Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

URETERAL CATH CONE TIP 10FR

Facility

$195.00

Hospital Charge Code	270331130
Hospital Revenue Code	278
Min. Negotiated Rate	$4.70
Max. Negotiated Rate	$97.50
Rate for Payer: Aetna Commercial	$74.10
Rate for Payer: Aetna Medicare Advantage	$58.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.73
Rate for Payer: Cigna Commercial	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.90
Rate for Payer: Qualcare PPO/HMO/WC	$29.25
Rate for Payer: UnitedHealthcare Community & State	$4.70
Rate for Payer: Wellpoint Medicaid Managed Care	$5.17

URETERAL CATHETER OPEN TIP 6FR

Facility

$126.00

Hospital Charge Code	270331746
Hospital Revenue Code	278
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$30.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.72
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

URETERAL CATHETER OPEN TIP 6FR

Facility

$126.00

Hospital Charge Code	270331746
Hospital Revenue Code	278
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$63.00
Rate for Payer: Aetna Commercial	$47.88
Rate for Payer: Aetna Medicare Advantage	$37.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.13
Rate for Payer: Cigna Commercial	$63.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.72
Rate for Payer: Qualcare PPO/HMO/WC	$18.90
Rate for Payer: UnitedHealthcare Community & State	$3.04
Rate for Payer: Wellpoint Medicaid Managed Care	$3.34

URETERAL ILLUMINATOR CATHETER

Facility

$709.00

Hospital Charge Code	270331756
Hospital Revenue Code	272
Min. Negotiated Rate	$106.35
Max. Negotiated Rate	$106.35
Rate for Payer: Qualcare PPO/HMO/WC	$106.35

URETERAL ILLUMINATOR CATHETER

Facility

$709.00

Hospital Charge Code	270331756
Hospital Revenue Code	272
Min. Negotiated Rate	$17.09
Max. Negotiated Rate	$354.50
Rate for Payer: Aetna Commercial	$269.42
Rate for Payer: Aetna Medicare Advantage	$212.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$180.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$180.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$180.79
Rate for Payer: Cigna Commercial	$354.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.70
Rate for Payer: Oxford Commercial	$141.80
Rate for Payer: Qualcare PPO/HMO/WC	$106.35
Rate for Payer: UnitedHealthcare Commercial	$141.80
Rate for Payer: UnitedHealthcare Community & State	$17.09
Rate for Payer: Wellpoint Medicaid Managed Care	$18.79

URETERAL UROMAX 5.8 FR X75cm

Facility

$2,182.15

Service Code	HCPCS C1726
Hospital Charge Code	270679680
Hospital Revenue Code	278
Min. Negotiated Rate	$52.59
Max. Negotiated Rate	$1,091.08
Rate for Payer: Aetna Commercial	$829.22
Rate for Payer: Aetna Medicare Advantage	$654.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$556.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$556.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$436.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$556.45
Rate for Payer: Cigna Commercial	$1,091.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$528.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$480.07
Rate for Payer: Qualcare PPO/HMO/WC	$327.32
Rate for Payer: UnitedHealthcare Community & State	$52.59
Rate for Payer: Wellpoint Medicaid Managed Care	$57.83

URETERAL UROMAX 5.8 FR X75cm

Facility

$2,182.15

Service Code	HCPCS C1726
Hospital Charge Code	270679680
Hospital Revenue Code	278
Min. Negotiated Rate	$327.32
Max. Negotiated Rate	$528.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$436.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$528.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$480.07
Rate for Payer: Qualcare PPO/HMO/WC	$327.32

URETEROSCOPE DIS 10X 7.5 FR

Facility

$3,240.00

Hospital Charge Code	270702750
Hospital Revenue Code	270
Min. Negotiated Rate	$486.00
Max. Negotiated Rate	$486.00
Rate for Payer: Qualcare PPO/HMO/WC	$486.00

URETEROSCOPE DIS 10X 7.5 FR

Facility

$3,240.00

Hospital Charge Code	270702750
Hospital Revenue Code	270
Min. Negotiated Rate	$78.08
Max. Negotiated Rate	$1,620.00
Rate for Payer: Aetna Commercial	$1,231.20
Rate for Payer: Aetna Medicare Advantage	$972.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$826.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$826.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$826.20
Rate for Payer: Cigna Commercial	$1,620.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$972.00
Rate for Payer: Oxford Commercial	$648.00
Rate for Payer: Qualcare PPO/HMO/WC	$486.00
Rate for Payer: UnitedHealthcare Commercial	$648.00
Rate for Payer: UnitedHealthcare Community & State	$78.08
Rate for Payer: Wellpoint Medicaid Managed Care	$85.86

URETEROSCOPIC RETRIEVAL LOOP

Facility

$588.00

Hospital Charge Code	270331490
Hospital Revenue Code	272
Min. Negotiated Rate	$14.17
Max. Negotiated Rate	$294.00
Rate for Payer: Aetna Commercial	$223.44
Rate for Payer: Aetna Medicare Advantage	$176.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.94
Rate for Payer: Cigna Commercial	$294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.40
Rate for Payer: Oxford Commercial	$117.60
Rate for Payer: Qualcare PPO/HMO/WC	$88.20
Rate for Payer: UnitedHealthcare Commercial	$117.60
Rate for Payer: UnitedHealthcare Community & State	$14.17
Rate for Payer: Wellpoint Medicaid Managed Care	$15.58

URETEROSCOPIC RETRIEVAL LOOP

Facility

$588.00

Hospital Charge Code	270331490
Hospital Revenue Code	272
Min. Negotiated Rate	$88.20
Max. Negotiated Rate	$88.20
Rate for Payer: Qualcare PPO/HMO/WC	$88.20

URETEX TO3 SLING 485053

Facility

$3,670.45

Hospital Charge Code	270636198
Hospital Revenue Code	272
Min. Negotiated Rate	$88.46
Max. Negotiated Rate	$1,835.22
Rate for Payer: Aetna Commercial	$1,394.77
Rate for Payer: Aetna Medicare Advantage	$1,101.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$935.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$935.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$935.96
Rate for Payer: Cigna Commercial	$1,835.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,101.13
Rate for Payer: Oxford Commercial	$734.09
Rate for Payer: Qualcare PPO/HMO/WC	$550.57
Rate for Payer: UnitedHealthcare Commercial	$734.09
Rate for Payer: UnitedHealthcare Community & State	$88.46
Rate for Payer: Wellpoint Medicaid Managed Care	$97.27

URETEX TO3 SLING 485053

Facility

$3,670.45

Hospital Charge Code	270636198
Hospital Revenue Code	272
Min. Negotiated Rate	$550.57
Max. Negotiated Rate	$550.57
Rate for Payer: Qualcare PPO/HMO/WC	$550.57

URETEX TO SLING 485050

Facility

$3,670.45

Hospital Charge Code	270634047
Hospital Revenue Code	272
Min. Negotiated Rate	$550.57
Max. Negotiated Rate	$550.57
Rate for Payer: Qualcare PPO/HMO/WC	$550.57

URETEX TO SLING 485050

Facility

$3,670.45

Hospital Charge Code	270634047
Hospital Revenue Code	272
Min. Negotiated Rate	$88.46
Max. Negotiated Rate	$1,835.22
Rate for Payer: Aetna Commercial	$1,394.77
Rate for Payer: Aetna Medicare Advantage	$1,101.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$935.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$935.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$935.96
Rate for Payer: Cigna Commercial	$1,835.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,101.13
Rate for Payer: Oxford Commercial	$734.09
Rate for Payer: Qualcare PPO/HMO/WC	$550.57
Rate for Payer: UnitedHealthcare Commercial	$734.09
Rate for Payer: UnitedHealthcare Community & State	$88.46
Rate for Payer: Wellpoint Medicaid Managed Care	$97.27

URETHRAL AND TRANSURETHRAL PROCEDURES

Facility

$19,864.31

Service Code	APR-DRG 4463
Min. Negotiated Rate	$19,474.81
Max. Negotiated Rate	$19,864.31
Rate for Payer: UnitedHealthcare Community & State	$19,474.81
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,864.31
Rate for Payer: Wellpoint Medicaid Managed Care	$19,474.81

URETHRAL AND TRANSURETHRAL PROCEDURES

Facility

$34,757.10

Service Code	APR-DRG 4464
Min. Negotiated Rate	$34,075.59
Max. Negotiated Rate	$34,757.10
Rate for Payer: UnitedHealthcare Community & State	$34,075.59
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$34,757.10
Rate for Payer: Wellpoint Medicaid Managed Care	$34,075.59

URETHRAL AND TRANSURETHRAL PROCEDURES

Facility

$12,597.28

Service Code	APR-DRG 4462
Min. Negotiated Rate	$12,350.27
Max. Negotiated Rate	$12,597.28
Rate for Payer: UnitedHealthcare Community & State	$12,350.27
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,597.28
Rate for Payer: Wellpoint Medicaid Managed Care	$12,350.27

URETHRAL AND TRANSURETHRAL PROCEDURES

Facility

$10,374.55

Service Code	APR-DRG 4461
Min. Negotiated Rate	$10,171.13
Max. Negotiated Rate	$10,374.55
Rate for Payer: UnitedHealthcare Community & State	$10,171.13
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,374.55
Rate for Payer: Wellpoint Medicaid Managed Care	$10,171.13

URETHRAL PROCEDURES WITH CC/MCC

Facility

$60,151.45

Service Code	MSDRG 671
Min. Negotiated Rate	$18,315.34
Max. Negotiated Rate	$60,151.45
Rate for Payer: Aetna Commercial	$41,588.24
Rate for Payer: Aetna Medicare Advantage	$60,151.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39,776.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39,776.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,279.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39,776.31
Rate for Payer: Cigna Commercial	$33,591.63
Rate for Payer: Cigna Medicare Advantage	$19,279.31
Rate for Payer: Clover Medicare Advantage	$18,315.34
Rate for Payer: EmblemHealth Commercial	$57,837.93
Rate for Payer: Humana Medicare Advantage	$19,857.69
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19,279.31
Rate for Payer: Oxford Commercial	$24,142.75
Rate for Payer: UnitedHealthcare Commercial	$42,335.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,279.31
Rate for Payer: Wellcare Medicare Advantage	$19,279.31

URETHRAL PROCEDURES WITHOUT CC/MCC

Facility

$37,025.32

Service Code	MSDRG 672
Min. Negotiated Rate	$11,273.74
Max. Negotiated Rate	$37,025.32
Rate for Payer: Aetna Commercial	$25,697.95
Rate for Payer: Aetna Medicare Advantage	$37,025.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,865.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,865.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,867.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21,865.34
Rate for Payer: Cigna Commercial	$20,201.76
Rate for Payer: Cigna Medicare Advantage	$11,867.09
Rate for Payer: Clover Medicare Advantage	$11,273.74
Rate for Payer: EmblemHealth Commercial	$35,601.27
Rate for Payer: Humana Medicare Advantage	$12,223.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11,867.09
Rate for Payer: Oxford Commercial	$14,519.27
Rate for Payer: UnitedHealthcare Commercial	$25,460.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,867.09
Rate for Payer: Wellcare Medicare Advantage	$11,867.09

URETHRAL REPAIR PROCEDURES

Facility

$16,607.90

Service Code	HCPCS 53502
Hospital Charge Code	93500202
Hospital Revenue Code	360
Min. Negotiated Rate	$2,491.18
Max. Negotiated Rate	$2,491.18
Rate for Payer: Qualcare PPO/HMO/WC	$2,491.18

URETHRAL REPAIR PROCEDURES

Facility

$16,607.90

Service Code	HCPCS 53502
Hospital Charge Code	93500202
Hospital Revenue Code	360
Min. Negotiated Rate	$400.25
Max. Negotiated Rate	$15,116.59
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,116.59
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,982.37
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,491.18
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$400.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$440.11

URETHRAL REPAIR PROCEDURES

Facility

$16,607.90

Service Code	HCPCS 53502
Hospital Charge Code	93500203
Hospital Revenue Code	361
Min. Negotiated Rate	$400.25
Max. Negotiated Rate	$15,116.59
Rate for Payer: Aetna Commercial	$11,390.73
Rate for Payer: Aetna Medicare Advantage	$13,568.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,116.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,187.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,116.59
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: Cigna Medicare Advantage	$4,187.77
Rate for Payer: Clover Medicare Advantage	$3,978.38
Rate for Payer: EmblemHealth Commercial	$12,563.31
Rate for Payer: Humana Medicare Advantage	$4,313.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,187.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,982.37
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,491.18
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$400.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,187.77
Rate for Payer: Wellcare Medicare Advantage	$4,187.77
Rate for Payer: Wellpoint Medicaid Managed Care	$440.11

URETHRAL REPAIR PROCEDURES

Facility

$16,607.90

Service Code	HCPCS 53502
Hospital Charge Code	93500203
Hospital Revenue Code	361
Min. Negotiated Rate	$2,491.18
Max. Negotiated Rate	$2,491.18
Rate for Payer: Qualcare PPO/HMO/WC	$2,491.18

Know your out-of-pocket cost for care.

All Charges