Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ALLOGENEIC BONE MARROW TRANSPLANT

Facility

$191,220.45

Service Code	APR-DRG 0074
Min. Negotiated Rate	$187,471.03
Max. Negotiated Rate	$191,220.45
Rate for Payer: UnitedHealthcare Community & State	$187,471.03
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$191,220.45
Rate for Payer: Wellpoint Medicaid Managed Care	$187,471.03

ALLOGENEIC BONE MARROW TRANSPLANT

Facility

$109,613.16

Service Code	APR-DRG 0073
Min. Negotiated Rate	$107,463.88
Max. Negotiated Rate	$109,613.16
Rate for Payer: UnitedHealthcare Community & State	$107,463.88
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$109,613.16
Rate for Payer: Wellpoint Medicaid Managed Care	$107,463.88

ALLOGENEIC BONE MARROW TRANSPLANT

Facility

$86,341.28

Service Code	APR-DRG 0072
Min. Negotiated Rate	$84,648.31
Max. Negotiated Rate	$86,341.28
Rate for Payer: UnitedHealthcare Community & State	$84,648.31
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$86,341.28
Rate for Payer: Wellpoint Medicaid Managed Care	$84,648.31

ALLOGENIC BONE CELLOGIX

Facility

$19,250.00

Service Code	HCPCS C1734
Hospital Charge Code	270692206
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.50
Max. Negotiated Rate	$4,658.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50

ALLOGENIC BONE CELLOGIX

Facility

$19,250.00

Service Code	HCPCS C1734
Hospital Charge Code	270692206
Hospital Revenue Code	278
Min. Negotiated Rate	$463.93
Max. Negotiated Rate	$9,625.00
Rate for Payer: Aetna Commercial	$7,315.00
Rate for Payer: Aetna Medicare Advantage	$5,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,908.75
Rate for Payer: Cigna Commercial	$9,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50
Rate for Payer: UnitedHealthcare Community & State	$463.93
Rate for Payer: Wellpoint Medicaid Managed Care	$510.12

ALLOGENIC BONE SCAFFOLD 10CC

Facility

$36,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692770
Hospital Revenue Code	278
Min. Negotiated Rate	$5,512.50
Max. Negotiated Rate	$8,893.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,893.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,085.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,512.50

ALLOGENIC BONE SCAFFOLD 10CC

Facility

$36,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692770
Hospital Revenue Code	278
Min. Negotiated Rate	$885.67
Max. Negotiated Rate	$18,375.00
Rate for Payer: Aetna Commercial	$13,965.00
Rate for Payer: Aetna Medicare Advantage	$11,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,371.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,371.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,371.25
Rate for Payer: Cigna Commercial	$18,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,893.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,085.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,512.50
Rate for Payer: UnitedHealthcare Community & State	$885.67
Rate for Payer: Wellpoint Medicaid Managed Care	$973.88

ALLOGFT MAGNUS VIABLE CELL 2CC

Facility

$9,475.00

Service Code	HCPCS C1763
Hospital Charge Code	270692963
Hospital Revenue Code	278
Min. Negotiated Rate	$228.35
Max. Negotiated Rate	$4,737.50
Rate for Payer: Aetna Commercial	$3,600.50
Rate for Payer: Aetna Medicare Advantage	$2,842.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,416.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,416.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,416.12
Rate for Payer: Cigna Commercial	$4,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,292.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,084.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,421.25
Rate for Payer: UnitedHealthcare Community & State	$228.35
Rate for Payer: Wellpoint Medicaid Managed Care	$251.09

ALLOGFT MAGNUS VIABLE CELL 2CC

Facility

$9,475.00

Service Code	HCPCS C1763
Hospital Charge Code	270692963
Hospital Revenue Code	278
Min. Negotiated Rate	$1,421.25
Max. Negotiated Rate	$2,292.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,292.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,084.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,421.25

ALLOGRAFT 10CC OF BONUS TRIAD

Facility

$29,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270691847
Hospital Revenue Code	278
Min. Negotiated Rate	$4,410.00
Max. Negotiated Rate	$7,114.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,114.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,468.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,410.00

ALLOGRAFT 10CC OF BONUS TRIAD

Facility

$29,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270691847
Hospital Revenue Code	278
Min. Negotiated Rate	$708.54
Max. Negotiated Rate	$14,700.00
Rate for Payer: Aetna Commercial	$11,172.00
Rate for Payer: Aetna Medicare Advantage	$8,820.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,497.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,497.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,880.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,497.00
Rate for Payer: Cigna Commercial	$14,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,114.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,468.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,410.00
Rate for Payer: UnitedHealthcare Community & State	$708.54
Rate for Payer: Wellpoint Medicaid Managed Care	$779.10

ALLOGRAFT 1cmx4cm 102007

Facility

$1,285.00

Hospital Charge Code	270639182
Hospital Revenue Code	636
Min. Negotiated Rate	$192.75
Max. Negotiated Rate	$310.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.97
Rate for Payer: Qualcare PPO/HMO/WC	$192.75

ALLOGRAFT 1cmx4cm 102007

Facility

$1,285.00

Hospital Charge Code	270639182
Hospital Revenue Code	636
Min. Negotiated Rate	$30.97
Max. Negotiated Rate	$642.50
Rate for Payer: Aetna Commercial	$488.30
Rate for Payer: Aetna Medicare Advantage	$385.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$327.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$327.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$327.68
Rate for Payer: Cigna Commercial	$642.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.97
Rate for Payer: Qualcare PPO/HMO/WC	$192.75
Rate for Payer: UnitedHealthcare Community & State	$30.97
Rate for Payer: Wellpoint Medicaid Managed Care	$34.05

ALLOGRAFT 4cmX9cm 101510

Facility

$1,798.20

Hospital Charge Code	270639183
Hospital Revenue Code	636
Min. Negotiated Rate	$43.34
Max. Negotiated Rate	$899.10
Rate for Payer: Aetna Commercial	$683.32
Rate for Payer: Aetna Medicare Advantage	$539.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$458.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$458.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$458.54
Rate for Payer: Cigna Commercial	$899.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.16
Rate for Payer: Qualcare PPO/HMO/WC	$269.73
Rate for Payer: UnitedHealthcare Community & State	$43.34
Rate for Payer: Wellpoint Medicaid Managed Care	$47.65

ALLOGRAFT 4cmX9cm 101510

Facility

$1,798.20

Hospital Charge Code	270639183
Hospital Revenue Code	636
Min. Negotiated Rate	$269.73
Max. Negotiated Rate	$435.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.16
Rate for Payer: Qualcare PPO/HMO/WC	$269.73

ALLOGRAFT 8MM X 30MM

Facility

$15,095.00

Hospital Charge Code	270658014
Hospital Revenue Code	278
Min. Negotiated Rate	$2,264.25
Max. Negotiated Rate	$3,652.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,019.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,652.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,320.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,264.25

ALLOGRAFT 8MM X 30MM

Facility

$15,095.00

Hospital Charge Code	270658014
Hospital Revenue Code	278
Min. Negotiated Rate	$363.79
Max. Negotiated Rate	$7,547.50
Rate for Payer: Aetna Commercial	$5,736.10
Rate for Payer: Aetna Medicare Advantage	$4,528.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,849.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,849.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,019.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,849.22
Rate for Payer: Cigna Commercial	$7,547.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,652.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,320.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,264.25
Rate for Payer: UnitedHealthcare Community & State	$363.79
Rate for Payer: Wellpoint Medicaid Managed Care	$400.02

ALLOGRAFT ACUPAC ADVANCE 10CC

Facility

$37,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270696335
Hospital Revenue Code	278
Min. Negotiated Rate	$909.77
Max. Negotiated Rate	$18,875.00
Rate for Payer: Aetna Commercial	$14,345.00
Rate for Payer: Aetna Medicare Advantage	$11,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,626.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,626.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,626.25
Rate for Payer: Cigna Commercial	$18,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,135.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,305.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,662.50
Rate for Payer: UnitedHealthcare Community & State	$909.77
Rate for Payer: Wellpoint Medicaid Managed Care	$1,000.38

ALLOGRAFT ACUPAC ADVANCE 10CC

Facility

$37,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270696335
Hospital Revenue Code	278
Min. Negotiated Rate	$5,662.50
Max. Negotiated Rate	$9,135.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,135.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,305.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,662.50

ALLOGRAFT AMINO EXCEL 4x8CM

Facility

$4,462.50

Service Code	HCPCS Q4137
Hospital Charge Code	270677589
Hospital Revenue Code	278
Min. Negotiated Rate	$669.38
Max. Negotiated Rate	$1,079.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$892.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,079.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$981.75
Rate for Payer: Qualcare PPO/HMO/WC	$669.38

ALLOGRAFT AMINO EXCEL 4x8CM

Facility

$4,462.50

Service Code	HCPCS Q4137
Hospital Charge Code	270677589
Hospital Revenue Code	278
Min. Negotiated Rate	$107.55
Max. Negotiated Rate	$1,079.92
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$533.66
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,079.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$981.75
Rate for Payer: Qualcare PPO/HMO/WC	$669.38
Rate for Payer: UnitedHealthcare Community & State	$107.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$118.26

ALLOGRAFT AMNIO MEMBRANE 2.0ML

Facility

$16,950.00

Service Code	HCPCS C1762
Hospital Charge Code	270662657
Hospital Revenue Code	278
Min. Negotiated Rate	$2,542.50
Max. Negotiated Rate	$4,101.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,101.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,729.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,542.50

ALLOGRAFT AMNIO MEMBRANE 2.0ML

Facility

$16,950.00

Service Code	HCPCS C1762
Hospital Charge Code	270662657
Hospital Revenue Code	278
Min. Negotiated Rate	$408.50
Max. Negotiated Rate	$8,475.00
Rate for Payer: Aetna Commercial	$6,441.00
Rate for Payer: Aetna Medicare Advantage	$5,085.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,322.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,322.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,322.25
Rate for Payer: Cigna Commercial	$8,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,101.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,729.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,542.50
Rate for Payer: UnitedHealthcare Community & State	$408.50
Rate for Payer: Wellpoint Medicaid Managed Care	$449.18

ALLOGRAFT AMNIOTC MEMBRANE 2x3

Facility

$5,883.75

Hospital Charge Code	270658378
Hospital Revenue Code	278
Min. Negotiated Rate	$141.80
Max. Negotiated Rate	$2,941.88
Rate for Payer: Aetna Commercial	$2,235.82
Rate for Payer: Aetna Medicare Advantage	$1,765.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,500.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,500.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,176.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,500.36
Rate for Payer: Cigna Commercial	$2,941.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,423.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,294.42
Rate for Payer: Qualcare PPO/HMO/WC	$882.56
Rate for Payer: UnitedHealthcare Community & State	$141.80
Rate for Payer: Wellpoint Medicaid Managed Care	$155.92

ALLOGRAFT AMNIOTC MEMBRANE 2x3

Facility

$5,883.75

Hospital Charge Code	270658378
Hospital Revenue Code	278
Min. Negotiated Rate	$882.56
Max. Negotiated Rate	$1,423.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,176.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,423.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,294.42
Rate for Payer: Qualcare PPO/HMO/WC	$882.56

Know your out-of-pocket cost for care.

All Charges