Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

EYE CONFORMER MEDIUM HOLE

Facility

$315.00

Hospital Charge Code	270688507
Hospital Revenue Code	278
Min. Negotiated Rate	$7.59
Max. Negotiated Rate	$157.50
Rate for Payer: Aetna Commercial	$119.70
Rate for Payer: Aetna Medicare Advantage	$94.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.33
Rate for Payer: Cigna Commercial	$157.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$69.30
Rate for Payer: Qualcare PPO/HMO/WC	$47.25
Rate for Payer: UnitedHealthcare Community & State	$7.59
Rate for Payer: Wellpoint Medicaid Managed Care	$8.35

EYE CONFORMER SMALL

Facility

$270.00

Hospital Charge Code	270688502
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$65.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.40
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

EYE CONFORMER SMALL

Facility

$270.00

Hospital Charge Code	270688502
Hospital Revenue Code	278
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.40
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Community & State	$6.51
Rate for Payer: Wellpoint Medicaid Managed Care	$7.16

EYE CONFORMER SMALL HOLE

Facility

$315.00

Hospital Charge Code	270688506
Hospital Revenue Code	278
Min. Negotiated Rate	$47.25
Max. Negotiated Rate	$76.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$69.30
Rate for Payer: Qualcare PPO/HMO/WC	$47.25

EYE CONFORMER SMALL HOLE

Facility

$315.00

Hospital Charge Code	270688506
Hospital Revenue Code	278
Min. Negotiated Rate	$7.59
Max. Negotiated Rate	$157.50
Rate for Payer: Aetna Commercial	$119.70
Rate for Payer: Aetna Medicare Advantage	$94.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.33
Rate for Payer: Cigna Commercial	$157.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$69.30
Rate for Payer: Qualcare PPO/HMO/WC	$47.25
Rate for Payer: UnitedHealthcare Community & State	$7.59
Rate for Payer: Wellpoint Medicaid Managed Care	$8.35

EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$12,090.42

Service Code	APR-DRG 0823
Min. Negotiated Rate	$11,853.35
Max. Negotiated Rate	$12,090.42
Rate for Payer: UnitedHealthcare Community & State	$11,853.35
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,090.42
Rate for Payer: Wellpoint Medicaid Managed Care	$11,853.35

EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$6,783.13

Service Code	APR-DRG 0821
Min. Negotiated Rate	$6,650.13
Max. Negotiated Rate	$6,783.13
Rate for Payer: UnitedHealthcare Community & State	$6,650.13
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,783.13
Rate for Payer: Wellpoint Medicaid Managed Care	$6,650.13

EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$8,298.61

Service Code	APR-DRG 0822
Min. Negotiated Rate	$8,135.89
Max. Negotiated Rate	$8,298.61
Rate for Payer: UnitedHealthcare Community & State	$8,135.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,298.61
Rate for Payer: Wellpoint Medicaid Managed Care	$8,135.89

EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$22,207.08

Service Code	APR-DRG 0824
Min. Negotiated Rate	$21,771.65
Max. Negotiated Rate	$22,207.08
Rate for Payer: UnitedHealthcare Community & State	$21,771.65
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,207.08
Rate for Payer: Wellpoint Medicaid Managed Care	$21,771.65

EYE PAD OVAL CURITY

Facility

$19.55

Hospital Charge Code	270655032
Hospital Revenue Code	272
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$2.93
Rate for Payer: Qualcare PPO/HMO/WC	$2.93

EYE PAD OVAL CURITY

Facility

$19.55

Hospital Charge Code	270655032
Hospital Revenue Code	272
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$9.78
Rate for Payer: Aetna Commercial	$7.43
Rate for Payer: Aetna Medicare Advantage	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.99
Rate for Payer: Cigna Commercial	$9.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.87
Rate for Payer: Oxford Commercial	$3.91
Rate for Payer: Qualcare PPO/HMO/WC	$2.93
Rate for Payer: UnitedHealthcare Commercial	$3.91
Rate for Payer: UnitedHealthcare Community & State	$0.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.52

EYE RX

Facility

$81.00

Hospital Charge Code	60634916
Hospital Revenue Code	250
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$12.15
Rate for Payer: Qualcare PPO/HMO/WC	$12.15

EYE RX

Facility

$81.00

Hospital Charge Code	60634916
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$40.50
Rate for Payer: Aetna Commercial	$30.78
Rate for Payer: Aetna Medicare Advantage	$24.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.66
Rate for Payer: Cigna Commercial	$40.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.30
Rate for Payer: Oxford Commercial	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$12.15
Rate for Payer: UnitedHealthcare Commercial	$16.20
Rate for Payer: UnitedHealthcare Community & State	$1.95
Rate for Payer: Wellpoint Medicaid Managed Care	$2.15

EYESHIELD PHOTOTHERAPY NEWBORN

Facility

$15.25

Hospital Charge Code	270654356
Hospital Revenue Code	270
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$7.62
Rate for Payer: Aetna Commercial	$5.79
Rate for Payer: Aetna Medicare Advantage	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.89
Rate for Payer: Cigna Commercial	$7.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.58
Rate for Payer: Oxford Commercial	$3.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.29
Rate for Payer: UnitedHealthcare Commercial	$3.05
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

EYESHIELD PHOTOTHERAPY NEWBORN

Facility

$15.25

Hospital Charge Code	270654356
Hospital Revenue Code	270
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$2.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.29

EYE SPHERE 20 MM

Facility

$270.00

Hospital Charge Code	270688500
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$65.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.40
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

EYE SPHERE 20 MM

Facility

$270.00

Hospital Charge Code	270688500
Hospital Revenue Code	278
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.40
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Community & State	$6.51
Rate for Payer: Wellpoint Medicaid Managed Care	$7.16

EYE SPHERE 22 MM

Facility

$270.00

Hospital Charge Code	270688501
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$65.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.40
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

EYE SPHERE 22 MM

Facility

$270.00

Hospital Charge Code	270688501
Hospital Revenue Code	278
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.40
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Community & State	$6.51
Rate for Payer: Wellpoint Medicaid Managed Care	$7.16

EYE SPHERE IMPLANT (SILICONE)

Facility

$48.00

Hospital Charge Code	270335006
Hospital Revenue Code	278
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna Commercial	$18.24
Rate for Payer: Aetna Medicare Advantage	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.24
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.56
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

EYE SPHERE IMPLANT (SILICONE)

Facility

$48.00

Hospital Charge Code	270335006
Hospital Revenue Code	278
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.56
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

EYE SPHERE W/ CONFORMER SILICO

Facility

$284.00

Hospital Charge Code	270335226
Hospital Revenue Code	278
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$142.00
Rate for Payer: Aetna Commercial	$107.92
Rate for Payer: Aetna Medicare Advantage	$85.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.42
Rate for Payer: Cigna Commercial	$142.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$62.48
Rate for Payer: Qualcare PPO/HMO/WC	$42.60
Rate for Payer: UnitedHealthcare Community & State	$6.84
Rate for Payer: Wellpoint Medicaid Managed Care	$7.53

EYE SPHERE W/ CONFORMER SILICO

Facility

$284.00

Hospital Charge Code	270335226
Hospital Revenue Code	278
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$68.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$62.48
Rate for Payer: Qualcare PPO/HMO/WC	$42.60

E-Z CLEAN BLADE

Facility

$26.91

Hospital Charge Code	270646995
Hospital Revenue Code	270
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$4.04
Rate for Payer: Qualcare PPO/HMO/WC	$4.04

E-Z CLEAN BLADE

Facility

$26.91

Hospital Charge Code	270646995
Hospital Revenue Code	270
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$13.46
Rate for Payer: Aetna Commercial	$10.23
Rate for Payer: Aetna Medicare Advantage	$8.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.86
Rate for Payer: Cigna Commercial	$13.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.07
Rate for Payer: Oxford Commercial	$5.38
Rate for Payer: Qualcare PPO/HMO/WC	$4.04
Rate for Payer: UnitedHealthcare Commercial	$5.38
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

Know your out-of-pocket cost for care.

All Charges