Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

ALEUTAIN 24X30MM 8DEG CON 17MM

Facility

$20,795.00

Hospital Charge Code	270670124
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 17MM

Facility

$20,795.00

Hospital Charge Code	270670124
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 19MM

Facility

$20,795.00

Hospital Charge Code	270670131
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 19MM

Facility

$20,795.00

Hospital Charge Code	270670131
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 9MM

Facility

$20,795.00

Hospital Charge Code	270670093
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 9MM

Facility

$20,795.00

Hospital Charge Code	270670093
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 28X36MM 10DEG LOR 9MM

Facility

$23,515.00

Hospital Charge Code	270670096
Hospital Revenue Code	278
Min. Negotiated Rate	$566.71
Max. Negotiated Rate	$11,757.50
Rate for Payer: Aetna Commercial	$8,935.70
Rate for Payer: Aetna Medicare Advantage	$7,054.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,996.32
Rate for Payer: Cigna Commercial	$11,757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25
Rate for Payer: UnitedHealthcare Community & State	$566.71
Rate for Payer: Wellpoint Medicaid Managed Care	$623.15

ALEUTAIN 28X36MM 10DEG LOR 9MM

Facility

$23,515.00

Hospital Charge Code	270670096
Hospital Revenue Code	278
Min. Negotiated Rate	$3,527.25
Max. Negotiated Rate	$5,690.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25

ALEUTAIN 28X36MM 10DG LOR 11MM

Facility

$23,515.00

Service Code	HCPCS C1713
Hospital Charge Code	270670104
Hospital Revenue Code	278
Min. Negotiated Rate	$3,527.25
Max. Negotiated Rate	$5,690.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25

ALEUTAIN 28X36MM 10DG LOR 11MM

Facility

$23,515.00

Service Code	HCPCS C1713
Hospital Charge Code	270670104
Hospital Revenue Code	278
Min. Negotiated Rate	$566.71
Max. Negotiated Rate	$11,757.50
Rate for Payer: Aetna Commercial	$8,935.70
Rate for Payer: Aetna Medicare Advantage	$7,054.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,996.32
Rate for Payer: Cigna Commercial	$11,757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25
Rate for Payer: UnitedHealthcare Community & State	$566.71
Rate for Payer: Wellpoint Medicaid Managed Care	$623.15

ALEUTAIN 28X36MM 10DG LOR 13MM

Facility

$23,515.00

Hospital Charge Code	270670113
Hospital Revenue Code	278
Min. Negotiated Rate	$566.71
Max. Negotiated Rate	$11,757.50
Rate for Payer: Aetna Commercial	$8,935.70
Rate for Payer: Aetna Medicare Advantage	$7,054.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,996.32
Rate for Payer: Cigna Commercial	$11,757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25
Rate for Payer: UnitedHealthcare Community & State	$566.71
Rate for Payer: Wellpoint Medicaid Managed Care	$623.15

ALEUTAIN 28X36MM 10DG LOR 13MM

Facility

$23,515.00

Hospital Charge Code	270670113
Hospital Revenue Code	278
Min. Negotiated Rate	$3,527.25
Max. Negotiated Rate	$5,690.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25

ALEUTAIN 28X36MM 10DG LOR 15MM

Facility

$23,515.00

Hospital Charge Code	270670121
Hospital Revenue Code	278
Min. Negotiated Rate	$3,527.25
Max. Negotiated Rate	$5,690.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25

ALEUTAIN 28X36MM 10DG LOR 15MM

Facility

$23,515.00

Hospital Charge Code	270670121
Hospital Revenue Code	278
Min. Negotiated Rate	$566.71
Max. Negotiated Rate	$11,757.50
Rate for Payer: Aetna Commercial	$8,935.70
Rate for Payer: Aetna Medicare Advantage	$7,054.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,996.32
Rate for Payer: Cigna Commercial	$11,757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25
Rate for Payer: UnitedHealthcare Community & State	$566.71
Rate for Payer: Wellpoint Medicaid Managed Care	$623.15

ALEUTAIN 28X36MM 10DG LOR 17MM

Facility

$23,515.00

Hospital Charge Code	270670129
Hospital Revenue Code	278
Min. Negotiated Rate	$566.71
Max. Negotiated Rate	$11,757.50
Rate for Payer: Aetna Commercial	$8,935.70
Rate for Payer: Aetna Medicare Advantage	$7,054.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,996.32
Rate for Payer: Cigna Commercial	$11,757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25
Rate for Payer: UnitedHealthcare Community & State	$566.71
Rate for Payer: Wellpoint Medicaid Managed Care	$623.15

ALEUTAIN 28X36MM 10DG LOR 17MM

Facility

$23,515.00

Hospital Charge Code	270670129
Hospital Revenue Code	278
Min. Negotiated Rate	$3,527.25
Max. Negotiated Rate	$5,690.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25

ALEUTAIN 28X36MM 10DG LOR 19MM

Facility

$23,515.00

Hospital Charge Code	270670136
Hospital Revenue Code	278
Min. Negotiated Rate	$566.71
Max. Negotiated Rate	$11,757.50
Rate for Payer: Aetna Commercial	$8,935.70
Rate for Payer: Aetna Medicare Advantage	$7,054.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,996.32
Rate for Payer: Cigna Commercial	$11,757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25
Rate for Payer: UnitedHealthcare Community & State	$566.71
Rate for Payer: Wellpoint Medicaid Managed Care	$623.15

ALEUTAIN 28X36MM 10DG LOR 19MM

Facility

$23,515.00

Hospital Charge Code	270670136
Hospital Revenue Code	278
Min. Negotiated Rate	$3,527.25
Max. Negotiated Rate	$5,690.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25

ALEUTAIN 28X36MM 15DG LOR 11MM

Facility

$23,515.00

Hospital Charge Code	270670103
Hospital Revenue Code	278
Min. Negotiated Rate	$566.71
Max. Negotiated Rate	$11,757.50
Rate for Payer: Aetna Commercial	$8,935.70
Rate for Payer: Aetna Medicare Advantage	$7,054.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,996.32
Rate for Payer: Cigna Commercial	$11,757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25
Rate for Payer: UnitedHealthcare Community & State	$566.71
Rate for Payer: Wellpoint Medicaid Managed Care	$623.15

ALEUTAIN 28X36MM 15DG LOR 11MM

Facility

$23,515.00

Hospital Charge Code	270670103
Hospital Revenue Code	278
Min. Negotiated Rate	$3,527.25
Max. Negotiated Rate	$5,690.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25

ALEUTAIN 28X36MM 15DG LOR 15MM

Facility

$23,515.00

Hospital Charge Code	270670120
Hospital Revenue Code	278
Min. Negotiated Rate	$566.71
Max. Negotiated Rate	$11,757.50
Rate for Payer: Aetna Commercial	$8,935.70
Rate for Payer: Aetna Medicare Advantage	$7,054.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,996.32
Rate for Payer: Cigna Commercial	$11,757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25
Rate for Payer: UnitedHealthcare Community & State	$566.71
Rate for Payer: Wellpoint Medicaid Managed Care	$623.15

ALEUTAIN 28X36MM 15DG LOR 15MM

Facility

$23,515.00

Hospital Charge Code	270670120
Hospital Revenue Code	278
Min. Negotiated Rate	$3,527.25
Max. Negotiated Rate	$5,690.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25

ALEUTAIN 28X36MM 15DG LOR 17MM

Facility

$23,515.00

Hospital Charge Code	270670128
Hospital Revenue Code	278
Min. Negotiated Rate	$3,527.25
Max. Negotiated Rate	$5,690.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25

ALEUTAIN 28X36MM 15DG LOR 17MM

Facility

$23,515.00

Hospital Charge Code	270670128
Hospital Revenue Code	278
Min. Negotiated Rate	$566.71
Max. Negotiated Rate	$11,757.50
Rate for Payer: Aetna Commercial	$8,935.70
Rate for Payer: Aetna Medicare Advantage	$7,054.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,996.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,996.32
Rate for Payer: Cigna Commercial	$11,757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,690.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,173.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,527.25
Rate for Payer: UnitedHealthcare Community & State	$566.71
Rate for Payer: Wellpoint Medicaid Managed Care	$623.15

Know your out-of-pocket cost for care.

All Charges