Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CORNEA FOR TRANSPLANT

Facility

$7,257.65

Hospital Charge Code	270605752
Hospital Revenue Code	278
Min. Negotiated Rate	$174.91
Max. Negotiated Rate	$3,628.82
Rate for Payer: Aetna Commercial	$2,757.91
Rate for Payer: Aetna Medicare Advantage	$2,177.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,850.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,850.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,451.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,850.70
Rate for Payer: Cigna Commercial	$3,628.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,756.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,596.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,088.65
Rate for Payer: UnitedHealthcare Community & State	$174.91
Rate for Payer: Wellpoint Medicaid Managed Care	$192.33

CORNEA FOR TRANSPLANT

Facility

$7,257.65

Hospital Charge Code	270605752
Hospital Revenue Code	278
Min. Negotiated Rate	$1,088.65
Max. Negotiated Rate	$1,756.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,451.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,756.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,596.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,088.65

CORNEA FOR TRANSPLANT

Facility

$11,632.00

Hospital Charge Code	270616072
Hospital Revenue Code	272
Min. Negotiated Rate	$280.33
Max. Negotiated Rate	$5,816.00
Rate for Payer: Aetna Commercial	$4,420.16
Rate for Payer: Aetna Medicare Advantage	$3,489.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,966.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,966.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,966.16
Rate for Payer: Cigna Commercial	$5,816.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,489.60
Rate for Payer: Oxford Commercial	$2,326.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,744.80
Rate for Payer: UnitedHealthcare Commercial	$2,326.40
Rate for Payer: UnitedHealthcare Community & State	$280.33
Rate for Payer: Wellpoint Medicaid Managed Care	$308.25

CORNEA FOR TRANSPLANT

Facility

$11,632.00

Hospital Charge Code	270616072
Hospital Revenue Code	272
Min. Negotiated Rate	$1,744.80
Max. Negotiated Rate	$1,744.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,744.80

CORNEA FULL THICKNES

Facility

$16,750.00

Hospital Charge Code	270678916
Hospital Revenue Code	278
Min. Negotiated Rate	$403.68
Max. Negotiated Rate	$8,375.00
Rate for Payer: Aetna Commercial	$6,365.00
Rate for Payer: Aetna Medicare Advantage	$5,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,271.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,271.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,271.25
Rate for Payer: Cigna Commercial	$8,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,053.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,685.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.50
Rate for Payer: UnitedHealthcare Community & State	$403.68
Rate for Payer: Wellpoint Medicaid Managed Care	$443.88

CORNEA FULL THICKNES

Facility

$16,750.00

Hospital Charge Code	270678916
Hospital Revenue Code	278
Min. Negotiated Rate	$2,512.50
Max. Negotiated Rate	$4,053.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,053.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,685.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.50

CORNEA GRAFT DSEK K002-DS

Facility

$21,500.00

Service Code	HCPCS V2785
Hospital Charge Code	270687298
Hospital Revenue Code	810
Min. Negotiated Rate	$518.15
Max. Negotiated Rate	$10,750.00
Rate for Payer: Aetna Commercial	$8,170.00
Rate for Payer: Aetna Medicare Advantage	$6,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,482.50
Rate for Payer: Cigna Commercial	$10,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,450.00
Rate for Payer: Oxford Commercial	$4,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00
Rate for Payer: UnitedHealthcare Commercial	$4,300.00
Rate for Payer: UnitedHealthcare Community & State	$518.15
Rate for Payer: Wellpoint Medicaid Managed Care	$569.75

CORNEA GRAFT DSEK K002-DS

Facility

$21,500.00

Service Code	HCPCS V2785
Hospital Charge Code	270687298
Hospital Revenue Code	810
Min. Negotiated Rate	$3,225.00
Max. Negotiated Rate	$3,225.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00

CORNEA HUMAN TISSUE

Facility

$19,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270670868
Hospital Revenue Code	810
Min. Negotiated Rate	$457.90
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$7,220.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,700.00
Rate for Payer: Oxford Commercial	$3,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Commercial	$3,800.00
Rate for Payer: UnitedHealthcare Community & State	$457.90
Rate for Payer: Wellpoint Medicaid Managed Care	$503.50

CORNEA HUMAN TISSUE

Facility

$19,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270670868
Hospital Revenue Code	810
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

CORNEA HUMAN TISSUE

Facility

$19,000.00

Hospital Charge Code	270662061
Hospital Revenue Code	810
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

CORNEA HUMAN TISSUE

Facility

$19,000.00

Hospital Charge Code	270662061
Hospital Revenue Code	810
Min. Negotiated Rate	$457.90
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$7,220.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,700.00
Rate for Payer: Oxford Commercial	$3,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Commercial	$3,800.00
Rate for Payer: UnitedHealthcare Community & State	$457.90
Rate for Payer: Wellpoint Medicaid Managed Care	$503.50

CORNEAL COLLAGEN SHIELD 24HR

Facility

$180.35

Hospital Charge Code	270650815
Hospital Revenue Code	272
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$90.17
Rate for Payer: Aetna Commercial	$68.53
Rate for Payer: Aetna Medicare Advantage	$54.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.99
Rate for Payer: Cigna Commercial	$90.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.10
Rate for Payer: Oxford Commercial	$36.07
Rate for Payer: Qualcare PPO/HMO/WC	$27.05
Rate for Payer: UnitedHealthcare Commercial	$36.07
Rate for Payer: UnitedHealthcare Community & State	$4.35
Rate for Payer: Wellpoint Medicaid Managed Care	$4.78

CORNEAL COLLAGEN SHIELD 24HR

Facility

$180.35

Hospital Charge Code	270650815
Hospital Revenue Code	272
Min. Negotiated Rate	$27.05
Max. Negotiated Rate	$27.05
Rate for Payer: Qualcare PPO/HMO/WC	$27.05

CORNEAL COLLAGEN SHIELD OASIS

Facility

$16.25

Hospital Charge Code	270655273
Hospital Revenue Code	270
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$2.44
Rate for Payer: Qualcare PPO/HMO/WC	$2.44

CORNEAL COLLAGEN SHIELD OASIS

Facility

$16.25

Hospital Charge Code	270655273
Hospital Revenue Code	270
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$8.12
Rate for Payer: Aetna Commercial	$6.17
Rate for Payer: Aetna Medicare Advantage	$4.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.14
Rate for Payer: Cigna Commercial	$8.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.88
Rate for Payer: Oxford Commercial	$3.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.44
Rate for Payer: UnitedHealthcare Commercial	$3.25
Rate for Payer: UnitedHealthcare Community & State	$0.39
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

CORNEAL PROTECTORS

Facility

$66.00

Hospital Charge Code	270335129
Hospital Revenue Code	272
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$25.08
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.80
Rate for Payer: Oxford Commercial	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$13.20
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

CORNEAL PROTECTORS

Facility

$66.00

Hospital Charge Code	270335129
Hospital Revenue Code	272
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

CORNEAL SHIELDS ADULT

Facility

$35.80

Hospital Charge Code	270620339
Hospital Revenue Code	272
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$17.90
Rate for Payer: Aetna Commercial	$13.60
Rate for Payer: Aetna Medicare Advantage	$10.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.13
Rate for Payer: Cigna Commercial	$17.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.74
Rate for Payer: Oxford Commercial	$7.16
Rate for Payer: Qualcare PPO/HMO/WC	$5.37
Rate for Payer: UnitedHealthcare Commercial	$7.16
Rate for Payer: UnitedHealthcare Community & State	$0.86
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

CORNEAL SHIELDS ADULT

Facility

$35.80

Hospital Charge Code	270620339
Hospital Revenue Code	272
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$5.37
Rate for Payer: Qualcare PPO/HMO/WC	$5.37

CORNEA Sclera, Quarter

Facility

$1,500.00

Hospital Charge Code	270682018
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

CORNEA Sclera, Quarter

Facility

$1,500.00

Hospital Charge Code	270682018
Hospital Revenue Code	278
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

CORNEA TISSUE

Facility

$19,000.00

Hospital Charge Code	270663595
Hospital Revenue Code	810
Min. Negotiated Rate	$457.90
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$7,220.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,700.00
Rate for Payer: Oxford Commercial	$3,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Commercial	$3,800.00
Rate for Payer: UnitedHealthcare Community & State	$457.90
Rate for Payer: Wellpoint Medicaid Managed Care	$503.50

CORNEA TISSUE

Facility

$16,000.00

Service Code	HCPCS V2785
Hospital Charge Code	270671570
Hospital Revenue Code	810
Min. Negotiated Rate	$385.60
Max. Negotiated Rate	$8,000.00
Rate for Payer: Aetna Commercial	$6,080.00
Rate for Payer: Aetna Medicare Advantage	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,080.00
Rate for Payer: Cigna Commercial	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,800.00
Rate for Payer: Oxford Commercial	$3,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00
Rate for Payer: UnitedHealthcare Commercial	$3,200.00
Rate for Payer: UnitedHealthcare Community & State	$385.60
Rate for Payer: Wellpoint Medicaid Managed Care	$424.00

CORNEA TISSUE

Facility

$19,000.00

Hospital Charge Code	270663595
Hospital Revenue Code	810
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

Know your out-of-pocket cost for care.

All Charges