Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

$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

$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

$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

DIALYSIS

Facility

$210.00

Hospital Charge Code	8200149
Hospital Revenue Code	271
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$79.80
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.00
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$42.00
Rate for Payer: UnitedHealthcare Community & State	$5.06
Rate for Payer: Wellpoint Medicaid Managed Care	$5.57

DIALYSIS

Facility

$648.00

Hospital Charge Code	27059772
Hospital Revenue Code	271
Min. Negotiated Rate	$97.20
Max. Negotiated Rate	$97.20
Rate for Payer: Qualcare PPO/HMO/WC	$97.20

DIALYSIS

Facility

$662.00

Hospital Charge Code	27059771
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

$662.00

Hospital Charge Code	27059771
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

$182.00

Hospital Charge Code	270603987
Hospital Revenue Code	270
Min. Negotiated Rate	$4.39
Max. Negotiated Rate	$91.00
Rate for Payer: Aetna Commercial	$69.16
Rate for Payer: Aetna Medicare Advantage	$54.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.41
Rate for Payer: Cigna Commercial	$91.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.60
Rate for Payer: Oxford Commercial	$36.40
Rate for Payer: Qualcare PPO/HMO/WC	$27.30
Rate for Payer: UnitedHealthcare Commercial	$36.40
Rate for Payer: UnitedHealthcare Community & State	$4.39
Rate for Payer: Wellpoint Medicaid Managed Care	$4.82

DIALYSIS

Facility

$15.40

Hospital Charge Code	8200321
Hospital Revenue Code	279
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$7.70
Rate for Payer: Aetna Commercial	$5.85
Rate for Payer: Aetna Medicare Advantage	$4.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.93
Rate for Payer: Cigna Commercial	$7.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.62
Rate for Payer: Oxford Commercial	$3.08
Rate for Payer: Qualcare PPO/HMO/WC	$2.31
Rate for Payer: UnitedHealthcare Commercial	$3.08
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

DIALYSIS

Facility

$6,000.00

Service Code	HCPCS 90960
Hospital Charge Code	8200043
Hospital Revenue Code	821
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$900.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

DIALYSIS

Facility

$182.00

Hospital Charge Code	270603987
Hospital Revenue Code	270
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$27.30

DIALYSIS

Facility

$1,118.00

Hospital Charge Code	27059769
Hospital Revenue Code	271
Min. Negotiated Rate	$167.70
Max. Negotiated Rate	$167.70
Rate for Payer: Qualcare PPO/HMO/WC	$167.70

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

$4,500.00

Service Code	HCPCS 90961
Hospital Charge Code	8200042
Hospital Revenue Code	821
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$4,468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,350.00
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	$675.00
Rate for Payer: UnitedHealthcare Commercial	$4,468.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

DIALYSIS

Facility

$1,385.00

Hospital Charge Code	8200057
Hospital Revenue Code	803
Min. Negotiated Rate	$33.38
Max. Negotiated Rate	$692.50
Rate for Payer: Aetna Commercial	$526.30
Rate for Payer: Aetna Medicare Advantage	$415.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$353.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$353.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$353.18
Rate for Payer: Cigna Commercial	$692.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.50
Rate for Payer: Oxford Commercial	$277.00
Rate for Payer: Qualcare PPO/HMO/WC	$207.75
Rate for Payer: UnitedHealthcare Commercial	$277.00
Rate for Payer: UnitedHealthcare Community & State	$33.38
Rate for Payer: Wellpoint Medicaid Managed Care	$36.70

DIALYSIS

Facility

$1,035.25

Service Code	HCPCS 90920
Hospital Charge Code	8200045
Hospital Revenue Code	821
Min. Negotiated Rate	$24.95
Max. Negotiated Rate	$4,468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.99
Rate for Payer: Cigna Commercial	$517.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.57
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	$155.29
Rate for Payer: UnitedHealthcare Commercial	$4,468.00
Rate for Payer: UnitedHealthcare Community & State	$24.95
Rate for Payer: Wellpoint Medicaid Managed Care	$27.43

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

$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

$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

$821.00

Hospital Charge Code	27059773
Hospital Revenue Code	271
Min. Negotiated Rate	$123.15
Max. Negotiated Rate	$123.15
Rate for Payer: Qualcare PPO/HMO/WC	$123.15

DIALYSIS

Facility

$6.77

Hospital Charge Code	8200328RS
Hospital Revenue Code	301
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$2.57
Rate for Payer: Aetna Medicare Advantage	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.73
Rate for Payer: Cigna Commercial	$3.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.02
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

DIALYSIS

Facility

$150.51

Service Code	HCPCS 90999
Hospital Charge Code	8200040R
Hospital Revenue Code	821
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$4,468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$753.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.38
Rate for Payer: Cigna Commercial	$75.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.15
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	$22.58
Rate for Payer: UnitedHealthcare Commercial	$4,468.00
Rate for Payer: UnitedHealthcare Community & State	$3.63
Rate for Payer: Wellpoint Medicaid Managed Care	$3.99

DIALYSIS

Facility

$638.00

Service Code	HCPCS 90993
Hospital Charge Code	8200070
Hospital Revenue Code	851
Min. Negotiated Rate	$95.70
Max. Negotiated Rate	$95.70
Rate for Payer: Qualcare PPO/HMO/WC	$95.70

Know your out-of-pocket cost for care.

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