Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DIALYSIS

Facility

$615.70

Hospital Charge Code	8200032
Hospital Revenue Code	809
Min. Negotiated Rate	$14.84
Max. Negotiated Rate	$307.85
Rate for Payer: Aetna Commercial	$233.97
Rate for Payer: Aetna Medicare Advantage	$184.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.00
Rate for Payer: Cigna Commercial	$307.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.71
Rate for Payer: Oxford Commercial	$123.14
Rate for Payer: Qualcare PPO/HMO/WC	$92.36
Rate for Payer: UnitedHealthcare Commercial	$123.14
Rate for Payer: UnitedHealthcare Community & State	$14.84
Rate for Payer: Wellpoint Medicaid Managed Care	$16.32

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

$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

$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

$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

$167.00

Hospital Charge Code	270605309
Hospital Revenue Code	270
Min. Negotiated Rate	$25.05
Max. Negotiated Rate	$25.05
Rate for Payer: Qualcare PPO/HMO/WC	$25.05

DIALYSIS

Facility

$210.00

Hospital Charge Code	8200149
Hospital Revenue Code	271
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

DIALYSIS

Facility

$167.00

Hospital Charge Code	270605309
Hospital Revenue Code	270
Min. Negotiated Rate	$4.02
Max. Negotiated Rate	$83.50
Rate for Payer: Aetna Commercial	$63.46
Rate for Payer: Aetna Medicare Advantage	$50.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.59
Rate for Payer: Cigna Commercial	$83.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.10
Rate for Payer: Oxford Commercial	$33.40
Rate for Payer: Qualcare PPO/HMO/WC	$25.05
Rate for Payer: UnitedHealthcare Commercial	$33.40
Rate for Payer: UnitedHealthcare Community & State	$4.02
Rate for Payer: Wellpoint Medicaid Managed Care	$4.43

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

$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

$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

$988.00

Hospital Charge Code	270607808
Hospital Revenue Code	270
Min. Negotiated Rate	$23.81
Max. Negotiated Rate	$494.00
Rate for Payer: Aetna Commercial	$375.44
Rate for Payer: Aetna Medicare Advantage	$296.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.94
Rate for Payer: Cigna Commercial	$494.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.40
Rate for Payer: Oxford Commercial	$197.60
Rate for Payer: Qualcare PPO/HMO/WC	$148.20
Rate for Payer: UnitedHealthcare Commercial	$197.60
Rate for Payer: UnitedHealthcare Community & State	$23.81
Rate for Payer: Wellpoint Medicaid Managed Care	$26.18

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

$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

$185.00

Hospital Charge Code	270605310
Hospital Revenue Code	270
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

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

$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

$496.00

Hospital Charge Code	270607809
Hospital Revenue Code	279
Min. Negotiated Rate	$74.40
Max. Negotiated Rate	$74.40
Rate for Payer: Qualcare PPO/HMO/WC	$74.40

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

$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

$106.00

Hospital Charge Code	27059766
Hospital Revenue Code	271
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$15.90
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

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

$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

$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

Know your out-of-pocket cost for care.

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