Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

Voice Goal Status CH

Facility

$0.01

Service Code	HCPCS G9172GNCH
Hospital Charge Code	74204085CH
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Voice Goal Status CH

Facility

$0.01

Service Code	HCPCS G9172GNCH
Hospital Charge Code	74204085CH
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

Voice Goal Status CI

Facility

$0.01

Service Code	HCPCS G9172GNCI
Hospital Charge Code	74204085CI
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

Voice Goal Status CI

Facility

$0.01

Service Code	HCPCS G9172GNCI
Hospital Charge Code	74204085CI
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Voice Goal Status CJ

Facility

$0.01

Service Code	HCPCS G9172GNCJ
Hospital Charge Code	74204085CJ
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

Voice Goal Status CJ

Facility

$0.01

Service Code	HCPCS G9172GNCJ
Hospital Charge Code	74204085CJ
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

VOICE GOAL STATUS CK

Facility

$0.01

Service Code	HCPCS G9172GNCK
Hospital Charge Code	74204085CK
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

VOICE GOAL STATUS CK

Facility

$0.01

Service Code	HCPCS G9172GNCK
Hospital Charge Code	74204085CK
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

Voice Goal Status CL

Facility

$0.01

Service Code	HCPCS G9172GNCL
Hospital Charge Code	74204085CL
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

Voice Goal Status CL

Facility

$0.01

Service Code	HCPCS G9172GNCL
Hospital Charge Code	74204085CL
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

VOICE GOAL STATUS CM

Facility

$0.01

Service Code	HCPCS G9172GNCM
Hospital Charge Code	74204085CM
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

VOICE GOAL STATUS CM

Facility

$0.01

Service Code	HCPCS G9172GNCM
Hospital Charge Code	74204085CM
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

VOICE GOAL STATUS CN

Facility

$0.01

Service Code	HCPCS G9172GNCN
Hospital Charge Code	74204085CN
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

VOICE GOAL STATUS CN

Facility

$0.01

Service Code	HCPCS G9172GNCN
Hospital Charge Code	74204085CN
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

VOLAR DISTAL RADIUS PLATE 3 HO

Facility

$4,093.75

Service Code	HCPCS C1713
Hospital Charge Code	270704872
Hospital Revenue Code	278
Min. Negotiated Rate	$614.06
Max. Negotiated Rate	$990.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$818.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$990.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$900.62
Rate for Payer: Qualcare PPO/HMO/WC	$614.06

VOLAR DISTAL RADIUS PLATE 3 HO

Facility

$4,093.75

Service Code	HCPCS C1713
Hospital Charge Code	270704872
Hospital Revenue Code	278
Min. Negotiated Rate	$98.66
Max. Negotiated Rate	$2,046.88
Rate for Payer: Aetna Commercial	$1,555.62
Rate for Payer: Aetna Medicare Advantage	$1,228.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,043.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,043.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,043.91
Rate for Payer: Cigna Commercial	$2,046.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$990.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$900.62
Rate for Payer: Qualcare PPO/HMO/WC	$614.06
Rate for Payer: UnitedHealthcare Community & State	$98.66
Rate for Payer: Wellpoint Medicaid Managed Care	$108.48

VOLATILES

Facility

$27.90

Service Code	HCPCS 82010
Hospital Charge Code	3035089B
Hospital Revenue Code	307
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$22.22
Rate for Payer: Aetna Medicare Advantage	$26.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.49
Rate for Payer: Cigna Commercial	$13.95
Rate for Payer: Cigna Medicare Advantage	$8.17
Rate for Payer: Clover Medicare Advantage	$7.76
Rate for Payer: EmblemHealth Commercial	$24.51
Rate for Payer: Humana Medicare Advantage	$8.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.37
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.18
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.17
Rate for Payer: Wellcare Medicare Advantage	$8.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

VOLATILES

Facility

$213.65

Service Code	HCPCS 80320
Hospital Charge Code	3035089C
Hospital Revenue Code	301
Min. Negotiated Rate	$32.05
Max. Negotiated Rate	$32.05
Rate for Payer: Qualcare PPO/HMO/WC	$32.05

VOLATILES

Facility

$213.65

Service Code	HCPCS 80320
Hospital Charge Code	3035089C
Hospital Revenue Code	301
Min. Negotiated Rate	$5.66
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$81.19
Rate for Payer: Aetna Medicare Advantage	$64.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.48
Rate for Payer: Cigna Commercial	$106.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$5.66

VOLATILES

Facility

$111.25

Service Code	HCPCS 84600
Hospital Charge Code	3035089D
Hospital Revenue Code	301
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$46.54
Rate for Payer: Aetna Medicare Advantage	$55.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.76
Rate for Payer: Cigna Commercial	$55.62
Rate for Payer: Cigna Medicare Advantage	$17.11
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Medicare Advantage	$17.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

VOLATILES

Facility

$111.25

Service Code	HCPCS 84600
Hospital Charge Code	3035089D
Hospital Revenue Code	301
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$16.69
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

VOLATILES

Facility

$190.45

Service Code	HCPCS 80320
Hospital Charge Code	3035089A
Hospital Revenue Code	301
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$72.37
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$5.05

VOLATILES

Facility

$190.45

Service Code	HCPCS 80320
Hospital Charge Code	3035089A
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

VOLATILES

Facility

$27.90

Service Code	HCPCS 82010
Hospital Charge Code	3035089B
Hospital Revenue Code	307
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$4.18
Rate for Payer: Qualcare PPO/HMO/WC	$4.18

VOLTAGE-GATED CALCIUM CH

Facility

$390.00

Service Code	HCPCS 83519
Hospital Charge Code	39900336
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges