Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC

Facility

$50,526.00

Service Code	MSDRG 855
Min. Negotiated Rate	$15,384.52
Max. Negotiated Rate	$50,526.00
Rate for Payer: Aetna Commercial	$34,974.45
Rate for Payer: Aetna Medicare Advantage	$50,526.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39,543.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39,543.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,194.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39,543.70
Rate for Payer: Cigna Commercial	$28,018.60
Rate for Payer: Cigna Medicare Advantage	$16,194.23
Rate for Payer: Clover Medicare Advantage	$15,384.52
Rate for Payer: EmblemHealth Commercial	$48,582.69
Rate for Payer: Humana Medicare Advantage	$16,680.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,194.23
Rate for Payer: Oxford Commercial	$20,137.34
Rate for Payer: UnitedHealthcare Commercial	$35,311.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,194.23
Rate for Payer: Wellcare Medicare Advantage	$16,194.23

INFED INJECTION

Facility

$196.00

Hospital Charge Code	60634865
Hospital Revenue Code	636
Min. Negotiated Rate	$29.40
Max. Negotiated Rate	$47.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.43
Rate for Payer: Qualcare PPO/HMO/WC	$29.40

INFED INJECTION

Facility

$196.00

Hospital Charge Code	60634865
Hospital Revenue Code	636
Min. Negotiated Rate	$4.72
Max. Negotiated Rate	$98.00
Rate for Payer: Aetna Commercial	$74.48
Rate for Payer: Aetna Medicare Advantage	$58.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.98
Rate for Payer: Cigna Commercial	$98.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.43
Rate for Payer: Qualcare PPO/HMO/WC	$29.40
Rate for Payer: UnitedHealthcare Community & State	$4.72
Rate for Payer: Wellpoint Medicaid Managed Care	$5.19

INFINITY TIPLESS 0.9 MM

Facility

$817.00

Hospital Charge Code	270655294
Hospital Revenue Code	270
Min. Negotiated Rate	$122.55
Max. Negotiated Rate	$122.55
Rate for Payer: Qualcare PPO/HMO/WC	$122.55

INFINITY TIPLESS 0.9 MM

Facility

$817.00

Hospital Charge Code	270655294
Hospital Revenue Code	270
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$408.50
Rate for Payer: Aetna Commercial	$310.46
Rate for Payer: Aetna Medicare Advantage	$245.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.34
Rate for Payer: Cigna Commercial	$408.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.10
Rate for Payer: Oxford Commercial	$163.40
Rate for Payer: Qualcare PPO/HMO/WC	$122.55
Rate for Payer: UnitedHealthcare Commercial	$163.40
Rate for Payer: UnitedHealthcare Community & State	$19.69
Rate for Payer: Wellpoint Medicaid Managed Care	$21.65

INFLAMASE FORTE 1%/5ML

Facility

$61.00

Hospital Charge Code	60634563
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

INFLAMASE FORTE 1%/5ML

Facility

$61.00

Hospital Charge Code	60634563
Hospital Revenue Code	250
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$23.18
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.30
Rate for Payer: Oxford Commercial	$12.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$12.20
Rate for Payer: UnitedHealthcare Community & State	$1.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.62

INFLAMASE MILD 0.125% OPH

Facility

$64.00

Hospital Charge Code	60633184
Hospital Revenue Code	250
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

INFLAMASE MILD 0.125% OPH

Facility

$64.00

Hospital Charge Code	60633184
Hospital Revenue Code	250
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$24.32
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.20
Rate for Payer: Oxford Commercial	$12.80
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$12.80
Rate for Payer: UnitedHealthcare Community & State	$1.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1.70

INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC

Facility

$50,063.86

Service Code	MSDRG 727
Min. Negotiated Rate	$15,243.80
Max. Negotiated Rate	$50,063.86
Rate for Payer: Aetna Commercial	$34,656.90
Rate for Payer: Aetna Medicare Advantage	$50,063.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37,682.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37,682.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,046.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37,682.82
Rate for Payer: Cigna Commercial	$27,750.99
Rate for Payer: Cigna Medicare Advantage	$16,046.11
Rate for Payer: Clover Medicare Advantage	$15,243.80
Rate for Payer: EmblemHealth Commercial	$48,138.33
Rate for Payer: Humana Medicare Advantage	$16,527.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,046.11
Rate for Payer: Oxford Commercial	$19,945.01
Rate for Payer: UnitedHealthcare Commercial	$34,974.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,046.11
Rate for Payer: Wellcare Medicare Advantage	$16,046.11

INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC

Facility

$28,353.41

Service Code	MSDRG 728
Min. Negotiated Rate	$8,633.25
Max. Negotiated Rate	$28,353.41
Rate for Payer: Aetna Commercial	$19,739.36
Rate for Payer: Aetna Medicare Advantage	$28,353.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18,608.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18,608.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,087.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18,608.80
Rate for Payer: Cigna Commercial	$15,180.80
Rate for Payer: Cigna Medicare Advantage	$9,087.63
Rate for Payer: Clover Medicare Advantage	$8,633.25
Rate for Payer: EmblemHealth Commercial	$27,262.89
Rate for Payer: Humana Medicare Advantage	$9,360.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,087.63
Rate for Payer: Oxford Commercial	$10,910.64
Rate for Payer: UnitedHealthcare Commercial	$19,132.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,087.63
Rate for Payer: Wellcare Medicare Advantage	$9,087.63

INFLAMMATORY BOWEL DISEASE

Facility

$12,689.20

Service Code	APR-DRG 2453
Min. Negotiated Rate	$12,440.39
Max. Negotiated Rate	$12,689.20
Rate for Payer: UnitedHealthcare Community & State	$12,440.39
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,689.20
Rate for Payer: Wellpoint Medicaid Managed Care	$12,440.39

INFLAMMATORY BOWEL DISEASE

Facility

$8,885.87

Service Code	APR-DRG 2452
Min. Negotiated Rate	$8,711.64
Max. Negotiated Rate	$8,885.87
Rate for Payer: UnitedHealthcare Community & State	$8,711.64
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,885.87
Rate for Payer: Wellpoint Medicaid Managed Care	$8,711.64

INFLAMMATORY BOWEL DISEASE

Facility

$21,802.34

Service Code	APR-DRG 2454
Min. Negotiated Rate	$21,374.84
Max. Negotiated Rate	$21,802.34
Rate for Payer: UnitedHealthcare Community & State	$21,374.84
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,802.34
Rate for Payer: Wellpoint Medicaid Managed Care	$21,374.84

INFLAMMATORY BOWEL DISEASE

Facility

$6,960.62

Service Code	APR-DRG 2451
Min. Negotiated Rate	$6,824.14
Max. Negotiated Rate	$6,960.62
Rate for Payer: UnitedHealthcare Community & State	$6,824.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,960.62
Rate for Payer: Wellpoint Medicaid Managed Care	$6,824.14

INFLAMMATORY BOWEL DISEASE WITH CC

Facility

$33,689.76

Service Code	MSDRG 386
Min. Negotiated Rate	$10,258.10
Max. Negotiated Rate	$33,689.76
Rate for Payer: Aetna Commercial	$23,406.01
Rate for Payer: Aetna Medicare Advantage	$33,689.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,563.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,563.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10,798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,563.17
Rate for Payer: Cigna Commercial	$18,270.48
Rate for Payer: Cigna Medicare Advantage	$10,798.00
Rate for Payer: Clover Medicare Advantage	$10,258.10
Rate for Payer: EmblemHealth Commercial	$32,394.00
Rate for Payer: Humana Medicare Advantage	$11,121.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10,798.00
Rate for Payer: Oxford Commercial	$13,131.24
Rate for Payer: UnitedHealthcare Commercial	$23,026.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$10,798.00
Rate for Payer: Wellcare Medicare Advantage	$10,798.00

INFLAMMATORY BOWEL DISEASE WITH MCC

Facility

$53,276.62

Service Code	MSDRG 385
Min. Negotiated Rate	$16,222.05
Max. Negotiated Rate	$53,276.62
Rate for Payer: Aetna Commercial	$36,864.42
Rate for Payer: Aetna Medicare Advantage	$53,276.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36,519.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36,519.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,075.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36,519.77
Rate for Payer: Cigna Commercial	$29,611.16
Rate for Payer: Cigna Medicare Advantage	$17,075.84
Rate for Payer: Clover Medicare Advantage	$16,222.05
Rate for Payer: EmblemHealth Commercial	$51,227.52
Rate for Payer: Humana Medicare Advantage	$17,588.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17,075.84
Rate for Payer: Oxford Commercial	$21,281.94
Rate for Payer: UnitedHealthcare Commercial	$37,318.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,075.84
Rate for Payer: Wellcare Medicare Advantage	$17,075.84

INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC

Facility

$24,154.82

Service Code	MSDRG 387
Min. Negotiated Rate	$7,354.83
Max. Negotiated Rate	$24,154.82
Rate for Payer: Aetna Commercial	$16,854.44
Rate for Payer: Aetna Medicare Advantage	$24,154.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,817.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,817.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,741.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,817.48
Rate for Payer: Cigna Commercial	$12,749.85
Rate for Payer: Cigna Medicare Advantage	$7,741.93
Rate for Payer: Clover Medicare Advantage	$7,354.83
Rate for Payer: EmblemHealth Commercial	$23,225.79
Rate for Payer: Humana Medicare Advantage	$7,974.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,741.93
Rate for Payer: Oxford Commercial	$9,163.49
Rate for Payer: UnitedHealthcare Commercial	$16,068.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,741.93
Rate for Payer: Wellcare Medicare Advantage	$7,741.93

INFLATABLE PENILE 12MMX24CM

Facility

$65,452.55

Hospital Charge Code	270702098
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.41
Max. Negotiated Rate	$32,726.28
Rate for Payer: Aetna Commercial	$24,871.97
Rate for Payer: Aetna Medicare Advantage	$19,635.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,690.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,690.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,090.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16,690.40
Rate for Payer: Cigna Commercial	$32,726.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,839.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14,399.56
Rate for Payer: Qualcare PPO/HMO/WC	$9,817.88
Rate for Payer: UnitedHealthcare Community & State	$1,577.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1,734.49

INFLATABLE PENILE 12MMX24CM

Facility

$65,452.55

Hospital Charge Code	270702098
Hospital Revenue Code	278
Min. Negotiated Rate	$9,817.88
Max. Negotiated Rate	$15,839.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,090.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,839.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14,399.56
Rate for Payer: Qualcare PPO/HMO/WC	$9,817.88

INFLATABLE PENILE PROSTHESIS

Facility

$67,702.55

Hospital Charge Code	270702114
Hospital Revenue Code	278
Min. Negotiated Rate	$10,155.38
Max. Negotiated Rate	$16,384.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,540.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,384.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14,894.56
Rate for Payer: Qualcare PPO/HMO/WC	$10,155.38

INFLATABLE PENILE PROSTHESIS

Facility

$67,702.55

Hospital Charge Code	270702114
Hospital Revenue Code	278
Min. Negotiated Rate	$1,631.63
Max. Negotiated Rate	$33,851.28
Rate for Payer: Aetna Commercial	$25,726.97
Rate for Payer: Aetna Medicare Advantage	$20,310.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,264.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,264.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,540.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,264.15
Rate for Payer: Cigna Commercial	$33,851.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,384.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14,894.56
Rate for Payer: Qualcare PPO/HMO/WC	$10,155.38
Rate for Payer: UnitedHealthcare Community & State	$1,631.63
Rate for Payer: Wellpoint Medicaid Managed Care	$1,794.12

INFLATABLE PENILE PUMP 12MMX18

Facility

$65,452.55

Hospital Charge Code	270702096
Hospital Revenue Code	278
Min. Negotiated Rate	$9,817.88
Max. Negotiated Rate	$15,839.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,090.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,839.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14,399.56
Rate for Payer: Qualcare PPO/HMO/WC	$9,817.88

INFLATABLE PENILE PUMP 12MMX18

Facility

$65,452.55

Hospital Charge Code	270702096
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.41
Max. Negotiated Rate	$32,726.28
Rate for Payer: Aetna Commercial	$24,871.97
Rate for Payer: Aetna Medicare Advantage	$19,635.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,690.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,690.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,090.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16,690.40
Rate for Payer: Cigna Commercial	$32,726.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,839.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14,399.56
Rate for Payer: Qualcare PPO/HMO/WC	$9,817.88
Rate for Payer: UnitedHealthcare Community & State	$1,577.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1,734.49

INFLATION DEVICE ENCORE

Facility

$175.00

Hospital Charge Code	2706000658
Hospital Revenue Code	272
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.50
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$35.00
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

Know your out-of-pocket cost for care.

All Charges