Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DLU ENDO GIA 60 4.8 030316

Facility

$995.25

Hospital Charge Code	270600107
Hospital Revenue Code	272
Min. Negotiated Rate	$23.99
Max. Negotiated Rate	$497.62
Rate for Payer: Aetna Commercial	$378.19
Rate for Payer: Aetna Medicare Advantage	$298.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.79
Rate for Payer: Cigna Commercial	$497.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$298.57
Rate for Payer: Oxford Commercial	$199.05
Rate for Payer: Qualcare PPO/HMO/WC	$149.29
Rate for Payer: UnitedHealthcare Commercial	$199.05
Rate for Payer: UnitedHealthcare Community & State	$23.99
Rate for Payer: Wellpoint Medicaid Managed Care	$26.37

DLU ENDO GIA 60 4.8 030316

Facility

$995.25

Hospital Charge Code	270600107
Hospital Revenue Code	272
Min. Negotiated Rate	$149.29
Max. Negotiated Rate	$149.29
Rate for Payer: Qualcare PPO/HMO/WC	$149.29

DLU ENDO GIA II 30 2.5 030418

Facility

$715.25

Hospital Charge Code	270608863
Hospital Revenue Code	272
Min. Negotiated Rate	$107.29
Max. Negotiated Rate	$107.29
Rate for Payer: Qualcare PPO/HMO/WC	$107.29

DLU ENDO GIA II 30 2.5 030418

Facility

$715.25

Hospital Charge Code	270608863
Hospital Revenue Code	272
Min. Negotiated Rate	$17.24
Max. Negotiated Rate	$357.62
Rate for Payer: Aetna Commercial	$271.80
Rate for Payer: Aetna Medicare Advantage	$214.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.39
Rate for Payer: Cigna Commercial	$357.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.57
Rate for Payer: Oxford Commercial	$143.05
Rate for Payer: Qualcare PPO/HMO/WC	$107.29
Rate for Payer: UnitedHealthcare Commercial	$143.05
Rate for Payer: UnitedHealthcare Community & State	$17.24
Rate for Payer: Wellpoint Medicaid Managed Care	$18.95

DLU ENDO GIA II 30 3.5 030419

Facility

$439.47

Hospital Charge Code	270608864
Hospital Revenue Code	272
Min. Negotiated Rate	$10.59
Max. Negotiated Rate	$219.74
Rate for Payer: Aetna Commercial	$167.00
Rate for Payer: Aetna Medicare Advantage	$131.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.06
Rate for Payer: Cigna Commercial	$219.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.84
Rate for Payer: Oxford Commercial	$87.89
Rate for Payer: Qualcare PPO/HMO/WC	$65.92
Rate for Payer: UnitedHealthcare Commercial	$87.89
Rate for Payer: UnitedHealthcare Community & State	$10.59
Rate for Payer: Wellpoint Medicaid Managed Care	$11.65

DLU ENDO GIA II 30 3.5 030419

Facility

$439.47

Hospital Charge Code	270608864
Hospital Revenue Code	272
Min. Negotiated Rate	$65.92
Max. Negotiated Rate	$65.92
Rate for Payer: Qualcare PPO/HMO/WC	$65.92

DLU ENDO GIA II 45 2.5 030425

Facility

$439.47

Hospital Charge Code	270608865
Hospital Revenue Code	272
Min. Negotiated Rate	$10.59
Max. Negotiated Rate	$219.74
Rate for Payer: Aetna Commercial	$167.00
Rate for Payer: Aetna Medicare Advantage	$131.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.06
Rate for Payer: Cigna Commercial	$219.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.84
Rate for Payer: Oxford Commercial	$87.89
Rate for Payer: Qualcare PPO/HMO/WC	$65.92
Rate for Payer: UnitedHealthcare Commercial	$87.89
Rate for Payer: UnitedHealthcare Community & State	$10.59
Rate for Payer: Wellpoint Medicaid Managed Care	$11.65

DLU ENDO GIA II 45 2.5 030425

Facility

$439.47

Hospital Charge Code	270608865
Hospital Revenue Code	272
Min. Negotiated Rate	$65.92
Max. Negotiated Rate	$65.92
Rate for Payer: Qualcare PPO/HMO/WC	$65.92

DLU ENDO GIA II 45 4.8 030423

Facility

$737.65

Hospital Charge Code	270608867
Hospital Revenue Code	272
Min. Negotiated Rate	$17.78
Max. Negotiated Rate	$368.82
Rate for Payer: Aetna Commercial	$280.31
Rate for Payer: Aetna Medicare Advantage	$221.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.10
Rate for Payer: Cigna Commercial	$368.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.29
Rate for Payer: Oxford Commercial	$147.53
Rate for Payer: Qualcare PPO/HMO/WC	$110.65
Rate for Payer: UnitedHealthcare Commercial	$147.53
Rate for Payer: UnitedHealthcare Community & State	$17.78
Rate for Payer: Wellpoint Medicaid Managed Care	$19.55

DLU ENDO GIA II 45 4.8 030423

Facility

$737.65

Hospital Charge Code	270608867
Hospital Revenue Code	272
Min. Negotiated Rate	$110.65
Max. Negotiated Rate	$110.65
Rate for Payer: Qualcare PPO/HMO/WC	$110.65

DLU ENDO GIA II 60 2.5 030412

Facility

$760.00

Hospital Charge Code	270608868
Hospital Revenue Code	272
Min. Negotiated Rate	$18.32
Max. Negotiated Rate	$380.00
Rate for Payer: Aetna Commercial	$288.80
Rate for Payer: Aetna Medicare Advantage	$228.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$193.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$193.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$193.80
Rate for Payer: Cigna Commercial	$380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.00
Rate for Payer: Oxford Commercial	$152.00
Rate for Payer: Qualcare PPO/HMO/WC	$114.00
Rate for Payer: UnitedHealthcare Commercial	$152.00
Rate for Payer: UnitedHealthcare Community & State	$18.32
Rate for Payer: Wellpoint Medicaid Managed Care	$20.14

DLU ENDO GIA II 60 2.5 030412

Facility

$760.00

Hospital Charge Code	270608868
Hospital Revenue Code	272
Min. Negotiated Rate	$114.00
Max. Negotiated Rate	$114.00
Rate for Payer: Qualcare PPO/HMO/WC	$114.00

DLU ENDO GIA II 60 3.5 030414

Facility

$665.58

Hospital Charge Code	270608869
Hospital Revenue Code	272
Min. Negotiated Rate	$16.04
Max. Negotiated Rate	$332.79
Rate for Payer: Aetna Commercial	$252.92
Rate for Payer: Aetna Medicare Advantage	$199.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.72
Rate for Payer: Cigna Commercial	$332.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.67
Rate for Payer: Oxford Commercial	$133.12
Rate for Payer: Qualcare PPO/HMO/WC	$99.84
Rate for Payer: UnitedHealthcare Commercial	$133.12
Rate for Payer: UnitedHealthcare Community & State	$16.04
Rate for Payer: Wellpoint Medicaid Managed Care	$17.64

DLU ENDO GIA II 60 3.5 030414

Facility

$665.58

Hospital Charge Code	270608869
Hospital Revenue Code	272
Min. Negotiated Rate	$99.84
Max. Negotiated Rate	$99.84
Rate for Payer: Qualcare PPO/HMO/WC	$99.84

DLU ENDO GIA II 60 4.8 030415

Facility

$659.13

Hospital Charge Code	270608870
Hospital Revenue Code	272
Min. Negotiated Rate	$98.87
Max. Negotiated Rate	$98.87
Rate for Payer: Qualcare PPO/HMO/WC	$98.87

DLU ENDO GIA II 60 4.8 030415

Facility

$659.13

Hospital Charge Code	270608870
Hospital Revenue Code	272
Min. Negotiated Rate	$15.89
Max. Negotiated Rate	$329.56
Rate for Payer: Aetna Commercial	$250.47
Rate for Payer: Aetna Medicare Advantage	$197.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.08
Rate for Payer: Cigna Commercial	$329.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$197.74
Rate for Payer: Oxford Commercial	$131.83
Rate for Payer: Qualcare PPO/HMO/WC	$98.87
Rate for Payer: UnitedHealthcare Commercial	$131.83
Rate for Payer: UnitedHealthcare Community & State	$15.89
Rate for Payer: Wellpoint Medicaid Managed Care	$17.47

DLU ENDO HERNIA 4.8 174007

Facility

$354.45

Hospital Charge Code	270600086
Hospital Revenue Code	272
Min. Negotiated Rate	$53.17
Max. Negotiated Rate	$53.17
Rate for Payer: Qualcare PPO/HMO/WC	$53.17

DLU ENDO HERNIA 4.8 174007

Facility

$354.45

Hospital Charge Code	270600086
Hospital Revenue Code	272
Min. Negotiated Rate	$8.54
Max. Negotiated Rate	$177.22
Rate for Payer: Aetna Commercial	$134.69
Rate for Payer: Aetna Medicare Advantage	$106.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.38
Rate for Payer: Cigna Commercial	$177.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.33
Rate for Payer: Oxford Commercial	$70.89
Rate for Payer: Qualcare PPO/HMO/WC	$53.17
Rate for Payer: UnitedHealthcare Commercial	$70.89
Rate for Payer: UnitedHealthcare Community & State	$8.54
Rate for Payer: Wellpoint Medicaid Managed Care	$9.39

DLU ENDO HERNIA 4.O 174015

Facility

$338.45

Hospital Charge Code	270600087
Hospital Revenue Code	272
Min. Negotiated Rate	$50.77
Max. Negotiated Rate	$50.77
Rate for Payer: Qualcare PPO/HMO/WC	$50.77

DLU ENDO HERNIA 4.O 174015

Facility

$338.45

Hospital Charge Code	270600087
Hospital Revenue Code	272
Min. Negotiated Rate	$8.16
Max. Negotiated Rate	$169.22
Rate for Payer: Aetna Commercial	$128.61
Rate for Payer: Aetna Medicare Advantage	$101.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.30
Rate for Payer: Cigna Commercial	$169.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.53
Rate for Payer: Oxford Commercial	$67.69
Rate for Payer: Qualcare PPO/HMO/WC	$50.77
Rate for Payer: UnitedHealthcare Commercial	$67.69
Rate for Payer: UnitedHealthcare Community & State	$8.16
Rate for Payer: Wellpoint Medicaid Managed Care	$8.97

DLU ENDO TA 30 2.5 010911

Facility

$836.85

Hospital Charge Code	270600127
Hospital Revenue Code	272
Min. Negotiated Rate	$125.53
Max. Negotiated Rate	$125.53
Rate for Payer: Qualcare PPO/HMO/WC	$125.53

DLU ENDO TA 30 2.5 010911

Facility

$836.85

Hospital Charge Code	270600127
Hospital Revenue Code	272
Min. Negotiated Rate	$20.17
Max. Negotiated Rate	$418.43
Rate for Payer: Aetna Commercial	$318.00
Rate for Payer: Aetna Medicare Advantage	$251.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$213.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$213.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$213.40
Rate for Payer: Cigna Commercial	$418.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$251.06
Rate for Payer: Oxford Commercial	$167.37
Rate for Payer: Qualcare PPO/HMO/WC	$125.53
Rate for Payer: UnitedHealthcare Commercial	$167.37
Rate for Payer: UnitedHealthcare Community & State	$20.17
Rate for Payer: Wellpoint Medicaid Managed Care	$22.18

DLU ENDO TA 30 3.5 010913

Facility

$836.85

Hospital Charge Code	270600129
Hospital Revenue Code	272
Min. Negotiated Rate	$125.53
Max. Negotiated Rate	$125.53
Rate for Payer: Qualcare PPO/HMO/WC	$125.53

DLU ENDO TA 30 3.5 010913

Facility

$836.85

Hospital Charge Code	270600129
Hospital Revenue Code	272
Min. Negotiated Rate	$20.17
Max. Negotiated Rate	$418.43
Rate for Payer: Aetna Commercial	$318.00
Rate for Payer: Aetna Medicare Advantage	$251.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$213.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$213.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$213.40
Rate for Payer: Cigna Commercial	$418.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$251.06
Rate for Payer: Oxford Commercial	$167.37
Rate for Payer: Qualcare PPO/HMO/WC	$125.53
Rate for Payer: UnitedHealthcare Commercial	$167.37
Rate for Payer: UnitedHealthcare Community & State	$20.17
Rate for Payer: Wellpoint Medicaid Managed Care	$22.18

DLU ENDO UNIV 65 4.0 173054

Facility

$1,660.00

Hospital Charge Code	270600085
Hospital Revenue Code	272
Min. Negotiated Rate	$249.00
Max. Negotiated Rate	$249.00
Rate for Payer: Qualcare PPO/HMO/WC	$249.00

Know your out-of-pocket cost for care.

All Charges