Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

XR PERC PLACE IVC FILTER

Facility

$1,807.55

Hospital Charge Code	5600019
Hospital Revenue Code	320
Min. Negotiated Rate	$271.13
Max. Negotiated Rate	$271.13
Rate for Payer: Qualcare PPO/HMO/WC	$271.13

XR PERCUT ABLATE LIVER RF

Facility

$21,118.85

Service Code	HCPCS 47382
Hospital Charge Code	5600153
Hospital Revenue Code	361
Min. Negotiated Rate	$508.96
Max. Negotiated Rate	$25,925.77
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$25,925.77
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,335.65
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.83
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$508.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$559.65

XR PERCUT ABLATE LIVER RF

Facility

$21,118.85

Service Code	HCPCS 47382
Hospital Charge Code	5600153
Hospital Revenue Code	361
Min. Negotiated Rate	$3,167.83
Max. Negotiated Rate	$3,167.83
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.83

XR PERCUTANEOUS PORT VEIN CATH

Facility

$3,157.80

Service Code	HCPCS 36481
Hospital Charge Code	5600018
Hospital Revenue Code	361
Min. Negotiated Rate	$76.10
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,199.96
Rate for Payer: Aetna Medicare Advantage	$947.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$805.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$805.24
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	$805.24
Rate for Payer: Cigna Commercial	$1,578.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$947.34
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$473.67
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$76.10
Rate for Payer: Wellpoint Medicaid Managed Care	$83.68

XR PERCUTANEOUS PORT VEIN CATH

Facility

$3,179.25

Service Code	HCPCS 36481
Hospital Charge Code	7411445
Hospital Revenue Code	361
Min. Negotiated Rate	$476.89
Max. Negotiated Rate	$476.89
Rate for Payer: Qualcare PPO/HMO/WC	$476.89

XR PERCUTANEOUS PORT VEIN CATH

Facility

$3,179.25

Service Code	HCPCS 36481
Hospital Charge Code	7411445
Hospital Revenue Code	361
Min. Negotiated Rate	$76.62
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,208.12
Rate for Payer: Aetna Medicare Advantage	$953.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$810.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$810.71
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	$810.71
Rate for Payer: Cigna Commercial	$1,589.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$953.77
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$476.89
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$76.62
Rate for Payer: Wellpoint Medicaid Managed Care	$84.25

XR PERCUTANEOUS PORT VEIN CATH

Facility

$3,157.80

Service Code	HCPCS 36481
Hospital Charge Code	5600018
Hospital Revenue Code	361
Min. Negotiated Rate	$473.67
Max. Negotiated Rate	$473.67
Rate for Payer: Qualcare PPO/HMO/WC	$473.67

XR PERCUT KYPHOPLASTY LUMBAR

Facility

$15,443.85

Service Code	HCPCS 22525
Hospital Charge Code	2600200
Hospital Revenue Code	361
Min. Negotiated Rate	$372.20
Max. Negotiated Rate	$7,721.93
Rate for Payer: Aetna Commercial	$5,868.66
Rate for Payer: Aetna Medicare Advantage	$4,633.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,938.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,938.18
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	$3,938.18
Rate for Payer: Cigna Commercial	$7,721.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,633.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58
Rate for Payer: UnitedHealthcare Community & State	$372.20
Rate for Payer: Wellpoint Medicaid Managed Care	$409.26

XR PERCUT KYPHOPLASTY LUMBAR

Facility

$15,443.85

Service Code	HCPCS 22525
Hospital Charge Code	2600200
Hospital Revenue Code	361
Min. Negotiated Rate	$2,316.58
Max. Negotiated Rate	$2,316.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,316.58

XR PERICARDIOCENTESIS INITI

Facility

$3,036.85

Service Code	HCPCS 33010
Hospital Charge Code	2004075
Hospital Revenue Code	361
Min. Negotiated Rate	$73.19
Max. Negotiated Rate	$1,518.42
Rate for Payer: Aetna Commercial	$1,154.00
Rate for Payer: Aetna Medicare Advantage	$911.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$774.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$774.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$774.40
Rate for Payer: Cigna Commercial	$1,518.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$911.05
Rate for Payer: Qualcare PPO/HMO/WC	$455.53
Rate for Payer: UnitedHealthcare Community & State	$73.19
Rate for Payer: Wellpoint Medicaid Managed Care	$80.48

XR PERICARDIOCENTESIS INITI

Facility

$3,036.85

Service Code	HCPCS 33010
Hospital Charge Code	2004075
Hospital Revenue Code	361
Min. Negotiated Rate	$455.53
Max. Negotiated Rate	$455.53
Rate for Payer: Qualcare PPO/HMO/WC	$455.53

XR PERICARDIOCENTESIS SUBSEQ**

Facility

$162.00

Service Code	HCPCS 33011
Hospital Charge Code	2004083
Hospital Revenue Code	361
Min. Negotiated Rate	$24.30
Max. Negotiated Rate	$24.30
Rate for Payer: Qualcare PPO/HMO/WC	$24.30

XR PERICARDIOCENTESIS SUBSEQ**

Facility

$162.00

Service Code	HCPCS 33011
Hospital Charge Code	2004083
Hospital Revenue Code	361
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$1,016.00
Rate for Payer: Aetna Commercial	$61.56
Rate for Payer: Aetna Medicare Advantage	$48.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.31
Rate for Payer: Cigna Commercial	$81.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$24.30
Rate for Payer: UnitedHealthcare Community & State	$3.90
Rate for Payer: Wellpoint Medicaid Managed Care	$4.29

XR PERINEORAM

Facility

$906.25

Service Code	HCPCS 74775
Hospital Charge Code	2011372
Hospital Revenue Code	320
Min. Negotiated Rate	$135.94
Max. Negotiated Rate	$135.94
Rate for Payer: Qualcare PPO/HMO/WC	$135.94

XR PERINEORAM

Facility

$906.25

Service Code	HCPCS 74775
Hospital Charge Code	2011372
Hospital Revenue Code	320
Min. Negotiated Rate	$21.84
Max. Negotiated Rate	$1,975.00
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	$81.31
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	$198.43
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	$271.88
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.94
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$21.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$24.02

XR PERITONEOGRAM

Facility

$1,224.75

Service Code	HCPCS 74190
Hospital Charge Code	2011373
Hospital Revenue Code	320
Min. Negotiated Rate	$29.52
Max. Negotiated Rate	$2,343.27
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$454.41
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$367.43
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$183.71
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$29.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$32.46

XR PERITONEOGRAM

Facility

$1,224.75

Service Code	HCPCS 74190
Hospital Charge Code	2011373
Hospital Revenue Code	320
Min. Negotiated Rate	$183.71
Max. Negotiated Rate	$183.71
Rate for Payer: Qualcare PPO/HMO/WC	$183.71

XR PERQ RF ABLATE TX PUL TUMOR

Facility

$21,118.75

Service Code	HCPCS 32998
Hospital Charge Code	5600108
Hospital Revenue Code	361
Min. Negotiated Rate	$3,167.81
Max. Negotiated Rate	$3,167.81
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.81

XR PERQ RF ABLATE TX PUL TUMOR

Facility

$21,118.75

Service Code	HCPCS 32998
Hospital Charge Code	5600108
Hospital Revenue Code	361
Min. Negotiated Rate	$508.96
Max. Negotiated Rate	$25,925.77
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$25,925.77
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,335.62
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,167.81
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$508.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$559.65

XR PHARX/LARX W/ FLO

Facility

$491.25

Service Code	HCPCS 70370
Hospital Charge Code	2000495
Hospital Revenue Code	320
Min. Negotiated Rate	$11.84
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$281.22
Rate for Payer: Aetna Medicare Advantage	$334.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$103.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.21
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: Cigna Medicare Advantage	$72.37
Rate for Payer: Clover Medicare Advantage	$98.22
Rate for Payer: EmblemHealth Commercial	$310.17
Rate for Payer: Humana Medicare Advantage	$106.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$103.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.38
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.69
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$11.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$103.39
Rate for Payer: Wellcare Medicare Advantage	$103.39
Rate for Payer: Wellpoint Medicaid Managed Care	$13.02

XR PHARX/LARX W/ FLO

Facility

$491.25

Service Code	HCPCS 70370
Hospital Charge Code	2000495
Hospital Revenue Code	320
Min. Negotiated Rate	$73.69
Max. Negotiated Rate	$73.69
Rate for Payer: Qualcare PPO/HMO/WC	$73.69

XR PHELB VEINS-EXTREMIT TO 20

Facility

$12,426.40

Service Code	HCPCS 37765
Hospital Charge Code	5600148
Hospital Revenue Code	361
Min. Negotiated Rate	$299.48
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	$1,626.00
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	$3,727.92
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$299.48
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	$329.30

XR PHELB VEINS-EXTREMIT TO 20

Facility

$12,426.40

Service Code	HCPCS 37765
Hospital Charge Code	5600148
Hospital Revenue Code	361
Min. Negotiated Rate	$1,863.96
Max. Negotiated Rate	$1,863.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96

XR PHELB VEINS-EXTREMIT TO 20

Facility

$12,426.40

Service Code	HCPCS 37765
Hospital Charge Code	7411539
Hospital Revenue Code	361
Min. Negotiated Rate	$299.48
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	$1,626.00
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	$3,727.92
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$299.48
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	$329.30

XR PHELB VEINS-EXTREMIT TO 20

Facility

$12,426.40

Service Code	HCPCS 37765
Hospital Charge Code	7411539
Hospital Revenue Code	361
Min. Negotiated Rate	$1,863.96
Max. Negotiated Rate	$1,863.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,863.96

Know your out-of-pocket cost for care.

All Charges