Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FORCEP VCS CLIPTIP 6.0 061212

Facility

$440.85

Hospital Charge Code	270600146
Hospital Revenue Code	272
Min. Negotiated Rate	$10.62
Max. Negotiated Rate	$220.43
Rate for Payer: Aetna Commercial	$167.52
Rate for Payer: Aetna Medicare Advantage	$132.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.42
Rate for Payer: Cigna Commercial	$220.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.25
Rate for Payer: Oxford Commercial	$88.17
Rate for Payer: Qualcare PPO/HMO/WC	$66.13
Rate for Payer: UnitedHealthcare Commercial	$88.17
Rate for Payer: UnitedHealthcare Community & State	$10.62
Rate for Payer: Wellpoint Medicaid Managed Care	$11.68

FORCEP VCS CLIPTIP 6.0 061212

Facility

$440.85

Hospital Charge Code	270600146
Hospital Revenue Code	272
Min. Negotiated Rate	$66.13
Max. Negotiated Rate	$66.13
Rate for Payer: Qualcare PPO/HMO/WC	$66.13

FORCEP VEC TTS ESOPH 10 4110

Facility

$973.65

Hospital Charge Code	270603921
Hospital Revenue Code	270
Min. Negotiated Rate	$146.05
Max. Negotiated Rate	$146.05
Rate for Payer: Qualcare PPO/HMO/WC	$146.05

FORCEP VEC TTS ESOPH 10 4110

Facility

$973.65

Hospital Charge Code	270603921
Hospital Revenue Code	270
Min. Negotiated Rate	$23.46
Max. Negotiated Rate	$486.82
Rate for Payer: Aetna Commercial	$369.99
Rate for Payer: Aetna Medicare Advantage	$292.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.28
Rate for Payer: Cigna Commercial	$486.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.10
Rate for Payer: Oxford Commercial	$194.73
Rate for Payer: Qualcare PPO/HMO/WC	$146.05
Rate for Payer: UnitedHealthcare Commercial	$194.73
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$25.80

FORCEP VEC TTS ESOPH 12 4112

Facility

$973.65

Hospital Charge Code	270603922
Hospital Revenue Code	270
Min. Negotiated Rate	$23.46
Max. Negotiated Rate	$486.82
Rate for Payer: Aetna Commercial	$369.99
Rate for Payer: Aetna Medicare Advantage	$292.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.28
Rate for Payer: Cigna Commercial	$486.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.10
Rate for Payer: Oxford Commercial	$194.73
Rate for Payer: Qualcare PPO/HMO/WC	$146.05
Rate for Payer: UnitedHealthcare Commercial	$194.73
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$25.80

FORCEP VEC TTS ESOPH 12 4112

Facility

$973.65

Hospital Charge Code	270603922
Hospital Revenue Code	270
Min. Negotiated Rate	$146.05
Max. Negotiated Rate	$146.05
Rate for Payer: Qualcare PPO/HMO/WC	$146.05

FORCEP VEC TTS ESOPH 15 4115

Facility

$973.65

Hospital Charge Code	270603923
Hospital Revenue Code	270
Min. Negotiated Rate	$146.05
Max. Negotiated Rate	$146.05
Rate for Payer: Qualcare PPO/HMO/WC	$146.05

FORCEP VEC TTS ESOPH 15 4115

Facility

$973.65

Hospital Charge Code	270603923
Hospital Revenue Code	270
Min. Negotiated Rate	$23.46
Max. Negotiated Rate	$486.82
Rate for Payer: Aetna Commercial	$369.99
Rate for Payer: Aetna Medicare Advantage	$292.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.28
Rate for Payer: Cigna Commercial	$486.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.10
Rate for Payer: Oxford Commercial	$194.73
Rate for Payer: Qualcare PPO/HMO/WC	$146.05
Rate for Payer: UnitedHealthcare Commercial	$194.73
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$25.80

FORCEP VEC TTS ESOPH 18 4118

Facility

$973.65

Hospital Charge Code	270603924
Hospital Revenue Code	270
Min. Negotiated Rate	$146.05
Max. Negotiated Rate	$146.05
Rate for Payer: Qualcare PPO/HMO/WC	$146.05

FORCEP VEC TTS ESOPH 18 4118

Facility

$973.65

Hospital Charge Code	270603924
Hospital Revenue Code	270
Min. Negotiated Rate	$23.46
Max. Negotiated Rate	$486.82
Rate for Payer: Aetna Commercial	$369.99
Rate for Payer: Aetna Medicare Advantage	$292.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.28
Rate for Payer: Cigna Commercial	$486.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.10
Rate for Payer: Oxford Commercial	$194.73
Rate for Payer: Qualcare PPO/HMO/WC	$146.05
Rate for Payer: UnitedHealthcare Commercial	$194.73
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$25.80

FORCEP VEC TTS ESOPH 20 4120

Facility

$973.65

Hospital Charge Code	270603925
Hospital Revenue Code	270
Min. Negotiated Rate	$146.05
Max. Negotiated Rate	$146.05
Rate for Payer: Qualcare PPO/HMO/WC	$146.05

FORCEP VEC TTS ESOPH 20 4120

Facility

$973.65

Hospital Charge Code	270603925
Hospital Revenue Code	270
Min. Negotiated Rate	$23.46
Max. Negotiated Rate	$486.82
Rate for Payer: Aetna Commercial	$369.99
Rate for Payer: Aetna Medicare Advantage	$292.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.28
Rate for Payer: Cigna Commercial	$486.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.10
Rate for Payer: Oxford Commercial	$194.73
Rate for Payer: Qualcare PPO/HMO/WC	$146.05
Rate for Payer: UnitedHealthcare Commercial	$194.73
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$25.80

FORCEP VEC TTS ESOPH 6 4106

Facility

$973.65

Hospital Charge Code	270603919
Hospital Revenue Code	270
Min. Negotiated Rate	$146.05
Max. Negotiated Rate	$146.05
Rate for Payer: Qualcare PPO/HMO/WC	$146.05

FORCEP VEC TTS ESOPH 6 4106

Facility

$973.65

Hospital Charge Code	270603919
Hospital Revenue Code	270
Min. Negotiated Rate	$23.46
Max. Negotiated Rate	$486.82
Rate for Payer: Aetna Commercial	$369.99
Rate for Payer: Aetna Medicare Advantage	$292.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.28
Rate for Payer: Cigna Commercial	$486.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.10
Rate for Payer: Oxford Commercial	$194.73
Rate for Payer: Qualcare PPO/HMO/WC	$146.05
Rate for Payer: UnitedHealthcare Commercial	$194.73
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$25.80

FORCEP VEC TTS ESOPH 8 4108

Facility

$973.65

Hospital Charge Code	270603920
Hospital Revenue Code	270
Min. Negotiated Rate	$146.05
Max. Negotiated Rate	$146.05
Rate for Payer: Qualcare PPO/HMO/WC	$146.05

FORCEP VEC TTS ESOPH 8 4108

Facility

$973.65

Hospital Charge Code	270603920
Hospital Revenue Code	270
Min. Negotiated Rate	$23.46
Max. Negotiated Rate	$486.82
Rate for Payer: Aetna Commercial	$369.99
Rate for Payer: Aetna Medicare Advantage	$292.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.28
Rate for Payer: Cigna Commercial	$486.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.10
Rate for Payer: Oxford Commercial	$194.73
Rate for Payer: Qualcare PPO/HMO/WC	$146.05
Rate for Payer: UnitedHealthcare Commercial	$194.73
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$25.80

FORCEP VEC TTS PHLOR 12 4812

Facility

$973.65

Hospital Charge Code	270603929
Hospital Revenue Code	270
Min. Negotiated Rate	$23.46
Max. Negotiated Rate	$486.82
Rate for Payer: Aetna Commercial	$369.99
Rate for Payer: Aetna Medicare Advantage	$292.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.28
Rate for Payer: Cigna Commercial	$486.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.10
Rate for Payer: Oxford Commercial	$194.73
Rate for Payer: Qualcare PPO/HMO/WC	$146.05
Rate for Payer: UnitedHealthcare Commercial	$194.73
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$25.80

FORCEP VEC TTS PHLOR 12 4812

Facility

$973.65

Hospital Charge Code	270603929
Hospital Revenue Code	270
Min. Negotiated Rate	$146.05
Max. Negotiated Rate	$146.05
Rate for Payer: Qualcare PPO/HMO/WC	$146.05

FORCEP VEC TTS PYLOR 10 4810

Facility

$973.65

Hospital Charge Code	270603928
Hospital Revenue Code	270
Min. Negotiated Rate	$23.46
Max. Negotiated Rate	$486.82
Rate for Payer: Aetna Commercial	$369.99
Rate for Payer: Aetna Medicare Advantage	$292.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.28
Rate for Payer: Cigna Commercial	$486.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.10
Rate for Payer: Oxford Commercial	$194.73
Rate for Payer: Qualcare PPO/HMO/WC	$146.05
Rate for Payer: UnitedHealthcare Commercial	$194.73
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$25.80

FORCEP VEC TTS PYLOR 10 4810

Facility

$973.65

Hospital Charge Code	270603928
Hospital Revenue Code	270
Min. Negotiated Rate	$146.05
Max. Negotiated Rate	$146.05
Rate for Payer: Qualcare PPO/HMO/WC	$146.05

FORCEP VEC TTS PYLOR 15 4815

Facility

$973.65

Hospital Charge Code	270603930
Hospital Revenue Code	270
Min. Negotiated Rate	$146.05
Max. Negotiated Rate	$146.05
Rate for Payer: Qualcare PPO/HMO/WC	$146.05

FORCEP VEC TTS PYLOR 15 4815

Facility

$973.65

Hospital Charge Code	270603930
Hospital Revenue Code	270
Min. Negotiated Rate	$23.46
Max. Negotiated Rate	$486.82
Rate for Payer: Aetna Commercial	$369.99
Rate for Payer: Aetna Medicare Advantage	$292.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.28
Rate for Payer: Cigna Commercial	$486.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.10
Rate for Payer: Oxford Commercial	$194.73
Rate for Payer: Qualcare PPO/HMO/WC	$146.05
Rate for Payer: UnitedHealthcare Commercial	$194.73
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$25.80

FORCEP VEC TTS PYLOR 18 4818

Facility

$973.65

Hospital Charge Code	270603931
Hospital Revenue Code	270
Min. Negotiated Rate	$23.46
Max. Negotiated Rate	$486.82
Rate for Payer: Aetna Commercial	$369.99
Rate for Payer: Aetna Medicare Advantage	$292.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.28
Rate for Payer: Cigna Commercial	$486.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.10
Rate for Payer: Oxford Commercial	$194.73
Rate for Payer: Qualcare PPO/HMO/WC	$146.05
Rate for Payer: UnitedHealthcare Commercial	$194.73
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$25.80

FORCEP VEC TTS PYLOR 18 4818

Facility

$973.65

Hospital Charge Code	270603931
Hospital Revenue Code	270
Min. Negotiated Rate	$146.05
Max. Negotiated Rate	$146.05
Rate for Payer: Qualcare PPO/HMO/WC	$146.05

FORCEP VEC TTS PYLOR 6 4806

Facility

$973.65

Hospital Charge Code	270603926
Hospital Revenue Code	270
Min. Negotiated Rate	$23.46
Max. Negotiated Rate	$486.82
Rate for Payer: Aetna Commercial	$369.99
Rate for Payer: Aetna Medicare Advantage	$292.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.28
Rate for Payer: Cigna Commercial	$486.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.10
Rate for Payer: Oxford Commercial	$194.73
Rate for Payer: Qualcare PPO/HMO/WC	$146.05
Rate for Payer: UnitedHealthcare Commercial	$194.73
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$25.80

Know your out-of-pocket cost for care.

All Charges