Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

US GUIDANCE AMNIOCENTESIS

Facility

$953.35

Service Code	HCPCS 76946
Hospital Charge Code	2100154
Hospital Revenue Code	402
Min. Negotiated Rate	$22.98
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$362.27
Rate for Payer: Aetna Medicare Advantage	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.10
Rate for Payer: Cigna Commercial	$476.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$286.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$143.00
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$22.98
Rate for Payer: Wellpoint Medicaid Managed Care	$25.26

US GUIDANCE COMP PSEUDO-ANEUR

Facility

$3,485.00

Service Code	HCPCS 76936
Hospital Charge Code	2101105
Hospital Revenue Code	402
Min. Negotiated Rate	$522.75
Max. Negotiated Rate	$522.75
Rate for Payer: Qualcare PPO/HMO/WC	$522.75

US GUIDANCE COMP PSEUDO-ANEUR

Facility

$3,485.00

Service Code	HCPCS 76936
Hospital Charge Code	2101105
Hospital Revenue Code	402
Min. Negotiated Rate	$83.99
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$337.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$925.96
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,045.50
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$522.75
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$83.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$92.35

US GUIDANCE FOR INJ

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	1650116B
Hospital Revenue Code	402
Min. Negotiated Rate	$71.63
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) NJ Health	$71.63
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 GUIDANCE FOR INJ

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	1650116B
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 GUIDANCE FOR INJ

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	1650117B
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 GUIDANCE FOR INJ

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	1650117B
Hospital Revenue Code	402
Min. Negotiated Rate	$71.63
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) NJ Health	$71.63
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 GUIDANCE PERICARDIOCENTESIS

Facility

$859.25

Service Code	HCPCS 76930
Hospital Charge Code	2100956
Hospital Revenue Code	402
Min. Negotiated Rate	$20.71
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$326.51
Rate for Payer: Aetna Medicare Advantage	$257.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.11
Rate for Payer: Cigna Commercial	$429.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.77
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$128.89
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$20.71
Rate for Payer: Wellpoint Medicaid Managed Care	$22.77

US GUIDANCE PERICARDIOCENTESIS

Facility

$859.25

Service Code	HCPCS 76930
Hospital Charge Code	2100956
Hospital Revenue Code	402
Min. Negotiated Rate	$128.89
Max. Negotiated Rate	$128.89
Rate for Payer: Qualcare PPO/HMO/WC	$128.89

US GUIDANCE THORACENTESIS

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	2100220
Hospital Revenue Code	402
Min. Negotiated Rate	$71.63
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) NJ Health	$71.63
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 GUIDANCE THORACENTESIS

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	2100220
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 GUIDANCE TISSUE ABLATION

Facility

$1,521.25

Service Code	HCPCS 76940
Hospital Charge Code	2301016
Hospital Revenue Code	402
Min. Negotiated Rate	$228.19
Max. Negotiated Rate	$228.19
Rate for Payer: Qualcare PPO/HMO/WC	$228.19

US GUIDANCE TISSUE ABLATION

Facility

$1,521.25

Service Code	HCPCS 76940
Hospital Charge Code	2301016
Hospital Revenue Code	402
Min. Negotiated Rate	$36.66
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$578.08
Rate for Payer: Aetna Medicare Advantage	$456.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$387.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$387.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$387.92
Rate for Payer: Cigna Commercial	$760.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$456.38
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$228.19
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$36.66
Rate for Payer: Wellpoint Medicaid Managed Care	$40.31

US GUIDANCE WIRE LOCALIZATION

Facility

$1,429.00

Service Code	HCPCS 76942
Hospital Charge Code	2100245
Hospital Revenue Code	402
Min. Negotiated Rate	$34.44
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$543.02
Rate for Payer: Aetna Medicare Advantage	$428.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.39
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	$364.39
Rate for Payer: Cigna Commercial	$714.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.70
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$214.35
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$34.44
Rate for Payer: Wellpoint Medicaid Managed Care	$37.87

US GUIDANCE WIRE LOCALIZATION

Facility

$1,429.00

Service Code	HCPCS 76942
Hospital Charge Code	2100245
Hospital Revenue Code	402
Min. Negotiated Rate	$214.35
Max. Negotiated Rate	$214.35
Rate for Payer: Qualcare PPO/HMO/WC	$214.35

US-GUIDE ABSCESS DRAIN

Facility

$3,032.40

Hospital Charge Code	2309050
Hospital Revenue Code	320
Min. Negotiated Rate	$73.08
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$1,152.31
Rate for Payer: Aetna Medicare Advantage	$909.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$773.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$773.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$773.26
Rate for Payer: Cigna Commercial	$1,516.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$909.72
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$454.86
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$73.08
Rate for Payer: Wellpoint Medicaid Managed Care	$80.36

US-GUIDE ABSCESS DRAIN

Facility

$3,032.40

Hospital Charge Code	2309050
Hospital Revenue Code	320
Min. Negotiated Rate	$454.86
Max. Negotiated Rate	$454.86
Rate for Payer: Qualcare PPO/HMO/WC	$454.86

US GUIDED BREAST LOC LT

Facility

$776.25

Service Code	HCPCS 19285LT
Hospital Charge Code	2309102A
Hospital Revenue Code	361
Min. Negotiated Rate	$116.44
Max. Negotiated Rate	$116.44
Rate for Payer: Qualcare PPO/HMO/WC	$116.44

US GUIDED BREAST LOC LT

Facility

$776.25

Service Code	HCPCS 19285LT
Hospital Charge Code	2309102A
Hospital Revenue Code	361
Min. Negotiated Rate	$18.71
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$294.98
Rate for Payer: Aetna Medicare Advantage	$232.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.94
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	$197.94
Rate for Payer: Cigna Commercial	$388.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.88
Rate for Payer: Qualcare PPO/HMO/WC	$116.44
Rate for Payer: UnitedHealthcare Community & State	$18.71
Rate for Payer: Wellpoint Medicaid Managed Care	$20.57

US GUIDED BREAST LOC RT

Facility

$776.25

Service Code	HCPCS 19285RT
Hospital Charge Code	2309101A
Hospital Revenue Code	361
Min. Negotiated Rate	$18.71
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$294.98
Rate for Payer: Aetna Medicare Advantage	$232.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.94
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	$197.94
Rate for Payer: Cigna Commercial	$388.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.88
Rate for Payer: Qualcare PPO/HMO/WC	$116.44
Rate for Payer: UnitedHealthcare Community & State	$18.71
Rate for Payer: Wellpoint Medicaid Managed Care	$20.57

US GUIDED BREAST LOC RT

Facility

$776.25

Service Code	HCPCS 19285RT
Hospital Charge Code	2309101A
Hospital Revenue Code	361
Min. Negotiated Rate	$116.44
Max. Negotiated Rate	$116.44
Rate for Payer: Qualcare PPO/HMO/WC	$116.44

US GUIDED BRST BIOPSY 1ST LES

Facility

$6,419.95

Service Code	HCPCS 19083LT
Hospital Charge Code	94064005L
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 GUIDED BRST BIOPSY 1ST LES

Facility

$6,346.20

Service Code	HCPCS 19083
Hospital Charge Code	87502808
Hospital Revenue Code	361
Min. Negotiated Rate	$152.94
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	$1,903.86
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$951.93
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$152.94
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	$168.17

US GUIDED BRST BIOPSY 1ST LES

Facility

$12,839.90

Service Code	HCPCS 1908350
Hospital Charge Code	94064005
Hospital Revenue Code	361
Min. Negotiated Rate	$1,925.98
Max. Negotiated Rate	$1,925.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,925.98

US GUIDED BRST BIOPSY 1ST LES

Facility

$12,839.90

Service Code	HCPCS 1908350
Hospital Charge Code	94064005
Hospital Revenue Code	361
Min. Negotiated Rate	$309.44
Max. Negotiated Rate	$6,419.95
Rate for Payer: Aetna Commercial	$4,879.16
Rate for Payer: Aetna Medicare Advantage	$3,851.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,274.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,274.17
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	$3,274.17
Rate for Payer: Cigna Commercial	$6,419.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,851.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,925.98
Rate for Payer: UnitedHealthcare Community & State	$309.44
Rate for Payer: Wellpoint Medicaid Managed Care	$340.26

Know your out-of-pocket cost for care.

All Charges