Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DIALYSIS

Facility

$156.00

Hospital Charge Code	270614258
Hospital Revenue Code	270
Min. Negotiated Rate	$3.76
Max. Negotiated Rate	$78.00
Rate for Payer: Aetna Commercial	$59.28
Rate for Payer: Aetna Medicare Advantage	$46.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.78
Rate for Payer: Cigna Commercial	$78.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.80
Rate for Payer: Oxford Commercial	$31.20
Rate for Payer: Qualcare PPO/HMO/WC	$23.40
Rate for Payer: UnitedHealthcare Commercial	$31.20
Rate for Payer: UnitedHealthcare Community & State	$3.76
Rate for Payer: Wellpoint Medicaid Managed Care	$4.13

DIALYSIS

Facility

$1,155.00

Hospital Charge Code	8200065
Hospital Revenue Code	804
Min. Negotiated Rate	$27.84
Max. Negotiated Rate	$577.50
Rate for Payer: Aetna Commercial	$438.90
Rate for Payer: Aetna Medicare Advantage	$346.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$294.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$294.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$294.52
Rate for Payer: Cigna Commercial	$577.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.50
Rate for Payer: Oxford Commercial	$231.00
Rate for Payer: Qualcare PPO/HMO/WC	$173.25
Rate for Payer: UnitedHealthcare Commercial	$231.00
Rate for Payer: UnitedHealthcare Community & State	$27.84
Rate for Payer: Wellpoint Medicaid Managed Care	$30.61

DIALYSIS

Facility

$988.00

Hospital Charge Code	270607808
Hospital Revenue Code	270
Min. Negotiated Rate	$148.20
Max. Negotiated Rate	$148.20
Rate for Payer: Qualcare PPO/HMO/WC	$148.20

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

$615.70

Hospital Charge Code	8200032
Hospital Revenue Code	809
Min. Negotiated Rate	$92.36
Max. Negotiated Rate	$92.36
Rate for Payer: Qualcare PPO/HMO/WC	$92.36

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

$1,155.00

Hospital Charge Code	8200065
Hospital Revenue Code	804
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$173.25
Rate for Payer: Qualcare PPO/HMO/WC	$173.25

DIALYSIS

Facility

$15.40

Hospital Charge Code	8200321
Hospital Revenue Code	279
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$2.31
Rate for Payer: Qualcare PPO/HMO/WC	$2.31

DIALYSIS

Facility

$662.00

Service Code	HCPCS 90921
Hospital Charge Code	8200066
Hospital Revenue Code	855
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$4,468.00
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	$2,546.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.30
Rate for Payer: UnitedHealthcare Commercial	$4,468.00
Rate for Payer: UnitedHealthcare Community & State	$15.95
Rate for Payer: Wellpoint Medicaid Managed Care	$17.54

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

$96.00

Hospital Charge Code	27059765
Hospital Revenue Code	271
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$48.00
Rate for Payer: Aetna Commercial	$36.48
Rate for Payer: Aetna Medicare Advantage	$28.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.48
Rate for Payer: Cigna Commercial	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.80
Rate for Payer: Oxford Commercial	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$14.40
Rate for Payer: UnitedHealthcare Commercial	$19.20
Rate for Payer: UnitedHealthcare Community & State	$2.31
Rate for Payer: Wellpoint Medicaid Managed Care	$2.54

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

$6,000.00

Service Code	HCPCS 90960
Hospital Charge Code	8200043
Hospital Revenue Code	821
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$4,468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,800.00
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	$900.00
Rate for Payer: UnitedHealthcare Commercial	$4,468.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

DIALYSIS

Facility

$96.00

Hospital Charge Code	27059765
Hospital Revenue Code	271
Min. Negotiated Rate	$14.40
Max. Negotiated Rate	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$14.40

DIALYSIS

Facility

$638.00

Service Code	HCPCS 99333
Hospital Charge Code	8200071
Hospital Revenue Code	841
Min. Negotiated Rate	$15.38
Max. Negotiated Rate	$4,468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$162.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$162.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$162.69
Rate for Payer: Cigna Commercial	$319.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.40
Rate for Payer: Oxford Commercial	$2,546.00
Rate for Payer: Qualcare PPO/HMO/WC	$95.70
Rate for Payer: UnitedHealthcare Commercial	$4,468.00
Rate for Payer: UnitedHealthcare Community & State	$15.38
Rate for Payer: Wellpoint Medicaid Managed Care	$16.91

DIALYSIS

Facility

$9.00

Hospital Charge Code	270616286
Hospital Revenue Code	270
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

DIALYSIS

Facility

$154.00

Hospital Charge Code	8200081
Hospital Revenue Code	272
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$77.00
Rate for Payer: Aetna Commercial	$58.52
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.27
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.20
Rate for Payer: Oxford Commercial	$30.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
Rate for Payer: UnitedHealthcare Commercial	$30.80
Rate for Payer: UnitedHealthcare Community & State	$3.71
Rate for Payer: Wellpoint Medicaid Managed Care	$4.08

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

$1,035.25

Service Code	HCPCS 90920
Hospital Charge Code	8200045
Hospital Revenue Code	821
Min. Negotiated Rate	$155.29
Max. Negotiated Rate	$155.29
Rate for Payer: Qualcare PPO/HMO/WC	$155.29

DIALYSIS

Facility

$3,500.00

Service Code	HCPCS 90962
Hospital Charge Code	8200041
Hospital Revenue Code	821
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$525.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

DIALYSIS

Facility

$142.00

Hospital Charge Code	8200495
Hospital Revenue Code	272
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$21.30
Rate for Payer: Qualcare PPO/HMO/WC	$21.30

DIALYSIS

Facility

$648.00

Hospital Charge Code	27059772
Hospital Revenue Code	271
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$324.00
Rate for Payer: Aetna Commercial	$246.24
Rate for Payer: Aetna Medicare Advantage	$194.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.24
Rate for Payer: Cigna Commercial	$324.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.40
Rate for Payer: Oxford Commercial	$129.60
Rate for Payer: Qualcare PPO/HMO/WC	$97.20
Rate for Payer: UnitedHealthcare Commercial	$129.60
Rate for Payer: UnitedHealthcare Community & State	$15.62
Rate for Payer: Wellpoint Medicaid Managed Care	$17.17

DIALYSIS

Facility

$150.51

Service Code	HCPCS 90999
Hospital Charge Code	8200040R
Hospital Revenue Code	821
Min. Negotiated Rate	$22.58
Max. Negotiated Rate	$22.58
Rate for Payer: Qualcare PPO/HMO/WC	$22.58

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

$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

Know your out-of-pocket cost for care.

All Charges