Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HEAD W/O CONTR

Facility

$9,500.00

Service Code	HCPCS 70450
Hospital Charge Code	2200020
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/WO CONTRAST

Facility

$9,500.00

Service Code	HCPCS 70470
Hospital Charge Code	2200038
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	$332.60
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/WO CONTRAST

Facility

$9,500.00

Service Code	HCPCS 70470
Hospital Charge Code	2200038
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 XL DELTA BIOLOX 32MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270683290
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 XL DELTA BIOLOX 32MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270683290
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 ZIM FEM 22 3.0 8018-22-30

Facility

$3,371.25

Hospital Charge Code	270616842
Hospital Revenue Code	278
Min. Negotiated Rate	$505.69
Max. Negotiated Rate	$815.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$674.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$815.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$741.67
Rate for Payer: Qualcare PPO/HMO/WC	$505.69

HEAD ZIM FEM 22 3.0 8018-22-30

Facility

$3,371.25

Hospital Charge Code	270616842
Hospital Revenue Code	278
Min. Negotiated Rate	$81.25
Max. Negotiated Rate	$1,685.62
Rate for Payer: Aetna Commercial	$1,281.08
Rate for Payer: Aetna Medicare Advantage	$1,011.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$859.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$859.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$674.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$859.67
Rate for Payer: Cigna Commercial	$1,685.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$815.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$741.67
Rate for Payer: Qualcare PPO/HMO/WC	$505.69
Rate for Payer: UnitedHealthcare Community & State	$81.25
Rate for Payer: Wellpoint Medicaid Managed Care	$89.34

HEAD ZIM FEM 22MM 8018-22-02

Facility

$3,275.25

Hospital Charge Code	270616591
Hospital Revenue Code	278
Min. Negotiated Rate	$491.29
Max. Negotiated Rate	$792.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$655.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$792.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$720.55
Rate for Payer: Qualcare PPO/HMO/WC	$491.29

HEAD ZIM FEM 22MM 8018-22-02

Facility

$3,275.25

Hospital Charge Code	270616591
Hospital Revenue Code	278
Min. Negotiated Rate	$78.93
Max. Negotiated Rate	$1,637.62
Rate for Payer: Aetna Commercial	$1,244.60
Rate for Payer: Aetna Medicare Advantage	$982.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$835.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$835.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$655.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$835.19
Rate for Payer: Cigna Commercial	$1,637.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$792.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$720.55
Rate for Payer: Qualcare PPO/HMO/WC	$491.29
Rate for Payer: UnitedHealthcare Community & State	$78.93
Rate for Payer: Wellpoint Medicaid Managed Care	$86.79

HEAD ZIM FEM 22MM MED 9026-22

Facility

$3,490.45

Hospital Charge Code	270605859
Hospital Revenue Code	278
Min. Negotiated Rate	$523.57
Max. Negotiated Rate	$844.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$767.90
Rate for Payer: Qualcare PPO/HMO/WC	$523.57

HEAD ZIM FEM 22MM MED 9026-22

Facility

$3,490.45

Hospital Charge Code	270605859
Hospital Revenue Code	278
Min. Negotiated Rate	$84.12
Max. Negotiated Rate	$1,745.22
Rate for Payer: Aetna Commercial	$1,326.37
Rate for Payer: Aetna Medicare Advantage	$1,047.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$890.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$890.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$890.06
Rate for Payer: Cigna Commercial	$1,745.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$767.90
Rate for Payer: Qualcare PPO/HMO/WC	$523.57
Rate for Payer: UnitedHealthcare Community & State	$84.12
Rate for Payer: Wellpoint Medicaid Managed Care	$92.50

HEAD ZIM FEM 28MM 8018-28-01

Facility

$3,277.65

Hospital Charge Code	270613460
Hospital Revenue Code	278
Min. Negotiated Rate	$491.65
Max. Negotiated Rate	$793.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$655.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$793.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$721.08
Rate for Payer: Qualcare PPO/HMO/WC	$491.65

HEAD ZIM FEM 28MM 8018-28-01

Facility

$3,277.65

Hospital Charge Code	270613460
Hospital Revenue Code	278
Min. Negotiated Rate	$78.99
Max. Negotiated Rate	$1,638.83
Rate for Payer: Aetna Commercial	$1,245.51
Rate for Payer: Aetna Medicare Advantage	$983.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$835.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$835.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$655.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$835.80
Rate for Payer: Cigna Commercial	$1,638.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$793.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$721.08
Rate for Payer: Qualcare PPO/HMO/WC	$491.65
Rate for Payer: UnitedHealthcare Community & State	$78.99
Rate for Payer: Wellpoint Medicaid Managed Care	$86.86

HEAD ZIM FEM 28MM 8018-28-02

Facility

$3,490.45

Hospital Charge Code	270609818
Hospital Revenue Code	278
Min. Negotiated Rate	$84.12
Max. Negotiated Rate	$1,745.22
Rate for Payer: Aetna Commercial	$1,326.37
Rate for Payer: Aetna Medicare Advantage	$1,047.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$890.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$890.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$890.06
Rate for Payer: Cigna Commercial	$1,745.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$767.90
Rate for Payer: Qualcare PPO/HMO/WC	$523.57
Rate for Payer: UnitedHealthcare Community & State	$84.12
Rate for Payer: Wellpoint Medicaid Managed Care	$92.50

HEAD ZIM FEM 28MM 8018-28-02

Facility

$3,490.45

Hospital Charge Code	270609818
Hospital Revenue Code	278
Min. Negotiated Rate	$523.57
Max. Negotiated Rate	$844.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$767.90
Rate for Payer: Qualcare PPO/HMO/WC	$523.57

HEAD ZIM FEM 28MM 8018-28-04

Facility

$3,490.45

Hospital Charge Code	270608929
Hospital Revenue Code	278
Min. Negotiated Rate	$84.12
Max. Negotiated Rate	$1,745.22
Rate for Payer: Aetna Commercial	$1,326.37
Rate for Payer: Aetna Medicare Advantage	$1,047.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$890.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$890.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$890.06
Rate for Payer: Cigna Commercial	$1,745.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$767.90
Rate for Payer: Qualcare PPO/HMO/WC	$523.57
Rate for Payer: UnitedHealthcare Community & State	$84.12
Rate for Payer: Wellpoint Medicaid Managed Care	$92.50

HEAD ZIM FEM 28MM 8018-28-04

Facility

$3,490.45

Hospital Charge Code	270608929
Hospital Revenue Code	278
Min. Negotiated Rate	$523.57
Max. Negotiated Rate	$844.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$767.90
Rate for Payer: Qualcare PPO/HMO/WC	$523.57

HEAD ZIM FEM 28MM SHT 9026-28

Facility

$3,642.45

Hospital Charge Code	270606985
Hospital Revenue Code	278
Min. Negotiated Rate	$546.37
Max. Negotiated Rate	$881.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$728.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$881.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$801.34
Rate for Payer: Qualcare PPO/HMO/WC	$546.37

HEAD ZIM FEM 28MM SHT 9026-28

Facility

$3,642.45

Hospital Charge Code	270606985
Hospital Revenue Code	278
Min. Negotiated Rate	$87.78
Max. Negotiated Rate	$1,821.22
Rate for Payer: Aetna Commercial	$1,384.13
Rate for Payer: Aetna Medicare Advantage	$1,092.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$928.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$928.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$728.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$928.82
Rate for Payer: Cigna Commercial	$1,821.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$881.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$801.34
Rate for Payer: Qualcare PPO/HMO/WC	$546.37
Rate for Payer: UnitedHealthcare Community & State	$87.78
Rate for Payer: Wellpoint Medicaid Managed Care	$96.52

HEAD ZIM FEM 29MM 9026-29

Facility

$3,412.85

Hospital Charge Code	270605479
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

HEAD ZIM FEM 29MM 9026-29

Facility

$3,412.85

Hospital Charge Code	270605479
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

HEAD ZIM FEM 9026-28

Facility

$3,487.25

Hospital Charge Code	270607080
Hospital Revenue Code	278
Min. Negotiated Rate	$84.04
Max. Negotiated Rate	$1,743.62
Rate for Payer: Aetna Commercial	$1,325.15
Rate for Payer: Aetna Medicare Advantage	$1,046.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$889.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$889.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$697.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$889.25
Rate for Payer: Cigna Commercial	$1,743.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$843.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$767.20
Rate for Payer: Qualcare PPO/HMO/WC	$523.09
Rate for Payer: UnitedHealthcare Community & State	$84.04
Rate for Payer: Wellpoint Medicaid Managed Care	$92.41

HEAD ZIM FEM 9026-28

Facility

$3,487.25

Hospital Charge Code	270607080
Hospital Revenue Code	278
Min. Negotiated Rate	$523.09
Max. Negotiated Rate	$843.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$697.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$843.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$767.20
Rate for Payer: Qualcare PPO/HMO/WC	$523.09

HEAD ZIM HUM 13 4065-44

Facility

$5,725.65

Hospital Charge Code	270613410
Hospital Revenue Code	278
Min. Negotiated Rate	$137.99
Max. Negotiated Rate	$2,862.82
Rate for Payer: Aetna Commercial	$2,175.75
Rate for Payer: Aetna Medicare Advantage	$1,717.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,460.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,460.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,145.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,460.04
Rate for Payer: Cigna Commercial	$2,862.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,385.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,259.64
Rate for Payer: Qualcare PPO/HMO/WC	$858.85
Rate for Payer: UnitedHealthcare Community & State	$137.99
Rate for Payer: Wellpoint Medicaid Managed Care	$151.73

HEAD ZIM HUM 13 4065-44

Facility

$5,725.65

Hospital Charge Code	270613410
Hospital Revenue Code	278
Min. Negotiated Rate	$858.85
Max. Negotiated Rate	$1,385.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,145.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,385.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,259.64
Rate for Payer: Qualcare PPO/HMO/WC	$858.85

Know your out-of-pocket cost for care.

All Charges