Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GRAFT ZENITH AAA MAIN BODY

Facility

$41,060.00

Hospital Charge Code	270641632
Hospital Revenue Code	278
Min. Negotiated Rate	$6,159.00
Max. Negotiated Rate	$9,936.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,212.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,936.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,033.20
Rate for Payer: Qualcare PPO/HMO/WC	$6,159.00

GRAFT ZENITH AAA MAIN BODY

Facility

$39,255.00

Hospital Charge Code	270640599
Hospital Revenue Code	278
Min. Negotiated Rate	$5,888.25
Max. Negotiated Rate	$9,499.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,851.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,499.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,636.10
Rate for Payer: Qualcare PPO/HMO/WC	$5,888.25

GRAFT ZENITH AAA MAINB TFB3088

Facility

$37,000.00

Hospital Charge Code	270634659V
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 ZENITH AAA MAINB TFB3088

Facility

$36,704.00

Hospital Charge Code	270634659
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 ZENITH AAA MAINB TFB3088

Facility

$36,704.00

Hospital Charge Code	270634659
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 ZENITH AAA MAINB TFB3088

Facility

$37,000.00

Hospital Charge Code	270634659V
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 ZENITH ALPHA 30MM

Facility

$77,500.00

Hospital Charge Code	270677133
Hospital Revenue Code	278
Min. Negotiated Rate	$1,867.75
Max. Negotiated Rate	$38,750.00
Rate for Payer: Aetna Commercial	$29,450.00
Rate for Payer: Aetna Medicare Advantage	$23,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,762.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,762.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19,762.50
Rate for Payer: Cigna Commercial	$38,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18,755.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$17,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$11,625.00
Rate for Payer: UnitedHealthcare Community & State	$1,867.75
Rate for Payer: Wellpoint Medicaid Managed Care	$2,053.75

GRAFT ZENITH ALPHA 30MM

Facility

$77,500.00

Hospital Charge Code	270677133
Hospital Revenue Code	278
Min. Negotiated Rate	$11,625.00
Max. Negotiated Rate	$18,755.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18,755.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$17,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$11,625.00

GRAFT ZENITH LEG EXTENSION

Facility

$13,905.00

Hospital Charge Code	270639241
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 LEG EXTENSION

Facility

$13,905.00

Hospital Charge Code	270639241
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 REN MN BD RX12662

Facility

$26,075.00

Hospital Charge Code	270643453V
Hospital Revenue Code	278
Min. Negotiated Rate	$628.41
Max. Negotiated Rate	$13,037.50
Rate for Payer: Aetna Commercial	$9,908.50
Rate for Payer: Aetna Medicare Advantage	$7,822.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,649.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,649.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,649.12
Rate for Payer: Cigna Commercial	$13,037.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,310.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,736.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,911.25
Rate for Payer: UnitedHealthcare Community & State	$628.41
Rate for Payer: Wellpoint Medicaid Managed Care	$690.99

GRAFT ZENITH REN MN BD RX12662

Facility

$26,075.00

Hospital Charge Code	270643453V
Hospital Revenue Code	278
Min. Negotiated Rate	$3,911.25
Max. Negotiated Rate	$6,310.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,310.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,736.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,911.25

GRAFT ZENITH RENU 36MM

Facility

$31,625.00

Hospital Charge Code	270644764
Hospital Revenue Code	278
Min. Negotiated Rate	$762.16
Max. Negotiated Rate	$15,812.50
Rate for Payer: Aetna Commercial	$12,017.50
Rate for Payer: Aetna Medicare Advantage	$9,487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,064.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,064.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,064.38
Rate for Payer: Cigna Commercial	$15,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,653.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,957.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,743.75
Rate for Payer: UnitedHealthcare Community & State	$762.16
Rate for Payer: Wellpoint Medicaid Managed Care	$838.06

GRAFT ZENITH RENU 36MM

Facility

$31,625.00

Hospital Charge Code	270644764
Hospital Revenue Code	278
Min. Negotiated Rate	$4,743.75
Max. Negotiated Rate	$7,653.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,653.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,957.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,743.75

GRAF ZEN AAA LG EXT TFLE-16-71

Facility

$13,392.00

Hospital Charge Code	270634949
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

GRAF ZEN AAA LG EXT TFLE-16-71

Facility

$13,905.00

Hospital Charge Code	270634949V
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

GRAF ZEN AAA LG EXT TFLE-16-71

Facility

$13,905.00

Hospital Charge Code	270634949V
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

GRAF ZEN AAA LG EXT TFLE-16-71

Facility

$13,392.00

Hospital Charge Code	270634949
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

GRAMS STAIN

Facility

$390.00

Service Code	HCPCS 88312
Hospital Charge Code	3005277
Hospital Revenue Code	310
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$223.48
Rate for Payer: Aetna Commercial	$168.40
Rate for Payer: Aetna Medicare Advantage	$200.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.48
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$61.91
Rate for Payer: Clover Medicare Advantage	$58.81
Rate for Payer: EmblemHealth Commercial	$185.73
Rate for Payer: Humana Medicare Advantage	$63.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$61.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$92.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.91
Rate for Payer: Wellcare Medicare Advantage	$61.91
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

GRAMS STAIN

Facility

$390.00

Service Code	HCPCS 88312
Hospital Charge Code	3005277
Hospital Revenue Code	310
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

GRAM STAIN

Facility

$390.00

Service Code	HCPCS 87205
Hospital Charge Code	38475059
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

GRAM STAIN

Facility

$390.00

Service Code	HCPCS 87205
Hospital Charge Code	38475059
Hospital Revenue Code	309
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$11.61
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.41
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.27
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Medicare Advantage	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

GRAM STAIN

Facility

$390.00

Service Code	HCPCS 87205
Hospital Charge Code	3003530
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

GRAM STAIN

Facility

$390.00

Service Code	HCPCS 87205
Hospital Charge Code	3003530
Hospital Revenue Code	309
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$11.61
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.41
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.27
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Medicare Advantage	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

GRANISEHCLVL 1MG/ML2941490

Facility

$500.00

Hospital Charge Code	6010334
Hospital Revenue Code	636
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

Know your out-of-pocket cost for care.

All Charges