Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

US BIOPSY RENAL LEFT

Facility

$1,097.60

Service Code	HCPCS 76942
Hospital Charge Code	2301079
Hospital Revenue Code	402
Min. Negotiated Rate	$26.45
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$417.09
Rate for Payer: Aetna Medicare Advantage	$329.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$279.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$279.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$279.89
Rate for Payer: Cigna Commercial	$548.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.28
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$164.64
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$26.45
Rate for Payer: Wellpoint Medicaid Managed Care	$29.09

US BIOPSY RENAL LEFT

Facility

$1,097.60

Service Code	HCPCS 76942
Hospital Charge Code	2301079
Hospital Revenue Code	402
Min. Negotiated Rate	$164.64
Max. Negotiated Rate	$164.64
Rate for Payer: Qualcare PPO/HMO/WC	$164.64

US BIOPSY RENAL RIGHT

Facility

$1,097.60

Service Code	HCPCS 76942
Hospital Charge Code	2301080
Hospital Revenue Code	402
Min. Negotiated Rate	$164.64
Max. Negotiated Rate	$164.64
Rate for Payer: Qualcare PPO/HMO/WC	$164.64

US BIOPSY RENAL RIGHT

Facility

$1,097.60

Service Code	HCPCS 76942
Hospital Charge Code	2301080
Hospital Revenue Code	402
Min. Negotiated Rate	$26.45
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$417.09
Rate for Payer: Aetna Medicare Advantage	$329.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$279.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$279.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$279.89
Rate for Payer: Cigna Commercial	$548.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.28
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$164.64
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$26.45
Rate for Payer: Wellpoint Medicaid Managed Care	$29.09

US BIOPSY SOFT TISSUE NECK

Facility

$7,219.95

Service Code	HCPCS 21550
Hospital Charge Code	2101154
Hospital Revenue Code	361
Min. Negotiated Rate	$174.00
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	$862.00
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	$2,165.99
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,082.99
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$174.00
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	$191.33

US BIOPSY SOFT TISSUE NECK

Facility

$7,219.95

Service Code	HCPCS 21550
Hospital Charge Code	2101154
Hospital Revenue Code	361
Min. Negotiated Rate	$1,082.99
Max. Negotiated Rate	$1,082.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,082.99

US BLADDER/RESIDUAL URINE

Facility

$272.65

Service Code	HCPCS 51798
Hospital Charge Code	2301099
Hospital Revenue Code	361
Min. Negotiated Rate	$6.57
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
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	$252.97
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.80
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.90
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$6.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$7.23

US BLADDER/RESIDUAL URINE

Facility

$272.65

Service Code	HCPCS 51798
Hospital Charge Code	2301099
Hospital Revenue Code	361
Min. Negotiated Rate	$40.90
Max. Negotiated Rate	$40.90
Rate for Payer: Qualcare PPO/HMO/WC	$40.90

US BONE DENSITY

Facility

$217.60

Service Code	HCPCS 76977
Hospital Charge Code	2301004
Hospital Revenue Code	402
Min. Negotiated Rate	$5.24
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	$18.97
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	$65.28
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.64
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$5.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$5.77

US BONE DENSITY

Facility

$217.60

Service Code	HCPCS 76977
Hospital Charge Code	2301004
Hospital Revenue Code	402
Min. Negotiated Rate	$32.64
Max. Negotiated Rate	$32.64
Rate for Payer: Qualcare PPO/HMO/WC	$32.64

US BREAST BILATERAL

Facility

$1,943.95

Service Code	HCPCS 76645
Hospital Charge Code	2100386
Hospital Revenue Code	402
Min. Negotiated Rate	$46.85
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$738.70
Rate for Payer: Aetna Medicare Advantage	$583.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$495.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$495.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$495.71
Rate for Payer: Cigna Commercial	$971.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$583.18
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$291.59
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$46.85
Rate for Payer: Wellpoint Medicaid Managed Care	$51.51

US BREAST BILATERAL

Facility

$1,943.95

Service Code	HCPCS 76645
Hospital Charge Code	2100386
Hospital Revenue Code	402
Min. Negotiated Rate	$291.59
Max. Negotiated Rate	$291.59
Rate for Payer: Qualcare PPO/HMO/WC	$291.59

US BREAST BX PERC VAC ASSIST

Facility

$6,419.95

Service Code	HCPCS 19083
Hospital Charge Code	2000920
Hospital Revenue Code	361
Min. Negotiated Rate	$962.99
Max. Negotiated Rate	$962.99
Rate for Payer: Qualcare PPO/HMO/WC	$962.99

US BREAST BX PERC VAC ASSIST

Facility

$6,419.95

Service Code	HCPCS 19083
Hospital Charge Code	2000920
Hospital Revenue Code	361
Min. Negotiated Rate	$154.72
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	$1,925.98
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$962.99
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$154.72
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	$170.13

US BREAST BX W LOC LT

Facility

$6,419.95

Service Code	HCPCS 19083LT
Hospital Charge Code	2309103A
Hospital Revenue Code	361
Min. Negotiated Rate	$154.72
Max. Negotiated Rate	$3,209.97
Rate for Payer: Aetna Commercial	$2,439.58
Rate for Payer: Aetna Medicare Advantage	$1,925.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,637.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,637.09
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	$1,637.09
Rate for Payer: Cigna Commercial	$3,209.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,925.98
Rate for Payer: Qualcare PPO/HMO/WC	$962.99
Rate for Payer: UnitedHealthcare Community & State	$154.72
Rate for Payer: Wellpoint Medicaid Managed Care	$170.13

US BREAST BX W LOC LT

Facility

$6,419.95

Service Code	HCPCS 19083LT
Hospital Charge Code	2309103A
Hospital Revenue Code	361
Min. Negotiated Rate	$962.99
Max. Negotiated Rate	$962.99
Rate for Payer: Qualcare PPO/HMO/WC	$962.99

US BREAST BX W LOC RT

Facility

$6,419.95

Service Code	HCPCS 19083RT
Hospital Charge Code	2309100A
Hospital Revenue Code	361
Min. Negotiated Rate	$154.72
Max. Negotiated Rate	$3,209.97
Rate for Payer: Aetna Commercial	$2,439.58
Rate for Payer: Aetna Medicare Advantage	$1,925.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,637.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,637.09
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	$1,637.09
Rate for Payer: Cigna Commercial	$3,209.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,925.98
Rate for Payer: Qualcare PPO/HMO/WC	$962.99
Rate for Payer: UnitedHealthcare Community & State	$154.72
Rate for Payer: Wellpoint Medicaid Managed Care	$170.13

US BREAST BX W LOC RT

Facility

$6,419.95

Service Code	HCPCS 19083RT
Hospital Charge Code	2309100A
Hospital Revenue Code	361
Min. Negotiated Rate	$962.99
Max. Negotiated Rate	$962.99
Rate for Payer: Qualcare PPO/HMO/WC	$962.99

US BREAST COMPLETE BILAT

Facility

$6,700.00

Service Code	HCPCS 7664150
Hospital Charge Code	94061466
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

US BREAST COMPLETE BILAT

Facility

$6,700.00

Service Code	HCPCS 7664150
Hospital Charge Code	94061466
Hospital Revenue Code	402
Min. Negotiated Rate	$161.47
Max. Negotiated Rate	$3,350.00
Rate for Payer: Aetna Commercial	$2,546.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
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: Wellpoint Medicaid Managed Care	$177.55

US BREAST COMPLETE BILAT

Facility

$6,700.00

Service Code	HCPCS 7664150
Hospital Charge Code	2309094
Hospital Revenue Code	402
Min. Negotiated Rate	$161.47
Max. Negotiated Rate	$3,350.00
Rate for Payer: Aetna Commercial	$2,546.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
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: Wellpoint Medicaid Managed Care	$177.55

US BREAST COMPLETE BILAT

Facility

$6,700.00

Service Code	HCPCS 7664150
Hospital Charge Code	2309094
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

US BREAST COMPLETE DX UNI RT

Facility

$6,700.00

Service Code	HCPCS 76641RT
Hospital Charge Code	2309091
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

US BREAST COMPLETE DX UNI RT

Facility

$6,700.00

Service Code	HCPCS 76641RT
Hospital Charge Code	2309091
Hospital Revenue Code	402
Min. Negotiated Rate	$161.47
Max. Negotiated Rate	$3,350.00
Rate for Payer: Aetna Commercial	$2,546.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
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: Wellpoint Medicaid Managed Care	$177.55

US BREAST COMPLETE LT

Facility

$6,700.00

Service Code	HCPCS 76641LT
Hospital Charge Code	2309095
Hospital Revenue Code	402
Min. Negotiated Rate	$161.47
Max. Negotiated Rate	$3,350.00
Rate for Payer: Aetna Commercial	$2,546.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
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: Wellpoint Medicaid Managed Care	$177.55

Know your out-of-pocket cost for care.

All Charges