Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ALEUTAIN CX 11X14MM CON 9MM

Facility

$6,535.00

Hospital Charge Code	270670153
Hospital Revenue Code	278
Min. Negotiated Rate	$980.25
Max. Negotiated Rate	$1,581.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,437.70
Rate for Payer: Qualcare PPO/HMO/WC	$980.25

ALEUTAIN CX 11X14MM CON 9MM

Facility

$6,535.00

Hospital Charge Code	270670153
Hospital Revenue Code	278
Min. Negotiated Rate	$157.49
Max. Negotiated Rate	$3,267.50
Rate for Payer: Aetna Commercial	$2,483.30
Rate for Payer: Aetna Medicare Advantage	$1,960.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,666.42
Rate for Payer: Cigna Commercial	$3,267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,437.70
Rate for Payer: Qualcare PPO/HMO/WC	$980.25
Rate for Payer: UnitedHealthcare Community & State	$157.49
Rate for Payer: Wellpoint Medicaid Managed Care	$173.18

ALEUTAIN CX 11X14MM LOR 10MM

Facility

$6,535.00

Hospital Charge Code	270670156
Hospital Revenue Code	278
Min. Negotiated Rate	$157.49
Max. Negotiated Rate	$3,267.50
Rate for Payer: Aetna Commercial	$2,483.30
Rate for Payer: Aetna Medicare Advantage	$1,960.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,666.42
Rate for Payer: Cigna Commercial	$3,267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,437.70
Rate for Payer: Qualcare PPO/HMO/WC	$980.25
Rate for Payer: UnitedHealthcare Community & State	$157.49
Rate for Payer: Wellpoint Medicaid Managed Care	$173.18

ALEUTAIN CX 11X14MM LOR 10MM

Facility

$6,535.00

Hospital Charge Code	270670156
Hospital Revenue Code	278
Min. Negotiated Rate	$980.25
Max. Negotiated Rate	$1,581.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,437.70
Rate for Payer: Qualcare PPO/HMO/WC	$980.25

ALEUTAIN CX 11X14MM LOR 11MM

Facility

$6,805.00

Hospital Charge Code	270670168
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.75
Max. Negotiated Rate	$1,646.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,361.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,497.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.75

ALEUTAIN CX 11X14MM LOR 11MM

Facility

$6,805.00

Hospital Charge Code	270670168
Hospital Revenue Code	278
Min. Negotiated Rate	$164.00
Max. Negotiated Rate	$3,402.50
Rate for Payer: Aetna Commercial	$2,585.90
Rate for Payer: Aetna Medicare Advantage	$2,041.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,735.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,735.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,361.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,735.28
Rate for Payer: Cigna Commercial	$3,402.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,497.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.75
Rate for Payer: UnitedHealthcare Community & State	$164.00
Rate for Payer: Wellpoint Medicaid Managed Care	$180.33

ALEUTAIN CX 11X14MM LOR 12MM

Facility

$6,805.00

Hospital Charge Code	270670170
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.75
Max. Negotiated Rate	$1,646.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,361.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,497.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.75

ALEUTAIN CX 11X14MM LOR 12MM

Facility

$6,805.00

Hospital Charge Code	270670170
Hospital Revenue Code	278
Min. Negotiated Rate	$164.00
Max. Negotiated Rate	$3,402.50
Rate for Payer: Aetna Commercial	$2,585.90
Rate for Payer: Aetna Medicare Advantage	$2,041.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,735.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,735.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,361.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,735.28
Rate for Payer: Cigna Commercial	$3,402.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,497.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.75
Rate for Payer: UnitedHealthcare Community & State	$164.00
Rate for Payer: Wellpoint Medicaid Managed Care	$180.33

ALEUTAIN CX 11X14MM LOR 13MM

Facility

$6,805.00

Hospital Charge Code	270670172
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.75
Max. Negotiated Rate	$1,646.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,361.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,497.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.75

ALEUTAIN CX 11X14MM LOR 13MM

Facility

$6,805.00

Hospital Charge Code	270670172
Hospital Revenue Code	278
Min. Negotiated Rate	$164.00
Max. Negotiated Rate	$3,402.50
Rate for Payer: Aetna Commercial	$2,585.90
Rate for Payer: Aetna Medicare Advantage	$2,041.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,735.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,735.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,361.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,735.28
Rate for Payer: Cigna Commercial	$3,402.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,497.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.75
Rate for Payer: UnitedHealthcare Community & State	$164.00
Rate for Payer: Wellpoint Medicaid Managed Care	$180.33

ALEUTAIN CX 11X14MM LOR 14MM

Facility

$6,805.00

Hospital Charge Code	270670174
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.75
Max. Negotiated Rate	$1,646.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,361.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,497.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.75

ALEUTAIN CX 11X14MM LOR 14MM

Facility

$6,805.00

Hospital Charge Code	270670174
Hospital Revenue Code	278
Min. Negotiated Rate	$164.00
Max. Negotiated Rate	$3,402.50
Rate for Payer: Aetna Commercial	$2,585.90
Rate for Payer: Aetna Medicare Advantage	$2,041.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,735.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,735.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,361.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,735.28
Rate for Payer: Cigna Commercial	$3,402.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,497.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.75
Rate for Payer: UnitedHealthcare Community & State	$164.00
Rate for Payer: Wellpoint Medicaid Managed Care	$180.33

ALEUTAIN CX 11X14MM LOR 5MM

Facility

$6,535.00

Hospital Charge Code	270670146
Hospital Revenue Code	278
Min. Negotiated Rate	$157.49
Max. Negotiated Rate	$3,267.50
Rate for Payer: Aetna Commercial	$2,483.30
Rate for Payer: Aetna Medicare Advantage	$1,960.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,666.42
Rate for Payer: Cigna Commercial	$3,267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,437.70
Rate for Payer: Qualcare PPO/HMO/WC	$980.25
Rate for Payer: UnitedHealthcare Community & State	$157.49
Rate for Payer: Wellpoint Medicaid Managed Care	$173.18

ALEUTAIN CX 11X14MM LOR 5MM

Facility

$6,535.00

Hospital Charge Code	270670146
Hospital Revenue Code	278
Min. Negotiated Rate	$980.25
Max. Negotiated Rate	$1,581.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,437.70
Rate for Payer: Qualcare PPO/HMO/WC	$980.25

ALEUTAIN CX 11X14MM LOR 6MM

Facility

$6,535.00

Service Code	HCPCS C1889
Hospital Charge Code	270670148
Hospital Revenue Code	278
Min. Negotiated Rate	$980.25
Max. Negotiated Rate	$1,581.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,437.70
Rate for Payer: Qualcare PPO/HMO/WC	$980.25

ALEUTAIN CX 11X14MM LOR 6MM

Facility

$6,535.00

Service Code	HCPCS C1889
Hospital Charge Code	270670148
Hospital Revenue Code	278
Min. Negotiated Rate	$157.49
Max. Negotiated Rate	$3,267.50
Rate for Payer: Aetna Commercial	$2,483.30
Rate for Payer: Aetna Medicare Advantage	$1,960.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,666.42
Rate for Payer: Cigna Commercial	$3,267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,437.70
Rate for Payer: Qualcare PPO/HMO/WC	$980.25
Rate for Payer: UnitedHealthcare Community & State	$157.49
Rate for Payer: Wellpoint Medicaid Managed Care	$173.18

ALEUTAIN CX 11X14MM LOR 7MM

Facility

$6,535.00

Service Code	HCPCS C1713
Hospital Charge Code	270670150
Hospital Revenue Code	278
Min. Negotiated Rate	$980.25
Max. Negotiated Rate	$1,581.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,437.70
Rate for Payer: Qualcare PPO/HMO/WC	$980.25

ALEUTAIN CX 11X14MM LOR 7MM

Facility

$6,535.00

Service Code	HCPCS C1713
Hospital Charge Code	270670150
Hospital Revenue Code	278
Min. Negotiated Rate	$157.49
Max. Negotiated Rate	$3,267.50
Rate for Payer: Aetna Commercial	$2,483.30
Rate for Payer: Aetna Medicare Advantage	$1,960.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,666.42
Rate for Payer: Cigna Commercial	$3,267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,437.70
Rate for Payer: Qualcare PPO/HMO/WC	$980.25
Rate for Payer: UnitedHealthcare Community & State	$157.49
Rate for Payer: Wellpoint Medicaid Managed Care	$173.18

ALEUTAIN CX 11X14MM LOR 8MM

Facility

$6,535.00

Service Code	HCPCS C1713
Hospital Charge Code	270670152
Hospital Revenue Code	278
Min. Negotiated Rate	$157.49
Max. Negotiated Rate	$3,267.50
Rate for Payer: Aetna Commercial	$2,483.30
Rate for Payer: Aetna Medicare Advantage	$1,960.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,666.42
Rate for Payer: Cigna Commercial	$3,267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,437.70
Rate for Payer: Qualcare PPO/HMO/WC	$980.25
Rate for Payer: UnitedHealthcare Community & State	$157.49
Rate for Payer: Wellpoint Medicaid Managed Care	$173.18

ALEUTAIN CX 11X14MM LOR 8MM

Facility

$6,535.00

Service Code	HCPCS C1713
Hospital Charge Code	270670152
Hospital Revenue Code	278
Min. Negotiated Rate	$980.25
Max. Negotiated Rate	$1,581.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,437.70
Rate for Payer: Qualcare PPO/HMO/WC	$980.25

ALEUTAIN CX 11X14MM LOR 9MM

Facility

$6,535.00

Service Code	HCPCS C1713
Hospital Charge Code	270670154
Hospital Revenue Code	278
Min. Negotiated Rate	$980.25
Max. Negotiated Rate	$1,581.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,437.70
Rate for Payer: Qualcare PPO/HMO/WC	$980.25

ALEUTAIN CX 11X14MM LOR 9MM

Facility

$6,535.00

Service Code	HCPCS C1713
Hospital Charge Code	270670154
Hospital Revenue Code	278
Min. Negotiated Rate	$157.49
Max. Negotiated Rate	$3,267.50
Rate for Payer: Aetna Commercial	$2,483.30
Rate for Payer: Aetna Medicare Advantage	$1,960.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,666.42
Rate for Payer: Cigna Commercial	$3,267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,437.70
Rate for Payer: Qualcare PPO/HMO/WC	$980.25
Rate for Payer: UnitedHealthcare Community & State	$157.49
Rate for Payer: Wellpoint Medicaid Managed Care	$173.18

ALEUTAIN CX 13X16MM LOR 10MM

Facility

$7,080.00

Hospital Charge Code	270670180
Hospital Revenue Code	278
Min. Negotiated Rate	$1,062.00
Max. Negotiated Rate	$1,713.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,416.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,713.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,557.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,062.00

ALEUTAIN CX 13X16MM LOR 10MM

Facility

$7,080.00

Hospital Charge Code	270670180
Hospital Revenue Code	278
Min. Negotiated Rate	$170.63
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$2,690.40
Rate for Payer: Aetna Medicare Advantage	$2,124.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,805.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,805.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,416.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,805.40
Rate for Payer: Cigna Commercial	$3,540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,713.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,557.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,062.00
Rate for Payer: UnitedHealthcare Community & State	$170.63
Rate for Payer: Wellpoint Medicaid Managed Care	$187.62

ALEUTAIN CX 13X16MM LOR 11MM

Facility

$7,080.00

Hospital Charge Code	270670181
Hospital Revenue Code	278
Min. Negotiated Rate	$170.63
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$2,690.40
Rate for Payer: Aetna Medicare Advantage	$2,124.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,805.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,805.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,416.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,805.40
Rate for Payer: Cigna Commercial	$3,540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,713.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,557.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,062.00
Rate for Payer: UnitedHealthcare Community & State	$170.63
Rate for Payer: Wellpoint Medicaid Managed Care	$187.62

Know your out-of-pocket cost for care.

All Charges