Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

XR PHLEB VEINS- EXTERM 20+

Facility

$12,426.40

Service Code	HCPCS 37766
Hospital Charge Code	7411540
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 PHLEB VEINS- EXTERM 20+

Facility

$12,426.40

Service Code	HCPCS 37766
Hospital Charge Code	7411540
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 PHLEB VEINS- EXTERM 20+

Facility

$12,426.40

Service Code	HCPCS 37766
Hospital Charge Code	5600149
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 PHLEB VEINS- EXTERM 20+

Facility

$12,426.40

Service Code	HCPCS 37766
Hospital Charge Code	5600149
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 PHRYNX OR CERVICAL ESOPHAGS

Facility

$1,224.75

Service Code	HCPCS 74210
Hospital Charge Code	2011374
Hospital Revenue Code	320
Min. Negotiated Rate	$183.71
Max. Negotiated Rate	$183.71
Rate for Payer: Qualcare PPO/HMO/WC	$183.71

XR PHRYNX OR CERVICAL ESOPHAGS

Facility

$1,224.75

Service Code	HCPCS 74210
Hospital Charge Code	2011374
Hospital Revenue Code	320
Min. Negotiated Rate	$29.52
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$566.79
Rate for Payer: Aetna Medicare Advantage	$675.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$208.38
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	$752.19
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: Cigna Medicare Advantage	$145.87
Rate for Payer: Clover Medicare Advantage	$197.96
Rate for Payer: EmblemHealth Commercial	$625.14
Rate for Payer: Humana Medicare Advantage	$214.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$208.38
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	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellpoint Medicaid Managed Care	$32.46

XR PLACE CECOSTOMY TUBE PERC

Facility

$5,547.05

Service Code	HCPCS 49442
Hospital Charge Code	5600161
Hospital Revenue Code	361
Min. Negotiated Rate	$832.06
Max. Negotiated Rate	$832.06
Rate for Payer: Qualcare PPO/HMO/WC	$832.06

XR PLACE CECOSTOMY TUBE PERC

Facility

$5,547.05

Service Code	HCPCS 49442
Hospital Charge Code	5600161
Hospital Revenue Code	361
Min. Negotiated Rate	$133.68
Max. Negotiated Rate	$5,311.00
Rate for Payer: Aetna Commercial	$3,866.86
Rate for Payer: Aetna Medicare Advantage	$4,606.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,131.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,131.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,421.64
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	$5,131.69
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: Cigna Medicare Advantage	$1,421.64
Rate for Payer: Clover Medicare Advantage	$1,350.56
Rate for Payer: EmblemHealth Commercial	$4,264.92
Rate for Payer: Humana Medicare Advantage	$1,464.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,421.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,664.12
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$832.06
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$133.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,421.64
Rate for Payer: Wellcare Medicare Advantage	$1,421.64
Rate for Payer: Wellpoint Medicaid Managed Care	$147.00

XR PLACE DUOD/JEJ TUBE PERC

Facility

$3,929.65

Service Code	HCPCS 49441
Hospital Charge Code	5600160
Hospital Revenue Code	361
Min. Negotiated Rate	$94.70
Max. Negotiated Rate	$8,229.07
Rate for Payer: Aetna Commercial	$6,200.81
Rate for Payer: Aetna Medicare Advantage	$7,386.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,229.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,229.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,279.71
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	$8,229.07
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: Cigna Medicare Advantage	$2,279.71
Rate for Payer: Clover Medicare Advantage	$2,165.72
Rate for Payer: EmblemHealth Commercial	$6,839.13
Rate for Payer: Humana Medicare Advantage	$2,348.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,279.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,178.89
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$589.45
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$94.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,279.71
Rate for Payer: Wellcare Medicare Advantage	$2,279.71
Rate for Payer: Wellpoint Medicaid Managed Care	$104.14

XR PLACE DUOD/JEJ TUBE PERC

Facility

$3,929.65

Service Code	HCPCS 49441
Hospital Charge Code	5600160
Hospital Revenue Code	361
Min. Negotiated Rate	$589.45
Max. Negotiated Rate	$589.45
Rate for Payer: Qualcare PPO/HMO/WC	$589.45

XR PTA BALLOON FEMOR POPLITEAL

Facility

$8,843.05

Hospital Charge Code	5600006
Hospital Revenue Code	361
Min. Negotiated Rate	$1,326.46
Max. Negotiated Rate	$1,326.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,326.46

XR PTA BALLOON FEMOR POPLITEAL

Facility

$8,843.05

Hospital Charge Code	5600006
Hospital Revenue Code	361
Min. Negotiated Rate	$213.12
Max. Negotiated Rate	$4,421.52
Rate for Payer: Aetna Commercial	$3,360.36
Rate for Payer: Aetna Medicare Advantage	$2,652.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,254.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,254.98
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	$2,254.98
Rate for Payer: Cigna Commercial	$4,421.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,652.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,326.46
Rate for Payer: UnitedHealthcare Community & State	$213.12
Rate for Payer: Wellpoint Medicaid Managed Care	$234.34

XR PTA, BALLOON, ILIAC, BILAT

Facility

$21,962.30

Hospital Charge Code	2011175B
Hospital Revenue Code	360
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

XR PTA, BALLOON, ILIAC, BILAT

Facility

$21,962.30

Hospital Charge Code	2000843
Hospital Revenue Code	480
Min. Negotiated Rate	$529.29
Max. Negotiated Rate	$10,981.15
Rate for Payer: Aetna Commercial	$8,345.67
Rate for Payer: Aetna Medicare Advantage	$6,588.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,600.39
Rate for Payer: Cigna Commercial	$10,981.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,588.69
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$529.29
Rate for Payer: Wellpoint Medicaid Managed Care	$582.00

XR PTA, BALLOON, ILIAC, BILAT

Facility

$21,962.30

Hospital Charge Code	2011175B
Hospital Revenue Code	360
Min. Negotiated Rate	$529.29
Max. Negotiated Rate	$10,981.15
Rate for Payer: Aetna Commercial	$8,345.67
Rate for Payer: Aetna Medicare Advantage	$6,588.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.39
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	$5,600.39
Rate for Payer: Cigna Commercial	$10,981.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,588.69
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34
Rate for Payer: UnitedHealthcare Community & State	$529.29
Rate for Payer: Wellpoint Medicaid Managed Care	$582.00

XR PTA, BALLOON, ILIAC, BILAT

Facility

$21,962.30

Hospital Charge Code	2000843
Hospital Revenue Code	480
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

XR PTA EA ADD'L PERIPH ART

Facility

$1,547.25

Service Code	HCPCS 75964
Hospital Charge Code	2002533
Hospital Revenue Code	320
Min. Negotiated Rate	$232.09
Max. Negotiated Rate	$232.09
Rate for Payer: Qualcare PPO/HMO/WC	$232.09

XR PTA EA ADD'L PERIPH ART

Facility

$1,547.25

Service Code	HCPCS 75964
Hospital Charge Code	2002533
Hospital Revenue Code	320
Min. Negotiated Rate	$37.29
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$587.96
Rate for Payer: Aetna Medicare Advantage	$464.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.55
Rate for Payer: Cigna Commercial	$773.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.18
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.09
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$37.29
Rate for Payer: Wellpoint Medicaid Managed Care	$41.00

XR PTA EA ADD'L VISCERAL ARTER

Facility

$2,496.85

Service Code	HCPCS 75968
Hospital Charge Code	2002558
Hospital Revenue Code	320
Min. Negotiated Rate	$374.53
Max. Negotiated Rate	$374.53
Rate for Payer: Qualcare PPO/HMO/WC	$374.53

XR PTA EA ADD'L VISCERAL ARTER

Facility

$2,496.85

Service Code	HCPCS 75968
Hospital Charge Code	2002558
Hospital Revenue Code	320
Min. Negotiated Rate	$60.17
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$948.80
Rate for Payer: Aetna Medicare Advantage	$749.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$636.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$636.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$636.70
Rate for Payer: Cigna Commercial	$1,248.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$749.05
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$374.53
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$60.17
Rate for Payer: Wellpoint Medicaid Managed Care	$66.17

XR PTA VENOUS

Facility

$21,962.30

Service Code	HCPCS 35476
Hospital Charge Code	2011179
Hospital Revenue Code	361
Min. Negotiated Rate	$3,294.34
Max. Negotiated Rate	$3,294.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34

XR PTA VENOUS

Facility

$21,962.30

Service Code	HCPCS 35476
Hospital Charge Code	2011179
Hospital Revenue Code	361
Min. Negotiated Rate	$529.29
Max. Negotiated Rate	$10,981.15
Rate for Payer: Aetna Commercial	$8,345.67
Rate for Payer: Aetna Medicare Advantage	$6,588.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,600.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,600.39
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	$5,600.39
Rate for Payer: Cigna Commercial	$10,981.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,588.69
Rate for Payer: Qualcare PPO/HMO/WC	$3,294.34
Rate for Payer: UnitedHealthcare Community & State	$529.29
Rate for Payer: Wellpoint Medicaid Managed Care	$582.00

XR PTC CATHETER INTRO

Facility

$13,811.90

Service Code	HCPCS 47510
Hospital Charge Code	2004489
Hospital Revenue Code	361
Min. Negotiated Rate	$332.87
Max. Negotiated Rate	$6,905.95
Rate for Payer: Aetna Commercial	$5,248.52
Rate for Payer: Aetna Medicare Advantage	$4,143.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,522.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,522.03
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	$3,522.03
Rate for Payer: Cigna Commercial	$6,905.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,143.57
Rate for Payer: Qualcare PPO/HMO/WC	$2,071.78
Rate for Payer: UnitedHealthcare Community & State	$332.87
Rate for Payer: Wellpoint Medicaid Managed Care	$366.02

XR PTC CATHETER INTRO

Facility

$13,811.90

Service Code	HCPCS 47510
Hospital Charge Code	2004489
Hospital Revenue Code	361
Min. Negotiated Rate	$2,071.78
Max. Negotiated Rate	$2,071.78
Rate for Payer: Qualcare PPO/HMO/WC	$2,071.78

XR PYELOGRAM RETROGRADE

Facility

$5,100.00

Service Code	HCPCS 74420
Hospital Charge Code	2000750
Hospital Revenue Code	320
Min. Negotiated Rate	$94.86
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$1,127.36
Rate for Payer: Aetna Medicare Advantage	$1,342.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$414.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,496.11
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: Cigna Medicare Advantage	$290.13
Rate for Payer: Clover Medicare Advantage	$393.75
Rate for Payer: EmblemHealth Commercial	$1,243.41
Rate for Payer: Humana Medicare Advantage	$426.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$414.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$414.47
Rate for Payer: Wellcare Medicare Advantage	$414.47
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

Know your out-of-pocket cost for care.

All Charges