Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CENTRALIZER BMT 12MM 12-162615

Facility

$8,719.75

Hospital Charge Code	270607973
Hospital Revenue Code	278
Min. Negotiated Rate	$210.15
Max. Negotiated Rate	$4,359.88
Rate for Payer: Aetna Commercial	$3,313.51
Rate for Payer: Aetna Medicare Advantage	$2,615.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,223.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,223.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,223.54
Rate for Payer: Cigna Commercial	$4,359.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,110.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,918.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.96
Rate for Payer: UnitedHealthcare Community & State	$210.15
Rate for Payer: Wellpoint Medicaid Managed Care	$231.07

CENTRALIZER BMT DI 13MM 162658

Facility

$775.00

Service Code	HCPCS C1776
Hospital Charge Code	270609034
Hospital Revenue Code	278
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

CENTRALIZER BMT DI 13MM 162658

Facility

$775.00

Service Code	HCPCS C1776
Hospital Charge Code	270609034
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

CENTRALIZER BMT DI 15MM 162659

Facility

$892.85

Hospital Charge Code	270607974
Hospital Revenue Code	278
Min. Negotiated Rate	$21.52
Max. Negotiated Rate	$446.43
Rate for Payer: Aetna Commercial	$339.28
Rate for Payer: Aetna Medicare Advantage	$267.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.68
Rate for Payer: Cigna Commercial	$446.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.43
Rate for Payer: Qualcare PPO/HMO/WC	$133.93
Rate for Payer: UnitedHealthcare Community & State	$21.52
Rate for Payer: Wellpoint Medicaid Managed Care	$23.66

CENTRALIZER BMT DI 15MM 162659

Facility

$892.85

Hospital Charge Code	270607974
Hospital Revenue Code	278
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$216.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.43
Rate for Payer: Qualcare PPO/HMO/WC	$133.93

CENTRALIZER BMT DI 162660

Facility

$892.85

Hospital Charge Code	270605340
Hospital Revenue Code	278
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$216.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.43
Rate for Payer: Qualcare PPO/HMO/WC	$133.93

CENTRALIZER BMT DI 162660

Facility

$892.85

Hospital Charge Code	270605340
Hospital Revenue Code	278
Min. Negotiated Rate	$21.52
Max. Negotiated Rate	$446.43
Rate for Payer: Aetna Commercial	$339.28
Rate for Payer: Aetna Medicare Advantage	$267.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.68
Rate for Payer: Cigna Commercial	$446.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$196.43
Rate for Payer: Qualcare PPO/HMO/WC	$133.93
Rate for Payer: UnitedHealthcare Community & State	$21.52
Rate for Payer: Wellpoint Medicaid Managed Care	$23.66

CENTRALIZER BMT DISTAL

Facility

$348.00

Hospital Charge Code	270606327
Hospital Revenue Code	272
Min. Negotiated Rate	$52.20
Max. Negotiated Rate	$52.20
Rate for Payer: Qualcare PPO/HMO/WC	$52.20

CENTRALIZER BMT DISTAL

Facility

$348.00

Hospital Charge Code	270606327
Hospital Revenue Code	272
Min. Negotiated Rate	$8.39
Max. Negotiated Rate	$174.00
Rate for Payer: Aetna Commercial	$132.24
Rate for Payer: Aetna Medicare Advantage	$104.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.74
Rate for Payer: Cigna Commercial	$174.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.40
Rate for Payer: Oxford Commercial	$69.60
Rate for Payer: Qualcare PPO/HMO/WC	$52.20
Rate for Payer: UnitedHealthcare Commercial	$69.60
Rate for Payer: UnitedHealthcare Community & State	$8.39
Rate for Payer: Wellpoint Medicaid Managed Care	$9.22

CENTRALIZER BMT FEM 13 162713

Facility

$5,564.85

Hospital Charge Code	270617515
Hospital Revenue Code	278
Min. Negotiated Rate	$834.73
Max. Negotiated Rate	$1,346.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,112.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,346.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,224.27
Rate for Payer: Qualcare PPO/HMO/WC	$834.73

CENTRALIZER BMT FEM 13 162713

Facility

$5,564.85

Hospital Charge Code	270617515
Hospital Revenue Code	278
Min. Negotiated Rate	$134.11
Max. Negotiated Rate	$2,782.43
Rate for Payer: Aetna Commercial	$2,114.64
Rate for Payer: Aetna Medicare Advantage	$1,669.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,419.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,419.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,112.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,419.04
Rate for Payer: Cigna Commercial	$2,782.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,346.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,224.27
Rate for Payer: Qualcare PPO/HMO/WC	$834.73
Rate for Payer: UnitedHealthcare Community & State	$134.11
Rate for Payer: Wellpoint Medicaid Managed Care	$147.47

CENTRALIZER DIST 17 OD 785917

Facility

$437.30

Hospital Charge Code	270638867
Hospital Revenue Code	278
Min. Negotiated Rate	$65.59
Max. Negotiated Rate	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.21
Rate for Payer: Qualcare PPO/HMO/WC	$65.59

CENTRALIZER DIST 17 OD 785917

Facility

$437.30

Hospital Charge Code	270638867
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$218.65
Rate for Payer: Aetna Commercial	$166.17
Rate for Payer: Aetna Medicare Advantage	$131.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.51
Rate for Payer: Cigna Commercial	$218.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.21
Rate for Payer: Qualcare PPO/HMO/WC	$65.59
Rate for Payer: UnitedHealthcare Community & State	$10.54
Rate for Payer: Wellpoint Medicaid Managed Care	$11.59

CENTRALIZER DISTAL 11MM

Facility

$775.00

Service Code	HCPCS C1776
Hospital Charge Code	270605408
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

CENTRALIZER DISTAL 11MM

Facility

$775.00

Service Code	HCPCS C1776
Hospital Charge Code	270605408
Hospital Revenue Code	278
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

CENTRALIZER DISTAL 9mm 162656

Facility

$700.00

Service Code	HCPCS C1776
Hospital Charge Code	270625861
Hospital Revenue Code	278
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

CENTRALIZER DISTAL 9mm 162656

Facility

$700.00

Service Code	HCPCS C1776
Hospital Charge Code	270625861
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

CENTRALIZER ZIM VS 10MM 785910

Facility

$769.65

Hospital Charge Code	270606002
Hospital Revenue Code	278
Min. Negotiated Rate	$18.55
Max. Negotiated Rate	$384.82
Rate for Payer: Aetna Commercial	$292.47
Rate for Payer: Aetna Medicare Advantage	$230.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.26
Rate for Payer: Cigna Commercial	$384.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$169.32
Rate for Payer: Qualcare PPO/HMO/WC	$115.45
Rate for Payer: UnitedHealthcare Community & State	$18.55
Rate for Payer: Wellpoint Medicaid Managed Care	$20.40

CENTRALIZER ZIM VS 10MM 785910

Facility

$769.65

Hospital Charge Code	270606002
Hospital Revenue Code	278
Min. Negotiated Rate	$115.45
Max. Negotiated Rate	$186.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$169.32
Rate for Payer: Qualcare PPO/HMO/WC	$115.45

CENTRALIZER ZIM VS 11MM 785911

Facility

$769.65

Hospital Charge Code	270606809
Hospital Revenue Code	278
Min. Negotiated Rate	$18.55
Max. Negotiated Rate	$384.82
Rate for Payer: Aetna Commercial	$292.47
Rate for Payer: Aetna Medicare Advantage	$230.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.26
Rate for Payer: Cigna Commercial	$384.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$169.32
Rate for Payer: Qualcare PPO/HMO/WC	$115.45
Rate for Payer: UnitedHealthcare Community & State	$18.55
Rate for Payer: Wellpoint Medicaid Managed Care	$20.40

CENTRALIZER ZIM VS 11MM 785911

Facility

$769.65

Hospital Charge Code	270606809
Hospital Revenue Code	278
Min. Negotiated Rate	$115.45
Max. Negotiated Rate	$186.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$169.32
Rate for Payer: Qualcare PPO/HMO/WC	$115.45

CENTRALIZER ZIM VS 12MM 785912

Facility

$420.50

Hospital Charge Code	270609817
Hospital Revenue Code	278
Min. Negotiated Rate	$10.13
Max. Negotiated Rate	$210.25
Rate for Payer: Aetna Commercial	$159.79
Rate for Payer: Aetna Medicare Advantage	$126.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.23
Rate for Payer: Cigna Commercial	$210.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.51
Rate for Payer: Qualcare PPO/HMO/WC	$63.08
Rate for Payer: UnitedHealthcare Community & State	$10.13
Rate for Payer: Wellpoint Medicaid Managed Care	$11.14

CENTRALIZER ZIM VS 12MM 785912

Facility

$420.50

Hospital Charge Code	270609817
Hospital Revenue Code	278
Min. Negotiated Rate	$63.08
Max. Negotiated Rate	$101.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$92.51
Rate for Payer: Qualcare PPO/HMO/WC	$63.08

CENTRALIZER ZIM VS 13MM 785913

Facility

$525.65

Hospital Charge Code	270615367
Hospital Revenue Code	278
Min. Negotiated Rate	$12.67
Max. Negotiated Rate	$262.82
Rate for Payer: Aetna Commercial	$199.75
Rate for Payer: Aetna Medicare Advantage	$157.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$134.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$134.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$134.04
Rate for Payer: Cigna Commercial	$262.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.64
Rate for Payer: Qualcare PPO/HMO/WC	$78.85
Rate for Payer: UnitedHealthcare Community & State	$12.67
Rate for Payer: Wellpoint Medicaid Managed Care	$13.93

CENTRALIZER ZIM VS 13MM 785913

Facility

$525.65

Hospital Charge Code	270615367
Hospital Revenue Code	278
Min. Negotiated Rate	$78.85
Max. Negotiated Rate	$127.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.64
Rate for Payer: Qualcare PPO/HMO/WC	$78.85

Know your out-of-pocket cost for care.

All Charges