Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

XR INJ W/FLUOR EVAL CV DEVICE

Facility

$1,096.10

Service Code	HCPCS 36598
Hospital Charge Code	5600140
Hospital Revenue Code	361
Min. Negotiated Rate	$164.41
Max. Negotiated Rate	$164.41
Rate for Payer: Qualcare PPO/HMO/WC	$164.41

XR INJ W/FLUOR EVAL CV DEVICE

Facility

$1,113.85

Service Code	HCPCS 36598
Hospital Charge Code	411036598
Hospital Revenue Code	361
Min. Negotiated Rate	$26.84
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$912.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$912.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
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	$912.17
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.15
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$167.08
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$26.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$29.52

XR INJ W/FLUOR EVAL CV DEVICE

Facility

$1,096.10

Service Code	HCPCS 36598
Hospital Charge Code	321036598
Hospital Revenue Code	361
Min. Negotiated Rate	$164.41
Max. Negotiated Rate	$164.41
Rate for Payer: Qualcare PPO/HMO/WC	$164.41

XR INJ W/FLUOR EVAL CV DEVICE

Facility

$1,096.10

Service Code	HCPCS 36598
Hospital Charge Code	321036598
Hospital Revenue Code	361
Min. Negotiated Rate	$26.42
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$912.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$912.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
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	$912.17
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$328.83
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$164.41
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$26.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$29.05

XR INJ W/FLUOR EVAL CV DEVICE

Facility

$1,113.85

Service Code	HCPCS 36598
Hospital Charge Code	366836598
Hospital Revenue Code	361
Min. Negotiated Rate	$26.84
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$687.34
Rate for Payer: Aetna Medicare Advantage	$818.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$912.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$912.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$252.70
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	$912.17
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: Cigna Medicare Advantage	$252.70
Rate for Payer: Clover Medicare Advantage	$240.06
Rate for Payer: EmblemHealth Commercial	$758.10
Rate for Payer: Humana Medicare Advantage	$260.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$252.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.15
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$167.08
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$26.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$252.70
Rate for Payer: Wellcare Medicare Advantage	$252.70
Rate for Payer: Wellpoint Medicaid Managed Care	$29.52

XR INJ W/FLUOR EVAL CV DEVICE

Facility

$1,113.85

Service Code	HCPCS 36598
Hospital Charge Code	366836598
Hospital Revenue Code	361
Min. Negotiated Rate	$167.08
Max. Negotiated Rate	$167.08
Rate for Payer: Qualcare PPO/HMO/WC	$167.08

XR INSERT ABDOM DRAIN PERM

Facility

$13,564.25

Service Code	HCPCS 49421
Hospital Charge Code	5600157
Hospital Revenue Code	361
Min. Negotiated Rate	$2,034.64
Max. Negotiated Rate	$2,034.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,034.64

XR INSERT ABDOM DRAIN PERM

Facility

$13,564.25

Service Code	HCPCS 49421
Hospital Charge Code	5600157
Hospital Revenue Code	361
Min. Negotiated Rate	$326.90
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,069.28
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,034.64
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$326.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$359.45

XR INSERT ABDOM DRAIN TEMP

Facility

$13,564.25

Hospital Charge Code	5600156
Hospital Revenue Code	361
Min. Negotiated Rate	$326.90
Max. Negotiated Rate	$6,782.12
Rate for Payer: Aetna Commercial	$5,154.41
Rate for Payer: Aetna Medicare Advantage	$4,069.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,458.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,458.88
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	$3,458.88
Rate for Payer: Cigna Commercial	$6,782.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,069.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,034.64
Rate for Payer: UnitedHealthcare Community & State	$326.90
Rate for Payer: Wellpoint Medicaid Managed Care	$359.45

XR INSERT ABDOM DRAIN TEMP

Facility

$13,564.25

Hospital Charge Code	5600156
Hospital Revenue Code	361
Min. Negotiated Rate	$2,034.64
Max. Negotiated Rate	$2,034.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,034.64

XR INSERTION OF AIRWAY CATH

Facility

$2,480.00

Hospital Charge Code	2011225
Hospital Revenue Code	320
Min. Negotiated Rate	$59.77
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$942.40
Rate for Payer: Aetna Medicare Advantage	$744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$632.40
Rate for Payer: Cigna Commercial	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$372.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$59.77
Rate for Payer: Wellpoint Medicaid Managed Care	$65.72

XR INSERTION OF AIRWAY CATH

Facility

$2,480.00

Hospital Charge Code	2011225
Hospital Revenue Code	320
Min. Negotiated Rate	$372.00
Max. Negotiated Rate	$372.00
Rate for Payer: Qualcare PPO/HMO/WC	$372.00

XR INSERTION OF CATHETER, VEIN

Facility

$3,709.52

Service Code	HCPCS 36488
Hospital Charge Code	2011245
Hospital Revenue Code	320
Min. Negotiated Rate	$89.40
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$1,409.62
Rate for Payer: Aetna Medicare Advantage	$1,112.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$945.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$945.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$945.93
Rate for Payer: Cigna Commercial	$1,854.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,112.86
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$556.43
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$89.40
Rate for Payer: Wellpoint Medicaid Managed Care	$98.30

XR INSERTION OF CATHETER, VEIN

Facility

$3,709.52

Service Code	HCPCS 36488
Hospital Charge Code	2011245
Hospital Revenue Code	320
Min. Negotiated Rate	$556.43
Max. Negotiated Rate	$556.43
Rate for Payer: Qualcare PPO/HMO/WC	$556.43

XR INSERTION OF INFUSION PUMP

Facility

$13,510.10

Service Code	HCPCS 36563
Hospital Charge Code	2011250
Hospital Revenue Code	361
Min. Negotiated Rate	$325.59
Max. Negotiated Rate	$23,862.86
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,862.86
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$6,610.76
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,053.03
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,026.52
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$325.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$358.02

XR INSERTION OF INFUSION PUMP

Facility

$13,510.10

Service Code	HCPCS 36563
Hospital Charge Code	2011250
Hospital Revenue Code	361
Min. Negotiated Rate	$2,026.52
Max. Negotiated Rate	$2,026.52
Rate for Payer: Qualcare PPO/HMO/WC	$2,026.52

XR INSERT NONTUNNEL CV CATH

Facility

$6,107.50

Service Code	HCPCS 36555
Hospital Charge Code	5600124
Hospital Revenue Code	361
Min. Negotiated Rate	$147.19
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,832.25
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$916.12
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$147.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$161.85

XR INSERT NONTUNNEL CV CATH

Facility

$6,107.50

Service Code	HCPCS 36555
Hospital Charge Code	5600124
Hospital Revenue Code	361
Min. Negotiated Rate	$916.12
Max. Negotiated Rate	$916.12
Rate for Payer: Qualcare PPO/HMO/WC	$916.12

XR INSERT NONTUNNEL CV CATH

Facility

$6,107.50

Service Code	HCPCS 36555
Hospital Charge Code	7411447
Hospital Revenue Code	361
Min. Negotiated Rate	$916.12
Max. Negotiated Rate	$916.12
Rate for Payer: Qualcare PPO/HMO/WC	$916.12

XR INSERT NONTUNNEL CV CATH

Facility

$6,107.50

Service Code	HCPCS 36555
Hospital Charge Code	7411447
Hospital Revenue Code	361
Min. Negotiated Rate	$147.19
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,832.25
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$916.12
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$147.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$161.85

XR INSERT PACEMAKER W/ FLUORO

Facility

$817.65

Hospital Charge Code	2011090
Hospital Revenue Code	320
Min. Negotiated Rate	$19.71
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$310.71
Rate for Payer: Aetna Medicare Advantage	$245.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.50
Rate for Payer: Cigna Commercial	$408.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.29
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.65
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$19.71
Rate for Payer: Wellpoint Medicaid Managed Care	$21.67

XR INSERT PACEMAKER W/ FLUORO

Facility

$817.65

Hospital Charge Code	2011090
Hospital Revenue Code	320
Min. Negotiated Rate	$122.65
Max. Negotiated Rate	$122.65
Rate for Payer: Qualcare PPO/HMO/WC	$122.65

XR INSERT PICC CATH < 5 YEARS

Facility

$5,025.35

Service Code	HCPCS 36568
Hospital Charge Code	7411458
Hospital Revenue Code	361
Min. Negotiated Rate	$121.11
Max. Negotiated Rate	$6,750.64
Rate for Payer: Aetna Commercial	$5,086.78
Rate for Payer: Aetna Medicare Advantage	$6,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,750.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,750.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,870.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,750.64
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: Cigna Medicare Advantage	$1,870.14
Rate for Payer: Clover Medicare Advantage	$1,776.63
Rate for Payer: EmblemHealth Commercial	$5,610.42
Rate for Payer: Humana Medicare Advantage	$1,926.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,870.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,507.61
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$753.80
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$121.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellpoint Medicaid Managed Care	$133.17

XR INSERT PICC CATH < 5 YEARS

Facility

$5,025.35

Service Code	HCPCS 36568
Hospital Charge Code	7411458
Hospital Revenue Code	361
Min. Negotiated Rate	$753.80
Max. Negotiated Rate	$753.80
Rate for Payer: Qualcare PPO/HMO/WC	$753.80

XR INSERT PICC CATH < 5 YEARS

Facility

$5,025.35

Service Code	HCPCS 36568
Hospital Charge Code	5600129
Hospital Revenue Code	361
Min. Negotiated Rate	$753.80
Max. Negotiated Rate	$753.80
Rate for Payer: Qualcare PPO/HMO/WC	$753.80

Know your out-of-pocket cost for care.

All Charges