Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

US GUIDED NEEDLE INS

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	366876942
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 INSERT

Facility

$9,500.00

Service Code	HCPCS 76942
Hospital Charge Code	2250453
Hospital Revenue Code	402
Min. Negotiated Rate	$71.63
Max. Negotiated Rate	$4,750.00
Rate for Payer: Aetna Commercial	$3,610.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
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	$2,422.50
Rate for Payer: Cigna Commercial	$4,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,850.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$228.95
Rate for Payer: Wellpoint Medicaid Managed Care	$251.75

US GUIDED NEEDLE INSERT

Facility

$9,500.00

Service Code	HCPCS 76942
Hospital Charge Code	2250453
Hospital Revenue Code	402
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

US GUIDED NEEDLE PLACEMENT

Facility

$2,085.70

Service Code	HCPCS 76942
Hospital Charge Code	1600000374
Hospital Revenue Code	360
Min. Negotiated Rate	$312.86
Max. Negotiated Rate	$312.86
Rate for Payer: Qualcare PPO/HMO/WC	$312.86

US GUIDED NEEDLE PLACEMENT

Facility

$2,085.70

Service Code	HCPCS 76942
Hospital Charge Code	1600000374
Hospital Revenue Code	360
Min. Negotiated Rate	$50.27
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$792.57
Rate for Payer: Aetna Medicare Advantage	$625.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$531.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$531.85
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	$531.85
Rate for Payer: Cigna Commercial	$1,042.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$625.71
Rate for Payer: Qualcare PPO/HMO/WC	$312.86
Rate for Payer: UnitedHealthcare Community & State	$50.27
Rate for Payer: Wellpoint Medicaid Managed Care	$55.27

US GUIDED NEEDLE PLACEMENT S&I

Facility

$1,097.60

Service Code	HCPCS 76942
Hospital Charge Code	2301020
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 GUIDED NEEDLE PLACEMENT S&I

Facility

$1,097.60

Service Code	HCPCS 76942
Hospital Charge Code	2301020
Hospital Revenue Code	402
Min. Negotiated Rate	$164.64
Max. Negotiated Rate	$164.64
Rate for Payer: Qualcare PPO/HMO/WC	$164.64

US GUIDED OVA ASPIRATION

Facility

$905.70

Service Code	HCPCS 76948
Hospital Charge Code	2301021
Hospital Revenue Code	402
Min. Negotiated Rate	$135.85
Max. Negotiated Rate	$135.85
Rate for Payer: Qualcare PPO/HMO/WC	$135.85

US GUIDED OVA ASPIRATION

Facility

$905.70

Service Code	HCPCS 76948
Hospital Charge Code	2301022
Hospital Revenue Code	402
Min. Negotiated Rate	$135.85
Max. Negotiated Rate	$135.85
Rate for Payer: Qualcare PPO/HMO/WC	$135.85

US GUIDED OVA ASPIRATION

Facility

$905.70

Service Code	HCPCS 76948
Hospital Charge Code	2301021
Hospital Revenue Code	402
Min. Negotiated Rate	$21.83
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$344.17
Rate for Payer: Aetna Medicare Advantage	$271.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.95
Rate for Payer: Cigna Commercial	$452.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.71
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.85
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$21.83
Rate for Payer: Wellpoint Medicaid Managed Care	$24.00

US GUIDED OVA ASPIRATION

Facility

$905.70

Service Code	HCPCS 76948
Hospital Charge Code	2301022
Hospital Revenue Code	402
Min. Negotiated Rate	$21.83
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$344.17
Rate for Payer: Aetna Medicare Advantage	$271.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.95
Rate for Payer: Cigna Commercial	$452.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.71
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.85
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$21.83
Rate for Payer: Wellpoint Medicaid Managed Care	$24.00

US-GUIDED RFA

Facility

$420.00

Service Code	HCPCS 76940
Hospital Charge Code	2690265
Hospital Revenue Code	402
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$159.60
Rate for Payer: Aetna Medicare Advantage	$126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.10
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	$107.10
Rate for Payer: Cigna Commercial	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.00
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$10.12
Rate for Payer: Wellpoint Medicaid Managed Care	$11.13

US-GUIDED RFA

Facility

$420.00

Service Code	HCPCS 76940
Hospital Charge Code	2690265
Hospital Revenue Code	402
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$63.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

US-GUIDED RFA

Facility

$420.00

Service Code	HCPCS 76940
Hospital Charge Code	7411753
Hospital Revenue Code	402
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$63.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

US-GUIDED RFA

Facility

$420.00

Service Code	HCPCS 76940
Hospital Charge Code	7411753
Hospital Revenue Code	402
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$159.60
Rate for Payer: Aetna Medicare Advantage	$126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.10
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	$107.10
Rate for Payer: Cigna Commercial	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.00
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$10.12
Rate for Payer: Wellpoint Medicaid Managed Care	$11.13

US GUIDED THROM PSEUDOAN BUND

Facility

$2,101.17

Hospital Charge Code	2301001EX
Hospital Revenue Code	402
Min. Negotiated Rate	$315.18
Max. Negotiated Rate	$315.18
Rate for Payer: Qualcare PPO/HMO/WC	$315.18

US GUIDED THROM PSEUDOAN BUND

Facility

$2,101.17

Hospital Charge Code	2301001EX
Hospital Revenue Code	402
Min. Negotiated Rate	$50.64
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$798.44
Rate for Payer: Aetna Medicare Advantage	$630.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$535.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$535.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$535.80
Rate for Payer: Cigna Commercial	$1,050.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$630.35
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$315.18
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$50.64
Rate for Payer: Wellpoint Medicaid Managed Care	$55.68

US GUIDED THROM PSEUDOAN CLINC

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	23011001B
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 THROM PSEUDOAN CLINC

Facility

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	23011001B
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 THROM PSEUDOAN SURG

Facility

$1,003.57

Service Code	HCPCS 36002
Hospital Charge Code	23011001A
Hospital Revenue Code	361
Min. Negotiated Rate	$24.19
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,027.08
Rate for Payer: Aetna Medicare Advantage	$2,414.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$745.25
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	$2,690.13
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: Cigna Medicare Advantage	$745.25
Rate for Payer: Clover Medicare Advantage	$707.99
Rate for Payer: EmblemHealth Commercial	$2,235.75
Rate for Payer: Humana Medicare Advantage	$767.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.07
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.54
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$24.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$745.25
Rate for Payer: Wellcare Medicare Advantage	$745.25
Rate for Payer: Wellpoint Medicaid Managed Care	$26.59

US GUIDED THROM PSEUDOAN SURG

Facility

$1,003.57

Service Code	HCPCS 36002
Hospital Charge Code	23011001A
Hospital Revenue Code	361
Min. Negotiated Rate	$150.54
Max. Negotiated Rate	$150.54
Rate for Payer: Qualcare PPO/HMO/WC	$150.54

US GUIDE FOR CYST ASPIRATION

Facility

$1,097.60

Service Code	HCPCS 76942
Hospital Charge Code	2100931
Hospital Revenue Code	402
Min. Negotiated Rate	$164.64
Max. Negotiated Rate	$164.64
Rate for Payer: Qualcare PPO/HMO/WC	$164.64

US GUIDE FOR CYST ASPIRATION

Facility

$1,097.60

Service Code	HCPCS 76942
Hospital Charge Code	2100931
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 GUIDE/MONITOR TISSUE ABLAT

Facility

$1,071.00

Service Code	HCPCS 76940
Hospital Charge Code	2100160
Hospital Revenue Code	402
Min. Negotiated Rate	$160.65
Max. Negotiated Rate	$160.65
Rate for Payer: Qualcare PPO/HMO/WC	$160.65

US GUIDE/MONITOR TISSUE ABLAT

Facility

$1,071.00

Service Code	HCPCS 76940
Hospital Charge Code	2100160
Hospital Revenue Code	402
Min. Negotiated Rate	$25.81
Max. Negotiated Rate	$2,517.00
Rate for Payer: Aetna Commercial	$406.98
Rate for Payer: Aetna Medicare Advantage	$321.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.11
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	$273.11
Rate for Payer: Cigna Commercial	$535.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$321.30
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$160.65
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$25.81
Rate for Payer: Wellpoint Medicaid Managed Care	$28.38

Know your out-of-pocket cost for care.

All Charges