Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

ALEUTAIN CX 13X16MM LOR 12MM

Facility

$7,080.00

Hospital Charge Code	270670182
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 12MM

Facility

$7,080.00

Hospital Charge Code	270670182
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 5MM

Facility

$7,080.00

Hospital Charge Code	270670175
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 5MM

Facility

$7,080.00

Hospital Charge Code	270670175
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 6MM

Facility

$7,080.00

Hospital Charge Code	270670176
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 6MM

Facility

$7,080.00

Hospital Charge Code	270670176
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 7MM

Facility

$7,080.00

Service Code	HCPCS C1713
Hospital Charge Code	270670177
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 7MM

Facility

$7,080.00

Service Code	HCPCS C1713
Hospital Charge Code	270670177
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 8MM

Facility

$7,080.00

Service Code	HCPCS C1713
Hospital Charge Code	270670178
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 8MM

Facility

$7,080.00

Service Code	HCPCS C1713
Hospital Charge Code	270670178
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 9MM

Facility

$7,080.00

Service Code	HCPCS C1713
Hospital Charge Code	270670179
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 9MM

Facility

$7,080.00

Service Code	HCPCS C1713
Hospital Charge Code	270670179
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

ALEUTIAN 28X36MM 15DG LOR 13MM

Facility

$23,515.00

Service Code	HCPCS C1713
Hospital Charge Code	270670112
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

ALEUTIAN 28X36MM 15DG LOR 13MM

Facility

$23,515.00

Service Code	HCPCS C1713
Hospital Charge Code	270670112
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

ALEXIS CONTAINED EXTRACT 14 MM

Facility

$1,625.00

Hospital Charge Code	270692199
Hospital Revenue Code	272
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.50
Rate for Payer: Oxford Commercial	$325.00
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Commercial	$325.00
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

ALEXIS CONTAINED EXTRACT 14 MM

Facility

$1,625.00

Hospital Charge Code	270692199
Hospital Revenue Code	272
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$243.75
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

ALEXIS CONTAINED EXTRACT SYS

Facility

$1,100.00

Hospital Charge Code	270672042
Hospital Revenue Code	272
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

ALEXIS CONTAINED EXTRACT SYS

Facility

$1,100.00

Hospital Charge Code	270672042
Hospital Revenue Code	272
Min. Negotiated Rate	$26.51
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$418.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.00
Rate for Payer: Oxford Commercial	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Commercial	$220.00
Rate for Payer: UnitedHealthcare Community & State	$26.51
Rate for Payer: Wellpoint Medicaid Managed Care	$29.15

ALEXIS EXTRA SMALL

Facility

$225.00

Hospital Charge Code	270670487
Hospital Revenue Code	272
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.50
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$45.00
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

ALEXIS EXTRA SMALL

Facility

$225.00

Hospital Charge Code	270670487
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

ALFENTA/500MCG/1ML

Facility

$66.00

Hospital Charge Code	60632417
Hospital Revenue Code	250
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$25.08
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.80
Rate for Payer: Oxford Commercial	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$13.20
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

ALFENTA/500MCG/1ML

Facility

$42.00

Hospital Charge Code	60632416
Hospital Revenue Code	250
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

ALFENTA/500MCG/1ML

Facility

$42.00

Hospital Charge Code	60632416
Hospital Revenue Code	250
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$21.00
Rate for Payer: Aetna Commercial	$15.96
Rate for Payer: Aetna Medicare Advantage	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.71
Rate for Payer: Cigna Commercial	$21.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.60
Rate for Payer: Oxford Commercial	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Commercial	$8.40
Rate for Payer: UnitedHealthcare Community & State	$1.01
Rate for Payer: Wellpoint Medicaid Managed Care	$1.11

ALFENTA/500MCG/1ML

Facility

$66.00

Hospital Charge Code	60632417
Hospital Revenue Code	250
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

Know your out-of-pocket cost for care.

All Charges