Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GRAFT MCVL DBL VELR 22/11CM**

Facility

$2,716.00

Hospital Charge Code	1604180
Hospital Revenue Code	278
Min. Negotiated Rate	$407.40
Max. Negotiated Rate	$657.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$543.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$657.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$597.52
Rate for Payer: Qualcare PPO/HMO/WC	$407.40

GRAFT MCVL DBL VELR 24/12CM***

Facility

$2,716.00

Hospital Charge Code	1604198
Hospital Revenue Code	278
Min. Negotiated Rate	$407.40
Max. Negotiated Rate	$657.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$543.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$657.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$597.52
Rate for Payer: Qualcare PPO/HMO/WC	$407.40

GRAFT MCVL DBL VELR 24/12CM***

Facility

$2,716.00

Hospital Charge Code	1604198
Hospital Revenue Code	278
Min. Negotiated Rate	$65.46
Max. Negotiated Rate	$1,358.00
Rate for Payer: Aetna Commercial	$1,032.08
Rate for Payer: Aetna Medicare Advantage	$814.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$692.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$692.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$543.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$692.58
Rate for Payer: Cigna Commercial	$1,358.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$657.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$597.52
Rate for Payer: Qualcare PPO/HMO/WC	$407.40
Rate for Payer: UnitedHealthcare Community & State	$65.46
Rate for Payer: Wellpoint Medicaid Managed Care	$71.97

GRAFT MCVL DBL VELR HMSHLD

Facility

$1,994.00

Hospital Charge Code	1603984
Hospital Revenue Code	278
Min. Negotiated Rate	$48.06
Max. Negotiated Rate	$997.00
Rate for Payer: Aetna Commercial	$757.72
Rate for Payer: Aetna Medicare Advantage	$598.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$508.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$508.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$398.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$508.47
Rate for Payer: Cigna Commercial	$997.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$438.68
Rate for Payer: Qualcare PPO/HMO/WC	$299.10
Rate for Payer: UnitedHealthcare Community & State	$48.06
Rate for Payer: Wellpoint Medicaid Managed Care	$52.84

GRAFT MCVL DBL VELR HMSHLD

Facility

$1,994.00

Hospital Charge Code	1603984
Hospital Revenue Code	278
Min. Negotiated Rate	$299.10
Max. Negotiated Rate	$482.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$398.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$438.68
Rate for Payer: Qualcare PPO/HMO/WC	$299.10

GRAFT MCVL DBL VELR ST 20MM***

Facility

$1,994.00

Hospital Charge Code	1604214
Hospital Revenue Code	278
Min. Negotiated Rate	$48.06
Max. Negotiated Rate	$997.00
Rate for Payer: Aetna Commercial	$757.72
Rate for Payer: Aetna Medicare Advantage	$598.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$508.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$508.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$398.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$508.47
Rate for Payer: Cigna Commercial	$997.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$438.68
Rate for Payer: Qualcare PPO/HMO/WC	$299.10
Rate for Payer: UnitedHealthcare Community & State	$48.06
Rate for Payer: Wellpoint Medicaid Managed Care	$52.84

GRAFT MCVL DBL VELR ST 20MM***

Facility

$1,994.00

Hospital Charge Code	1604214
Hospital Revenue Code	278
Min. Negotiated Rate	$299.10
Max. Negotiated Rate	$482.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$398.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$438.68
Rate for Payer: Qualcare PPO/HMO/WC	$299.10

GRAFT MCVL DBL VELR ST 22MM***

Facility

$1,994.00

Hospital Charge Code	1604107
Hospital Revenue Code	278
Min. Negotiated Rate	$48.06
Max. Negotiated Rate	$997.00
Rate for Payer: Aetna Commercial	$757.72
Rate for Payer: Aetna Medicare Advantage	$598.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$508.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$508.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$398.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$508.47
Rate for Payer: Cigna Commercial	$997.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$438.68
Rate for Payer: Qualcare PPO/HMO/WC	$299.10
Rate for Payer: UnitedHealthcare Community & State	$48.06
Rate for Payer: Wellpoint Medicaid Managed Care	$52.84

GRAFT MCVL DBL VELR ST 22MM***

Facility

$1,994.00

Hospital Charge Code	1604107
Hospital Revenue Code	278
Min. Negotiated Rate	$299.10
Max. Negotiated Rate	$482.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$398.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$438.68
Rate for Payer: Qualcare PPO/HMO/WC	$299.10

GRAFT MCVL DBL VELR ST 24MM***

Facility

$1,794.00

Hospital Charge Code	1604164
Hospital Revenue Code	278
Min. Negotiated Rate	$43.24
Max. Negotiated Rate	$897.00
Rate for Payer: Aetna Commercial	$681.72
Rate for Payer: Aetna Medicare Advantage	$538.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$358.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.47
Rate for Payer: Cigna Commercial	$897.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.68
Rate for Payer: Qualcare PPO/HMO/WC	$269.10
Rate for Payer: UnitedHealthcare Community & State	$43.24
Rate for Payer: Wellpoint Medicaid Managed Care	$47.54

GRAFT MCVL DBL VELR ST 24MM***

Facility

$1,794.00

Hospital Charge Code	1604164
Hospital Revenue Code	278
Min. Negotiated Rate	$269.10
Max. Negotiated Rate	$434.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$358.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$394.68
Rate for Payer: Qualcare PPO/HMO/WC	$269.10

GRAFT MCVL DBL VELR ST8/60CM**

Facility

$1,944.00

Hospital Charge Code	1604131
Hospital Revenue Code	278
Min. Negotiated Rate	$46.85
Max. Negotiated Rate	$972.00
Rate for Payer: Aetna Commercial	$738.72
Rate for Payer: Aetna Medicare Advantage	$583.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$495.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$495.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$388.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$495.72
Rate for Payer: Cigna Commercial	$972.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$470.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$427.68
Rate for Payer: Qualcare PPO/HMO/WC	$291.60
Rate for Payer: UnitedHealthcare Community & State	$46.85
Rate for Payer: Wellpoint Medicaid Managed Care	$51.52

GRAFT MCVL DBL VELR ST8/60CM**

Facility

$1,944.00

Hospital Charge Code	1604131
Hospital Revenue Code	278
Min. Negotiated Rate	$291.60
Max. Negotiated Rate	$470.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$388.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$470.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$427.68
Rate for Payer: Qualcare PPO/HMO/WC	$291.60

GRAFT MCVL DBL VLR BIF20/10**

Facility

$3,015.00

Hospital Charge Code	1604206
Hospital Revenue Code	278
Min. Negotiated Rate	$72.66
Max. Negotiated Rate	$1,507.50
Rate for Payer: Aetna Commercial	$1,145.70
Rate for Payer: Aetna Medicare Advantage	$904.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$768.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$768.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$603.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$768.83
Rate for Payer: Cigna Commercial	$1,507.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$729.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$663.30
Rate for Payer: Qualcare PPO/HMO/WC	$452.25
Rate for Payer: UnitedHealthcare Community & State	$72.66
Rate for Payer: Wellpoint Medicaid Managed Care	$79.90

GRAFT MCVL DBL VLR BIF20/10**

Facility

$3,015.00

Hospital Charge Code	1604206
Hospital Revenue Code	278
Min. Negotiated Rate	$452.25
Max. Negotiated Rate	$729.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$603.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$729.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$663.30
Rate for Payer: Qualcare PPO/HMO/WC	$452.25

GRAFT MCVL ST 10MM/60CM*****

Facility

$1,335.00

Hospital Charge Code	270601143
Hospital Revenue Code	278
Min. Negotiated Rate	$32.17
Max. Negotiated Rate	$667.50
Rate for Payer: Aetna Commercial	$507.30
Rate for Payer: Aetna Medicare Advantage	$400.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.43
Rate for Payer: Cigna Commercial	$667.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$323.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$293.70
Rate for Payer: Qualcare PPO/HMO/WC	$200.25
Rate for Payer: UnitedHealthcare Community & State	$32.17
Rate for Payer: Wellpoint Medicaid Managed Care	$35.38

GRAFT MCVL ST 10MM/60CM*****

Facility

$1,335.00

Hospital Charge Code	270601143
Hospital Revenue Code	278
Min. Negotiated Rate	$200.25
Max. Negotiated Rate	$323.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$267.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$323.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$293.70
Rate for Payer: Qualcare PPO/HMO/WC	$200.25

GRAFT MCVL ST 16MM 30CM

Facility

$3,412.85

Hospital Charge Code	270601129
Hospital Revenue Code	278
Min. Negotiated Rate	$511.93
Max. Negotiated Rate	$825.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$682.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$750.83
Rate for Payer: Qualcare PPO/HMO/WC	$511.93

GRAFT MCVL ST 16MM 30CM

Facility

$3,412.85

Hospital Charge Code	270601129
Hospital Revenue Code	278
Min. Negotiated Rate	$82.25
Max. Negotiated Rate	$1,706.42
Rate for Payer: Aetna Commercial	$1,296.88
Rate for Payer: Aetna Medicare Advantage	$1,023.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$870.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$870.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$682.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$870.28
Rate for Payer: Cigna Commercial	$1,706.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$750.83
Rate for Payer: Qualcare PPO/HMO/WC	$511.93
Rate for Payer: UnitedHealthcare Community & State	$82.25
Rate for Payer: Wellpoint Medicaid Managed Care	$90.44

GRAFT MCVL ST 18MM/30CM

Facility

$3,412.85

Hospital Charge Code	270601125
Hospital Revenue Code	278
Min. Negotiated Rate	$511.93
Max. Negotiated Rate	$825.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$682.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$750.83
Rate for Payer: Qualcare PPO/HMO/WC	$511.93

GRAFT MCVL ST 18MM/30CM

Facility

$3,412.85

Hospital Charge Code	270601125
Hospital Revenue Code	278
Min. Negotiated Rate	$82.25
Max. Negotiated Rate	$1,706.42
Rate for Payer: Aetna Commercial	$1,296.88
Rate for Payer: Aetna Medicare Advantage	$1,023.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$870.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$870.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$682.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$870.28
Rate for Payer: Cigna Commercial	$1,706.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$750.83
Rate for Payer: Qualcare PPO/HMO/WC	$511.93
Rate for Payer: UnitedHealthcare Community & State	$82.25
Rate for Payer: Wellpoint Medicaid Managed Care	$90.44

GRAFT MCVL ST 20MM/30CM

Facility

$3,412.85

Hospital Charge Code	270601118
Hospital Revenue Code	278
Min. Negotiated Rate	$82.25
Max. Negotiated Rate	$1,706.42
Rate for Payer: Aetna Commercial	$1,296.88
Rate for Payer: Aetna Medicare Advantage	$1,023.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$870.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$870.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$682.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$870.28
Rate for Payer: Cigna Commercial	$1,706.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$750.83
Rate for Payer: Qualcare PPO/HMO/WC	$511.93
Rate for Payer: UnitedHealthcare Community & State	$82.25
Rate for Payer: Wellpoint Medicaid Managed Care	$90.44

GRAFT MCVL ST 20MM/30CM

Facility

$3,412.85

Hospital Charge Code	270601118
Hospital Revenue Code	278
Min. Negotiated Rate	$511.93
Max. Negotiated Rate	$825.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$682.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$750.83
Rate for Payer: Qualcare PPO/HMO/WC	$511.93

GRAFT MCVL ST 22MM/30CM

Facility

$3,412.85

Hospital Charge Code	270601147
Hospital Revenue Code	278
Min. Negotiated Rate	$82.25
Max. Negotiated Rate	$1,706.42
Rate for Payer: Aetna Commercial	$1,296.88
Rate for Payer: Aetna Medicare Advantage	$1,023.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$870.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$870.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$682.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$870.28
Rate for Payer: Cigna Commercial	$1,706.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$750.83
Rate for Payer: Qualcare PPO/HMO/WC	$511.93
Rate for Payer: UnitedHealthcare Community & State	$82.25
Rate for Payer: Wellpoint Medicaid Managed Care	$90.44

GRAFT MCVL ST 22MM/30CM

Facility

$3,412.85

Hospital Charge Code	270601147
Hospital Revenue Code	278
Min. Negotiated Rate	$511.93
Max. Negotiated Rate	$825.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$682.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$750.83
Rate for Payer: Qualcare PPO/HMO/WC	$511.93

Know your out-of-pocket cost for care.

All Charges