Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GRAFT ZEN AAA MAN BODY TFB3695

Facility

$37,000.00

Hospital Charge Code	270638290
Hospital Revenue Code	278
Min. Negotiated Rate	$891.70
Max. Negotiated Rate	$18,500.00
Rate for Payer: Aetna Commercial	$14,060.00
Rate for Payer: Aetna Medicare Advantage	$11,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,435.00
Rate for Payer: Cigna Commercial	$18,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,954.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,140.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,550.00
Rate for Payer: UnitedHealthcare Community & State	$891.70
Rate for Payer: Wellpoint Medicaid Managed Care	$980.50

GRAFT ZEN AAA MAN BODY TFB3695

Facility

$37,000.00

Hospital Charge Code	270638290V
Hospital Revenue Code	278
Min. Negotiated Rate	$891.70
Max. Negotiated Rate	$18,500.00
Rate for Payer: Aetna Commercial	$14,060.00
Rate for Payer: Aetna Medicare Advantage	$11,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,435.00
Rate for Payer: Cigna Commercial	$18,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,954.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,140.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,550.00
Rate for Payer: UnitedHealthcare Community & State	$891.70
Rate for Payer: Wellpoint Medicaid Managed Care	$980.50

GRAFT ZEN AAA MAN BODY TFB3695

Facility

$37,000.00

Hospital Charge Code	270638290
Hospital Revenue Code	278
Min. Negotiated Rate	$5,550.00
Max. Negotiated Rate	$8,954.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,954.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,140.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,550.00

GRAFT ZEN AAA MAN BODY TFB3695

Facility

$37,000.00

Hospital Charge Code	270638290V
Hospital Revenue Code	278
Min. Negotiated Rate	$5,550.00
Max. Negotiated Rate	$8,954.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,954.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,140.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,550.00

GRAFT ZEN AAA MN BODY TFB28117

Facility

$36,704.00

Hospital Charge Code	270634073
Hospital Revenue Code	278
Min. Negotiated Rate	$5,505.60
Max. Negotiated Rate	$8,882.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,340.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,882.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,074.88
Rate for Payer: Qualcare PPO/HMO/WC	$5,505.60

GRAFT ZEN AAA MN BODY TFB28117

Facility

$36,704.00

Hospital Charge Code	270634073
Hospital Revenue Code	278
Min. Negotiated Rate	$884.57
Max. Negotiated Rate	$18,352.00
Rate for Payer: Aetna Commercial	$13,947.52
Rate for Payer: Aetna Medicare Advantage	$11,011.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,359.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,359.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,340.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,359.52
Rate for Payer: Cigna Commercial	$18,352.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,882.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,074.88
Rate for Payer: Qualcare PPO/HMO/WC	$5,505.60
Rate for Payer: UnitedHealthcare Community & State	$884.57
Rate for Payer: Wellpoint Medicaid Managed Care	$972.66

GRAFT ZEN FLX AAA EXT ESBE2658

Facility

$9,435.00

Hospital Charge Code	270643454V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,415.25
Max. Negotiated Rate	$2,283.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,887.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,283.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,075.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,415.25

GRAFT ZEN FLX AAA EXT ESBE2658

Facility

$9,435.00

Hospital Charge Code	270643454V
Hospital Revenue Code	278
Min. Negotiated Rate	$227.38
Max. Negotiated Rate	$4,717.50
Rate for Payer: Aetna Commercial	$3,585.30
Rate for Payer: Aetna Medicare Advantage	$2,830.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,405.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,405.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,887.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,405.93
Rate for Payer: Cigna Commercial	$4,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,283.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,075.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,415.25
Rate for Payer: UnitedHealthcare Community & State	$227.38
Rate for Payer: Wellpoint Medicaid Managed Care	$250.03

GRAFT ZENITH AAA ILIAC LEG

Facility

$14,980.00

Hospital Charge Code	270642911
Hospital Revenue Code	278
Min. Negotiated Rate	$2,247.00
Max. Negotiated Rate	$3,625.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,996.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,625.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,295.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,247.00

GRAFT ZENITH AAA ILIAC LEG

Facility

$14,320.00

Hospital Charge Code	270635151
Hospital Revenue Code	278
Min. Negotiated Rate	$2,148.00
Max. Negotiated Rate	$3,465.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,864.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,465.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,150.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,148.00

GRAFT ZENITH AAA ILIAC LEG

Facility

$14,320.00

Hospital Charge Code	270635151
Hospital Revenue Code	278
Min. Negotiated Rate	$345.11
Max. Negotiated Rate	$7,160.00
Rate for Payer: Aetna Commercial	$5,441.60
Rate for Payer: Aetna Medicare Advantage	$4,296.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,651.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,651.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,651.60
Rate for Payer: Cigna Commercial	$7,160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,465.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,150.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,148.00
Rate for Payer: UnitedHealthcare Community & State	$345.11
Rate for Payer: Wellpoint Medicaid Managed Care	$379.48

GRAFT ZENITH AAA ILIAC LEG

Facility

$13,905.00

Hospital Charge Code	270635150
Hospital Revenue Code	278
Min. Negotiated Rate	$335.11
Max. Negotiated Rate	$6,952.50
Rate for Payer: Aetna Commercial	$5,283.90
Rate for Payer: Aetna Medicare Advantage	$4,171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,545.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,545.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,781.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,545.78
Rate for Payer: Cigna Commercial	$6,952.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,365.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,059.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,085.75
Rate for Payer: UnitedHealthcare Community & State	$335.11
Rate for Payer: Wellpoint Medicaid Managed Care	$368.48

GRAFT ZENITH AAA ILIAC LEG

Facility

$13,905.00

Hospital Charge Code	270635150
Hospital Revenue Code	278
Min. Negotiated Rate	$2,085.75
Max. Negotiated Rate	$3,365.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,781.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,365.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,059.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,085.75

GRAFT ZENITH AAA ILIAC LEG

Facility

$14,980.00

Hospital Charge Code	270642911
Hospital Revenue Code	278
Min. Negotiated Rate	$361.02
Max. Negotiated Rate	$7,490.00
Rate for Payer: Aetna Commercial	$5,692.40
Rate for Payer: Aetna Medicare Advantage	$4,494.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,819.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,819.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,996.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,819.90
Rate for Payer: Cigna Commercial	$7,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,625.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,295.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,247.00
Rate for Payer: UnitedHealthcare Community & State	$361.02
Rate for Payer: Wellpoint Medicaid Managed Care	$396.97

GRAFT ZENITH AAA ILIAC LEG

Facility

$14,980.00

Hospital Charge Code	270642910
Hospital Revenue Code	278
Min. Negotiated Rate	$361.02
Max. Negotiated Rate	$7,490.00
Rate for Payer: Aetna Commercial	$5,692.40
Rate for Payer: Aetna Medicare Advantage	$4,494.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,819.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,819.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,996.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,819.90
Rate for Payer: Cigna Commercial	$7,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,625.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,295.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,247.00
Rate for Payer: UnitedHealthcare Community & State	$361.02
Rate for Payer: Wellpoint Medicaid Managed Care	$396.97

GRAFT ZENITH AAA ILIAC LEG

Facility

$14,980.00

Hospital Charge Code	270642910
Hospital Revenue Code	278
Min. Negotiated Rate	$2,247.00
Max. Negotiated Rate	$3,625.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,996.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,625.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,295.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,247.00

GRAFT ZENITH AAA LEG EXT

Facility

$13,392.00

Hospital Charge Code	270636179
Hospital Revenue Code	278
Min. Negotiated Rate	$2,008.80
Max. Negotiated Rate	$3,240.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,678.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,240.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,946.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,008.80

GRAFT ZENITH AAA LEG EXT

Facility

$13,392.00

Hospital Charge Code	270636179
Hospital Revenue Code	278
Min. Negotiated Rate	$322.75
Max. Negotiated Rate	$6,696.00
Rate for Payer: Aetna Commercial	$5,088.96
Rate for Payer: Aetna Medicare Advantage	$4,017.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,414.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,414.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,678.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,414.96
Rate for Payer: Cigna Commercial	$6,696.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,240.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,946.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,008.80
Rate for Payer: UnitedHealthcare Community & State	$322.75
Rate for Payer: Wellpoint Medicaid Managed Care	$354.89

GRAFT ZENITH AAA LEG EXTENSION

Facility

$13,392.00

Hospital Charge Code	270636178
Hospital Revenue Code	278
Min. Negotiated Rate	$322.75
Max. Negotiated Rate	$6,696.00
Rate for Payer: Aetna Commercial	$5,088.96
Rate for Payer: Aetna Medicare Advantage	$4,017.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,414.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,414.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,678.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,414.96
Rate for Payer: Cigna Commercial	$6,696.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,240.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,946.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,008.80
Rate for Payer: UnitedHealthcare Community & State	$322.75
Rate for Payer: Wellpoint Medicaid Managed Care	$354.89

GRAFT ZENITH AAA LEG EXTENSION

Facility

$13,392.00

Hospital Charge Code	270636178
Hospital Revenue Code	278
Min. Negotiated Rate	$2,008.80
Max. Negotiated Rate	$3,240.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,678.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,240.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,946.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,008.80

GRAFT ZENITH AAA LEG EXTENSION

Facility

$14,980.00

Hospital Charge Code	270642373
Hospital Revenue Code	278
Min. Negotiated Rate	$361.02
Max. Negotiated Rate	$7,490.00
Rate for Payer: Aetna Commercial	$5,692.40
Rate for Payer: Aetna Medicare Advantage	$4,494.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,819.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,819.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,996.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,819.90
Rate for Payer: Cigna Commercial	$7,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,625.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,295.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,247.00
Rate for Payer: UnitedHealthcare Community & State	$361.02
Rate for Payer: Wellpoint Medicaid Managed Care	$396.97

GRAFT ZENITH AAA LEG EXTENSION

Facility

$14,980.00

Hospital Charge Code	270642395
Hospital Revenue Code	278
Min. Negotiated Rate	$361.02
Max. Negotiated Rate	$7,490.00
Rate for Payer: Aetna Commercial	$5,692.40
Rate for Payer: Aetna Medicare Advantage	$4,494.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,819.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,819.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,996.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,819.90
Rate for Payer: Cigna Commercial	$7,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,625.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,295.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,247.00
Rate for Payer: UnitedHealthcare Community & State	$361.02
Rate for Payer: Wellpoint Medicaid Managed Care	$396.97

GRAFT ZENITH AAA LEG EXTENSION

Facility

$14,980.00

Hospital Charge Code	270642396
Hospital Revenue Code	278
Min. Negotiated Rate	$361.02
Max. Negotiated Rate	$7,490.00
Rate for Payer: Aetna Commercial	$5,692.40
Rate for Payer: Aetna Medicare Advantage	$4,494.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,819.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,819.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,996.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,819.90
Rate for Payer: Cigna Commercial	$7,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,625.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,295.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,247.00
Rate for Payer: UnitedHealthcare Community & State	$361.02
Rate for Payer: Wellpoint Medicaid Managed Care	$396.97

GRAFT ZENITH AAA LEG EXTENSION

Facility

$14,980.00

Hospital Charge Code	270642374
Hospital Revenue Code	278
Min. Negotiated Rate	$2,247.00
Max. Negotiated Rate	$3,625.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,996.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,625.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,295.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,247.00

GRAFT ZENITH AAA LEG EXTENSION

Facility

$14,980.00

Hospital Charge Code	270642396
Hospital Revenue Code	278
Min. Negotiated Rate	$2,247.00
Max. Negotiated Rate	$3,625.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,996.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,625.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,295.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,247.00

Know your out-of-pocket cost for care.

All Charges