Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE

Facility

$7,721.53

Service Code	APR-DRG 0551
Min. Negotiated Rate	$7,570.13
Max. Negotiated Rate	$7,721.53
Rate for Payer: UnitedHealthcare Community & State	$7,570.13
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,721.53
Rate for Payer: Wellpoint Medicaid Managed Care	$7,570.13

HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE

Facility

$29,968.19

Service Code	APR-DRG 0554
Min. Negotiated Rate	$29,380.58
Max. Negotiated Rate	$29,968.19
Rate for Payer: UnitedHealthcare Community & State	$29,380.58
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,968.19
Rate for Payer: Wellpoint Medicaid Managed Care	$29,380.58

HEAD UNIPOLAR 52MM

Facility

$5,525.00

Service Code	HCPCS C1776
Hospital Charge Code	270677230
Hospital Revenue Code	278
Min. Negotiated Rate	$133.15
Max. Negotiated Rate	$2,762.50
Rate for Payer: Aetna Commercial	$2,099.50
Rate for Payer: Aetna Medicare Advantage	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,408.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,408.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,408.88
Rate for Payer: Cigna Commercial	$2,762.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,337.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,215.50
Rate for Payer: Qualcare PPO/HMO/WC	$828.75
Rate for Payer: UnitedHealthcare Community & State	$133.15
Rate for Payer: Wellpoint Medicaid Managed Care	$146.41

HEAD UNIPOLAR 52MM

Facility

$5,525.00

Service Code	HCPCS C1776
Hospital Charge Code	270677230
Hospital Revenue Code	278
Min. Negotiated Rate	$828.75
Max. Negotiated Rate	$1,337.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,337.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,215.50
Rate for Payer: Qualcare PPO/HMO/WC	$828.75

HEAD UNIV BIPOLAR 46X26MM

Facility

$2,745.55

Service Code	HCPCS C1776
Hospital Charge Code	270700360
Hospital Revenue Code	278
Min. Negotiated Rate	$411.83
Max. Negotiated Rate	$664.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$549.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$664.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$604.02
Rate for Payer: Qualcare PPO/HMO/WC	$411.83

HEAD UNIV BIPOLAR 46X26MM

Facility

$2,745.55

Service Code	HCPCS C1776
Hospital Charge Code	270700360
Hospital Revenue Code	278
Min. Negotiated Rate	$66.17
Max. Negotiated Rate	$1,372.78
Rate for Payer: Aetna Commercial	$1,043.31
Rate for Payer: Aetna Medicare Advantage	$823.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$700.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$700.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$549.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$700.12
Rate for Payer: Cigna Commercial	$1,372.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$664.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$604.02
Rate for Payer: Qualcare PPO/HMO/WC	$411.83
Rate for Payer: UnitedHealthcare Community & State	$66.17
Rate for Payer: Wellpoint Medicaid Managed Care	$72.76

HEAD UNIVERSAL

Facility

$8,380.00

Service Code	HCPCS C1776
Hospital Charge Code	270660307
Hospital Revenue Code	278
Min. Negotiated Rate	$1,257.00
Max. Negotiated Rate	$2,027.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,676.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,027.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,843.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,257.00

HEAD UNIVERSAL

Facility

$8,380.00

Service Code	HCPCS C1776
Hospital Charge Code	270660307
Hospital Revenue Code	278
Min. Negotiated Rate	$201.96
Max. Negotiated Rate	$4,190.00
Rate for Payer: Aetna Commercial	$3,184.40
Rate for Payer: Aetna Medicare Advantage	$2,514.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,136.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,136.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,676.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,136.90
Rate for Payer: Cigna Commercial	$4,190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,027.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,843.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,257.00
Rate for Payer: UnitedHealthcare Community & State	$201.96
Rate for Payer: Wellpoint Medicaid Managed Care	$222.07

HEAD UNIVERSAL 47x28MM

Facility

$2,933.00

Service Code	HCPCS C1776
Hospital Charge Code	270676940
Hospital Revenue Code	278
Min. Negotiated Rate	$70.69
Max. Negotiated Rate	$1,466.50
Rate for Payer: Aetna Commercial	$1,114.54
Rate for Payer: Aetna Medicare Advantage	$879.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$747.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$747.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$586.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$747.91
Rate for Payer: Cigna Commercial	$1,466.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$709.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$645.26
Rate for Payer: Qualcare PPO/HMO/WC	$439.95
Rate for Payer: UnitedHealthcare Community & State	$70.69
Rate for Payer: Wellpoint Medicaid Managed Care	$77.72

HEAD UNIVERSAL 47x28MM

Facility

$2,933.00

Service Code	HCPCS C1776
Hospital Charge Code	270676940
Hospital Revenue Code	278
Min. Negotiated Rate	$439.95
Max. Negotiated Rate	$709.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$586.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$709.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$645.26
Rate for Payer: Qualcare PPO/HMO/WC	$439.95

HEAD UNIVERSAL 49 x 26MM

Facility

$3,763.65

Service Code	HCPCS C1776
Hospital Charge Code	270681701
Hospital Revenue Code	278
Min. Negotiated Rate	$90.70
Max. Negotiated Rate	$1,881.83
Rate for Payer: Aetna Commercial	$1,430.19
Rate for Payer: Aetna Medicare Advantage	$1,129.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$959.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$959.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$752.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$959.73
Rate for Payer: Cigna Commercial	$1,881.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$910.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$828.00
Rate for Payer: Qualcare PPO/HMO/WC	$564.55
Rate for Payer: UnitedHealthcare Community & State	$90.70
Rate for Payer: Wellpoint Medicaid Managed Care	$99.74

HEAD UNIVERSAL 49 x 26MM

Facility

$3,763.65

Service Code	HCPCS C1776
Hospital Charge Code	270681701
Hospital Revenue Code	278
Min. Negotiated Rate	$564.55
Max. Negotiated Rate	$910.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$752.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$910.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$828.00
Rate for Payer: Qualcare PPO/HMO/WC	$564.55

HEAD UNIVERSAL 50x28MM

Facility

$3,770.00

Service Code	HCPCS C1776
Hospital Charge Code	270676560
Hospital Revenue Code	278
Min. Negotiated Rate	$565.50
Max. Negotiated Rate	$912.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$754.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$912.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$829.40
Rate for Payer: Qualcare PPO/HMO/WC	$565.50

HEAD UNIVERSAL 50x28MM

Facility

$3,770.00

Service Code	HCPCS C1776
Hospital Charge Code	270676560
Hospital Revenue Code	278
Min. Negotiated Rate	$90.86
Max. Negotiated Rate	$1,885.00
Rate for Payer: Aetna Commercial	$1,432.60
Rate for Payer: Aetna Medicare Advantage	$1,131.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$961.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$961.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$754.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$961.35
Rate for Payer: Cigna Commercial	$1,885.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$912.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$829.40
Rate for Payer: Qualcare PPO/HMO/WC	$565.50
Rate for Payer: UnitedHealthcare Community & State	$90.86
Rate for Payer: Wellpoint Medicaid Managed Care	$99.91

HEAD UNIVERSAL 54x26MM

Facility

$5,609.50

Service Code	HCPCS C1776
Hospital Charge Code	270680587
Hospital Revenue Code	278
Min. Negotiated Rate	$135.19
Max. Negotiated Rate	$2,804.75
Rate for Payer: Aetna Commercial	$2,131.61
Rate for Payer: Aetna Medicare Advantage	$1,682.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,430.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,430.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,121.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,430.42
Rate for Payer: Cigna Commercial	$2,804.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,357.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,234.09
Rate for Payer: Qualcare PPO/HMO/WC	$841.42
Rate for Payer: UnitedHealthcare Community & State	$135.19
Rate for Payer: Wellpoint Medicaid Managed Care	$148.65

HEAD UNIVERSAL 54x26MM

Facility

$5,609.50

Service Code	HCPCS C1776
Hospital Charge Code	270680587
Hospital Revenue Code	278
Min. Negotiated Rate	$841.42
Max. Negotiated Rate	$1,357.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,121.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,357.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,234.09
Rate for Payer: Qualcare PPO/HMO/WC	$841.42

HEAD UNIVERSAL BIPOL 43X26MM

Facility

$7,675.00

Service Code	HCPCS C1776
Hospital Charge Code	270694418
Hospital Revenue Code	278
Min. Negotiated Rate	$184.97
Max. Negotiated Rate	$3,837.50
Rate for Payer: Aetna Commercial	$2,916.50
Rate for Payer: Aetna Medicare Advantage	$2,302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,957.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,957.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,535.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,957.12
Rate for Payer: Cigna Commercial	$3,837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,857.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,688.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,151.25
Rate for Payer: UnitedHealthcare Community & State	$184.97
Rate for Payer: Wellpoint Medicaid Managed Care	$203.39

HEAD UNIVERSAL BIPOL 43X26MM

Facility

$7,675.00

Service Code	HCPCS C1776
Hospital Charge Code	270694418
Hospital Revenue Code	278
Min. Negotiated Rate	$1,151.25
Max. Negotiated Rate	$1,857.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,857.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,688.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,151.25

HEAD UNIVERSAL BIPOLAR 42x26MM

Facility

$2,743.60

Service Code	HCPCS C1776
Hospital Charge Code	270673426
Hospital Revenue Code	278
Min. Negotiated Rate	$411.54
Max. Negotiated Rate	$663.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$548.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$603.59
Rate for Payer: Qualcare PPO/HMO/WC	$411.54

HEAD UNIVERSAL BIPOLAR 42x26MM

Facility

$2,743.60

Service Code	HCPCS C1776
Hospital Charge Code	270673426
Hospital Revenue Code	278
Min. Negotiated Rate	$66.12
Max. Negotiated Rate	$1,371.80
Rate for Payer: Aetna Commercial	$1,042.57
Rate for Payer: Aetna Medicare Advantage	$823.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$699.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$699.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$548.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$699.62
Rate for Payer: Cigna Commercial	$1,371.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$603.59
Rate for Payer: Qualcare PPO/HMO/WC	$411.54
Rate for Payer: UnitedHealthcare Community & State	$66.12
Rate for Payer: Wellpoint Medicaid Managed Care	$72.71

HEAD VERSA 46MMX21MMX50MM HUM

Facility

$5,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270687428
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

HEAD VERSA 46MMX21MMX50MM HUM

Facility

$5,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270687428
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

HEAD W/CONTRAST

Facility

$9,500.00

Service Code	HCPCS 70460
Hospital Charge Code	2200012
Hospital Revenue Code	351
Min. Negotiated Rate	$145.87
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$566.79
Rate for Payer: Aetna Medicare Advantage	$675.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$208.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.19
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: Cigna Medicare Advantage	$145.87
Rate for Payer: Clover Medicare Advantage	$197.96
Rate for Payer: EmblemHealth Commercial	$625.14
Rate for Payer: Humana Medicare Advantage	$214.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$208.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,850.00
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$228.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$208.38
Rate for Payer: Wellcare Medicare Advantage	$208.38
Rate for Payer: Wellpoint Medicaid Managed Care	$251.75

HEAD W/CONTRAST

Facility

$9,500.00

Service Code	HCPCS 70460
Hospital Charge Code	2200012
Hospital Revenue Code	351
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

HEAD W/O CONTR

Facility

$9,500.00

Service Code	HCPCS 70450
Hospital Charge Code	2200020
Hospital Revenue Code	351
Min. Negotiated Rate	$86.94
Max. Negotiated Rate	$3,354.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$266.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,850.00
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,354.00
Rate for Payer: UnitedHealthcare Community & State	$228.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$251.75

Know your out-of-pocket cost for care.

All Charges