Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

VENOGRAM UPPER EXTRY BILATERAL

Facility

$331.55

Service Code	HCPCS 3601150
Hospital Charge Code	5100567
Hospital Revenue Code	361
Min. Negotiated Rate	$49.73
Max. Negotiated Rate	$49.73
Rate for Payer: Qualcare PPO/HMO/WC	$49.73

VENOGRAM UPPER EXTRY BILATERAL

Facility

$331.55

Service Code	HCPCS 3601150
Hospital Charge Code	5100567
Hospital Revenue Code	361
Min. Negotiated Rate	$7.99
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$125.99
Rate for Payer: Aetna Medicare Advantage	$99.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.55
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	$84.55
Rate for Payer: Cigna Commercial	$165.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.47
Rate for Payer: Qualcare PPO/HMO/WC	$49.73
Rate for Payer: UnitedHealthcare Community & State	$7.99
Rate for Payer: Wellpoint Medicaid Managed Care	$8.79

VENOUS ******

Facility

$160.00

Hospital Charge Code	8002438
Hospital Revenue Code	279
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

VENOUS ******

Facility

$160.00

Hospital Charge Code	8002438
Hospital Revenue Code	279
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$60.80
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.00
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$32.00
Rate for Payer: UnitedHealthcare Community & State	$3.86
Rate for Payer: Wellpoint Medicaid Managed Care	$4.24

VENOUS ACCESS DEVICE MAINTEN**

Facility

$68.40

Service Code	HCPCS 96530
Hospital Charge Code	3400108
Hospital Revenue Code	331
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$25.99
Rate for Payer: Aetna Medicare Advantage	$20.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.44
Rate for Payer: Cigna Commercial	$34.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.52
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.26
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$1.65
Rate for Payer: Wellpoint Medicaid Managed Care	$1.81

VENOUS ACCESS DEVICE MAINTEN**

Facility

$68.40

Service Code	HCPCS 96530
Hospital Charge Code	3400108
Hospital Revenue Code	331
Min. Negotiated Rate	$10.26
Max. Negotiated Rate	$10.26
Rate for Payer: Qualcare PPO/HMO/WC	$10.26

VENOUS BLOOD GAS SHOCK PANEL

Facility

$1,255.57

Service Code	HCPCS 82803
Hospital Charge Code	397360012
Hospital Revenue Code	301
Min. Negotiated Rate	$188.34
Max. Negotiated Rate	$188.34
Rate for Payer: Qualcare PPO/HMO/WC	$188.34

VENOUS BLOOD GAS SHOCK PANEL

Facility

$1,255.57

Service Code	HCPCS 82803
Hospital Charge Code	397360012
Hospital Revenue Code	301
Min. Negotiated Rate	$20.86
Max. Negotiated Rate	$627.78
Rate for Payer: Aetna Commercial	$70.91
Rate for Payer: Aetna Medicare Advantage	$84.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.10
Rate for Payer: Cigna Commercial	$627.78
Rate for Payer: Cigna Medicare Advantage	$26.07
Rate for Payer: Clover Medicare Advantage	$24.77
Rate for Payer: EmblemHealth Commercial	$78.21
Rate for Payer: Humana Medicare Advantage	$26.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$376.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$188.34
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$20.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.07
Rate for Payer: Wellcare Medicare Advantage	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$33.27

VENOUSCATH/SELECTORGANBLDSAMPL

Facility

$813.00

Service Code	HCPCS 3650050
Hospital Charge Code	7411798
Hospital Revenue Code	361
Min. Negotiated Rate	$121.95
Max. Negotiated Rate	$121.95
Rate for Payer: Qualcare PPO/HMO/WC	$121.95

VENOUSCATH/SELECTORGANBLDSAMPL

Facility

$813.00

Service Code	HCPCS 3650050
Hospital Charge Code	7411798
Hospital Revenue Code	361
Min. Negotiated Rate	$19.59
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$308.94
Rate for Payer: Aetna Medicare Advantage	$243.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.31
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	$207.31
Rate for Payer: Cigna Commercial	$406.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.90
Rate for Payer: Qualcare PPO/HMO/WC	$121.95
Rate for Payer: UnitedHealthcare Community & State	$19.59
Rate for Payer: Wellpoint Medicaid Managed Care	$21.54

VENOUSCATH/SELECTORGANBLDSAMPL

Facility

$813.00

Service Code	HCPCS 3650050
Hospital Charge Code	2680385
Hospital Revenue Code	361
Min. Negotiated Rate	$121.95
Max. Negotiated Rate	$121.95
Rate for Payer: Qualcare PPO/HMO/WC	$121.95

VENOUSCATH/SELECTORGANBLDSAMPL

Facility

$813.00

Service Code	HCPCS 3650050
Hospital Charge Code	2680385
Hospital Revenue Code	361
Min. Negotiated Rate	$19.59
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$308.94
Rate for Payer: Aetna Medicare Advantage	$243.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.31
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	$207.31
Rate for Payer: Cigna Commercial	$406.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.90
Rate for Payer: Qualcare PPO/HMO/WC	$121.95
Rate for Payer: UnitedHealthcare Community & State	$19.59
Rate for Payer: Wellpoint Medicaid Managed Care	$21.54

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	74115044
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	74117044
Hospital Revenue Code	921
Min. Negotiated Rate	$269.30
Max. Negotiated Rate	$6,760.00
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	$873.14
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	$5,160.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$414.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$455.80

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	74117044
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	2692185
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	2692185
Hospital Revenue Code	921
Min. Negotiated Rate	$269.30
Max. Negotiated Rate	$6,760.00
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	$873.14
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	$5,160.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$414.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$455.80

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	94053275
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	74115044
Hospital Revenue Code	921
Min. Negotiated Rate	$269.30
Max. Negotiated Rate	$6,760.00
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	$873.14
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	$5,160.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$414.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$455.80

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	74116044
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	74116044
Hospital Revenue Code	921
Min. Negotiated Rate	$269.30
Max. Negotiated Rate	$6,760.00
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	$873.14
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	$5,160.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$414.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$455.80

VENOUS DUPLEX SCAN LOW EXT BI

Facility

$17,200.00

Service Code	HCPCS 93970
Hospital Charge Code	94053275
Hospital Revenue Code	921
Min. Negotiated Rate	$269.30
Max. Negotiated Rate	$6,760.00
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	$873.14
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	$5,160.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$414.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$455.80

VENOUS DUPLEX SCAN LOW EXT LT

Facility

$17,200.00

Service Code	HCPCS 93971
Hospital Charge Code	74116059
Hospital Revenue Code	921
Min. Negotiated Rate	$117.99
Max. Negotiated Rate	$6,760.00
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	$844.10
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	$5,160.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$6,760.00
Rate for Payer: UnitedHealthcare Community & State	$414.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$455.80

VENOUS DUPLEX SCAN LOW EXT LT

Facility

$2,497.57

Service Code	HCPCS 93971
Hospital Charge Code	94053280
Hospital Revenue Code	921
Min. Negotiated Rate	$374.64
Max. Negotiated Rate	$374.64
Rate for Payer: Qualcare PPO/HMO/WC	$374.64

VENOUS DUPLEX SCAN LOW EXT LT

Facility

$17,200.00

Service Code	HCPCS 93971
Hospital Charge Code	74117059
Hospital Revenue Code	921
Min. Negotiated Rate	$2,580.00
Max. Negotiated Rate	$2,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00

Know your out-of-pocket cost for care.

All Charges