Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ABDOMEN WITH CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74160
Hospital Charge Code	2200046
Hospital Revenue Code	352
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

ABDOMEN WITH CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74160
Hospital Charge Code	2200046
Hospital Revenue Code	352
Min. Negotiated Rate	$145.87
Max. Negotiated Rate	$3,354.00
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	$323.91
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	$2,850.00
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$228.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellpoint Medicaid Managed Care	$251.75

ABDOMEN W/O CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74150
Hospital Charge Code	2200053
Hospital Revenue Code	352
Min. Negotiated Rate	$86.94
Max. Negotiated Rate	$3,354.00
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	$275.32
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	$86.94
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	$2,850.00
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$228.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$251.75

ABDOMEN W/O CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74150
Hospital Charge Code	2200053
Hospital Revenue Code	352
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

ABDOMEN W/WO CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74170
Hospital Charge Code	2200061
Hospital Revenue Code	352
Min. Negotiated Rate	$145.87
Max. Negotiated Rate	$3,354.00
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	$338.80
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	$2,850.00
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$228.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellpoint Medicaid Managed Care	$251.75

ABDOMEN W/WO CONTRAST

Facility

$9,500.00

Service Code	HCPCS 74170
Hospital Charge Code	2200061
Hospital Revenue Code	352
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

ABDOMINAL AORTA

Facility

$6,700.00

Service Code	HCPCS 76705
Hospital Charge Code	94061165
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

ABDOMINAL AORTA

Facility

$6,700.00

Service Code	HCPCS 76705
Hospital Charge Code	94061165
Hospital Revenue Code	402
Min. Negotiated Rate	$85.18
Max. Negotiated Rate	$2,517.00
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	$85.18
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	$2,010.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$161.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$177.55

ABDOMINAL AORTOGRAM

Facility

$13,077.65

Service Code	HCPCS 76525
Hospital Charge Code	1600000660
Hospital Revenue Code	360
Min. Negotiated Rate	$1,961.65
Max. Negotiated Rate	$1,961.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.65

ABDOMINAL AORTOGRAM

Facility

$21,359.77

Hospital Charge Code	2009045
Hospital Revenue Code	323
Min. Negotiated Rate	$514.77
Max. Negotiated Rate	$10,679.89
Rate for Payer: Aetna Commercial	$8,116.71
Rate for Payer: Aetna Medicare Advantage	$6,407.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,446.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,446.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,446.74
Rate for Payer: Cigna Commercial	$10,679.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,407.93
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$514.77
Rate for Payer: Wellpoint Medicaid Managed Care	$566.03

ABDOMINAL AORTOGRAM

Facility

$13,077.65

Service Code	HCPCS 76525
Hospital Charge Code	1600000660
Hospital Revenue Code	360
Min. Negotiated Rate	$315.17
Max. Negotiated Rate	$6,538.82
Rate for Payer: Aetna Commercial	$4,969.51
Rate for Payer: Aetna Medicare Advantage	$3,923.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,334.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,334.80
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	$3,334.80
Rate for Payer: Cigna Commercial	$6,538.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,923.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.65
Rate for Payer: UnitedHealthcare Community & State	$315.17
Rate for Payer: Wellpoint Medicaid Managed Care	$346.56

ABDOMINAL AORTOGRAM

Facility

$21,359.77

Hospital Charge Code	2009045
Hospital Revenue Code	323
Min. Negotiated Rate	$3,203.97
Max. Negotiated Rate	$3,203.97
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97

ABDOMINAL BINDER 3PANEL 30-45

Facility

$38.55

Hospital Charge Code	270649881
Hospital Revenue Code	270
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$5.78
Rate for Payer: Qualcare PPO/HMO/WC	$5.78

ABDOMINAL BINDER 3PANEL 30-45

Facility

$38.55

Hospital Charge Code	270649881
Hospital Revenue Code	270
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$19.27
Rate for Payer: Aetna Commercial	$14.65
Rate for Payer: Aetna Medicare Advantage	$11.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.83
Rate for Payer: Cigna Commercial	$19.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.56
Rate for Payer: Oxford Commercial	$7.71
Rate for Payer: Qualcare PPO/HMO/WC	$5.78
Rate for Payer: UnitedHealthcare Commercial	$7.71
Rate for Payer: UnitedHealthcare Community & State	$0.93
Rate for Payer: Wellpoint Medicaid Managed Care	$1.02

ABDOMINAL BINDER 3PANEL 46-64

Facility

$38.95

Hospital Charge Code	270649882
Hospital Revenue Code	270
Min. Negotiated Rate	$5.84
Max. Negotiated Rate	$5.84
Rate for Payer: Qualcare PPO/HMO/WC	$5.84

ABDOMINAL BINDER 3PANEL 46-64

Facility

$38.95

Hospital Charge Code	270649882
Hospital Revenue Code	270
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$19.48
Rate for Payer: Aetna Commercial	$14.80
Rate for Payer: Aetna Medicare Advantage	$11.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.93
Rate for Payer: Cigna Commercial	$19.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.69
Rate for Payer: Oxford Commercial	$7.79
Rate for Payer: Qualcare PPO/HMO/WC	$5.84
Rate for Payer: UnitedHealthcare Commercial	$7.79
Rate for Payer: UnitedHealthcare Community & State	$0.94
Rate for Payer: Wellpoint Medicaid Managed Care	$1.03

ABDOMINAL BINDER 3 PANEL 74-84

Facility

$51.55

Hospital Charge Code	270649883
Hospital Revenue Code	270
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$25.77
Rate for Payer: Aetna Commercial	$19.59
Rate for Payer: Aetna Medicare Advantage	$15.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.15
Rate for Payer: Cigna Commercial	$25.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.46
Rate for Payer: Oxford Commercial	$10.31
Rate for Payer: Qualcare PPO/HMO/WC	$7.73
Rate for Payer: UnitedHealthcare Commercial	$10.31
Rate for Payer: UnitedHealthcare Community & State	$1.24
Rate for Payer: Wellpoint Medicaid Managed Care	$1.37

ABDOMINAL BINDER 3 PANEL 74-84

Facility

$51.55

Hospital Charge Code	270649883
Hospital Revenue Code	270
Min. Negotiated Rate	$7.73
Max. Negotiated Rate	$7.73
Rate for Payer: Qualcare PPO/HMO/WC	$7.73

ABDOMINAL MASS

Facility

$692.10

Service Code	HCPCS 88305
Hospital Charge Code	3000501
Hospital Revenue Code	310
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$223.48
Rate for Payer: Aetna Commercial	$168.40
Rate for Payer: Aetna Medicare Advantage	$200.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.48
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$61.91
Rate for Payer: Clover Medicare Advantage	$58.81
Rate for Payer: EmblemHealth Commercial	$185.73
Rate for Payer: Humana Medicare Advantage	$63.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$61.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.63
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$103.81
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$57.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.91
Rate for Payer: Wellcare Medicare Advantage	$61.91
Rate for Payer: Wellpoint Medicaid Managed Care	$18.34

ABDOMINAL MASS

Facility

$692.10

Service Code	HCPCS 88305
Hospital Charge Code	3000501
Hospital Revenue Code	310
Min. Negotiated Rate	$103.81
Max. Negotiated Rate	$103.81
Rate for Payer: Qualcare PPO/HMO/WC	$103.81

ABDOMINAL PAIN

Facility

$5,867.75

Service Code	APR-DRG 2511
Min. Negotiated Rate	$5,752.70
Max. Negotiated Rate	$5,867.75
Rate for Payer: UnitedHealthcare Community & State	$5,752.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,867.75
Rate for Payer: Wellpoint Medicaid Managed Care	$5,752.70

ABDOMINAL PAIN

Facility

$15,481.40

Service Code	APR-DRG 2514
Min. Negotiated Rate	$15,177.84
Max. Negotiated Rate	$15,481.40
Rate for Payer: UnitedHealthcare Community & State	$15,177.84
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,481.40
Rate for Payer: Wellpoint Medicaid Managed Care	$15,177.84

ABDOMINAL PAIN

Facility

$7,528.76

Service Code	APR-DRG 2512
Min. Negotiated Rate	$7,381.14
Max. Negotiated Rate	$7,528.76
Rate for Payer: UnitedHealthcare Community & State	$7,381.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,528.76
Rate for Payer: Wellpoint Medicaid Managed Care	$7,381.14

ABDOMINAL PAIN

Facility

$9,950.68

Service Code	APR-DRG 2513
Min. Negotiated Rate	$9,755.57
Max. Negotiated Rate	$9,950.68
Rate for Payer: UnitedHealthcare Community & State	$9,755.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,950.68
Rate for Payer: Wellpoint Medicaid Managed Care	$9,755.57

ABDOMNAL AORTA W/ RUN-OFF

Facility

$6,122.00

Hospital Charge Code	2009050
Hospital Revenue Code	323
Min. Negotiated Rate	$147.54
Max. Negotiated Rate	$3,061.00
Rate for Payer: Aetna Commercial	$2,326.36
Rate for Payer: Aetna Medicare Advantage	$1,836.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,561.11
Rate for Payer: Cigna Commercial	$3,061.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.60
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$918.30
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$147.54
Rate for Payer: Wellpoint Medicaid Managed Care	$162.23

Know your out-of-pocket cost for care.

All Charges