Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$962.99
Max. Negotiated Rate	$962.99
Rate for Payer: Qualcare PPO/HMO/WC	$962.99

US GUIDED BRST BIOPSY 1ST LES

Facility

$6,419.95

Service Code	HCPCS 19083RT
Hospital Charge Code	94064005R
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	$951.93
Max. Negotiated Rate	$951.93
Rate for Payer: Qualcare PPO/HMO/WC	$951.93

US GUIDED BRST BIOPSY 1ST LES

Facility

$6,419.95

Service Code	HCPCS 19083RT
Hospital Charge Code	94064005R
Hospital Revenue Code	361
Min. Negotiated Rate	$962.99
Max. Negotiated Rate	$962.99
Rate for Payer: Qualcare PPO/HMO/WC	$962.99

US GUIDED BRST BIOPSY ADD LES

Facility

$3,173.10

Service Code	HCPCS 19084
Hospital Charge Code	94064007L
Hospital Revenue Code	361
Min. Negotiated Rate	$76.47
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,205.78
Rate for Payer: Aetna Medicare Advantage	$951.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.14
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	$809.14
Rate for Payer: Cigna Commercial	$1,586.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$951.93
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$475.96
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$76.47
Rate for Payer: Wellpoint Medicaid Managed Care	$84.09

US GUIDED BRST BIOPSY ADD LES

Facility

$3,173.10

Service Code	HCPCS 19084
Hospital Charge Code	87502809
Hospital Revenue Code	361
Min. Negotiated Rate	$475.96
Max. Negotiated Rate	$475.96
Rate for Payer: Qualcare PPO/HMO/WC	$475.96

US GUIDED BRST BIOPSY ADD LES

Facility

$3,173.10

Service Code	HCPCS 19084
Hospital Charge Code	87502809
Hospital Revenue Code	361
Min. Negotiated Rate	$76.47
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,205.78
Rate for Payer: Aetna Medicare Advantage	$951.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.14
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	$809.14
Rate for Payer: Cigna Commercial	$1,586.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$951.93
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$475.96
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$76.47
Rate for Payer: Wellpoint Medicaid Managed Care	$84.09

US GUIDED BRST BIOPSY ADD LES

Facility

$3,173.10

Service Code	HCPCS 19084
Hospital Charge Code	94064007R
Hospital Revenue Code	361
Min. Negotiated Rate	$76.47
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,205.78
Rate for Payer: Aetna Medicare Advantage	$951.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.14
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	$809.14
Rate for Payer: Cigna Commercial	$1,586.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$951.93
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$475.96
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$76.47
Rate for Payer: Wellpoint Medicaid Managed Care	$84.09

US GUIDED BRST BIOPSY ADD LES

Facility

$3,173.10

Service Code	HCPCS 19084
Hospital Charge Code	94064007R
Hospital Revenue Code	361
Min. Negotiated Rate	$475.96
Max. Negotiated Rate	$475.96
Rate for Payer: Qualcare PPO/HMO/WC	$475.96

US GUIDED BRST BIOPSY ADD LES

Facility

$6,346.20

Service Code	HCPCS 19084
Hospital Charge Code	94064007
Hospital Revenue Code	361
Min. Negotiated Rate	$951.93
Max. Negotiated Rate	$951.93
Rate for Payer: Qualcare PPO/HMO/WC	$951.93

US GUIDED BRST BIOPSY ADD LES

Facility

$6,346.20

Service Code	HCPCS 19084
Hospital Charge Code	94064007
Hospital Revenue Code	361
Min. Negotiated Rate	$152.94
Max. Negotiated Rate	$3,173.10
Rate for Payer: Aetna Commercial	$2,411.56
Rate for Payer: Aetna Medicare Advantage	$1,903.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,618.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,618.28
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	$1,618.28
Rate for Payer: Cigna Commercial	$3,173.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,903.86
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$951.93
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$152.94
Rate for Payer: Wellpoint Medicaid Managed Care	$168.17

US GUIDED BRST BIOPSY ADD LES

Facility

$3,173.10

Service Code	HCPCS 19084
Hospital Charge Code	94064007L
Hospital Revenue Code	361
Min. Negotiated Rate	$475.96
Max. Negotiated Rate	$475.96
Rate for Payer: Qualcare PPO/HMO/WC	$475.96

US GUIDED CHORIONIC VILLUS SAM

Facility

$370.90

Service Code	HCPCS 76945
Hospital Charge Code	2301017
Hospital Revenue Code	402
Min. Negotiated Rate	$55.63
Max. Negotiated Rate	$55.63
Rate for Payer: Qualcare PPO/HMO/WC	$55.63

US GUIDED CHORIONIC VILLUS SAM

Facility

$370.90

Service Code	HCPCS 76945
Hospital Charge Code	2301017
Hospital Revenue Code	402
Min. Negotiated Rate	$8.94
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$140.94
Rate for Payer: Aetna Medicare Advantage	$111.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.58
Rate for Payer: Cigna Commercial	$185.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.27
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.63
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$8.94
Rate for Payer: Wellpoint Medicaid Managed Care	$9.83

US GUIDED COMPRESS ART FL

Facility

$6,700.00

Service Code	HCPCS 76936
Hospital Charge Code	2692010
Hospital Revenue Code	402
Min. Negotiated Rate	$161.47
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	$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	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$177.55

US GUIDED COMPRESS ART FL

Facility

$6,700.00

Service Code	HCPCS 76936
Hospital Charge Code	2692010
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 GUIDED ENDOMYOCARDIAL BOPSY

Facility

$370.90

Service Code	HCPCS 76932
Hospital Charge Code	2301018
Hospital Revenue Code	402
Min. Negotiated Rate	$55.63
Max. Negotiated Rate	$55.63
Rate for Payer: Qualcare PPO/HMO/WC	$55.63

US GUIDED ENDOMYOCARDIAL BOPSY

Facility

$370.90

Service Code	HCPCS 76932
Hospital Charge Code	2301018
Hospital Revenue Code	402
Min. Negotiated Rate	$8.94
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$140.94
Rate for Payer: Aetna Medicare Advantage	$111.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.58
Rate for Payer: Cigna Commercial	$185.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.27
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.63
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$8.94
Rate for Payer: Wellpoint Medicaid Managed Care	$9.83

US GUIDED FETAL TRANSFUSION

Facility

$370.90

Service Code	HCPCS 76941
Hospital Charge Code	2301019
Hospital Revenue Code	402
Min. Negotiated Rate	$55.63
Max. Negotiated Rate	$55.63
Rate for Payer: Qualcare PPO/HMO/WC	$55.63

US GUIDED FETAL TRANSFUSION

Facility

$370.90

Service Code	HCPCS 76941
Hospital Charge Code	2301019
Hospital Revenue Code	402
Min. Negotiated Rate	$8.94
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$140.94
Rate for Payer: Aetna Medicare Advantage	$111.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.58
Rate for Payer: Cigna Commercial	$185.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.27
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.63
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$8.94
Rate for Payer: Wellpoint Medicaid Managed Care	$9.83

US GUIDED NEEDLE BIOPSY

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	2100238
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 GUIDED NEEDLE BIOPSY

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	2100238
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 GUIDED NEEDLE INS

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	366876942
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 GUIDED NEEDLE INS

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	7411169
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 GUIDED NEEDLE INS

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	7411169
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

Know your out-of-pocket cost for care.

All Charges