Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LEAD MEDT PCEMKR ENDCP 5867-3M

Facility

$280.00

Hospital Charge Code	270608507
Hospital Revenue Code	275
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$106.40
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.60
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Community & State	$6.75
Rate for Payer: Wellpoint Medicaid Managed Care	$7.42

LEAD MEDT PCEMKR ENDCP 5867-3M

Facility

$280.00

Hospital Charge Code	270608507
Hospital Revenue Code	275
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$67.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.60
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

LEAD MEDT PCEMKR ENDCP 5867-3M

Facility

$280.00

Hospital Charge Code	270608507C
Hospital Revenue Code	275
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$67.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.60
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

LEAD MEDT PCEMKR FIX 4067

Facility

$2,615.05

Hospital Charge Code	270602752
Hospital Revenue Code	275
Min. Negotiated Rate	$392.26
Max. Negotiated Rate	$632.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$523.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$632.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$575.31
Rate for Payer: Qualcare PPO/HMO/WC	$392.26

LEAD MEDT PCEMKR FIX 4067

Facility

$2,615.05

Hospital Charge Code	270602752
Hospital Revenue Code	275
Min. Negotiated Rate	$63.02
Max. Negotiated Rate	$1,307.53
Rate for Payer: Aetna Commercial	$993.72
Rate for Payer: Aetna Medicare Advantage	$784.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$666.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$666.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$523.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$666.84
Rate for Payer: Cigna Commercial	$1,307.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$632.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$575.31
Rate for Payer: Qualcare PPO/HMO/WC	$392.26
Rate for Payer: UnitedHealthcare Community & State	$63.02
Rate for Payer: Wellpoint Medicaid Managed Care	$69.30

LEAD MEDT PCEMKR FIX 4067

Facility

$3,750.00

Hospital Charge Code	270602752C
Hospital Revenue Code	275
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

LEAD MEDT PCEMKR FIX 4067

Facility

$3,750.00

Hospital Charge Code	270602752C
Hospital Revenue Code	275
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

LEAD MEDT PCEMKR FIX 4068-58

Facility

$3,625.00

Service Code	HCPCS C1779
Hospital Charge Code	270602750
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 FIX 4068-58

Facility

$3,625.00

Service Code	HCPCS C1779
Hospital Charge Code	270602750
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 FIX 4068-58

Facility

$3,625.00

Hospital Charge Code	270602750C
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 FIX 4068-58

Facility

$3,625.00

Hospital Charge Code	270602750C
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 FIX 4568

Facility

$3,026.45

Hospital Charge Code	270602751
Hospital Revenue Code	275
Min. Negotiated Rate	$72.94
Max. Negotiated Rate	$1,513.22
Rate for Payer: Aetna Commercial	$1,150.05
Rate for Payer: Aetna Medicare Advantage	$907.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$771.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$771.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$771.74
Rate for Payer: Cigna Commercial	$1,513.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$665.82
Rate for Payer: Qualcare PPO/HMO/WC	$453.97
Rate for Payer: UnitedHealthcare Community & State	$72.94
Rate for Payer: Wellpoint Medicaid Managed Care	$80.20

LEAD MEDT PCEMKR FIX 4568

Facility

$3,026.45

Hospital Charge Code	270602751
Hospital Revenue Code	275
Min. Negotiated Rate	$453.97
Max. Negotiated Rate	$732.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$665.82
Rate for Payer: Qualcare PPO/HMO/WC	$453.97

LEAD MEDT PCEMKR FIX 4568

Facility

$3,026.45

Hospital Charge Code	270602751C
Hospital Revenue Code	275
Min. Negotiated Rate	$72.94
Max. Negotiated Rate	$1,513.22
Rate for Payer: Aetna Commercial	$1,150.05
Rate for Payer: Aetna Medicare Advantage	$907.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$771.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$771.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$771.74
Rate for Payer: Cigna Commercial	$1,513.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$665.82
Rate for Payer: Qualcare PPO/HMO/WC	$453.97
Rate for Payer: UnitedHealthcare Community & State	$72.94
Rate for Payer: Wellpoint Medicaid Managed Care	$80.20

LEAD MEDT PCEMKR FIX 4568

Facility

$3,026.45

Hospital Charge Code	270602751C
Hospital Revenue Code	275
Min. Negotiated Rate	$453.97
Max. Negotiated Rate	$732.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$665.82
Rate for Payer: Qualcare PPO/HMO/WC	$453.97

LEAD MEDT PCEMKR SP 4023

Facility

$2,724.00

Hospital Charge Code	270602745
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 SP 4023

Facility

$2,724.00

Hospital Charge Code	270602745
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 SP 4024

Facility

$2,724.00

Hospital Charge Code	270602741
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 SP 4024

Facility

$2,724.00

Hospital Charge Code	270602741
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 SP 4523

Facility

$2,724.00

Hospital Charge Code	270602746
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 SP 4523

Facility

$2,724.00

Hospital Charge Code	270602746
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 SP 4524

Facility

$2,724.00

Hospital Charge Code	270602742
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 SP 4524

Facility

$2,724.00

Hospital Charge Code	270602742
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 SP 5023M

Facility

$2,724.00

Hospital Charge Code	270602747
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 SP 5023M

Facility

$2,724.00

Hospital Charge Code	270602747
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

Know your out-of-pocket cost for care.

All Charges