Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT

Facility

$20,667.38

Service Code	APR-DRG 8411
Min. Negotiated Rate	$20,262.14
Max. Negotiated Rate	$20,667.38
Rate for Payer: UnitedHealthcare Community & State	$20,262.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,667.38
Rate for Payer: Wellpoint Medicaid Managed Care	$20,262.14

EXTENSOR TENDON REALIGNMENT

Facility

$12,289.60

Service Code	HCPCS 26437
Hospital Charge Code	16000620
Hospital Revenue Code	360
Min. Negotiated Rate	$296.18
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,686.88
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,843.44
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$296.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$325.67

EXTENSOR TENDON REALIGNMENT

Facility

$12,289.60

Service Code	HCPCS 26437
Hospital Charge Code	16000620
Hospital Revenue Code	360
Min. Negotiated Rate	$1,843.44
Max. Negotiated Rate	$1,843.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,843.44

EXTENSOR TENDON REPAIR EACH

Facility

$15,596.70

Service Code	HCPCS 26418
Hospital Charge Code	1600000803
Hospital Revenue Code	360
Min. Negotiated Rate	$375.88
Max. Negotiated Rate	$6,895.75
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,679.01
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,339.51
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$375.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$413.31

EXTENSOR TENDON REPAIR EACH

Facility

$15,596.70

Service Code	HCPCS 26418
Hospital Charge Code	1600000803
Hospital Revenue Code	360
Min. Negotiated Rate	$2,339.51
Max. Negotiated Rate	$2,339.51
Rate for Payer: Qualcare PPO/HMO/WC	$2,339.51

EXTENT STEM MAXIM 12x80 141612

Facility

$5,366.75

Hospital Charge Code	270635585
Hospital Revenue Code	272
Min. Negotiated Rate	$805.01
Max. Negotiated Rate	$805.01
Rate for Payer: Qualcare PPO/HMO/WC	$805.01

EXTENT STEM MAXIM 12x80 141612

Facility

$5,366.75

Hospital Charge Code	270635585
Hospital Revenue Code	272
Min. Negotiated Rate	$129.34
Max. Negotiated Rate	$2,683.38
Rate for Payer: Aetna Commercial	$2,039.37
Rate for Payer: Aetna Medicare Advantage	$1,610.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,368.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,368.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,368.52
Rate for Payer: Cigna Commercial	$2,683.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,610.03
Rate for Payer: Oxford Commercial	$1,073.35
Rate for Payer: Qualcare PPO/HMO/WC	$805.01
Rate for Payer: UnitedHealthcare Commercial	$1,073.35
Rate for Payer: UnitedHealthcare Community & State	$129.34
Rate for Payer: Wellpoint Medicaid Managed Care	$142.22

EXTERNAL DRAINAGE AND

Facility

$1,683.00

Hospital Charge Code	270659525
Hospital Revenue Code	270
Min. Negotiated Rate	$40.56
Max. Negotiated Rate	$841.50
Rate for Payer: Aetna Commercial	$639.54
Rate for Payer: Aetna Medicare Advantage	$504.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$429.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$429.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$429.17
Rate for Payer: Cigna Commercial	$841.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$504.90
Rate for Payer: Oxford Commercial	$336.60
Rate for Payer: Qualcare PPO/HMO/WC	$252.45
Rate for Payer: UnitedHealthcare Commercial	$336.60
Rate for Payer: UnitedHealthcare Community & State	$40.56
Rate for Payer: Wellpoint Medicaid Managed Care	$44.60

EXTERNAL DRAINAGE AND

Facility

$1,683.00

Hospital Charge Code	270659525
Hospital Revenue Code	270
Min. Negotiated Rate	$252.45
Max. Negotiated Rate	$252.45
Rate for Payer: Qualcare PPO/HMO/WC	$252.45

EXTERNAL DRAINAGE&MONITORING

Facility

$319.00

Hospital Charge Code	270335584
Hospital Revenue Code	272
Min. Negotiated Rate	$47.85
Max. Negotiated Rate	$47.85
Rate for Payer: Qualcare PPO/HMO/WC	$47.85

EXTERNAL DRAINAGE&MONITORING

Facility

$319.00

Hospital Charge Code	270335584
Hospital Revenue Code	272
Min. Negotiated Rate	$7.69
Max. Negotiated Rate	$159.50
Rate for Payer: Aetna Commercial	$121.22
Rate for Payer: Aetna Medicare Advantage	$95.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.34
Rate for Payer: Cigna Commercial	$159.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.70
Rate for Payer: Oxford Commercial	$63.80
Rate for Payer: Qualcare PPO/HMO/WC	$47.85
Rate for Payer: UnitedHealthcare Commercial	$63.80
Rate for Payer: UnitedHealthcare Community & State	$7.69
Rate for Payer: Wellpoint Medicaid Managed Care	$8.45

EXTERNAL HEART ASSIST DEVICES

Facility

$60,090.91

Service Code	APR-DRG 1781
Min. Negotiated Rate	$58,912.66
Max. Negotiated Rate	$60,090.91
Rate for Payer: UnitedHealthcare Community & State	$58,912.66
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$60,090.91
Rate for Payer: Wellpoint Medicaid Managed Care	$58,912.66

EXTERNAL HEART ASSIST DEVICES

Facility

$96,648.19

Service Code	APR-DRG 1784
Min. Negotiated Rate	$94,753.13
Max. Negotiated Rate	$96,648.19
Rate for Payer: UnitedHealthcare Community & State	$94,753.13
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$96,648.19
Rate for Payer: Wellpoint Medicaid Managed Care	$94,753.13

EXTERNAL HEART ASSIST DEVICES

Facility

$74,056.82

Service Code	APR-DRG 1783
Min. Negotiated Rate	$72,604.73
Max. Negotiated Rate	$74,056.82
Rate for Payer: UnitedHealthcare Community & State	$72,604.73
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$74,056.82
Rate for Payer: Wellpoint Medicaid Managed Care	$72,604.73

EXTERNAL HEART ASSIST DEVICES

Facility

$65,730.09

Service Code	APR-DRG 1782
Min. Negotiated Rate	$64,441.26
Max. Negotiated Rate	$65,730.09
Rate for Payer: UnitedHealthcare Community & State	$64,441.26
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$65,730.09
Rate for Payer: Wellpoint Medicaid Managed Care	$64,441.26

EXTERNAL NEUROSTIMULATOR

Facility

$2,000.00

Hospital Charge Code	270671694
Hospital Revenue Code	272
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

EXTERNAL NEUROSTIMULATOR

Facility

$2,000.00

Hospital Charge Code	270671694
Hospital Revenue Code	272
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Commercial	$400.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

EXTERNAL TRIAL STIMULATOR

Facility

$1,100.00

Service Code	HCPCS C1778
Hospital Charge Code	270702026
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$266.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

EXTERNAL TRIAL STIMULATOR

Facility

$1,100.00

Service Code	HCPCS C1778
Hospital Charge Code	270702026
Hospital Revenue Code	278
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) NJ Health	$220.00
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	$266.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Community & State	$26.51
Rate for Payer: Wellpoint Medicaid Managed Care	$29.15

EXT EXC THROMBOTIC HEMORROID

Facility

$6,384.10

Service Code	HCPCS 46320
Hospital Charge Code	5780230
Hospital Revenue Code	450
Min. Negotiated Rate	$957.62
Max. Negotiated Rate	$957.62
Rate for Payer: Qualcare PPO/HMO/WC	$957.62

EXT EXC THROMBOTIC HEMORROID

Facility

$6,384.10

Service Code	HCPCS 46320
Hospital Charge Code	5780230
Hospital Revenue Code	450
Min. Negotiated Rate	$67.76
Max. Negotiated Rate	$5,131.69
Rate for Payer: Aetna Commercial	$3,866.86
Rate for Payer: Aetna Medicare Advantage	$4,606.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,131.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,131.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,421.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,131.69
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: Cigna Medicare Advantage	$1,421.64
Rate for Payer: Clover Medicare Advantage	$1,350.56
Rate for Payer: EmblemHealth Commercial	$4,264.92
Rate for Payer: Humana Medicare Advantage	$1,464.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,421.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$957.62
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,421.64
Rate for Payer: Wellcare Medicare Advantage	$1,421.64
Rate for Payer: Wellpoint Medicaid Managed Care	$169.18

EXT LG AAA ILIAC ZENH ESLE1255

Facility

$7,440.00

Hospital Charge Code	270633655
Hospital Revenue Code	278
Min. Negotiated Rate	$179.30
Max. Negotiated Rate	$3,720.00
Rate for Payer: Aetna Commercial	$2,827.20
Rate for Payer: Aetna Medicare Advantage	$2,232.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,897.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,897.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,897.20
Rate for Payer: Cigna Commercial	$3,720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,800.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,636.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,116.00
Rate for Payer: UnitedHealthcare Community & State	$179.30
Rate for Payer: Wellpoint Medicaid Managed Care	$197.16

EXT LG AAA ILIAC ZENH ESLE1255

Facility

$7,440.00

Hospital Charge Code	270633655
Hospital Revenue Code	278
Min. Negotiated Rate	$1,116.00
Max. Negotiated Rate	$1,800.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,800.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,636.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,116.00

EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$196,798.34

Service Code	APR-DRG 0094
Min. Negotiated Rate	$192,939.55
Max. Negotiated Rate	$196,798.34
Rate for Payer: UnitedHealthcare Community & State	$192,939.55
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$196,798.34
Rate for Payer: Wellpoint Medicaid Managed Care	$192,939.55

EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$89,119.44

Service Code	APR-DRG 0093
Min. Negotiated Rate	$87,372.00
Max. Negotiated Rate	$89,119.44
Rate for Payer: UnitedHealthcare Community & State	$87,372.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$89,119.44
Rate for Payer: Wellpoint Medicaid Managed Care	$87,372.00

Know your out-of-pocket cost for care.

All Charges