Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BUTTON NSL SEPT 1PC SM AP29-3

Facility

$811.25

Hospital Charge Code	270608812
Hospital Revenue Code	278
Min. Negotiated Rate	$121.69
Max. Negotiated Rate	$196.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$178.47
Rate for Payer: Qualcare PPO/HMO/WC	$121.69

BUTTON NSL SEPT 2PC LG AP30-7

Facility

$616.00

Hospital Charge Code	270608816
Hospital Revenue Code	278
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$308.00
Rate for Payer: Aetna Commercial	$234.08
Rate for Payer: Aetna Medicare Advantage	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.08
Rate for Payer: Cigna Commercial	$308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$92.40
Rate for Payer: UnitedHealthcare Community & State	$14.85
Rate for Payer: Wellpoint Medicaid Managed Care	$16.32

BUTTON NSL SEPT 2PC LG AP30-7

Facility

$616.00

Hospital Charge Code	270608816
Hospital Revenue Code	278
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$149.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$92.40

BUTTON NSL SEPT 2PC MED AP30

Facility

$616.00

Hospital Charge Code	270608815
Hospital Revenue Code	278
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$149.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$92.40

BUTTON NSL SEPT 2PC MED AP30

Facility

$616.00

Hospital Charge Code	270608815
Hospital Revenue Code	278
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$308.00
Rate for Payer: Aetna Commercial	$234.08
Rate for Payer: Aetna Medicare Advantage	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.08
Rate for Payer: Cigna Commercial	$308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$92.40
Rate for Payer: UnitedHealthcare Community & State	$14.85
Rate for Payer: Wellpoint Medicaid Managed Care	$16.32

BUTTON NSL SEPT 2PC XLG AP30-8

Facility

$616.00

Hospital Charge Code	270608817
Hospital Revenue Code	278
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$149.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$92.40

BUTTON NSL SEPT 2PC XLG AP30-8

Facility

$616.00

Hospital Charge Code	270608817
Hospital Revenue Code	278
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$308.00
Rate for Payer: Aetna Commercial	$234.08
Rate for Payer: Aetna Medicare Advantage	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.08
Rate for Payer: Cigna Commercial	$308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$92.40
Rate for Payer: UnitedHealthcare Community & State	$14.85
Rate for Payer: Wellpoint Medicaid Managed Care	$16.32

BUTTON PATELLA 34MM 11-150828

Facility

$3,045.00

Hospital Charge Code	270606322
Hospital Revenue Code	278
Min. Negotiated Rate	$456.75
Max. Negotiated Rate	$736.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$609.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$736.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$669.90
Rate for Payer: Qualcare PPO/HMO/WC	$456.75

BUTTON PATELLA 34MM 11-150828

Facility

$3,045.00

Hospital Charge Code	270606322
Hospital Revenue Code	278
Min. Negotiated Rate	$73.38
Max. Negotiated Rate	$1,522.50
Rate for Payer: Aetna Commercial	$1,157.10
Rate for Payer: Aetna Medicare Advantage	$913.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$776.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$776.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$609.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$776.48
Rate for Payer: Cigna Commercial	$1,522.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$736.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$669.90
Rate for Payer: Qualcare PPO/HMO/WC	$456.75
Rate for Payer: UnitedHealthcare Community & State	$73.38
Rate for Payer: Wellpoint Medicaid Managed Care	$80.69

BUTTON PROXIMAL TENODESIS

Facility

$2,175.00

Hospital Charge Code	270676803
Hospital Revenue Code	272
Min. Negotiated Rate	$326.25
Max. Negotiated Rate	$326.25
Rate for Payer: Qualcare PPO/HMO/WC	$326.25

BUTTON PROXIMAL TENODESIS

Facility

$2,175.00

Hospital Charge Code	270676803
Hospital Revenue Code	272
Min. Negotiated Rate	$52.42
Max. Negotiated Rate	$1,087.50
Rate for Payer: Aetna Commercial	$826.50
Rate for Payer: Aetna Medicare Advantage	$652.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$554.62
Rate for Payer: Cigna Commercial	$1,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$652.50
Rate for Payer: Oxford Commercial	$435.00
Rate for Payer: Qualcare PPO/HMO/WC	$326.25
Rate for Payer: UnitedHealthcare Commercial	$435.00
Rate for Payer: UnitedHealthcare Community & State	$52.42
Rate for Payer: Wellpoint Medicaid Managed Care	$57.64

BUTTON ZIM PATELLA 5972-65-41

Facility

$3,436.85

Hospital Charge Code	270608597
Hospital Revenue Code	272
Min. Negotiated Rate	$515.53
Max. Negotiated Rate	$515.53
Rate for Payer: Qualcare PPO/HMO/WC	$515.53

BUTTON ZIM PATELLA 5972-65-41

Facility

$3,436.85

Hospital Charge Code	270608597
Hospital Revenue Code	272
Min. Negotiated Rate	$82.83
Max. Negotiated Rate	$1,718.42
Rate for Payer: Aetna Commercial	$1,306.00
Rate for Payer: Aetna Medicare Advantage	$1,031.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$876.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$876.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$876.40
Rate for Payer: Cigna Commercial	$1,718.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,031.06
Rate for Payer: Oxford Commercial	$687.37
Rate for Payer: Qualcare PPO/HMO/WC	$515.53
Rate for Payer: UnitedHealthcare Commercial	$687.37
Rate for Payer: UnitedHealthcare Community & State	$82.83
Rate for Payer: Wellpoint Medicaid Managed Care	$91.08

BUY ROUND FLUTE 4.0 MM 6

Facility

$1,435.00

Hospital Charge Code	270658117
Hospital Revenue Code	278
Min. Negotiated Rate	$34.58
Max. Negotiated Rate	$717.50
Rate for Payer: Aetna Commercial	$545.30
Rate for Payer: Aetna Medicare Advantage	$430.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$365.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$365.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$287.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$365.93
Rate for Payer: Cigna Commercial	$717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$315.70
Rate for Payer: Qualcare PPO/HMO/WC	$215.25
Rate for Payer: UnitedHealthcare Community & State	$34.58
Rate for Payer: Wellpoint Medicaid Managed Care	$38.03

BUY ROUND FLUTE 4.0 MM 6

Facility

$1,435.00

Hospital Charge Code	270658117
Hospital Revenue Code	278
Min. Negotiated Rate	$215.25
Max. Negotiated Rate	$347.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$287.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$315.70
Rate for Payer: Qualcare PPO/HMO/WC	$215.25

BX BREAST 1ST LESION STRTCT

Facility

$8,338.90

Service Code	HCPCS 19081
Hospital Charge Code	16000602
Hospital Revenue Code	360
Min. Negotiated Rate	$1,250.84
Max. Negotiated Rate	$1,250.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,250.84

BX BREAST 1ST LESION STRTCT

Facility

$8,338.90

Service Code	HCPCS 19081
Hospital Charge Code	16000602
Hospital Revenue Code	360
Min. Negotiated Rate	$200.97
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,501.67
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,250.84
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$200.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$220.98

BX BREAST 1ST LESION US IMAG

Facility

$8,338.90

Service Code	HCPCS 19083
Hospital Charge Code	16000663
Hospital Revenue Code	360
Min. Negotiated Rate	$1,250.84
Max. Negotiated Rate	$1,250.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,250.84

BX BREAST 1ST LESION US IMAG

Facility

$8,338.90

Service Code	HCPCS 19083
Hospital Charge Code	16000663
Hospital Revenue Code	360
Min. Negotiated Rate	$200.97
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,501.67
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,250.84
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$200.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$220.98

BX BREAST MR GUIDE EA ADD LESN

Facility

$4,789.30

Service Code	HCPCS 19086
Hospital Charge Code	2409030
Hospital Revenue Code	361
Min. Negotiated Rate	$115.42
Max. Negotiated Rate	$2,394.65
Rate for Payer: Aetna Commercial	$1,819.93
Rate for Payer: Aetna Medicare Advantage	$1,436.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,221.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,221.27
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	$1,221.27
Rate for Payer: Cigna Commercial	$2,394.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,436.79
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$718.39
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$115.42
Rate for Payer: Wellpoint Medicaid Managed Care	$126.92

BX BREAST MR GUIDE EA ADD LESN

Facility

$4,789.30

Service Code	HCPCS 19086
Hospital Charge Code	2409030
Hospital Revenue Code	361
Min. Negotiated Rate	$718.39
Max. Negotiated Rate	$718.39
Rate for Payer: Qualcare PPO/HMO/WC	$718.39

BX PROSTATE,NEEDLE OR PUNCH

Facility

$10,187.80

Service Code	HCPCS 55700
Hospital Charge Code	1600000847
Hospital Revenue Code	360
Min. Negotiated Rate	$245.53
Max. Negotiated Rate	$5,311.00
Rate for Payer: Aetna Commercial	$3,871.36
Rate for Payer: Aetna Medicare Advantage	$3,056.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,597.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,597.89
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	$2,597.89
Rate for Payer: Cigna Commercial	$5,093.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,056.34
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$245.53
Rate for Payer: Wellpoint Medicaid Managed Care	$269.98

BX PROSTATE,NEEDLE OR PUNCH

Facility

$10,187.80

Service Code	HCPCS 55700
Hospital Charge Code	1600000847
Hospital Revenue Code	360
Min. Negotiated Rate	$1,528.17
Max. Negotiated Rate	$1,528.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,528.17

BX-SKIN SQ/MM,EA ADDTL

Facility

$994.50

Service Code	HCPCS 11200
Hospital Charge Code	1600000404
Hospital Revenue Code	360
Min. Negotiated Rate	$23.97
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
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	$860.41
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$298.35
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$149.18
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$23.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$26.35

BX-SKIN SQ/MM,EA ADDTL

Facility

$994.50

Service Code	HCPCS 11200
Hospital Charge Code	1600000404
Hospital Revenue Code	360
Min. Negotiated Rate	$149.18
Max. Negotiated Rate	$149.18
Rate for Payer: Qualcare PPO/HMO/WC	$149.18

Know your out-of-pocket cost for care.

All Charges