Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LEAD PCEMKR CPSRE NVUS 6092-58

Facility

$2,940.00

Hospital Charge Code	270647014C
Hospital Revenue Code	275
Min. Negotiated Rate	$441.00
Max. Negotiated Rate	$711.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$588.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$711.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$646.80
Rate for Payer: Qualcare PPO/HMO/WC	$441.00

LEAD PEDIATRIC

Facility

$111.25

Service Code	HCPCS 83655
Hospital Charge Code	3001770
Hospital Revenue Code	301
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.94
Rate for Payer: Aetna Medicare Advantage	$39.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$55.62
Rate for Payer: Cigna Medicare Advantage	$12.11
Rate for Payer: Clover Medicare Advantage	$11.50
Rate for Payer: EmblemHealth Commercial	$36.33
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.11
Rate for Payer: Wellcare Medicare Advantage	$12.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

LEAD PEDIATRIC

Facility

$111.25

Service Code	HCPCS 83655
Hospital Charge Code	3001770
Hospital Revenue Code	301
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$16.69
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

LEAD PENTA 3228

Facility

$39,250.00

Service Code	HCPCS C1778
Hospital Charge Code	270693177
Hospital Revenue Code	278
Min. Negotiated Rate	$945.92
Max. Negotiated Rate	$19,625.00
Rate for Payer: Aetna Commercial	$14,915.00
Rate for Payer: Aetna Medicare Advantage	$11,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,008.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,008.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,008.75
Rate for Payer: Cigna Commercial	$19,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,498.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,635.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,887.50
Rate for Payer: UnitedHealthcare Community & State	$945.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1,040.12

LEAD PENTA 3228

Facility

$39,250.00

Service Code	HCPCS C1778
Hospital Charge Code	270693177
Hospital Revenue Code	278
Min. Negotiated Rate	$5,887.50
Max. Negotiated Rate	$9,498.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,498.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,635.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,887.50

LEAD PISCES QD COMP 33c 388733

Facility

$6,646.45

Hospital Charge Code	270631618
Hospital Revenue Code	275
Min. Negotiated Rate	$996.97
Max. Negotiated Rate	$1,608.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,329.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,608.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,462.22
Rate for Payer: Qualcare PPO/HMO/WC	$996.97

LEAD PISCES QD COMP 33c 388733

Facility

$6,646.45

Hospital Charge Code	270631618
Hospital Revenue Code	275
Min. Negotiated Rate	$160.18
Max. Negotiated Rate	$3,323.22
Rate for Payer: Aetna Commercial	$2,525.65
Rate for Payer: Aetna Medicare Advantage	$1,993.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,694.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,694.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,329.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,694.84
Rate for Payer: Cigna Commercial	$3,323.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,608.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,462.22
Rate for Payer: Qualcare PPO/HMO/WC	$996.97
Rate for Payer: UnitedHealthcare Community & State	$160.18
Rate for Payer: Wellpoint Medicaid Managed Care	$176.13

LEAD PISCES QUAD 45cm 3487A45

Facility

$6,646.45

Hospital Charge Code	270632002
Hospital Revenue Code	275
Min. Negotiated Rate	$160.18
Max. Negotiated Rate	$3,323.22
Rate for Payer: Aetna Commercial	$2,525.65
Rate for Payer: Aetna Medicare Advantage	$1,993.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,694.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,694.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,329.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,694.84
Rate for Payer: Cigna Commercial	$3,323.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,608.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,462.22
Rate for Payer: Qualcare PPO/HMO/WC	$996.97
Rate for Payer: UnitedHealthcare Community & State	$160.18
Rate for Payer: Wellpoint Medicaid Managed Care	$176.13

LEAD PISCES QUAD 45cm 3487A45

Facility

$6,646.45

Hospital Charge Code	270632002
Hospital Revenue Code	275
Min. Negotiated Rate	$996.97
Max. Negotiated Rate	$1,608.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,329.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,608.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,462.22
Rate for Payer: Qualcare PPO/HMO/WC	$996.97

LEADPLUS U_US

Facility

$2,850.00

Hospital Charge Code	270665501
Hospital Revenue Code	270
Min. Negotiated Rate	$427.50
Max. Negotiated Rate	$427.50
Rate for Payer: Qualcare PPO/HMO/WC	$427.50

LEADPLUS U_US

Facility

$2,850.00

Hospital Charge Code	270665501
Hospital Revenue Code	270
Min. Negotiated Rate	$68.69
Max. Negotiated Rate	$1,425.00
Rate for Payer: Aetna Commercial	$1,083.00
Rate for Payer: Aetna Medicare Advantage	$855.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$726.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$726.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$726.75
Rate for Payer: Cigna Commercial	$1,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$855.00
Rate for Payer: Oxford Commercial	$570.00
Rate for Payer: Qualcare PPO/HMO/WC	$427.50
Rate for Payer: UnitedHealthcare Commercial	$570.00
Rate for Payer: UnitedHealthcare Community & State	$68.69
Rate for Payer: Wellpoint Medicaid Managed Care	$75.53

LEAD PMAKER RA CAPE FIX 407645

Facility

$3,224.00

Hospital Charge Code	270634241
Hospital Revenue Code	275
Min. Negotiated Rate	$483.60
Max. Negotiated Rate	$780.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$644.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$709.28
Rate for Payer: Qualcare PPO/HMO/WC	$483.60

LEAD PMAKER RA CAPE FIX 407645

Facility

$3,224.00

Hospital Charge Code	270634241C
Hospital Revenue Code	275
Min. Negotiated Rate	$483.60
Max. Negotiated Rate	$780.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$644.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$709.28
Rate for Payer: Qualcare PPO/HMO/WC	$483.60

LEAD PMAKER RA CAPE FIX 407645

Facility

$3,224.00

Hospital Charge Code	270634241C
Hospital Revenue Code	275
Min. Negotiated Rate	$77.70
Max. Negotiated Rate	$1,612.00
Rate for Payer: Aetna Commercial	$1,225.12
Rate for Payer: Aetna Medicare Advantage	$967.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$822.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$822.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$644.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$822.12
Rate for Payer: Cigna Commercial	$1,612.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$709.28
Rate for Payer: Qualcare PPO/HMO/WC	$483.60
Rate for Payer: UnitedHealthcare Community & State	$77.70
Rate for Payer: Wellpoint Medicaid Managed Care	$85.44

LEAD PMAKER RA CAPE FIX 407645

Facility

$3,224.00

Hospital Charge Code	270634241
Hospital Revenue Code	275
Min. Negotiated Rate	$77.70
Max. Negotiated Rate	$1,612.00
Rate for Payer: Aetna Commercial	$1,225.12
Rate for Payer: Aetna Medicare Advantage	$967.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$822.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$822.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$644.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$822.12
Rate for Payer: Cigna Commercial	$1,612.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$709.28
Rate for Payer: Qualcare PPO/HMO/WC	$483.60
Rate for Payer: UnitedHealthcare Community & State	$77.70
Rate for Payer: Wellpoint Medicaid Managed Care	$85.44

LEAD PM CAPSURE ATRIAL 559453C

Facility

$3,875.00

Hospital Charge Code	270642021C
Hospital Revenue Code	275
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$852.50
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

LEAD PM CAPSURE ATRIAL 559453C

Facility

$3,875.00

Hospital Charge Code	270642021C
Hospital Revenue Code	275
Min. Negotiated Rate	$93.39
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,472.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$852.50
Rate for Payer: Qualcare PPO/HMO/WC	$581.25
Rate for Payer: UnitedHealthcare Community & State	$93.39
Rate for Payer: Wellpoint Medicaid Managed Care	$102.69

LEAD PM CAPSUREFX NOVUS 507645

Facility

$3,844.00

Hospital Charge Code	270623756C
Hospital Revenue Code	275
Min. Negotiated Rate	$576.60
Max. Negotiated Rate	$930.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$845.68
Rate for Payer: Qualcare PPO/HMO/WC	$576.60

LEAD PM CAPSUREFX NOVUS 507645

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270623756
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 PM CAPSUREFX NOVUS 507645

Facility

$2,795.00

Service Code	HCPCS C1779
Hospital Charge Code	270623756
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

LEAD PM CAPSUREFX NOVUS 507645

Facility

$3,844.00

Hospital Charge Code	270623756C
Hospital Revenue Code	275
Min. Negotiated Rate	$92.64
Max. Negotiated Rate	$1,922.00
Rate for Payer: Aetna Commercial	$1,460.72
Rate for Payer: Aetna Medicare Advantage	$1,153.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$980.22
Rate for Payer: Cigna Commercial	$1,922.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$845.68
Rate for Payer: Qualcare PPO/HMO/WC	$576.60
Rate for Payer: UnitedHealthcare Community & State	$92.64
Rate for Payer: Wellpoint Medicaid Managed Care	$101.87

LEAD QUAD COMPACT 33cml 389133

Facility

$8,200.00

Service Code	HCPCS C1779
Hospital Charge Code	270633682
Hospital Revenue Code	275
Min. Negotiated Rate	$1,230.00
Max. Negotiated Rate	$1,984.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,984.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,804.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,230.00

LEAD QUAD COMPACT 33cml 389133

Facility

$8,200.00

Service Code	HCPCS C1779
Hospital Charge Code	270633682
Hospital Revenue Code	275
Min. Negotiated Rate	$197.62
Max. Negotiated Rate	$4,100.00
Rate for Payer: Aetna Commercial	$3,116.00
Rate for Payer: Aetna Medicare Advantage	$2,460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,091.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,091.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,640.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,091.00
Rate for Payer: Cigna Commercial	$4,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,984.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,804.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,230.00
Rate for Payer: UnitedHealthcare Community & State	$197.62
Rate for Payer: Wellpoint Medicaid Managed Care	$217.30

LEAD QUI ENDOCARD 59CM 4035

Facility

$3,427.25

Hospital Charge Code	270617495
Hospital Revenue Code	278
Min. Negotiated Rate	$82.60
Max. Negotiated Rate	$1,713.62
Rate for Payer: Aetna Commercial	$1,302.36
Rate for Payer: Aetna Medicare Advantage	$1,028.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$873.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$873.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$685.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$873.95
Rate for Payer: Cigna Commercial	$1,713.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$829.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$754.00
Rate for Payer: Qualcare PPO/HMO/WC	$514.09
Rate for Payer: UnitedHealthcare Community & State	$82.60
Rate for Payer: Wellpoint Medicaid Managed Care	$90.82

LEAD QUI ENDOCARD 59CM 4035

Facility

$3,427.25

Hospital Charge Code	270617495
Hospital Revenue Code	278
Min. Negotiated Rate	$514.09
Max. Negotiated Rate	$829.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$685.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$829.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$754.00
Rate for Payer: Qualcare PPO/HMO/WC	$514.09

Know your out-of-pocket cost for care.

All Charges