Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CARDIAC MONITOR IMPLANTABLE

Facility

$21,850.00

Hospital Charge Code	270663950
Hospital Revenue Code	278
Min. Negotiated Rate	$526.59
Max. Negotiated Rate	$10,925.00
Rate for Payer: Aetna Commercial	$8,303.00
Rate for Payer: Aetna Medicare Advantage	$6,555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,571.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,571.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,571.75
Rate for Payer: Cigna Commercial	$10,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,287.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,807.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,277.50
Rate for Payer: UnitedHealthcare Community & State	$526.59
Rate for Payer: Wellpoint Medicaid Managed Care	$579.02

CARDIAC OUTPUT****

Facility

$75.00

Service Code	HCPCS 93561
Hospital Charge Code	5100151
Hospital Revenue Code	481
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

CARDIAC OUTPUT****

Facility

$75.00

Service Code	HCPCS 93561
Hospital Charge Code	5100151
Hospital Revenue Code	481
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

CARDIAC OUTPUT ADDL

Facility

$116.85

Service Code	HCPCS 93562
Hospital Charge Code	5100094
Hospital Revenue Code	481
Min. Negotiated Rate	$2.82
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$44.40
Rate for Payer: Aetna Medicare Advantage	$35.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.80
Rate for Payer: Cigna Commercial	$58.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.53
Rate for Payer: UnitedHealthcare Community & State	$2.82
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

CARDIAC OUTPUT ADDL

Facility

$116.85

Service Code	HCPCS 93562
Hospital Charge Code	74110013
Hospital Revenue Code	481
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$17.53
Rate for Payer: Qualcare PPO/HMO/WC	$17.53

CARDIAC OUTPUT ADDL

Facility

$116.85

Service Code	HCPCS 93562
Hospital Charge Code	74110013
Hospital Revenue Code	481
Min. Negotiated Rate	$2.82
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$44.40
Rate for Payer: Aetna Medicare Advantage	$35.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.80
Rate for Payer: Cigna Commercial	$58.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.53
Rate for Payer: UnitedHealthcare Community & State	$2.82
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

CARDIAC OUTPUT ADDL

Facility

$116.85

Service Code	HCPCS 93562
Hospital Charge Code	5100094
Hospital Revenue Code	481
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$17.53
Rate for Payer: Qualcare PPO/HMO/WC	$17.53

CARDIAC OUTPUT BRIDGE

Facility

$61.00

Hospital Charge Code	270650555
Hospital Revenue Code	270
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$23.18
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.30
Rate for Payer: Oxford Commercial	$12.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$12.20
Rate for Payer: UnitedHealthcare Community & State	$1.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.62

CARDIAC OUTPUT BRIDGE

Facility

$61.00

Hospital Charge Code	270650555
Hospital Revenue Code	270
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$40,550.88

Service Code	APR-DRG 1774
Min. Negotiated Rate	$39,755.76
Max. Negotiated Rate	$40,550.88
Rate for Payer: UnitedHealthcare Community & State	$39,755.76
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$40,550.88
Rate for Payer: Wellpoint Medicaid Managed Care	$39,755.76

CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$21,132.08

Service Code	APR-DRG 1772
Min. Negotiated Rate	$20,717.73
Max. Negotiated Rate	$21,132.08
Rate for Payer: UnitedHealthcare Community & State	$20,717.73
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,132.08
Rate for Payer: Wellpoint Medicaid Managed Care	$20,717.73

CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$29,106.41

Service Code	APR-DRG 1773
Min. Negotiated Rate	$28,535.70
Max. Negotiated Rate	$29,106.41
Rate for Payer: UnitedHealthcare Community & State	$28,535.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,106.41
Rate for Payer: Wellpoint Medicaid Managed Care	$28,535.70

CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT

Facility

$14,721.73

Service Code	APR-DRG 1771
Min. Negotiated Rate	$14,433.07
Max. Negotiated Rate	$14,721.73
Rate for Payer: UnitedHealthcare Community & State	$14,433.07
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,721.73
Rate for Payer: Wellpoint Medicaid Managed Care	$14,433.07

CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC

Facility

$103,691.92

Service Code	MSDRG 258
Min. Negotiated Rate	$31,572.86
Max. Negotiated Rate	$103,691.92
Rate for Payer: Aetna Commercial	$71,505.48
Rate for Payer: Aetna Medicare Advantage	$103,691.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63,037.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63,037.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$33,234.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63,037.31
Rate for Payer: Cigna Commercial	$58,801.26
Rate for Payer: Cigna Medicare Advantage	$33,234.59
Rate for Payer: Clover Medicare Advantage	$31,572.86
Rate for Payer: EmblemHealth Commercial	$99,703.77
Rate for Payer: Humana Medicare Advantage	$34,231.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$33,234.59
Rate for Payer: Oxford Commercial	$42,261.25
Rate for Payer: UnitedHealthcare Commercial	$74,106.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$33,234.59
Rate for Payer: Wellcare Medicare Advantage	$33,234.59

CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC

Facility

$67,491.68

Service Code	MSDRG 259
Min. Negotiated Rate	$20,550.35
Max. Negotiated Rate	$67,491.68
Rate for Payer: Aetna Commercial	$46,631.82
Rate for Payer: Aetna Medicare Advantage	$67,491.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43,498.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43,498.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,631.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43,498.07
Rate for Payer: Cigna Commercial	$37,841.58
Rate for Payer: Cigna Medicare Advantage	$21,631.95
Rate for Payer: Clover Medicare Advantage	$20,550.35
Rate for Payer: EmblemHealth Commercial	$64,895.85
Rate for Payer: Humana Medicare Advantage	$22,280.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,631.95
Rate for Payer: Oxford Commercial	$27,197.24
Rate for Payer: UnitedHealthcare Commercial	$47,691.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,631.95
Rate for Payer: Wellcare Medicare Advantage	$21,631.95

CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC

Facility

$63,238.16

Service Code	MSDRG 261
Min. Negotiated Rate	$19,255.21
Max. Negotiated Rate	$63,238.16
Rate for Payer: Aetna Commercial	$43,709.17
Rate for Payer: Aetna Medicare Advantage	$63,238.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43,730.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43,730.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,268.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43,730.68
Rate for Payer: Cigna Commercial	$35,378.82
Rate for Payer: Cigna Medicare Advantage	$20,268.64
Rate for Payer: Clover Medicare Advantage	$19,255.21
Rate for Payer: EmblemHealth Commercial	$60,805.92
Rate for Payer: Humana Medicare Advantage	$20,876.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,268.64
Rate for Payer: Oxford Commercial	$25,427.22
Rate for Payer: UnitedHealthcare Commercial	$44,587.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,268.64
Rate for Payer: Wellcare Medicare Advantage	$20,268.64

CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC

Facility

$107,269.97

Service Code	MSDRG 260
Min. Negotiated Rate	$32,662.33
Max. Negotiated Rate	$107,269.97
Rate for Payer: Aetna Commercial	$73,964.02
Rate for Payer: Aetna Medicare Advantage	$107,269.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77,226.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77,226.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34,381.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77,226.52
Rate for Payer: Cigna Commercial	$60,872.90
Rate for Payer: Cigna Medicare Advantage	$34,381.40
Rate for Payer: Clover Medicare Advantage	$32,662.33
Rate for Payer: EmblemHealth Commercial	$103,144.20
Rate for Payer: Humana Medicare Advantage	$35,412.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34,381.40
Rate for Payer: Oxford Commercial	$43,750.16
Rate for Payer: UnitedHealthcare Commercial	$76,717.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$34,381.40
Rate for Payer: Wellcare Medicare Advantage	$34,381.40

CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC

Facility

$54,815.09

Service Code	MSDRG 262
Min. Negotiated Rate	$16,690.49
Max. Negotiated Rate	$54,815.09
Rate for Payer: Aetna Commercial	$37,921.54
Rate for Payer: Aetna Medicare Advantage	$54,815.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38,380.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38,380.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,568.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38,380.65
Rate for Payer: Cigna Commercial	$30,501.95
Rate for Payer: Cigna Medicare Advantage	$17,568.94
Rate for Payer: Clover Medicare Advantage	$16,690.49
Rate for Payer: EmblemHealth Commercial	$52,706.82
Rate for Payer: Humana Medicare Advantage	$18,096.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17,568.94
Rate for Payer: Oxford Commercial	$21,922.15
Rate for Payer: UnitedHealthcare Commercial	$38,441.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,568.94
Rate for Payer: Wellcare Medicare Advantage	$17,568.94

CARDIAC RISK ASSESSMENT***

Facility

$68.20

Service Code	HCPCS 80061
Hospital Charge Code	3006475
Hospital Revenue Code	301
Min. Negotiated Rate	$10.23
Max. Negotiated Rate	$10.23
Rate for Payer: Qualcare PPO/HMO/WC	$10.23

CARDIAC RISK ASSESSMENT***

Facility

$68.20

Service Code	HCPCS 80061
Hospital Charge Code	3006475
Hospital Revenue Code	301
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$36.42
Rate for Payer: Aetna Medicare Advantage	$43.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.33
Rate for Payer: Cigna Commercial	$34.10
Rate for Payer: Cigna Medicare Advantage	$13.39
Rate for Payer: Clover Medicare Advantage	$12.72
Rate for Payer: EmblemHealth Commercial	$40.17
Rate for Payer: Humana Medicare Advantage	$13.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.23
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.39
Rate for Payer: Wellcare Medicare Advantage	$13.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.81

CARDIAC STRUCTURAL AND VALVULAR DISORDERS

Facility

$11,650.01

Service Code	APR-DRG 2003
Min. Negotiated Rate	$11,421.58
Max. Negotiated Rate	$11,650.01
Rate for Payer: UnitedHealthcare Community & State	$11,421.58
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,650.01
Rate for Payer: Wellpoint Medicaid Managed Care	$11,421.58

CARDIAC STRUCTURAL AND VALVULAR DISORDERS

Facility

$5,635.40

Service Code	APR-DRG 2001
Min. Negotiated Rate	$5,524.90
Max. Negotiated Rate	$5,635.40
Rate for Payer: UnitedHealthcare Community & State	$5,524.90
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,635.40
Rate for Payer: Wellpoint Medicaid Managed Care	$5,524.90

CARDIAC STRUCTURAL AND VALVULAR DISORDERS

Facility

$20,672.47

Service Code	APR-DRG 2004
Min. Negotiated Rate	$20,267.13
Max. Negotiated Rate	$20,672.47
Rate for Payer: UnitedHealthcare Community & State	$20,267.13
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,672.47
Rate for Payer: Wellpoint Medicaid Managed Care	$20,267.13

CARDIAC STRUCTURAL AND VALVULAR DISORDERS

Facility

$7,951.38

Service Code	APR-DRG 2002
Min. Negotiated Rate	$7,795.47
Max. Negotiated Rate	$7,951.38
Rate for Payer: UnitedHealthcare Community & State	$7,795.47
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,951.38
Rate for Payer: Wellpoint Medicaid Managed Care	$7,795.47

CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC

Facility

$214,658.65

Service Code	MSDRG 217
Min. Negotiated Rate	$65,360.81
Max. Negotiated Rate	$214,658.65
Rate for Payer: Aetna Commercial	$147,752.29
Rate for Payer: Aetna Medicare Advantage	$214,658.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148,172.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148,172.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$68,800.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148,172.57
Rate for Payer: Cigna Commercial	$123,050.16
Rate for Payer: Cigna Medicare Advantage	$68,800.85
Rate for Payer: Clover Medicare Advantage	$65,360.81
Rate for Payer: EmblemHealth Commercial	$206,402.55
Rate for Payer: Humana Medicare Advantage	$70,864.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$68,800.85
Rate for Payer: Oxford Commercial	$88,437.79
Rate for Payer: UnitedHealthcare Commercial	$155,078.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$68,800.85
Rate for Payer: Wellcare Medicare Advantage	$68,800.85

Know your out-of-pocket cost for care.

All Charges