Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ALLOGRAFT FLOW 1CC FD

Facility

$650.00

Hospital Charge Code	270671267
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

ALLOGRAFT FLOW 1CC FD

Facility

$650.00

Hospital Charge Code	270671267
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

ALLOGRAFT FLOW .5CC FD

Facility

$400.00

Hospital Charge Code	270671266
Hospital Revenue Code	278
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

ALLOGRAFT FLOW .5CC FD

Facility

$400.00

Hospital Charge Code	270671266
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

ALLOGRAFT FLOW 5CC FD

Facility

$2,610.00

Hospital Charge Code	270671268
Hospital Revenue Code	278
Min. Negotiated Rate	$391.50
Max. Negotiated Rate	$631.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$522.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$631.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$574.20
Rate for Payer: Qualcare PPO/HMO/WC	$391.50

ALLOGRAFT FLOW 5CC FD

Facility

$2,610.00

Hospital Charge Code	270671268
Hospital Revenue Code	278
Min. Negotiated Rate	$62.90
Max. Negotiated Rate	$1,305.00
Rate for Payer: Aetna Commercial	$991.80
Rate for Payer: Aetna Medicare Advantage	$783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$665.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$665.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$522.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$665.55
Rate for Payer: Cigna Commercial	$1,305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$631.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$574.20
Rate for Payer: Qualcare PPO/HMO/WC	$391.50
Rate for Payer: UnitedHealthcare Community & State	$62.90
Rate for Payer: Wellpoint Medicaid Managed Care	$69.17

ALLOGRAFT GRAFTLINK CONV PK

Facility

$4,700.00

Hospital Charge Code	270676749
Hospital Revenue Code	272
Min. Negotiated Rate	$113.27
Max. Negotiated Rate	$2,350.00
Rate for Payer: Aetna Commercial	$1,786.00
Rate for Payer: Aetna Medicare Advantage	$1,410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,198.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,198.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,198.50
Rate for Payer: Cigna Commercial	$2,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,410.00
Rate for Payer: Oxford Commercial	$940.00
Rate for Payer: Qualcare PPO/HMO/WC	$705.00
Rate for Payer: UnitedHealthcare Commercial	$940.00
Rate for Payer: UnitedHealthcare Community & State	$113.27
Rate for Payer: Wellpoint Medicaid Managed Care	$124.55

ALLOGRAFT GRAFTLINK CONV PK

Facility

$4,700.00

Hospital Charge Code	270676749
Hospital Revenue Code	272
Min. Negotiated Rate	$705.00
Max. Negotiated Rate	$705.00
Rate for Payer: Qualcare PPO/HMO/WC	$705.00

ALLOGRAFT HD 8X16

Facility

$23,345.00

Hospital Charge Code	270664855
Hospital Revenue Code	278
Min. Negotiated Rate	$562.61
Max. Negotiated Rate	$11,672.50
Rate for Payer: Aetna Commercial	$8,871.10
Rate for Payer: Aetna Medicare Advantage	$7,003.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,952.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,952.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,669.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,952.98
Rate for Payer: Cigna Commercial	$11,672.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,649.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,135.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,501.75
Rate for Payer: UnitedHealthcare Community & State	$562.61
Rate for Payer: Wellpoint Medicaid Managed Care	$618.64

ALLOGRAFT HD 8X16

Facility

$23,345.00

Hospital Charge Code	270664855
Hospital Revenue Code	278
Min. Negotiated Rate	$3,501.75
Max. Negotiated Rate	$5,649.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,669.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,649.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,135.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,501.75

ALLOGRAFT HTM SELECT 16X20CM

Facility

$69,780.00

Service Code	HCPCS Q4116
Hospital Charge Code	270695111
Hospital Revenue Code	278
Min. Negotiated Rate	$10,467.00
Max. Negotiated Rate	$16,886.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,956.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,886.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15,351.60
Rate for Payer: Qualcare PPO/HMO/WC	$10,467.00

ALLOGRAFT HTM SELECT 16X20CM

Facility

$69,780.00

Service Code	HCPCS Q4116
Hospital Charge Code	270695111
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$16,886.76
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	$13,956.00
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	$16,886.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15,351.60
Rate for Payer: Qualcare PPO/HMO/WC	$10,467.00
Rate for Payer: UnitedHealthcare Community & State	$1,681.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$1,849.17

ALLOGRAFT IC RT MOLD 10CC FD

Facility

$5,165.00

Hospital Charge Code	270671272
Hospital Revenue Code	278
Min. Negotiated Rate	$124.48
Max. Negotiated Rate	$2,582.50
Rate for Payer: Aetna Commercial	$1,962.70
Rate for Payer: Aetna Medicare Advantage	$1,549.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,317.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,317.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,033.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,317.08
Rate for Payer: Cigna Commercial	$2,582.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,249.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,136.30
Rate for Payer: Qualcare PPO/HMO/WC	$774.75
Rate for Payer: UnitedHealthcare Community & State	$124.48
Rate for Payer: Wellpoint Medicaid Managed Care	$136.87

ALLOGRAFT IC RT MOLD 10CC FD

Facility

$5,165.00

Hospital Charge Code	270671272
Hospital Revenue Code	278
Min. Negotiated Rate	$774.75
Max. Negotiated Rate	$1,249.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,033.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,249.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,136.30
Rate for Payer: Qualcare PPO/HMO/WC	$774.75

ALLOGRAFT IC RT MOLD 20CC FD

Facility

$10,360.00

Hospital Charge Code	270671273
Hospital Revenue Code	278
Min. Negotiated Rate	$1,554.00
Max. Negotiated Rate	$2,507.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,072.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,507.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,279.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,554.00

ALLOGRAFT IC RT MOLD 20CC FD

Facility

$10,360.00

Hospital Charge Code	270671273
Hospital Revenue Code	278
Min. Negotiated Rate	$249.68
Max. Negotiated Rate	$5,180.00
Rate for Payer: Aetna Commercial	$3,936.80
Rate for Payer: Aetna Medicare Advantage	$3,108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,641.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,641.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,072.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,641.80
Rate for Payer: Cigna Commercial	$5,180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,507.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,279.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,554.00
Rate for Payer: UnitedHealthcare Community & State	$249.68
Rate for Payer: Wellpoint Medicaid Managed Care	$274.54

ALLOGRAFT IC RT MOLD 2CC FD

Facility

$1,715.00

Hospital Charge Code	270671270
Hospital Revenue Code	278
Min. Negotiated Rate	$257.25
Max. Negotiated Rate	$415.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$343.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$377.30
Rate for Payer: Qualcare PPO/HMO/WC	$257.25

ALLOGRAFT IC RT MOLD 2CC FD

Facility

$1,715.00

Hospital Charge Code	270671270
Hospital Revenue Code	278
Min. Negotiated Rate	$41.33
Max. Negotiated Rate	$857.50
Rate for Payer: Aetna Commercial	$651.70
Rate for Payer: Aetna Medicare Advantage	$514.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$437.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$437.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$343.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$437.32
Rate for Payer: Cigna Commercial	$857.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$377.30
Rate for Payer: Qualcare PPO/HMO/WC	$257.25
Rate for Payer: UnitedHealthcare Community & State	$41.33
Rate for Payer: Wellpoint Medicaid Managed Care	$45.45

ALLOGRAFT IC RT MOLD 5CC FD

Facility

$3,360.00

Hospital Charge Code	270671271
Hospital Revenue Code	278
Min. Negotiated Rate	$504.00
Max. Negotiated Rate	$813.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$672.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$813.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$739.20
Rate for Payer: Qualcare PPO/HMO/WC	$504.00

ALLOGRAFT IC RT MOLD 5CC FD

Facility

$3,360.00

Hospital Charge Code	270671271
Hospital Revenue Code	278
Min. Negotiated Rate	$80.98
Max. Negotiated Rate	$1,680.00
Rate for Payer: Aetna Commercial	$1,276.80
Rate for Payer: Aetna Medicare Advantage	$1,008.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$856.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$856.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$672.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$856.80
Rate for Payer: Cigna Commercial	$1,680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$813.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$739.20
Rate for Payer: Qualcare PPO/HMO/WC	$504.00
Rate for Payer: UnitedHealthcare Community & State	$80.98
Rate for Payer: Wellpoint Medicaid Managed Care	$89.04

ALLOGRAFT IMPLANT SYS FOR INTE

Facility

$10,068.25

Service Code	HCPCS C1889
Hospital Charge Code	270705066
Hospital Revenue Code	278
Min. Negotiated Rate	$242.64
Max. Negotiated Rate	$5,034.12
Rate for Payer: Aetna Commercial	$3,825.93
Rate for Payer: Aetna Medicare Advantage	$3,020.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,567.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,567.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,013.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,567.40
Rate for Payer: Cigna Commercial	$5,034.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,436.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,215.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,510.24
Rate for Payer: UnitedHealthcare Community & State	$242.64
Rate for Payer: Wellpoint Medicaid Managed Care	$266.81

ALLOGRAFT IMPLANT SYS FOR INTE

Facility

$10,068.25

Service Code	HCPCS C1889
Hospital Charge Code	270705066
Hospital Revenue Code	278
Min. Negotiated Rate	$1,510.24
Max. Negotiated Rate	$2,436.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,013.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,436.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,215.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,510.24

ALLOGRAFT MAGNUS 10 CC

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693724
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

ALLOGRAFT MAGNUS 10 CC

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693724
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

ALLOGRAFT MAGNUS 2.5CC

Facility

$5,975.00

Service Code	HCPCS C1763
Hospital Charge Code	270698652
Hospital Revenue Code	278
Min. Negotiated Rate	$896.25
Max. Negotiated Rate	$1,445.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,314.50
Rate for Payer: Qualcare PPO/HMO/WC	$896.25

Know your out-of-pocket cost for care.

All Charges