Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DIALYSIS

Facility

$797.45

Hospital Charge Code	270606376
Hospital Revenue Code	820
Min. Negotiated Rate	$119.62
Max. Negotiated Rate	$119.62
Rate for Payer: Qualcare PPO/HMO/WC	$119.62

DIALYSIS

Facility

$46.25

Hospital Charge Code	260120
Hospital Revenue Code	771
Min. Negotiated Rate	$6.94
Max. Negotiated Rate	$6.94
Rate for Payer: Qualcare PPO/HMO/WC	$6.94

DIALYSIS

Facility

$1,118.00

Hospital Charge Code	27059769
Hospital Revenue Code	271
Min. Negotiated Rate	$26.94
Max. Negotiated Rate	$559.00
Rate for Payer: Aetna Commercial	$424.84
Rate for Payer: Aetna Medicare Advantage	$335.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.09
Rate for Payer: Cigna Commercial	$559.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.40
Rate for Payer: Oxford Commercial	$223.60
Rate for Payer: Qualcare PPO/HMO/WC	$167.70
Rate for Payer: UnitedHealthcare Commercial	$223.60
Rate for Payer: UnitedHealthcare Community & State	$26.94
Rate for Payer: Wellpoint Medicaid Managed Care	$29.63

DIALYSIS

Facility

$662.00

Hospital Charge Code	27059770
Hospital Revenue Code	271
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$99.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

DIALYSIS

Facility

$154.00

Hospital Charge Code	8200081
Hospital Revenue Code	272
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

DIALYSIS

Facility

$662.00

Hospital Charge Code	27059770
Hospital Revenue Code	271
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$331.00
Rate for Payer: Aetna Commercial	$251.56
Rate for Payer: Aetna Medicare Advantage	$198.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.81
Rate for Payer: Cigna Commercial	$331.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.60
Rate for Payer: Oxford Commercial	$132.40
Rate for Payer: Qualcare PPO/HMO/WC	$99.30
Rate for Payer: UnitedHealthcare Commercial	$132.40
Rate for Payer: UnitedHealthcare Community & State	$15.95
Rate for Payer: Wellpoint Medicaid Managed Care	$17.54

DIALYSIS

Facility

$496.00

Hospital Charge Code	270607809
Hospital Revenue Code	279
Min. Negotiated Rate	$11.95
Max. Negotiated Rate	$248.00
Rate for Payer: Aetna Commercial	$188.48
Rate for Payer: Aetna Medicare Advantage	$148.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.48
Rate for Payer: Cigna Commercial	$248.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.80
Rate for Payer: Oxford Commercial	$99.20
Rate for Payer: Qualcare PPO/HMO/WC	$74.40
Rate for Payer: UnitedHealthcare Commercial	$99.20
Rate for Payer: UnitedHealthcare Community & State	$11.95
Rate for Payer: Wellpoint Medicaid Managed Care	$13.14

DIALYSIS

Facility

$364.00

Service Code	HCPCS 90945
Hospital Charge Code	8200067
Hospital Revenue Code	841
Min. Negotiated Rate	$8.77
Max. Negotiated Rate	$4,468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,789.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,789.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$495.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$371.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,789.40
Rate for Payer: Cigna Commercial	$993.68
Rate for Payer: Clover Medicare Advantage	$470.93
Rate for Payer: EmblemHealth Commercial	$1,487.16
Rate for Payer: Humana Medicare Advantage	$510.59
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$495.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.20
Rate for Payer: Oxford Commercial	$2,546.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Commercial	$4,468.00
Rate for Payer: UnitedHealthcare Community & State	$8.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$495.72
Rate for Payer: Wellcare Medicare Advantage	$495.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.65

DIALYSIS

Facility

$821.00

Hospital Charge Code	27059773
Hospital Revenue Code	271
Min. Negotiated Rate	$19.79
Max. Negotiated Rate	$410.50
Rate for Payer: Aetna Commercial	$311.98
Rate for Payer: Aetna Medicare Advantage	$246.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.35
Rate for Payer: Cigna Commercial	$410.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.30
Rate for Payer: Oxford Commercial	$164.20
Rate for Payer: Qualcare PPO/HMO/WC	$123.15
Rate for Payer: UnitedHealthcare Commercial	$164.20
Rate for Payer: UnitedHealthcare Community & State	$19.79
Rate for Payer: Wellpoint Medicaid Managed Care	$21.76

DIALYSIS

Facility

$106.00

Hospital Charge Code	27059766
Hospital Revenue Code	271
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$53.00
Rate for Payer: Aetna Commercial	$40.28
Rate for Payer: Aetna Medicare Advantage	$31.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.03
Rate for Payer: Cigna Commercial	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.80
Rate for Payer: Oxford Commercial	$21.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.90
Rate for Payer: UnitedHealthcare Commercial	$21.20
Rate for Payer: UnitedHealthcare Community & State	$2.55
Rate for Payer: Wellpoint Medicaid Managed Care	$2.81

DIALYSIS

Facility

$207.00

Hospital Charge Code	27059767
Hospital Revenue Code	271
Min. Negotiated Rate	$31.05
Max. Negotiated Rate	$31.05
Rate for Payer: Qualcare PPO/HMO/WC	$31.05

DIALYSIS

Facility

$662.00

Service Code	HCPCS 90921
Hospital Charge Code	8200066
Hospital Revenue Code	855
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$99.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

DIALYSIS

Facility

$262.00

Hospital Charge Code	8200461
Hospital Revenue Code	271
Min. Negotiated Rate	$6.31
Max. Negotiated Rate	$131.00
Rate for Payer: Aetna Commercial	$99.56
Rate for Payer: Aetna Medicare Advantage	$78.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.81
Rate for Payer: Cigna Commercial	$131.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.60
Rate for Payer: Oxford Commercial	$52.40
Rate for Payer: Qualcare PPO/HMO/WC	$39.30
Rate for Payer: UnitedHealthcare Commercial	$52.40
Rate for Payer: UnitedHealthcare Community & State	$6.31
Rate for Payer: Wellpoint Medicaid Managed Care	$6.94

DIALYSIS

Facility

$262.00

Hospital Charge Code	8200461
Hospital Revenue Code	271
Min. Negotiated Rate	$39.30
Max. Negotiated Rate	$39.30
Rate for Payer: Qualcare PPO/HMO/WC	$39.30

DIALYSIS

Facility

$395.55

Hospital Charge Code	270607581
Hospital Revenue Code	809
Min. Negotiated Rate	$59.33
Max. Negotiated Rate	$59.33
Rate for Payer: Qualcare PPO/HMO/WC	$59.33

DIALYSIS

Facility

$142.00

Hospital Charge Code	8200495
Hospital Revenue Code	272
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$71.00
Rate for Payer: Aetna Commercial	$53.96
Rate for Payer: Aetna Medicare Advantage	$42.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.21
Rate for Payer: Cigna Commercial	$71.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.60
Rate for Payer: Oxford Commercial	$28.40
Rate for Payer: Qualcare PPO/HMO/WC	$21.30
Rate for Payer: UnitedHealthcare Commercial	$28.40
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: Wellpoint Medicaid Managed Care	$3.76

DIALYSIS

Facility

$207.00

Hospital Charge Code	27059767
Hospital Revenue Code	271
Min. Negotiated Rate	$4.99
Max. Negotiated Rate	$103.50
Rate for Payer: Aetna Commercial	$78.66
Rate for Payer: Aetna Medicare Advantage	$62.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.78
Rate for Payer: Cigna Commercial	$103.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.10
Rate for Payer: Oxford Commercial	$41.40
Rate for Payer: Qualcare PPO/HMO/WC	$31.05
Rate for Payer: UnitedHealthcare Commercial	$41.40
Rate for Payer: UnitedHealthcare Community & State	$4.99
Rate for Payer: Wellpoint Medicaid Managed Care	$5.49

DIALYSIS

Facility

$111.00

Hospital Charge Code	27059768
Hospital Revenue Code	271
Min. Negotiated Rate	$16.65
Max. Negotiated Rate	$16.65
Rate for Payer: Qualcare PPO/HMO/WC	$16.65

DIALYSIS

Facility

$111.00

Hospital Charge Code	27059768
Hospital Revenue Code	271
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$55.50
Rate for Payer: Aetna Commercial	$42.18
Rate for Payer: Aetna Medicare Advantage	$33.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.30
Rate for Payer: Cigna Commercial	$55.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.30
Rate for Payer: Oxford Commercial	$22.20
Rate for Payer: Qualcare PPO/HMO/WC	$16.65
Rate for Payer: UnitedHealthcare Commercial	$22.20
Rate for Payer: UnitedHealthcare Community & State	$2.68
Rate for Payer: Wellpoint Medicaid Managed Care	$2.94

DIALYSIS

Facility

$185.00

Hospital Charge Code	270605310
Hospital Revenue Code	270
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$92.50
Rate for Payer: Aetna Commercial	$70.30
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.50
Rate for Payer: Oxford Commercial	$37.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Commercial	$37.00
Rate for Payer: UnitedHealthcare Community & State	$4.46
Rate for Payer: Wellpoint Medicaid Managed Care	$4.90

DIALYSIS

Facility

$147.00

Hospital Charge Code	270615916
Hospital Revenue Code	272
Min. Negotiated Rate	$3.54
Max. Negotiated Rate	$73.50
Rate for Payer: Aetna Commercial	$55.86
Rate for Payer: Aetna Medicare Advantage	$44.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.48
Rate for Payer: Cigna Commercial	$73.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.10
Rate for Payer: Oxford Commercial	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$22.05
Rate for Payer: UnitedHealthcare Commercial	$29.40
Rate for Payer: UnitedHealthcare Community & State	$3.54
Rate for Payer: Wellpoint Medicaid Managed Care	$3.90

DIALYSIS

Facility

$797.45

Hospital Charge Code	270606376
Hospital Revenue Code	820
Min. Negotiated Rate	$19.22
Max. Negotiated Rate	$4,468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.35
Rate for Payer: Cigna Commercial	$398.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$700.00
Rate for Payer: Oxford Commercial	$2,546.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.62
Rate for Payer: UnitedHealthcare Commercial	$4,468.00
Rate for Payer: UnitedHealthcare Community & State	$19.22
Rate for Payer: Wellpoint Medicaid Managed Care	$21.13

DIALYSIS

Facility

$6.77

Hospital Charge Code	8200328RS
Hospital Revenue Code	301
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.02

DIALYSIS

Facility

$147.00

Hospital Charge Code	270615916
Hospital Revenue Code	272
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$22.05
Rate for Payer: Qualcare PPO/HMO/WC	$22.05

DIALYSIS

Facility

$364.00

Service Code	HCPCS 90945
Hospital Charge Code	8200067
Hospital Revenue Code	841
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

Know your out-of-pocket cost for care.

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