Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

US FETAL BIOPHYS PRFL W/O NSTR

Facility

$563.15

Service Code	HCPCS 76818
Hospital Charge Code	2301011
Hospital Revenue Code	402
Min. Negotiated Rate	$84.47
Max. Negotiated Rate	$84.47
Rate for Payer: Qualcare PPO/HMO/WC	$84.47

US FETAL BIOPHYS PRFL W/O NSTR

Facility

$563.15

Service Code	HCPCS 76818
Hospital Charge Code	2301011
Hospital Revenue Code	402
Min. Negotiated Rate	$13.57
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	$117.13
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	$168.94
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.47
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$13.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$14.92

US-FETAL BIOPHYS WO NST

Facility

$632.85

Hospital Charge Code	2309020
Hospital Revenue Code	402
Min. Negotiated Rate	$94.93
Max. Negotiated Rate	$94.93
Rate for Payer: Qualcare PPO/HMO/WC	$94.93

US-FETAL BIOPHYS WO NST

Facility

$632.85

Hospital Charge Code	2309020
Hospital Revenue Code	402
Min. Negotiated Rate	$15.25
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$240.48
Rate for Payer: Aetna Medicare Advantage	$189.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.38
Rate for Payer: Cigna Commercial	$316.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.85
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.93
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$15.25
Rate for Payer: Wellpoint Medicaid Managed Care	$16.77

US FETAL DOPPLER ECHO

Facility

$594.40

Service Code	HCPCS 76827
Hospital Charge Code	2301012
Hospital Revenue Code	402
Min. Negotiated Rate	$14.33
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	$127.78
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	$178.32
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.16
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$14.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$15.75

US FETAL DOPPLER ECHO

Facility

$594.40

Service Code	HCPCS 76827
Hospital Charge Code	2301012
Hospital Revenue Code	402
Min. Negotiated Rate	$89.16
Max. Negotiated Rate	$89.16
Rate for Payer: Qualcare PPO/HMO/WC	$89.16

US FETAL DOPPLER ECHO FLLW UP

Facility

$536.20

Service Code	HCPCS 76828
Hospital Charge Code	2301013
Hospital Revenue Code	402
Min. Negotiated Rate	$12.92
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	$105.42
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	$160.86
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$80.43
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$12.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$14.21

US FETAL DOPPLER ECHO FLLW UP

Facility

$536.20

Service Code	HCPCS 76828
Hospital Charge Code	2301013
Hospital Revenue Code	402
Min. Negotiated Rate	$80.43
Max. Negotiated Rate	$80.43
Rate for Payer: Qualcare PPO/HMO/WC	$80.43

US FETAL ECHO 2D

Facility

$594.40

Service Code	HCPCS 76825
Hospital Charge Code	2301014
Hospital Revenue Code	402
Min. Negotiated Rate	$14.33
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$649.16
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.32
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.16
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$14.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$15.75

US FETAL ECHO 2D

Facility

$594.40

Service Code	HCPCS 76825
Hospital Charge Code	2301014
Hospital Revenue Code	402
Min. Negotiated Rate	$89.16
Max. Negotiated Rate	$89.16
Rate for Payer: Qualcare PPO/HMO/WC	$89.16

US FETAL ECHO FOLLOW UP

Facility

$536.20

Service Code	HCPCS 76826
Hospital Charge Code	2301015
Hospital Revenue Code	402
Min. Negotiated Rate	$80.43
Max. Negotiated Rate	$80.43
Rate for Payer: Qualcare PPO/HMO/WC	$80.43

US FETAL ECHO FOLLOW UP

Facility

$536.20

Service Code	HCPCS 76826
Hospital Charge Code	2301015
Hospital Revenue Code	402
Min. Negotiated Rate	$12.92
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.86
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$80.43
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$12.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$14.21

US FINE NDL ASP W/IMAGE GUIDE

Facility

$2,403.20

Service Code	HCPCS 10022
Hospital Charge Code	2101153
Hospital Revenue Code	361
Min. Negotiated Rate	$57.92
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$913.22
Rate for Payer: Aetna Medicare Advantage	$720.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.82
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	$612.82
Rate for Payer: Cigna Commercial	$1,201.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.96
Rate for Payer: Qualcare PPO/HMO/WC	$360.48
Rate for Payer: UnitedHealthcare Community & State	$57.92
Rate for Payer: Wellpoint Medicaid Managed Care	$63.68

US FINE NDL ASP W/IMAGE GUIDE

Facility

$2,403.20

Service Code	HCPCS 10022
Hospital Charge Code	2101153
Hospital Revenue Code	361
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

US FOLLOW UP STUDY

Facility

$511.25

Service Code	HCPCS 76970
Hospital Charge Code	2101124
Hospital Revenue Code	402
Min. Negotiated Rate	$76.69
Max. Negotiated Rate	$76.69
Rate for Payer: Qualcare PPO/HMO/WC	$76.69

US FOLLOW UP STUDY

Facility

$511.25

Service Code	HCPCS 76970
Hospital Charge Code	2101124
Hospital Revenue Code	402
Min. Negotiated Rate	$12.32
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$194.28
Rate for Payer: Aetna Medicare Advantage	$153.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.37
Rate for Payer: Cigna Commercial	$255.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.38
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$76.69
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$12.32
Rate for Payer: Wellpoint Medicaid Managed Care	$13.55

US GALL BLADDER

Facility

$6,700.00

Service Code	HCPCS 76705
Hospital Charge Code	2100048
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 GALL BLADDER

Facility

$6,700.00

Service Code	HCPCS 76705
Hospital Charge Code	2100048
Hospital Revenue Code	402
Min. Negotiated Rate	$85.18
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	$85.18
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

US GI ENDO SCOPE

Facility

$746.45

Service Code	HCPCS 76975
Hospital Charge Code	2101126
Hospital Revenue Code	402
Min. Negotiated Rate	$17.99
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.94
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.97
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$17.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.78

US GI ENDO SCOPE

Facility

$746.45

Service Code	HCPCS 76975
Hospital Charge Code	2101126
Hospital Revenue Code	402
Min. Negotiated Rate	$111.97
Max. Negotiated Rate	$111.97
Rate for Payer: Qualcare PPO/HMO/WC	$111.97

US GI ENDO W ENDO US

Facility

$833.65

Service Code	HCPCS 43259
Hospital Charge Code	2101139
Hospital Revenue Code	750
Min. Negotiated Rate	$125.05
Max. Negotiated Rate	$125.05
Rate for Payer: Qualcare PPO/HMO/WC	$125.05

US GI ENDO W ENDO US

Facility

$833.65

Service Code	HCPCS 43259
Hospital Charge Code	2101139
Hospital Revenue Code	750
Min. Negotiated Rate	$20.09
Max. Negotiated Rate	$8,229.07
Rate for Payer: Aetna Commercial	$6,200.81
Rate for Payer: Aetna Medicare Advantage	$7,386.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,229.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,229.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,279.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,229.07
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: Cigna Medicare Advantage	$2,279.71
Rate for Payer: Clover Medicare Advantage	$2,165.72
Rate for Payer: EmblemHealth Commercial	$6,839.13
Rate for Payer: Humana Medicare Advantage	$2,348.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,279.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.09
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$125.05
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$20.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,279.71
Rate for Payer: Wellcare Medicare Advantage	$2,279.71
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,829.61
Rate for Payer: Wellpoint Medicaid Managed Care	$22.09

US GUIDANCE ABD PARACENTESIS

Facility

$1,097.60

Service Code	HCPCS 76942
Hospital Charge Code	2100949
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 GUIDANCE ABD PARACENTESIS

Facility

$1,097.60

Service Code	HCPCS 76942
Hospital Charge Code	2100949
Hospital Revenue Code	402
Min. Negotiated Rate	$164.64
Max. Negotiated Rate	$164.64
Rate for Payer: Qualcare PPO/HMO/WC	$164.64

US GUIDANCE AMNIOCENTESIS

Facility

$953.35

Service Code	HCPCS 76946
Hospital Charge Code	2100154
Hospital Revenue Code	402
Min. Negotiated Rate	$143.00
Max. Negotiated Rate	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$143.00

Know your out-of-pocket cost for care.

All Charges