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$31,518.02
Rate for Payer: Wellcare Medicare Advantage	$31,518.02

ULTRASOUND EA 15 MIN CQ

Facility

$65.65

Service Code	HCPCS 97035GP
Hospital Charge Code	409197035Q
Hospital Revenue Code	420
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$24.95
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.70
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.74

ULTRASOUND EA 15 MIN CQ

Facility

$65.65

Service Code	HCPCS 97035GP
Hospital Charge Code	409197035Q
Hospital Revenue Code	420
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

ULTRASOUND ECHOENCEPHALGRAPHY

Facility

$6,700.00

Service Code	HCPCS 76506
Hospital Charge Code	2100106
Hospital Revenue Code	402
Min. Negotiated Rate	$81.31
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$161.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$177.55

ULTRASOUND ECHOENCEPHALGRAPHY

Facility

$6,700.00

Service Code	HCPCS 76506
Hospital Charge Code	2100106
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

ULTRASOUND GEL .25 LTR

Facility

$10.23

Hospital Charge Code	270653056
Hospital Revenue Code	270
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.12
Rate for Payer: Aetna Commercial	$3.89
Rate for Payer: Aetna Medicare Advantage	$3.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.61
Rate for Payer: Cigna Commercial	$5.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.07
Rate for Payer: Oxford Commercial	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.53
Rate for Payer: UnitedHealthcare Commercial	$2.05
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

ULTRASOUND GEL .25 LTR

Facility

$10.23

Hospital Charge Code	270653056
Hospital Revenue Code	270
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$1.53
Rate for Payer: Qualcare PPO/HMO/WC	$1.53

ULTRASOUND PREG UTERUS LIMITED

Facility

$650.00

Service Code	HCPCS 76815
Hospital Charge Code	1800069
Hospital Revenue Code	402
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

ULTRASOUND PREG UTERUS LIMITED

Facility

$650.00

Service Code	HCPCS 76815
Hospital Charge Code	1800069
Hospital Revenue Code	402
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

ULTRASOUND, TRANSVAGINAL

Facility

$2,298.80

Service Code	HCPCS 76830
Hospital Charge Code	83653115
Hospital Revenue Code	402
Min. Negotiated Rate	$55.40
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.64
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$344.82
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$55.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$60.92

ULTRASOUND, TRANSVAGINAL

Facility

$2,298.80

Service Code	HCPCS 76830
Hospital Charge Code	83653115
Hospital Revenue Code	402
Min. Negotiated Rate	$344.82
Max. Negotiated Rate	$344.82
Rate for Payer: Qualcare PPO/HMO/WC	$344.82

Know your out-of-pocket cost for care.

All Charges