Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LEAD MEDT PCEMKR 4503M

Facility

$4,968.85

Hospital Charge Code	270602749
Hospital Revenue Code	275
Min. Negotiated Rate	$745.33
Max. Negotiated Rate	$1,202.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,202.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,093.15
Rate for Payer: Qualcare PPO/HMO/WC	$745.33

LEAD MEDT PCEMKR 4557M

Facility

$2,724.00

Hospital Charge Code	270602757
Hospital Revenue Code	275
Min. Negotiated Rate	$408.60
Max. Negotiated Rate	$659.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$544.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$599.28
Rate for Payer: Qualcare PPO/HMO/WC	$408.60

LEAD MEDT PCEMKR 4557M

Facility

$2,724.00

Hospital Charge Code	270602757
Hospital Revenue Code	275
Min. Negotiated Rate	$65.65
Max. Negotiated Rate	$1,362.00
Rate for Payer: Aetna Commercial	$1,035.12
Rate for Payer: Aetna Medicare Advantage	$817.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$694.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$694.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$544.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$694.62
Rate for Payer: Cigna Commercial	$1,362.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$599.28
Rate for Payer: Qualcare PPO/HMO/WC	$408.60
Rate for Payer: UnitedHealthcare Community & State	$65.65
Rate for Payer: Wellpoint Medicaid Managed Care	$72.19

LEAD MEDT PCEMKR 4558M-53

Facility

$2,724.00

Hospital Charge Code	270602758
Hospital Revenue Code	275
Min. Negotiated Rate	$408.60
Max. Negotiated Rate	$659.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$544.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$599.28
Rate for Payer: Qualcare PPO/HMO/WC	$408.60

LEAD MEDT PCEMKR 4558M-53

Facility

$3,000.00

Hospital Charge Code	270602758C
Hospital Revenue Code	275
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

LEAD MEDT PCEMKR 4558M-53

Facility

$3,000.00

Hospital Charge Code	270602758C
Hospital Revenue Code	275
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

LEAD MEDT PCEMKR 4558M-53

Facility

$2,724.00

Hospital Charge Code	270602758
Hospital Revenue Code	275
Min. Negotiated Rate	$65.65
Max. Negotiated Rate	$1,362.00
Rate for Payer: Aetna Commercial	$1,035.12
Rate for Payer: Aetna Medicare Advantage	$817.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$694.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$694.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$544.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$694.62
Rate for Payer: Cigna Commercial	$1,362.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$599.28
Rate for Payer: Qualcare PPO/HMO/WC	$408.60
Rate for Payer: UnitedHealthcare Community & State	$65.65
Rate for Payer: Wellpoint Medicaid Managed Care	$72.19

LEAD MEDT PCEMKR 4568-53

Facility

$3,268.85

Hospital Charge Code	270610216
Hospital Revenue Code	275
Min. Negotiated Rate	$490.33
Max. Negotiated Rate	$791.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$653.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$791.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$719.15
Rate for Payer: Qualcare PPO/HMO/WC	$490.33

LEAD MEDT PCEMKR 4568-53

Facility

$3,268.85

Hospital Charge Code	270610216
Hospital Revenue Code	275
Min. Negotiated Rate	$78.78
Max. Negotiated Rate	$1,634.42
Rate for Payer: Aetna Commercial	$1,242.16
Rate for Payer: Aetna Medicare Advantage	$980.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$833.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$833.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$653.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$833.56
Rate for Payer: Cigna Commercial	$1,634.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$791.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$719.15
Rate for Payer: Qualcare PPO/HMO/WC	$490.33
Rate for Payer: UnitedHealthcare Community & State	$78.78
Rate for Payer: Wellpoint Medicaid Managed Care	$86.62

LEAD MEDT PCEMKR 4568-53

Facility

$3,268.85

Hospital Charge Code	270607756
Hospital Revenue Code	275
Min. Negotiated Rate	$490.33
Max. Negotiated Rate	$791.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$653.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$791.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$719.15
Rate for Payer: Qualcare PPO/HMO/WC	$490.33

LEAD MEDT PCEMKR 4568-53

Facility

$3,268.85

Hospital Charge Code	270607756
Hospital Revenue Code	275
Min. Negotiated Rate	$78.78
Max. Negotiated Rate	$1,634.42
Rate for Payer: Aetna Commercial	$1,242.16
Rate for Payer: Aetna Medicare Advantage	$980.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$833.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$833.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$653.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$833.56
Rate for Payer: Cigna Commercial	$1,634.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$791.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$719.15
Rate for Payer: Qualcare PPO/HMO/WC	$490.33
Rate for Payer: UnitedHealthcare Community & State	$78.78
Rate for Payer: Wellpoint Medicaid Managed Care	$86.62

LEAD MEDT PCEMKR 5024M

Facility

$3,000.00

Hospital Charge Code	270602743C
Hospital Revenue Code	275
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

LEAD MEDT PCEMKR 5024M

Facility

$3,000.00

Hospital Charge Code	270602743C
Hospital Revenue Code	275
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

LEAD MEDT PCEMKR 5034

Facility

$3,158.45

Hospital Charge Code	270602738
Hospital Revenue Code	275
Min. Negotiated Rate	$473.77
Max. Negotiated Rate	$764.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$631.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$764.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$694.86
Rate for Payer: Qualcare PPO/HMO/WC	$473.77

LEAD MEDT PCEMKR 5034

Facility

$3,158.45

Hospital Charge Code	270602738
Hospital Revenue Code	275
Min. Negotiated Rate	$76.12
Max. Negotiated Rate	$1,579.22
Rate for Payer: Aetna Commercial	$1,200.21
Rate for Payer: Aetna Medicare Advantage	$947.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$805.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$805.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$631.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$805.40
Rate for Payer: Cigna Commercial	$1,579.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$764.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$694.86
Rate for Payer: Qualcare PPO/HMO/WC	$473.77
Rate for Payer: UnitedHealthcare Community & State	$76.12
Rate for Payer: Wellpoint Medicaid Managed Care	$83.70

LEAD MEDT PCEMKR 5034

Facility

$3,625.00

Hospital Charge Code	270602738C
Hospital Revenue Code	275
Min. Negotiated Rate	$87.36
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,377.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$797.50
Rate for Payer: Qualcare PPO/HMO/WC	$543.75
Rate for Payer: UnitedHealthcare Community & State	$87.36
Rate for Payer: Wellpoint Medicaid Managed Care	$96.06

LEAD MEDT PCEMKR 5034

Facility

$3,625.00

Hospital Charge Code	270602738C
Hospital Revenue Code	275
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$877.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$797.50
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

LEAD MEDT PCEMKR 5034-58

Facility

$3,158.45

Hospital Charge Code	270610681
Hospital Revenue Code	275
Min. Negotiated Rate	$76.12
Max. Negotiated Rate	$1,579.22
Rate for Payer: Aetna Commercial	$1,200.21
Rate for Payer: Aetna Medicare Advantage	$947.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$805.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$805.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$631.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$805.40
Rate for Payer: Cigna Commercial	$1,579.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$764.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$694.86
Rate for Payer: Qualcare PPO/HMO/WC	$473.77
Rate for Payer: UnitedHealthcare Community & State	$76.12
Rate for Payer: Wellpoint Medicaid Managed Care	$83.70

LEAD MEDT PCEMKR 5034-58

Facility

$3,158.45

Hospital Charge Code	270610681
Hospital Revenue Code	275
Min. Negotiated Rate	$473.77
Max. Negotiated Rate	$764.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$631.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$764.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$694.86
Rate for Payer: Qualcare PPO/HMO/WC	$473.77

LEAD MEDT PCEMKR 5058

Facility

$2,724.00

Hospital Charge Code	270602753
Hospital Revenue Code	275
Min. Negotiated Rate	$408.60
Max. Negotiated Rate	$659.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$544.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$599.28
Rate for Payer: Qualcare PPO/HMO/WC	$408.60

LEAD MEDT PCEMKR 5058

Facility

$2,724.00

Hospital Charge Code	270602753
Hospital Revenue Code	275
Min. Negotiated Rate	$65.65
Max. Negotiated Rate	$1,362.00
Rate for Payer: Aetna Commercial	$1,035.12
Rate for Payer: Aetna Medicare Advantage	$817.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$694.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$694.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$544.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$694.62
Rate for Payer: Cigna Commercial	$1,362.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$599.28
Rate for Payer: Qualcare PPO/HMO/WC	$408.60
Rate for Payer: UnitedHealthcare Community & State	$65.65
Rate for Payer: Wellpoint Medicaid Managed Care	$72.19

LEAD MEDT PCEMKR 5058

Facility

$3,125.00

Hospital Charge Code	270602753C
Hospital Revenue Code	275
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

LEAD MEDT PCEMKR 5058

Facility

$3,125.00

Hospital Charge Code	270602753C
Hospital Revenue Code	275
Min. Negotiated Rate	$75.31
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$75.31
Rate for Payer: Wellpoint Medicaid Managed Care	$82.81

LEAD MEDT PCEMKR 5076-52

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270623124
Hospital Revenue Code	275
Min. Negotiated Rate	$67.36
Max. Negotiated Rate	$1,397.50
Rate for Payer: Aetna Commercial	$1,062.10
Rate for Payer: Aetna Medicare Advantage	$838.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$712.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$712.73
Rate for Payer: Cigna Commercial	$1,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$614.90
Rate for Payer: Qualcare PPO/HMO/WC	$419.25
Rate for Payer: UnitedHealthcare Community & State	$67.36
Rate for Payer: Wellpoint Medicaid Managed Care	$74.07

LEAD MEDT PCEMKR 5076-52

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270623124
Hospital Revenue Code	275
Min. Negotiated Rate	$419.25
Max. Negotiated Rate	$676.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$614.90
Rate for Payer: Qualcare PPO/HMO/WC	$419.25

Know your out-of-pocket cost for care.

All Charges