Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ALEUTAIN 24X30MM 15DG LOR 19MM

Facility

$21,870.00

Hospital Charge Code	270670132
Hospital Revenue Code	278
Min. Negotiated Rate	$527.07
Max. Negotiated Rate	$10,935.00
Rate for Payer: Aetna Commercial	$8,310.60
Rate for Payer: Aetna Medicare Advantage	$6,561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,576.85
Rate for Payer: Cigna Commercial	$10,935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,811.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50
Rate for Payer: UnitedHealthcare Community & State	$527.07
Rate for Payer: Wellpoint Medicaid Managed Care	$579.55

ALEUTAIN 24X30MM 15DG LOR 19MM

Facility

$21,870.00

Hospital Charge Code	270670132
Hospital Revenue Code	278
Min. Negotiated Rate	$3,280.50
Max. Negotiated Rate	$5,292.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,811.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50

ALEUTAIN 24X30MM 5DEG LOR 11MM

Facility

$21,870.00

Hospital Charge Code	270670102
Hospital Revenue Code	278
Min. Negotiated Rate	$527.07
Max. Negotiated Rate	$10,935.00
Rate for Payer: Aetna Commercial	$8,310.60
Rate for Payer: Aetna Medicare Advantage	$6,561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,576.85
Rate for Payer: Cigna Commercial	$10,935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,811.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50
Rate for Payer: UnitedHealthcare Community & State	$527.07
Rate for Payer: Wellpoint Medicaid Managed Care	$579.55

ALEUTAIN 24X30MM 5DEG LOR 11MM

Facility

$21,870.00

Hospital Charge Code	270670102
Hospital Revenue Code	278
Min. Negotiated Rate	$3,280.50
Max. Negotiated Rate	$5,292.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,811.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50

ALEUTAIN 24X30MM 5DEG LOR 13MM

Facility

$21,870.00

Hospital Charge Code	270670111
Hospital Revenue Code	278
Min. Negotiated Rate	$3,280.50
Max. Negotiated Rate	$5,292.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,811.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50

ALEUTAIN 24X30MM 5DEG LOR 13MM

Facility

$21,870.00

Hospital Charge Code	270670111
Hospital Revenue Code	278
Min. Negotiated Rate	$527.07
Max. Negotiated Rate	$10,935.00
Rate for Payer: Aetna Commercial	$8,310.60
Rate for Payer: Aetna Medicare Advantage	$6,561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,576.85
Rate for Payer: Cigna Commercial	$10,935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,811.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50
Rate for Payer: UnitedHealthcare Community & State	$527.07
Rate for Payer: Wellpoint Medicaid Managed Care	$579.55

ALEUTAIN 24X30MM 5DEG LOR 15MM

Facility

$21,870.00

Hospital Charge Code	270670119
Hospital Revenue Code	278
Min. Negotiated Rate	$527.07
Max. Negotiated Rate	$10,935.00
Rate for Payer: Aetna Commercial	$8,310.60
Rate for Payer: Aetna Medicare Advantage	$6,561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,576.85
Rate for Payer: Cigna Commercial	$10,935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,811.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50
Rate for Payer: UnitedHealthcare Community & State	$527.07
Rate for Payer: Wellpoint Medicaid Managed Care	$579.55

ALEUTAIN 24X30MM 5DEG LOR 15MM

Facility

$21,870.00

Hospital Charge Code	270670119
Hospital Revenue Code	278
Min. Negotiated Rate	$3,280.50
Max. Negotiated Rate	$5,292.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,811.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50

ALEUTAIN 24X30MM 5DEG LOR 17MM

Facility

$21,870.00

Hospital Charge Code	270670127
Hospital Revenue Code	278
Min. Negotiated Rate	$3,280.50
Max. Negotiated Rate	$5,292.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,811.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50

ALEUTAIN 24X30MM 5DEG LOR 17MM

Facility

$21,870.00

Hospital Charge Code	270670127
Hospital Revenue Code	278
Min. Negotiated Rate	$527.07
Max. Negotiated Rate	$10,935.00
Rate for Payer: Aetna Commercial	$8,310.60
Rate for Payer: Aetna Medicare Advantage	$6,561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,576.85
Rate for Payer: Cigna Commercial	$10,935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,811.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50
Rate for Payer: UnitedHealthcare Community & State	$527.07
Rate for Payer: Wellpoint Medicaid Managed Care	$579.55

ALEUTAIN 24X30MM 5DEG LOR 19MM

Facility

$21,870.00

Hospital Charge Code	270670134
Hospital Revenue Code	278
Min. Negotiated Rate	$3,280.50
Max. Negotiated Rate	$5,292.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,811.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50

ALEUTAIN 24X30MM 5DEG LOR 19MM

Facility

$21,870.00

Hospital Charge Code	270670134
Hospital Revenue Code	278
Min. Negotiated Rate	$527.07
Max. Negotiated Rate	$10,935.00
Rate for Payer: Aetna Commercial	$8,310.60
Rate for Payer: Aetna Medicare Advantage	$6,561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,576.85
Rate for Payer: Cigna Commercial	$10,935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,811.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50
Rate for Payer: UnitedHealthcare Community & State	$527.07
Rate for Payer: Wellpoint Medicaid Managed Care	$579.55

ALEUTAIN 24X30MM 5DEG LOR 9MM

Facility

$21,870.00

Hospital Charge Code	270670095
Hospital Revenue Code	278
Min. Negotiated Rate	$527.07
Max. Negotiated Rate	$10,935.00
Rate for Payer: Aetna Commercial	$8,310.60
Rate for Payer: Aetna Medicare Advantage	$6,561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,576.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,576.85
Rate for Payer: Cigna Commercial	$10,935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,811.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50
Rate for Payer: UnitedHealthcare Community & State	$527.07
Rate for Payer: Wellpoint Medicaid Managed Care	$579.55

ALEUTAIN 24X30MM 5DEG LOR 9MM

Facility

$21,870.00

Hospital Charge Code	270670095
Hospital Revenue Code	278
Min. Negotiated Rate	$3,280.50
Max. Negotiated Rate	$5,292.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,292.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,811.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,280.50

ALEUTAIN 24X30MM 8DEG CON 10MM

Facility

$20,795.00

Hospital Charge Code	270670098
Hospital Revenue Code	278
Min. Negotiated Rate	$501.16
Max. Negotiated Rate	$10,397.50
Rate for Payer: Aetna Commercial	$7,902.10
Rate for Payer: Aetna Medicare Advantage	$6,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,302.73
Rate for Payer: Cigna Commercial	$10,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,574.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25
Rate for Payer: UnitedHealthcare Community & State	$501.16
Rate for Payer: Wellpoint Medicaid Managed Care	$551.07

ALEUTAIN 24X30MM 8DEG CON 10MM

Facility

$20,795.00

Hospital Charge Code	270670098
Hospital Revenue Code	278
Min. Negotiated Rate	$3,119.25
Max. Negotiated Rate	$5,032.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,574.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25

ALEUTAIN 24X30MM 8DEG CON 11MM

Facility

$20,795.00

Hospital Charge Code	270670099
Hospital Revenue Code	278
Min. Negotiated Rate	$3,119.25
Max. Negotiated Rate	$5,032.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,574.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25

ALEUTAIN 24X30MM 8DEG CON 11MM

Facility

$20,795.00

Hospital Charge Code	270670099
Hospital Revenue Code	278
Min. Negotiated Rate	$501.16
Max. Negotiated Rate	$10,397.50
Rate for Payer: Aetna Commercial	$7,902.10
Rate for Payer: Aetna Medicare Advantage	$6,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,302.73
Rate for Payer: Cigna Commercial	$10,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,574.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25
Rate for Payer: UnitedHealthcare Community & State	$501.16
Rate for Payer: Wellpoint Medicaid Managed Care	$551.07

ALEUTAIN 24X30MM 8DEG CON 12MM

Facility

$20,795.00

Hospital Charge Code	270670106
Hospital Revenue Code	278
Min. Negotiated Rate	$501.16
Max. Negotiated Rate	$10,397.50
Rate for Payer: Aetna Commercial	$7,902.10
Rate for Payer: Aetna Medicare Advantage	$6,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,302.73
Rate for Payer: Cigna Commercial	$10,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,574.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25
Rate for Payer: UnitedHealthcare Community & State	$501.16
Rate for Payer: Wellpoint Medicaid Managed Care	$551.07

ALEUTAIN 24X30MM 8DEG CON 12MM

Facility

$20,795.00

Hospital Charge Code	270670106
Hospital Revenue Code	278
Min. Negotiated Rate	$3,119.25
Max. Negotiated Rate	$5,032.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,574.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25

ALEUTAIN 24X30MM 8DEG CON 14MM

Facility

$20,795.00

Hospital Charge Code	270670115
Hospital Revenue Code	278
Min. Negotiated Rate	$501.16
Max. Negotiated Rate	$10,397.50
Rate for Payer: Aetna Commercial	$7,902.10
Rate for Payer: Aetna Medicare Advantage	$6,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,302.73
Rate for Payer: Cigna Commercial	$10,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,574.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25
Rate for Payer: UnitedHealthcare Community & State	$501.16
Rate for Payer: Wellpoint Medicaid Managed Care	$551.07

ALEUTAIN 24X30MM 8DEG CON 14MM

Facility

$20,795.00

Hospital Charge Code	270670115
Hospital Revenue Code	278
Min. Negotiated Rate	$3,119.25
Max. Negotiated Rate	$5,032.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,574.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25

ALEUTAIN 24X30MM 8DEG CON 15MM

Facility

$20,795.00

Hospital Charge Code	270670116
Hospital Revenue Code	278
Min. Negotiated Rate	$501.16
Max. Negotiated Rate	$10,397.50
Rate for Payer: Aetna Commercial	$7,902.10
Rate for Payer: Aetna Medicare Advantage	$6,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,302.73
Rate for Payer: Cigna Commercial	$10,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,574.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25
Rate for Payer: UnitedHealthcare Community & State	$501.16
Rate for Payer: Wellpoint Medicaid Managed Care	$551.07

ALEUTAIN 24X30MM 8DEG CON 15MM

Facility

$20,795.00

Hospital Charge Code	270670116
Hospital Revenue Code	278
Min. Negotiated Rate	$3,119.25
Max. Negotiated Rate	$5,032.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,574.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25

ALEUTAIN 24X30MM 8DEG CON 16MM

Facility

$20,795.00

Hospital Charge Code	270670123
Hospital Revenue Code	278
Min. Negotiated Rate	$3,119.25
Max. Negotiated Rate	$5,032.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,032.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,574.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,119.25

Know your out-of-pocket cost for care.

All Charges