Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GENDER RELATED PROCEDURES

Facility

$34,177.52

Service Code	APR-DRG 8513
Min. Negotiated Rate	$33,507.37
Max. Negotiated Rate	$34,177.52
Rate for Payer: UnitedHealthcare Community & State	$33,507.37
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$34,177.52
Rate for Payer: Wellpoint Medicaid Managed Care	$33,507.37

GENERAL ANESTHESIA GAS

Facility

$213.80

Hospital Charge Code	6065064
Hospital Revenue Code	250
Min. Negotiated Rate	$5.15
Max. Negotiated Rate	$106.90
Rate for Payer: Aetna Commercial	$81.24
Rate for Payer: Aetna Medicare Advantage	$64.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.52
Rate for Payer: Cigna Commercial	$106.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.14
Rate for Payer: Oxford Commercial	$42.76
Rate for Payer: Qualcare PPO/HMO/WC	$32.07
Rate for Payer: UnitedHealthcare Commercial	$42.76
Rate for Payer: UnitedHealthcare Community & State	$5.15
Rate for Payer: Wellpoint Medicaid Managed Care	$5.67

GENERAL ANESTHESIA GAS

Facility

$213.80

Hospital Charge Code	6065064
Hospital Revenue Code	250
Min. Negotiated Rate	$32.07
Max. Negotiated Rate	$32.07
Rate for Payer: Qualcare PPO/HMO/WC	$32.07

GENERAL ANESTHESIA GAS

Facility

$164.50

Hospital Charge Code	6027056
Hospital Revenue Code	250
Min. Negotiated Rate	$24.68
Max. Negotiated Rate	$24.68
Rate for Payer: Qualcare PPO/HMO/WC	$24.68

GENERAL ANESTHESIA GAS

Facility

$164.50

Hospital Charge Code	6027056
Hospital Revenue Code	250
Min. Negotiated Rate	$3.96
Max. Negotiated Rate	$82.25
Rate for Payer: Aetna Commercial	$62.51
Rate for Payer: Aetna Medicare Advantage	$49.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.95
Rate for Payer: Cigna Commercial	$82.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.35
Rate for Payer: Oxford Commercial	$32.90
Rate for Payer: Qualcare PPO/HMO/WC	$24.68
Rate for Payer: UnitedHealthcare Commercial	$32.90
Rate for Payer: UnitedHealthcare Community & State	$3.96
Rate for Payer: Wellpoint Medicaid Managed Care	$4.36

GENERAL CYTOLOGY (NON-GYN)

Facility

$425.00

Service Code	HCPCS 88104
Hospital Charge Code	38474025
Hospital Revenue Code	311
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

GENERAL CYTOLOGY (NON-GYN)

Facility

$425.00

Service Code	HCPCS 88104
Hospital Charge Code	38474025
Hospital Revenue Code	311
Min. Negotiated Rate	$11.26
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$120.69
Rate for Payer: Aetna Medicare Advantage	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.16
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$44.37
Rate for Payer: Clover Medicare Advantage	$42.15
Rate for Payer: EmblemHealth Commercial	$133.11
Rate for Payer: Humana Medicare Advantage	$45.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$61.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.37
Rate for Payer: Wellcare Medicare Advantage	$44.37
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

GENERAL MIS INSTRUMENT SET

Facility

$625.00

Hospital Charge Code	270684550
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

GENERAL MIS INSTRUMENT SET

Facility

$625.00

Hospital Charge Code	270684550
Hospital Revenue Code	272
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

GENERAL REPAIR-MRI HVAC SYSTEM

Facility

$38,475.00

Hospital Charge Code	270659120
Hospital Revenue Code	278
Min. Negotiated Rate	$5,771.25
Max. Negotiated Rate	$9,310.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,310.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,464.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,771.25

GENERAL REPAIR-MRI HVAC SYSTEM

Facility

$38,475.00

Hospital Charge Code	270659120
Hospital Revenue Code	278
Min. Negotiated Rate	$927.25
Max. Negotiated Rate	$19,237.50
Rate for Payer: Aetna Commercial	$14,620.50
Rate for Payer: Aetna Medicare Advantage	$11,542.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,811.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,811.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,811.12
Rate for Payer: Cigna Commercial	$19,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,310.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,464.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,771.25
Rate for Payer: UnitedHealthcare Community & State	$927.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1,019.59

GENERATO 20S SPINE REN 7209812

Facility

$2,500.00

Hospital Charge Code	270639693
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

GENERATO 20S SPINE REN 7209812

Facility

$2,500.00

Hospital Charge Code	270639693
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

GENERATOR DUAL CHAMBER PULSE

Facility

$30,500.00

Hospital Charge Code	270657497
Hospital Revenue Code	278
Min. Negotiated Rate	$735.05
Max. Negotiated Rate	$15,250.00
Rate for Payer: Aetna Commercial	$11,590.00
Rate for Payer: Aetna Medicare Advantage	$9,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,777.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,777.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,777.50
Rate for Payer: Cigna Commercial	$15,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,381.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,710.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,575.00
Rate for Payer: UnitedHealthcare Community & State	$735.05
Rate for Payer: Wellpoint Medicaid Managed Care	$808.25

GENERATOR DUAL CHAMBER PULSE

Facility

$30,500.00

Hospital Charge Code	270657497
Hospital Revenue Code	278
Min. Negotiated Rate	$4,575.00
Max. Negotiated Rate	$7,381.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,381.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,710.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,575.00

GENERATOR DUAL LV PACEMAKER

Facility

$30,400.00

Service Code	HCPCS C2619
Hospital Charge Code	270668041
Hospital Revenue Code	275
Min. Negotiated Rate	$732.64
Max. Negotiated Rate	$15,200.00
Rate for Payer: Aetna Commercial	$11,552.00
Rate for Payer: Aetna Medicare Advantage	$9,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,752.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,752.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,752.00
Rate for Payer: Cigna Commercial	$15,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,356.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,688.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,560.00
Rate for Payer: UnitedHealthcare Community & State	$732.64
Rate for Payer: Wellpoint Medicaid Managed Care	$805.60

GENERATOR DUAL LV PACEMAKER

Facility

$30,400.00

Service Code	HCPCS C2619
Hospital Charge Code	270668041
Hospital Revenue Code	275
Min. Negotiated Rate	$4,560.00
Max. Negotiated Rate	$7,356.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,356.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,688.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,560.00

GENERATOR EON IPG 16-CHAN

Facility

$104,940.00

Service Code	HCPCS C1767
Hospital Charge Code	270675086
Hospital Revenue Code	278
Min. Negotiated Rate	$15,741.00
Max. Negotiated Rate	$25,395.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20,988.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25,395.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$23,086.80
Rate for Payer: Qualcare PPO/HMO/WC	$15,741.00

GENERATOR EON IPG 16-CHAN

Facility

$104,940.00

Service Code	HCPCS C1767
Hospital Charge Code	270675086
Hospital Revenue Code	278
Min. Negotiated Rate	$2,529.05
Max. Negotiated Rate	$52,470.00
Rate for Payer: Aetna Commercial	$39,877.20
Rate for Payer: Aetna Medicare Advantage	$31,482.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,759.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,759.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20,988.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26,759.70
Rate for Payer: Cigna Commercial	$52,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25,395.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$23,086.80
Rate for Payer: Qualcare PPO/HMO/WC	$15,741.00
Rate for Payer: UnitedHealthcare Community & State	$2,529.05
Rate for Payer: Wellpoint Medicaid Managed Care	$2,780.91

GENERATOR EON MINI IPG 16-CHAN

Facility

$104,940.00

Service Code	HCPCS C1820
Hospital Charge Code	270642321
Hospital Revenue Code	278
Min. Negotiated Rate	$15,741.00
Max. Negotiated Rate	$25,395.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20,988.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25,395.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$23,086.80
Rate for Payer: Qualcare PPO/HMO/WC	$15,741.00

GENERATOR EON MINI IPG 16-CHAN

Facility

$104,940.00

Service Code	HCPCS C1820
Hospital Charge Code	270642321
Hospital Revenue Code	278
Min. Negotiated Rate	$2,529.05
Max. Negotiated Rate	$52,470.00
Rate for Payer: Aetna Commercial	$39,877.20
Rate for Payer: Aetna Medicare Advantage	$31,482.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,759.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,759.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20,988.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26,759.70
Rate for Payer: Cigna Commercial	$52,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25,395.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$23,086.80
Rate for Payer: Qualcare PPO/HMO/WC	$15,741.00
Rate for Payer: UnitedHealthcare Community & State	$2,529.05
Rate for Payer: Wellpoint Medicaid Managed Care	$2,780.91

GENERATOR MULTIGEN RADIOFREQCY

Facility

$7,500.00

Hospital Charge Code	270650122
Hospital Revenue Code	270
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,250.00
Rate for Payer: Oxford Commercial	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Commercial	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$180.75
Rate for Payer: Wellpoint Medicaid Managed Care	$198.75

GENERATOR MULTIGEN RADIOFREQCY

Facility

$7,500.00

Hospital Charge Code	270650122
Hospital Revenue Code	270
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

GENERATOR PACEMAKER***

Facility

$18,002.00

Hospital Charge Code	270606661
Hospital Revenue Code	275
Min. Negotiated Rate	$433.85
Max. Negotiated Rate	$9,001.00
Rate for Payer: Aetna Commercial	$6,840.76
Rate for Payer: Aetna Medicare Advantage	$5,400.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,590.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,590.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,600.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,590.51
Rate for Payer: Cigna Commercial	$9,001.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,356.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,960.44
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.30
Rate for Payer: UnitedHealthcare Community & State	$433.85
Rate for Payer: Wellpoint Medicaid Managed Care	$477.05

GENERATOR PACEMAKER***

Facility

$18,002.00

Hospital Charge Code	270606661
Hospital Revenue Code	275
Min. Negotiated Rate	$2,700.30
Max. Negotiated Rate	$4,356.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,600.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,356.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,960.44
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.30

Know your out-of-pocket cost for care.

All Charges