Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CK MB

Facility

$807.65

Service Code	HCPCS 82553
Hospital Charge Code	3031432
Hospital Revenue Code	301
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$403.82
Rate for Payer: Aetna Commercial	$31.42
Rate for Payer: Aetna Medicare Advantage	$37.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.69
Rate for Payer: Cigna Commercial	$403.82
Rate for Payer: Cigna Medicare Advantage	$11.55
Rate for Payer: Clover Medicare Advantage	$10.97
Rate for Payer: EmblemHealth Commercial	$34.65
Rate for Payer: Humana Medicare Advantage	$11.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.29
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$121.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.55
Rate for Payer: Wellcare Medicare Advantage	$11.55
Rate for Payer: Wellpoint Medicaid Managed Care	$21.40

CKMB

Facility

$240.00

Service Code	HCPCS 82553
Hospital Charge Code	38479006
Hospital Revenue Code	301
Min. Negotiated Rate	$6.36
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$31.42
Rate for Payer: Aetna Medicare Advantage	$37.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.69
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: Cigna Medicare Advantage	$11.55
Rate for Payer: Clover Medicare Advantage	$10.97
Rate for Payer: EmblemHealth Commercial	$34.65
Rate for Payer: Humana Medicare Advantage	$11.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.55
Rate for Payer: Wellcare Medicare Advantage	$11.55
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

CKMB

Facility

$240.00

Service Code	HCPCS 82553
Hospital Charge Code	38479006
Hospital Revenue Code	301
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

CK MB CALCULATION %

Facility

$471.82

Service Code	HCPCS 82553
Hospital Charge Code	3031416
Hospital Revenue Code	301
Min. Negotiated Rate	$70.77
Max. Negotiated Rate	$70.77
Rate for Payer: Qualcare PPO/HMO/WC	$70.77

CK MB CALCULATION %

Facility

$471.82

Service Code	HCPCS 82553
Hospital Charge Code	3031416
Hospital Revenue Code	301
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$235.91
Rate for Payer: Aetna Commercial	$31.42
Rate for Payer: Aetna Medicare Advantage	$37.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.69
Rate for Payer: Cigna Commercial	$235.91
Rate for Payer: Cigna Medicare Advantage	$11.55
Rate for Payer: Clover Medicare Advantage	$10.97
Rate for Payer: EmblemHealth Commercial	$34.65
Rate for Payer: Humana Medicare Advantage	$11.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.55
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.77
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.55
Rate for Payer: Wellcare Medicare Advantage	$11.55
Rate for Payer: Wellpoint Medicaid Managed Care	$12.50

CLADRIBINE 10ML

Facility

$13.00

Hospital Charge Code	60635529
Hospital Revenue Code	636
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

CLADRIBINE 10ML

Facility

$13.00

Hospital Charge Code	60635529
Hospital Revenue Code	636
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$3.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

CLAM IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	401186003B
Hospital Revenue Code	302
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CLAM IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	401186003B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

C-LAMINOPLASTY W/GRAFT/PLATE

Facility

$7,680.28

Service Code	HCPCS 63051
Hospital Charge Code	1600000521
Hospital Revenue Code	360
Min. Negotiated Rate	$1,152.04
Max. Negotiated Rate	$1,152.04
Rate for Payer: Qualcare PPO/HMO/WC	$1,152.04

C-LAMINOPLASTY W/GRAFT/PLATE

Facility

$7,680.28

Service Code	HCPCS 63051
Hospital Charge Code	1600000521
Hospital Revenue Code	360
Min. Negotiated Rate	$185.09
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$2,918.51
Rate for Payer: Aetna Medicare Advantage	$2,304.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,958.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,958.47
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	$1,958.47
Rate for Payer: Cigna Commercial	$3,840.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,304.08
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,152.04
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$185.09
Rate for Payer: Wellpoint Medicaid Managed Care	$203.53

CLAMP****

Facility

$21.00

Hospital Charge Code	8001364
Hospital Revenue Code	279
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$10.50
Rate for Payer: Aetna Commercial	$7.98
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.30
Rate for Payer: Oxford Commercial	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$4.20
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

CLAMP****

Facility

$21.00

Hospital Charge Code	8001364
Hospital Revenue Code	279
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

CLAMP 11MM CRANOFIX 2 TITANIUM

Facility

$654.00

Hospital Charge Code	270654483
Hospital Revenue Code	272
Min. Negotiated Rate	$15.76
Max. Negotiated Rate	$327.00
Rate for Payer: Aetna Commercial	$248.52
Rate for Payer: Aetna Medicare Advantage	$196.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.77
Rate for Payer: Cigna Commercial	$327.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.20
Rate for Payer: Oxford Commercial	$130.80
Rate for Payer: Qualcare PPO/HMO/WC	$98.10
Rate for Payer: UnitedHealthcare Commercial	$130.80
Rate for Payer: UnitedHealthcare Community & State	$15.76
Rate for Payer: Wellpoint Medicaid Managed Care	$17.33

CLAMP 11MM CRANOFIX 2 TITANIUM

Facility

$654.00

Hospital Charge Code	270654483
Hospital Revenue Code	272
Min. Negotiated Rate	$98.10
Max. Negotiated Rate	$98.10
Rate for Payer: Qualcare PPO/HMO/WC	$98.10

CLAMP 16MM CRANOFIX 2 TITANIUM

Facility

$720.97

Hospital Charge Code	270684901
Hospital Revenue Code	272
Min. Negotiated Rate	$17.38
Max. Negotiated Rate	$360.49
Rate for Payer: Aetna Commercial	$273.97
Rate for Payer: Aetna Medicare Advantage	$216.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.85
Rate for Payer: Cigna Commercial	$360.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.29
Rate for Payer: Oxford Commercial	$144.19
Rate for Payer: Qualcare PPO/HMO/WC	$108.15
Rate for Payer: UnitedHealthcare Commercial	$144.19
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellpoint Medicaid Managed Care	$19.11

CLAMP 16MM CRANOFIX 2 TITANIUM

Facility

$720.97

Hospital Charge Code	270684901
Hospital Revenue Code	272
Min. Negotiated Rate	$108.15
Max. Negotiated Rate	$108.15
Rate for Payer: Qualcare PPO/HMO/WC	$108.15

CLAMP 20MM CRANOFIX 2 TITANIUM

Facility

$877.69

Hospital Charge Code	270684900
Hospital Revenue Code	272
Min. Negotiated Rate	$131.65
Max. Negotiated Rate	$131.65
Rate for Payer: Qualcare PPO/HMO/WC	$131.65

CLAMP 20MM CRANOFIX 2 TITANIUM

Facility

$877.69

Hospital Charge Code	270684900
Hospital Revenue Code	272
Min. Negotiated Rate	$21.15
Max. Negotiated Rate	$438.85
Rate for Payer: Aetna Commercial	$333.52
Rate for Payer: Aetna Medicare Advantage	$263.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.81
Rate for Payer: Cigna Commercial	$438.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$263.31
Rate for Payer: Oxford Commercial	$175.54
Rate for Payer: Qualcare PPO/HMO/WC	$131.65
Rate for Payer: UnitedHealthcare Commercial	$175.54
Rate for Payer: UnitedHealthcare Community & State	$21.15
Rate for Payer: Wellpoint Medicaid Managed Care	$23.26

CLAMP 2 3/5 POST

Facility

$1,080.00

Hospital Charge Code	270665211
Hospital Revenue Code	278
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$261.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$237.60
Rate for Payer: Qualcare PPO/HMO/WC	$162.00

CLAMP 2 3/5 POST

Facility

$1,080.00

Hospital Charge Code	270665211
Hospital Revenue Code	278
Min. Negotiated Rate	$26.03
Max. Negotiated Rate	$540.00
Rate for Payer: Aetna Commercial	$410.40
Rate for Payer: Aetna Medicare Advantage	$324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.40
Rate for Payer: Cigna Commercial	$540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$237.60
Rate for Payer: Qualcare PPO/HMO/WC	$162.00
Rate for Payer: UnitedHealthcare Community & State	$26.03
Rate for Payer: Wellpoint Medicaid Managed Care	$28.62

CLAMP 2-BAR BLUE 75MM PIN

Facility

$6,700.00

Hospital Charge Code	270668708
Hospital Revenue Code	278
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,621.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,621.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,474.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

CLAMP 2-BAR BLUE 75MM PIN

Facility

$6,700.00

Hospital Charge Code	270668708
Hospital Revenue Code	278
Min. Negotiated Rate	$161.47
Max. Negotiated Rate	$3,350.00
Rate for Payer: Aetna Commercial	$2,546.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,340.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,621.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,474.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Community & State	$161.47
Rate for Payer: Wellpoint Medicaid Managed Care	$177.55

CLAMP 3-D BLUE BAR TO BAR

Facility

$2,830.75

Hospital Charge Code	270668706
Hospital Revenue Code	278
Min. Negotiated Rate	$424.61
Max. Negotiated Rate	$685.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$566.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$685.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$622.76
Rate for Payer: Qualcare PPO/HMO/WC	$424.61

CLAMP 3-D BLUE BAR TO BAR

Facility

$2,830.75

Hospital Charge Code	270668706
Hospital Revenue Code	278
Min. Negotiated Rate	$68.22
Max. Negotiated Rate	$1,415.38
Rate for Payer: Aetna Commercial	$1,075.68
Rate for Payer: Aetna Medicare Advantage	$849.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$721.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$721.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$566.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$721.84
Rate for Payer: Cigna Commercial	$1,415.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$685.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$622.76
Rate for Payer: Qualcare PPO/HMO/WC	$424.61
Rate for Payer: UnitedHealthcare Community & State	$68.22
Rate for Payer: Wellpoint Medicaid Managed Care	$75.01

Know your out-of-pocket cost for care.

All Charges