Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

VEIN ACCESS CUTDOWN < 1 YR

Facility

$36.87

Service Code	HCPCS 36420
Hospital Charge Code	5100080
Hospital Revenue Code	361
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
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	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.06
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.53
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$0.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.98

VEIN ACCESS CUTDOWN < 1 YR

Facility

$36.87

Service Code	HCPCS 36420
Hospital Charge Code	5100080
Hospital Revenue Code	361
Min. Negotiated Rate	$5.53
Max. Negotiated Rate	$5.53
Rate for Payer: Qualcare PPO/HMO/WC	$5.53

VEIN ACCESS CUTDOWN > 1 YR

Facility

$36.87

Service Code	HCPCS 36425
Hospital Charge Code	5100087
Hospital Revenue Code	361
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,443.56
Rate for Payer: Aetna Medicare Advantage	$1,719.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,915.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,915.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$530.72
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	$1,915.74
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: Cigna Medicare Advantage	$530.72
Rate for Payer: Clover Medicare Advantage	$504.18
Rate for Payer: EmblemHealth Commercial	$1,592.16
Rate for Payer: Humana Medicare Advantage	$546.64
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$530.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.06
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.53
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$0.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$530.72
Rate for Payer: Wellcare Medicare Advantage	$530.72
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37
Rate for Payer: Wellpoint Medicaid Managed Care	$193.50

VEIN ACCESS CUTDOWN > 1 YR

Facility

$36.87

Service Code	HCPCS 36425
Hospital Charge Code	5100087
Hospital Revenue Code	361
Min. Negotiated Rate	$5.53
Max. Negotiated Rate	$5.53
Rate for Payer: Qualcare PPO/HMO/WC	$5.53

VEIN CYTO

Facility

$37,000.00

Hospital Charge Code	270676622
Hospital Revenue Code	278
Min. Negotiated Rate	$891.70
Max. Negotiated Rate	$18,500.00
Rate for Payer: Aetna Commercial	$14,060.00
Rate for Payer: Aetna Medicare Advantage	$11,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,435.00
Rate for Payer: Cigna Commercial	$18,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,954.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,140.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,550.00
Rate for Payer: UnitedHealthcare Community & State	$891.70
Rate for Payer: Wellpoint Medicaid Managed Care	$980.50

VEIN CYTO

Facility

$37,000.00

Hospital Charge Code	270676622
Hospital Revenue Code	278
Min. Negotiated Rate	$5,550.00
Max. Negotiated Rate	$8,954.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,954.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,140.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,550.00

VEIN IMPLANT

Facility

$36,750.00

Hospital Charge Code	270668663
Hospital Revenue Code	278
Min. Negotiated Rate	$885.67
Max. Negotiated Rate	$18,375.00
Rate for Payer: Aetna Commercial	$13,965.00
Rate for Payer: Aetna Medicare Advantage	$11,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,371.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,371.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,371.25
Rate for Payer: Cigna Commercial	$18,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,893.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,085.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,512.50
Rate for Payer: UnitedHealthcare Community & State	$885.67
Rate for Payer: Wellpoint Medicaid Managed Care	$973.88

VEIN IMPLANT

Facility

$36,750.00

Hospital Charge Code	270668663
Hospital Revenue Code	278
Min. Negotiated Rate	$5,512.50
Max. Negotiated Rate	$8,893.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,893.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,085.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,512.50

VEIN LIGATION AND STRIPPING

Facility

$100,954.31

Service Code	MSDRG 263
Min. Negotiated Rate	$30,739.29
Max. Negotiated Rate	$100,954.31
Rate for Payer: Aetna Commercial	$69,624.42
Rate for Payer: Aetna Medicare Advantage	$100,954.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65,828.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65,828.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$32,357.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65,828.63
Rate for Payer: Cigna Commercial	$57,216.18
Rate for Payer: Cigna Medicare Advantage	$32,357.15
Rate for Payer: Clover Medicare Advantage	$30,739.29
Rate for Payer: EmblemHealth Commercial	$97,071.45
Rate for Payer: Humana Medicare Advantage	$33,327.86
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$32,357.15
Rate for Payer: Oxford Commercial	$41,122.03
Rate for Payer: UnitedHealthcare Commercial	$72,108.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$32,357.15
Rate for Payer: Wellcare Medicare Advantage	$32,357.15

VEIN MINI-HARVEST M/L 178200

Facility

$765.65

Hospital Charge Code	270600139
Hospital Revenue Code	272
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$382.82
Rate for Payer: Aetna Commercial	$290.95
Rate for Payer: Aetna Medicare Advantage	$229.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.24
Rate for Payer: Cigna Commercial	$382.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.69
Rate for Payer: Oxford Commercial	$153.13
Rate for Payer: Qualcare PPO/HMO/WC	$114.85
Rate for Payer: UnitedHealthcare Commercial	$153.13
Rate for Payer: UnitedHealthcare Community & State	$18.45
Rate for Payer: Wellpoint Medicaid Managed Care	$20.29

VEIN MINI-HARVEST M/L 178200

Facility

$765.65

Hospital Charge Code	270600139
Hospital Revenue Code	272
Min. Negotiated Rate	$114.85
Max. Negotiated Rate	$114.85
Rate for Payer: Qualcare PPO/HMO/WC	$114.85

VEIN SAPHENOUS

Facility

$39,750.00

Hospital Charge Code	270680373
Hospital Revenue Code	278
Min. Negotiated Rate	$957.98
Max. Negotiated Rate	$19,875.00
Rate for Payer: Aetna Commercial	$15,105.00
Rate for Payer: Aetna Medicare Advantage	$11,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,136.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,136.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,136.25
Rate for Payer: Cigna Commercial	$19,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,619.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,745.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,962.50
Rate for Payer: UnitedHealthcare Community & State	$957.98
Rate for Payer: Wellpoint Medicaid Managed Care	$1,053.38

VEIN SAPHENOUS

Facility

$39,750.00

Hospital Charge Code	270680373
Hospital Revenue Code	278
Min. Negotiated Rate	$5,962.50
Max. Negotiated Rate	$9,619.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,619.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,745.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,962.50

VEIN SAPHENOUS 5MM 46CM V01046

Facility

$15,292.00

Hospital Charge Code	270618638
Hospital Revenue Code	278
Min. Negotiated Rate	$368.54
Max. Negotiated Rate	$7,646.00
Rate for Payer: Aetna Commercial	$5,810.96
Rate for Payer: Aetna Medicare Advantage	$4,587.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,899.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,899.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,058.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,899.46
Rate for Payer: Cigna Commercial	$7,646.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,700.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,364.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,293.80
Rate for Payer: UnitedHealthcare Community & State	$368.54
Rate for Payer: Wellpoint Medicaid Managed Care	$405.24

VEIN SAPHENOUS 5MM 46CM V01046

Facility

$15,292.00

Hospital Charge Code	270618638
Hospital Revenue Code	278
Min. Negotiated Rate	$2,293.80
Max. Negotiated Rate	$3,700.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,058.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,700.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,364.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,293.80

VEIN SAPHENOUS 5MM 47CM V01047

Facility

$15,292.00

Hospital Charge Code	270618639
Hospital Revenue Code	278
Min. Negotiated Rate	$2,293.80
Max. Negotiated Rate	$3,700.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,058.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,700.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,364.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,293.80

VEIN SAPHENOUS 5MM 47CM V01047

Facility

$15,292.00

Hospital Charge Code	270618639
Hospital Revenue Code	278
Min. Negotiated Rate	$368.54
Max. Negotiated Rate	$7,646.00
Rate for Payer: Aetna Commercial	$5,810.96
Rate for Payer: Aetna Medicare Advantage	$4,587.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,899.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,899.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,058.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,899.46
Rate for Payer: Cigna Commercial	$7,646.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,700.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,364.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,293.80
Rate for Payer: UnitedHealthcare Community & State	$368.54
Rate for Payer: Wellpoint Medicaid Managed Care	$405.24

VEIN SAPHENOUS 67cm

Facility

$36,750.00

Hospital Charge Code	270675973
Hospital Revenue Code	278
Min. Negotiated Rate	$885.67
Max. Negotiated Rate	$18,375.00
Rate for Payer: Aetna Commercial	$13,965.00
Rate for Payer: Aetna Medicare Advantage	$11,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,371.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,371.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,371.25
Rate for Payer: Cigna Commercial	$18,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,893.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,085.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,512.50
Rate for Payer: UnitedHealthcare Community & State	$885.67
Rate for Payer: Wellpoint Medicaid Managed Care	$973.88

VEIN SAPHENOUS 67cm

Facility

$36,750.00

Hospital Charge Code	270675973
Hospital Revenue Code	278
Min. Negotiated Rate	$5,512.50
Max. Negotiated Rate	$8,893.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,893.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,085.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,512.50

VEIN SAPHENOUS 71-80CM

Facility

$38,250.00

Service Code	HCPCS C1768
Hospital Charge Code	270676724
Hospital Revenue Code	278
Min. Negotiated Rate	$921.83
Max. Negotiated Rate	$19,125.00
Rate for Payer: Aetna Commercial	$14,535.00
Rate for Payer: Aetna Medicare Advantage	$11,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,753.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,753.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,753.75
Rate for Payer: Cigna Commercial	$19,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,256.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,415.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,737.50
Rate for Payer: UnitedHealthcare Community & State	$921.83
Rate for Payer: Wellpoint Medicaid Managed Care	$1,013.62

VEIN SAPHENOUS 71-80CM

Facility

$38,250.00

Service Code	HCPCS C1768
Hospital Charge Code	270676724
Hospital Revenue Code	278
Min. Negotiated Rate	$5,737.50
Max. Negotiated Rate	$9,256.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,256.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,415.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,737.50

VEIN SAPHENOUS 80-100CM

Facility

$46,750.00

Hospital Charge Code	270680417
Hospital Revenue Code	278
Min. Negotiated Rate	$7,012.50
Max. Negotiated Rate	$11,313.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,313.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10,285.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,012.50

VEIN SAPHENOUS 80-100CM

Facility

$46,750.00

Hospital Charge Code	270680417
Hospital Revenue Code	278
Min. Negotiated Rate	$1,126.67
Max. Negotiated Rate	$23,375.00
Rate for Payer: Aetna Commercial	$17,765.00
Rate for Payer: Aetna Medicare Advantage	$14,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,921.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,921.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,921.25
Rate for Payer: Cigna Commercial	$23,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,313.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10,285.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,012.50
Rate for Payer: UnitedHealthcare Community & State	$1,126.67
Rate for Payer: Wellpoint Medicaid Managed Care	$1,238.88

VEIN SAPHENOUS TISS 56 V010-56

Facility

$20,732.85

Hospital Charge Code	270630638
Hospital Revenue Code	278
Min. Negotiated Rate	$3,109.93
Max. Negotiated Rate	$5,017.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,146.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,017.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,561.23
Rate for Payer: Qualcare PPO/HMO/WC	$3,109.93

VEIN SAPHENOUS TISS 56 V010-56

Facility

$20,732.85

Hospital Charge Code	270630638
Hospital Revenue Code	278
Min. Negotiated Rate	$499.66
Max. Negotiated Rate	$10,366.42
Rate for Payer: Aetna Commercial	$7,878.48
Rate for Payer: Aetna Medicare Advantage	$6,219.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,146.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,286.88
Rate for Payer: Cigna Commercial	$10,366.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,017.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,561.23
Rate for Payer: Qualcare PPO/HMO/WC	$3,109.93
Rate for Payer: UnitedHealthcare Community & State	$499.66
Rate for Payer: Wellpoint Medicaid Managed Care	$549.42

Know your out-of-pocket cost for care.

All Charges