Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IMPLANT MOD PLUS PROFILE 457CC

Facility

$3,750.00

Hospital Charge Code	270669960
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

IMPLANT MOD PLUS PROFILE 575CC

Facility

$3,750.00

Hospital Charge Code	270670914
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

IMPLANT MOD PLUS PROFILE 575CC

Facility

$3,750.00

Hospital Charge Code	270670914
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

IMPLANT MOD PLUS PROFILE 616CC

Facility

$3,750.00

Hospital Charge Code	270670915
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

IMPLANT MOD PLUS PROFILE 616CC

Facility

$3,750.00

Hospital Charge Code	270670915
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

IMPLANT MOD PLUS PROFILE 700CC

Facility

$3,750.00

Hospital Charge Code	270670916
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

IMPLANT MOD PLUS PROFILE 700CC

Facility

$3,750.00

Hospital Charge Code	270670916
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

IMPLANT MTR MAMMARY SALIN 1620

Facility

$2,883.25

Hospital Charge Code	270615791
Hospital Revenue Code	278
Min. Negotiated Rate	$432.49
Max. Negotiated Rate	$697.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$576.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$697.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$634.32
Rate for Payer: Qualcare PPO/HMO/WC	$432.49

IMPLANT MTR MAMMARY SALIN 1620

Facility

$2,883.25

Hospital Charge Code	270615791
Hospital Revenue Code	278
Min. Negotiated Rate	$69.49
Max. Negotiated Rate	$1,441.62
Rate for Payer: Aetna Commercial	$1,095.63
Rate for Payer: Aetna Medicare Advantage	$864.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$735.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$735.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$576.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$735.23
Rate for Payer: Cigna Commercial	$1,441.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$697.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$634.32
Rate for Payer: Qualcare PPO/HMO/WC	$432.49
Rate for Payer: UnitedHealthcare Community & State	$69.49
Rate for Payer: Wellpoint Medicaid Managed Care	$76.41

IMPLANT MTR MAMMARY SALIN 2610

Facility

$3,145.65

Hospital Charge Code	270616401
Hospital Revenue Code	278
Min. Negotiated Rate	$471.85
Max. Negotiated Rate	$761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$629.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$761.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$692.04
Rate for Payer: Qualcare PPO/HMO/WC	$471.85

IMPLANT MTR MAMMARY SALIN 2610

Facility

$3,145.65

Hospital Charge Code	270616401
Hospital Revenue Code	278
Min. Negotiated Rate	$75.81
Max. Negotiated Rate	$1,572.83
Rate for Payer: Aetna Commercial	$1,195.35
Rate for Payer: Aetna Medicare Advantage	$943.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$802.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$802.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$629.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$802.14
Rate for Payer: Cigna Commercial	$1,572.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$761.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$692.04
Rate for Payer: Qualcare PPO/HMO/WC	$471.85
Rate for Payer: UnitedHealthcare Community & State	$75.81
Rate for Payer: Wellpoint Medicaid Managed Care	$83.36

IMPLANT MTR MAMMARY SALIN 2615

Facility

$3,145.65

Hospital Charge Code	270616403
Hospital Revenue Code	278
Min. Negotiated Rate	$471.85
Max. Negotiated Rate	$761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$629.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$761.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$692.04
Rate for Payer: Qualcare PPO/HMO/WC	$471.85

IMPLANT MTR MAMMARY SALIN 2615

Facility

$3,145.65

Hospital Charge Code	270616403
Hospital Revenue Code	278
Min. Negotiated Rate	$75.81
Max. Negotiated Rate	$1,572.83
Rate for Payer: Aetna Commercial	$1,195.35
Rate for Payer: Aetna Medicare Advantage	$943.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$802.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$802.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$629.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$802.14
Rate for Payer: Cigna Commercial	$1,572.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$761.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$692.04
Rate for Payer: Qualcare PPO/HMO/WC	$471.85
Rate for Payer: UnitedHealthcare Community & State	$75.81
Rate for Payer: Wellpoint Medicaid Managed Care	$83.36

IMPLANT MTR MAMMARY SALIN 2620

Facility

$3,145.65

Hospital Charge Code	270616404
Hospital Revenue Code	278
Min. Negotiated Rate	$471.85
Max. Negotiated Rate	$761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$629.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$761.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$692.04
Rate for Payer: Qualcare PPO/HMO/WC	$471.85

IMPLANT MTR MAMMARY SALIN 2620

Facility

$3,145.65

Hospital Charge Code	270616404
Hospital Revenue Code	278
Min. Negotiated Rate	$75.81
Max. Negotiated Rate	$1,572.83
Rate for Payer: Aetna Commercial	$1,195.35
Rate for Payer: Aetna Medicare Advantage	$943.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$802.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$802.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$629.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$802.14
Rate for Payer: Cigna Commercial	$1,572.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$761.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$692.04
Rate for Payer: Qualcare PPO/HMO/WC	$471.85
Rate for Payer: UnitedHealthcare Community & State	$75.81
Rate for Payer: Wellpoint Medicaid Managed Care	$83.36

IMPLANT MTR MAMMARY SALIN 2625

Facility

$3,145.65

Hospital Charge Code	270621089
Hospital Revenue Code	278
Min. Negotiated Rate	$471.85
Max. Negotiated Rate	$761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$629.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$761.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$692.04
Rate for Payer: Qualcare PPO/HMO/WC	$471.85

IMPLANT MTR MAMMARY SALIN 2625

Facility

$3,145.65

Hospital Charge Code	270621089
Hospital Revenue Code	278
Min. Negotiated Rate	$75.81
Max. Negotiated Rate	$1,572.83
Rate for Payer: Aetna Commercial	$1,195.35
Rate for Payer: Aetna Medicare Advantage	$943.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$802.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$802.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$629.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$802.14
Rate for Payer: Cigna Commercial	$1,572.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$761.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$692.04
Rate for Payer: Qualcare PPO/HMO/WC	$471.85
Rate for Payer: UnitedHealthcare Community & State	$75.81
Rate for Payer: Wellpoint Medicaid Managed Care	$83.36

IMPLANT MTR MAMMARY SALIN 2645

Facility

$3,145.65

Hospital Charge Code	270621640
Hospital Revenue Code	278
Min. Negotiated Rate	$75.81
Max. Negotiated Rate	$1,572.83
Rate for Payer: Aetna Commercial	$1,195.35
Rate for Payer: Aetna Medicare Advantage	$943.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$802.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$802.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$629.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$802.14
Rate for Payer: Cigna Commercial	$1,572.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$761.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$692.04
Rate for Payer: Qualcare PPO/HMO/WC	$471.85
Rate for Payer: UnitedHealthcare Community & State	$75.81
Rate for Payer: Wellpoint Medicaid Managed Care	$83.36

IMPLANT MTR MAMMARY SALIN 2645

Facility

$3,145.65

Hospital Charge Code	270621640
Hospital Revenue Code	278
Min. Negotiated Rate	$471.85
Max. Negotiated Rate	$761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$629.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$761.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$692.04
Rate for Payer: Qualcare PPO/HMO/WC	$471.85

IMPLANT MTR MAMMARY SALIN 2655

Facility

$3,145.65

Hospital Charge Code	270621642
Hospital Revenue Code	278
Min. Negotiated Rate	$75.81
Max. Negotiated Rate	$1,572.83
Rate for Payer: Aetna Commercial	$1,195.35
Rate for Payer: Aetna Medicare Advantage	$943.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$802.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$802.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$629.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$802.14
Rate for Payer: Cigna Commercial	$1,572.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$761.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$692.04
Rate for Payer: Qualcare PPO/HMO/WC	$471.85
Rate for Payer: UnitedHealthcare Community & State	$75.81
Rate for Payer: Wellpoint Medicaid Managed Care	$83.36

IMPLANT MTR MAMMARY SALIN 2655

Facility

$3,145.65

Hospital Charge Code	270621642
Hospital Revenue Code	278
Min. Negotiated Rate	$471.85
Max. Negotiated Rate	$761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$629.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$761.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$692.04
Rate for Payer: Qualcare PPO/HMO/WC	$471.85

IMPLANT MTR MAMMARY SALIN 2910

Facility

$3,407.25

Hospital Charge Code	270616406
Hospital Revenue Code	278
Min. Negotiated Rate	$511.09
Max. Negotiated Rate	$824.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$681.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$824.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$749.60
Rate for Payer: Qualcare PPO/HMO/WC	$511.09

IMPLANT MTR MAMMARY SALIN 2910

Facility

$3,407.25

Hospital Charge Code	270616406
Hospital Revenue Code	278
Min. Negotiated Rate	$82.11
Max. Negotiated Rate	$1,703.62
Rate for Payer: Aetna Commercial	$1,294.76
Rate for Payer: Aetna Medicare Advantage	$1,022.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$868.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$868.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$681.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$868.85
Rate for Payer: Cigna Commercial	$1,703.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$824.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$749.60
Rate for Payer: Qualcare PPO/HMO/WC	$511.09
Rate for Payer: UnitedHealthcare Community & State	$82.11
Rate for Payer: Wellpoint Medicaid Managed Care	$90.29

IMPLANT MTR MAMMARY SALIN 2911

Facility

$3,407.25

Hospital Charge Code	270621092
Hospital Revenue Code	278
Min. Negotiated Rate	$511.09
Max. Negotiated Rate	$824.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$681.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$824.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$749.60
Rate for Payer: Qualcare PPO/HMO/WC	$511.09

IMPLANT MTR MAMMARY SALIN 2911

Facility

$3,407.25

Hospital Charge Code	270621092
Hospital Revenue Code	278
Min. Negotiated Rate	$82.11
Max. Negotiated Rate	$1,703.62
Rate for Payer: Aetna Commercial	$1,294.76
Rate for Payer: Aetna Medicare Advantage	$1,022.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$868.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$868.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$681.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$868.85
Rate for Payer: Cigna Commercial	$1,703.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$824.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$749.60
Rate for Payer: Qualcare PPO/HMO/WC	$511.09
Rate for Payer: UnitedHealthcare Community & State	$82.11
Rate for Payer: Wellpoint Medicaid Managed Care	$90.29

Know your out-of-pocket cost for care.

All Charges