Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HEAD BIXCUT MOD REAMER 9MM

Facility

$2,610.00

Hospital Charge Code	270670459
Hospital Revenue Code	272
Min. Negotiated Rate	$62.90
Max. Negotiated Rate	$1,305.00
Rate for Payer: Aetna Commercial	$991.80
Rate for Payer: Aetna Medicare Advantage	$783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$665.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$665.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$665.55
Rate for Payer: Cigna Commercial	$1,305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$783.00
Rate for Payer: Oxford Commercial	$522.00
Rate for Payer: Qualcare PPO/HMO/WC	$391.50
Rate for Payer: UnitedHealthcare Commercial	$522.00
Rate for Payer: UnitedHealthcare Community & State	$62.90
Rate for Payer: Wellpoint Medicaid Managed Care	$69.17

HEAD BMT MALL 13 170 11-104904

Facility

$26,310.00

Hospital Charge Code	270622582
Hospital Revenue Code	278
Min. Negotiated Rate	$3,946.50
Max. Negotiated Rate	$6,367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,262.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,367.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,788.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,946.50

HEAD BMT MALL 13 170 11-104904

Facility

$26,310.00

Hospital Charge Code	270622582
Hospital Revenue Code	278
Min. Negotiated Rate	$634.07
Max. Negotiated Rate	$13,155.00
Rate for Payer: Aetna Commercial	$9,997.80
Rate for Payer: Aetna Medicare Advantage	$7,893.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,709.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,709.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,262.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,709.05
Rate for Payer: Cigna Commercial	$13,155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,367.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,788.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,946.50
Rate for Payer: UnitedHealthcare Community & State	$634.07
Rate for Payer: Wellpoint Medicaid Managed Care	$697.22

HEAD BMT MALL 9 220 11-104958

Facility

$22,080.00

Hospital Charge Code	270611648
Hospital Revenue Code	278
Min. Negotiated Rate	$532.13
Max. Negotiated Rate	$11,040.00
Rate for Payer: Aetna Commercial	$8,390.40
Rate for Payer: Aetna Medicare Advantage	$6,624.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,630.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,630.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,416.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,630.40
Rate for Payer: Cigna Commercial	$11,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,343.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,857.60
Rate for Payer: Qualcare PPO/HMO/WC	$3,312.00
Rate for Payer: UnitedHealthcare Community & State	$532.13
Rate for Payer: Wellpoint Medicaid Managed Care	$585.12

HEAD BMT MALL 9 220 11-104958

Facility

$22,080.00

Hospital Charge Code	270611648
Hospital Revenue Code	278
Min. Negotiated Rate	$3,312.00
Max. Negotiated Rate	$5,343.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,416.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,343.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,857.60
Rate for Payer: Qualcare PPO/HMO/WC	$3,312.00

HEAD BMT MOD 139028

Facility

$2,616.85

Hospital Charge Code	270608617
Hospital Revenue Code	278
Min. Negotiated Rate	$63.07
Max. Negotiated Rate	$1,308.42
Rate for Payer: Aetna Commercial	$994.40
Rate for Payer: Aetna Medicare Advantage	$785.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$667.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$667.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$523.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$667.30
Rate for Payer: Cigna Commercial	$1,308.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$633.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$575.71
Rate for Payer: Qualcare PPO/HMO/WC	$392.53
Rate for Payer: UnitedHealthcare Community & State	$63.07
Rate for Payer: Wellpoint Medicaid Managed Care	$69.35

HEAD BMT MOD 139028

Facility

$2,616.85

Hospital Charge Code	270608617
Hospital Revenue Code	278
Min. Negotiated Rate	$392.53
Max. Negotiated Rate	$633.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$523.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$633.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$575.71
Rate for Payer: Qualcare PPO/HMO/WC	$392.53

HEAD BMT MOD 28 6 163660

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270607276
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

HEAD BMT MOD 28 6 163660

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270607276
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

HEAD BMT MOD COMP 28 163662

Facility

$2,967.25

Hospital Charge Code	270622512
Hospital Revenue Code	278
Min. Negotiated Rate	$445.09
Max. Negotiated Rate	$718.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$593.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$718.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$652.79
Rate for Payer: Qualcare PPO/HMO/WC	$445.09

HEAD BMT MOD COMP 28 163662

Facility

$2,967.25

Hospital Charge Code	270622512
Hospital Revenue Code	278
Min. Negotiated Rate	$71.51
Max. Negotiated Rate	$1,483.62
Rate for Payer: Aetna Commercial	$1,127.56
Rate for Payer: Aetna Medicare Advantage	$890.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$756.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$756.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$593.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$756.65
Rate for Payer: Cigna Commercial	$1,483.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$718.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$652.79
Rate for Payer: Qualcare PPO/HMO/WC	$445.09
Rate for Payer: UnitedHealthcare Community & State	$71.51
Rate for Payer: Wellpoint Medicaid Managed Care	$78.63

HEAD BMT MOD HMRL 44 113766

Facility

$4,125.65

Hospital Charge Code	270609677
Hospital Revenue Code	278
Min. Negotiated Rate	$99.43
Max. Negotiated Rate	$2,062.82
Rate for Payer: Aetna Commercial	$1,567.75
Rate for Payer: Aetna Medicare Advantage	$1,237.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,052.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,052.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,052.04
Rate for Payer: Cigna Commercial	$2,062.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$907.64
Rate for Payer: Qualcare PPO/HMO/WC	$618.85
Rate for Payer: UnitedHealthcare Community & State	$99.43
Rate for Payer: Wellpoint Medicaid Managed Care	$109.33

HEAD BMT MOD HMRL 44 113766

Facility

$4,125.65

Hospital Charge Code	270609677
Hospital Revenue Code	278
Min. Negotiated Rate	$618.85
Max. Negotiated Rate	$998.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$907.64
Rate for Payer: Qualcare PPO/HMO/WC	$618.85

HEAD BMT MOD HMRL 44 15 113763

Facility

$4,667.25

Hospital Charge Code	270619987
Hospital Revenue Code	278
Min. Negotiated Rate	$112.48
Max. Negotiated Rate	$2,333.62
Rate for Payer: Aetna Commercial	$1,773.56
Rate for Payer: Aetna Medicare Advantage	$1,400.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,190.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,190.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$933.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,190.15
Rate for Payer: Cigna Commercial	$2,333.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,129.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,026.80
Rate for Payer: Qualcare PPO/HMO/WC	$700.09
Rate for Payer: UnitedHealthcare Community & State	$112.48
Rate for Payer: Wellpoint Medicaid Managed Care	$123.68

HEAD BMT MOD HMRL 44 15 113763

Facility

$4,667.25

Hospital Charge Code	270619987
Hospital Revenue Code	278
Min. Negotiated Rate	$700.09
Max. Negotiated Rate	$1,129.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$933.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,129.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,026.80
Rate for Payer: Qualcare PPO/HMO/WC	$700.09

HEAD BMT MOD HMRL 44 17 113764

Facility

$6,110.00

Hospital Charge Code	270620916
Hospital Revenue Code	278
Min. Negotiated Rate	$147.25
Max. Negotiated Rate	$3,055.00
Rate for Payer: Aetna Commercial	$2,321.80
Rate for Payer: Aetna Medicare Advantage	$1,833.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,558.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,558.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,222.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,558.05
Rate for Payer: Cigna Commercial	$3,055.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,478.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,344.20
Rate for Payer: Qualcare PPO/HMO/WC	$916.50
Rate for Payer: UnitedHealthcare Community & State	$147.25
Rate for Payer: Wellpoint Medicaid Managed Care	$161.91

HEAD BMT MOD HMRL 44 17 113764

Facility

$6,110.00

Hospital Charge Code	270620916
Hospital Revenue Code	278
Min. Negotiated Rate	$916.50
Max. Negotiated Rate	$1,478.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,222.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,478.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,344.20
Rate for Payer: Qualcare PPO/HMO/WC	$916.50

HEAD BMT STD NECK 38 173662

Facility

$5,200.00

Hospital Charge Code	270628617
Hospital Revenue Code	278
Min. Negotiated Rate	$125.32
Max. Negotiated Rate	$2,600.00
Rate for Payer: Aetna Commercial	$1,976.00
Rate for Payer: Aetna Medicare Advantage	$1,560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,326.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,326.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,326.00
Rate for Payer: Cigna Commercial	$2,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,144.00
Rate for Payer: Qualcare PPO/HMO/WC	$780.00
Rate for Payer: UnitedHealthcare Community & State	$125.32
Rate for Payer: Wellpoint Medicaid Managed Care	$137.80

HEAD BMT STD NECK 38 173662

Facility

$5,200.00

Hospital Charge Code	270628617
Hospital Revenue Code	278
Min. Negotiated Rate	$780.00
Max. Negotiated Rate	$1,258.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,144.00
Rate for Payer: Qualcare PPO/HMO/WC	$780.00

HEAD CERAMIC 28mm TYPE 16/18

Facility

$6,310.00

Service Code	HCPCS C1776
Hospital Charge Code	270645466
Hospital Revenue Code	278
Min. Negotiated Rate	$152.07
Max. Negotiated Rate	$3,155.00
Rate for Payer: Aetna Commercial	$2,397.80
Rate for Payer: Aetna Medicare Advantage	$1,893.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,609.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,609.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,262.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,609.05
Rate for Payer: Cigna Commercial	$3,155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,527.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,388.20
Rate for Payer: Qualcare PPO/HMO/WC	$946.50
Rate for Payer: UnitedHealthcare Community & State	$152.07
Rate for Payer: Wellpoint Medicaid Managed Care	$167.22

HEAD CERAMIC 28mm TYPE 16/18

Facility

$6,310.00

Service Code	HCPCS C1776
Hospital Charge Code	270645466
Hospital Revenue Code	278
Min. Negotiated Rate	$946.50
Max. Negotiated Rate	$1,527.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,262.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,527.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,388.20
Rate for Payer: Qualcare PPO/HMO/WC	$946.50

HEAD CERC 40 16/18 TAP 6501058

Facility

$11,040.00

Service Code	HCPCS C1776
Hospital Charge Code	270644874
Hospital Revenue Code	278
Min. Negotiated Rate	$1,656.00
Max. Negotiated Rate	$2,671.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,208.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,671.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,428.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,656.00

HEAD CERC 40 16/18 TAP 6501058

Facility

$11,040.00

Service Code	HCPCS C1776
Hospital Charge Code	270644874
Hospital Revenue Code	278
Min. Negotiated Rate	$266.06
Max. Negotiated Rate	$5,520.00
Rate for Payer: Aetna Commercial	$4,195.20
Rate for Payer: Aetna Medicare Advantage	$3,312.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,815.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,815.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,208.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,815.20
Rate for Payer: Cigna Commercial	$5,520.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,671.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,428.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,656.00
Rate for Payer: UnitedHealthcare Community & State	$266.06
Rate for Payer: Wellpoint Medicaid Managed Care	$292.56

HEAD COCR M 36M

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270681920
Hospital Revenue Code	278
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

HEAD COCR M 36M

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270681920
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

Know your out-of-pocket cost for care.

All Charges