Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LOADING UNIT GIA60-3.8(BLUE)

Facility

$236.20

Hospital Charge Code	270657208
Hospital Revenue Code	270
Min. Negotiated Rate	$35.43
Max. Negotiated Rate	$35.43
Rate for Payer: Qualcare PPO/HMO/WC	$35.43

LOAD UNIT 35 2.5 WH TR35W

Facility

$1,310.45

Hospital Charge Code	270608738
Hospital Revenue Code	272
Min. Negotiated Rate	$31.58
Max. Negotiated Rate	$655.23
Rate for Payer: Aetna Commercial	$497.97
Rate for Payer: Aetna Medicare Advantage	$393.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$334.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$334.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$334.16
Rate for Payer: Cigna Commercial	$655.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.13
Rate for Payer: Oxford Commercial	$262.09
Rate for Payer: Qualcare PPO/HMO/WC	$196.57
Rate for Payer: UnitedHealthcare Commercial	$262.09
Rate for Payer: UnitedHealthcare Community & State	$31.58
Rate for Payer: Wellpoint Medicaid Managed Care	$34.73

LOAD UNIT 35 2.5 WH TR35W

Facility

$1,310.45

Hospital Charge Code	270608738
Hospital Revenue Code	272
Min. Negotiated Rate	$196.57
Max. Negotiated Rate	$196.57
Rate for Payer: Qualcare PPO/HMO/WC	$196.57

LOAD UNIT 35 3.5 BL TR35B

Facility

$1,310.45

Hospital Charge Code	270608736
Hospital Revenue Code	272
Min. Negotiated Rate	$196.57
Max. Negotiated Rate	$196.57
Rate for Payer: Qualcare PPO/HMO/WC	$196.57

LOAD UNIT 35 3.5 BL TR35B

Facility

$1,310.45

Hospital Charge Code	270608736
Hospital Revenue Code	272
Min. Negotiated Rate	$31.58
Max. Negotiated Rate	$655.23
Rate for Payer: Aetna Commercial	$497.97
Rate for Payer: Aetna Medicare Advantage	$393.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$334.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$334.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$334.16
Rate for Payer: Cigna Commercial	$655.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.13
Rate for Payer: Oxford Commercial	$262.09
Rate for Payer: Qualcare PPO/HMO/WC	$196.57
Rate for Payer: UnitedHealthcare Commercial	$262.09
Rate for Payer: UnitedHealthcare Community & State	$31.58
Rate for Payer: Wellpoint Medicaid Managed Care	$34.73

LOAD UNIT 55 2.5 WH TVR55

Facility

$266.90

Hospital Charge Code	270608734
Hospital Revenue Code	272
Min. Negotiated Rate	$40.03
Max. Negotiated Rate	$40.03
Rate for Payer: Qualcare PPO/HMO/WC	$40.03

LOAD UNIT 55 2.5 WH TVR55

Facility

$266.90

Hospital Charge Code	270608734
Hospital Revenue Code	272
Min. Negotiated Rate	$6.43
Max. Negotiated Rate	$133.45
Rate for Payer: Aetna Commercial	$101.42
Rate for Payer: Aetna Medicare Advantage	$80.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.06
Rate for Payer: Cigna Commercial	$133.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.07
Rate for Payer: Oxford Commercial	$53.38
Rate for Payer: Qualcare PPO/HMO/WC	$40.03
Rate for Payer: UnitedHealthcare Commercial	$53.38
Rate for Payer: UnitedHealthcare Community & State	$6.43
Rate for Payer: Wellpoint Medicaid Managed Care	$7.07

LOAD UNIT ENDO GIA 30-2.5R

Facility

$683.60

Hospital Charge Code	270651833
Hospital Revenue Code	272
Min. Negotiated Rate	$102.54
Max. Negotiated Rate	$102.54
Rate for Payer: Qualcare PPO/HMO/WC	$102.54

LOAD UNIT ENDO GIA 30-2.5R

Facility

$683.60

Hospital Charge Code	270651833
Hospital Revenue Code	272
Min. Negotiated Rate	$16.47
Max. Negotiated Rate	$341.80
Rate for Payer: Aetna Commercial	$259.77
Rate for Payer: Aetna Medicare Advantage	$205.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.32
Rate for Payer: Cigna Commercial	$341.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.08
Rate for Payer: Oxford Commercial	$136.72
Rate for Payer: Qualcare PPO/HMO/WC	$102.54
Rate for Payer: UnitedHealthcare Commercial	$136.72
Rate for Payer: UnitedHealthcare Community & State	$16.47
Rate for Payer: Wellpoint Medicaid Managed Care	$18.12

LOAD UNIT ENDO GIA 30MMVAS/MED

Facility

$1,512.03

Hospital Charge Code	270655977
Hospital Revenue Code	272
Min. Negotiated Rate	$36.44
Max. Negotiated Rate	$756.01
Rate for Payer: Aetna Commercial	$574.57
Rate for Payer: Aetna Medicare Advantage	$453.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$385.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$385.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$385.57
Rate for Payer: Cigna Commercial	$756.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.61
Rate for Payer: Oxford Commercial	$302.41
Rate for Payer: Qualcare PPO/HMO/WC	$226.80
Rate for Payer: UnitedHealthcare Commercial	$302.41
Rate for Payer: UnitedHealthcare Community & State	$36.44
Rate for Payer: Wellpoint Medicaid Managed Care	$40.07

LOAD UNIT ENDO GIA 30MMVAS/MED

Facility

$1,512.03

Hospital Charge Code	270655977
Hospital Revenue Code	272
Min. Negotiated Rate	$226.80
Max. Negotiated Rate	$226.80
Rate for Payer: Qualcare PPO/HMO/WC	$226.80

LOAD UNIT ENDO GIA 45 2.5R

Facility

$781.22

Hospital Charge Code	270619587
Hospital Revenue Code	272
Min. Negotiated Rate	$117.18
Max. Negotiated Rate	$117.18
Rate for Payer: Qualcare PPO/HMO/WC	$117.18

LOAD UNIT ENDO GIA 45 2.5R

Facility

$781.22

Hospital Charge Code	270619587
Hospital Revenue Code	272
Min. Negotiated Rate	$18.83
Max. Negotiated Rate	$390.61
Rate for Payer: Aetna Commercial	$296.86
Rate for Payer: Aetna Medicare Advantage	$234.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.21
Rate for Payer: Cigna Commercial	$390.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.37
Rate for Payer: Oxford Commercial	$156.24
Rate for Payer: Qualcare PPO/HMO/WC	$117.18
Rate for Payer: UnitedHealthcare Commercial	$156.24
Rate for Payer: UnitedHealthcare Community & State	$18.83
Rate for Payer: Wellpoint Medicaid Managed Care	$20.70

LOAD UNIT ENDO GIA 45 3.5R

Facility

$781.22

Hospital Charge Code	270619588
Hospital Revenue Code	272
Min. Negotiated Rate	$117.18
Max. Negotiated Rate	$117.18
Rate for Payer: Qualcare PPO/HMO/WC	$117.18

LOAD UNIT ENDO GIA 45 3.5R

Facility

$781.22

Hospital Charge Code	270619588
Hospital Revenue Code	272
Min. Negotiated Rate	$18.83
Max. Negotiated Rate	$390.61
Rate for Payer: Aetna Commercial	$296.86
Rate for Payer: Aetna Medicare Advantage	$234.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.21
Rate for Payer: Cigna Commercial	$390.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.37
Rate for Payer: Oxford Commercial	$156.24
Rate for Payer: Qualcare PPO/HMO/WC	$117.18
Rate for Payer: UnitedHealthcare Commercial	$156.24
Rate for Payer: UnitedHealthcare Community & State	$18.83
Rate for Payer: Wellpoint Medicaid Managed Care	$20.70

LOAD UNIT ENDO GIA 45 4.8R

Facility

$820.33

Hospital Charge Code	270640220
Hospital Revenue Code	272
Min. Negotiated Rate	$123.05
Max. Negotiated Rate	$123.05
Rate for Payer: Qualcare PPO/HMO/WC	$123.05

LOAD UNIT ENDO GIA 45 4.8R

Facility

$820.33

Hospital Charge Code	270640220
Hospital Revenue Code	272
Min. Negotiated Rate	$19.77
Max. Negotiated Rate	$410.17
Rate for Payer: Aetna Commercial	$311.73
Rate for Payer: Aetna Medicare Advantage	$246.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.18
Rate for Payer: Cigna Commercial	$410.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.10
Rate for Payer: Oxford Commercial	$164.07
Rate for Payer: Qualcare PPO/HMO/WC	$123.05
Rate for Payer: UnitedHealthcare Commercial	$164.07
Rate for Payer: UnitedHealthcare Community & State	$19.77
Rate for Payer: Wellpoint Medicaid Managed Care	$21.74

LOAD UNIT ENDO GIA 60-3.5R

Facility

$1,777.35

Hospital Charge Code	270660575
Hospital Revenue Code	272
Min. Negotiated Rate	$42.83
Max. Negotiated Rate	$888.67
Rate for Payer: Aetna Commercial	$675.39
Rate for Payer: Aetna Medicare Advantage	$533.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$453.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$453.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$453.22
Rate for Payer: Cigna Commercial	$888.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$533.21
Rate for Payer: Oxford Commercial	$355.47
Rate for Payer: Qualcare PPO/HMO/WC	$266.60
Rate for Payer: UnitedHealthcare Commercial	$355.47
Rate for Payer: UnitedHealthcare Community & State	$42.83
Rate for Payer: Wellpoint Medicaid Managed Care	$47.10

LOAD UNIT ENDO GIA 60-3.5R

Facility

$1,777.35

Hospital Charge Code	270660575
Hospital Revenue Code	272
Min. Negotiated Rate	$266.60
Max. Negotiated Rate	$266.60
Rate for Payer: Qualcare PPO/HMO/WC	$266.60

LOAD UNIT ENDO GIA II 30-3.5

Facility

$439.47

Hospital Charge Code	270621874
Hospital Revenue Code	272
Min. Negotiated Rate	$10.59
Max. Negotiated Rate	$219.74
Rate for Payer: Aetna Commercial	$167.00
Rate for Payer: Aetna Medicare Advantage	$131.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.06
Rate for Payer: Cigna Commercial	$219.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.84
Rate for Payer: Oxford Commercial	$87.89
Rate for Payer: Qualcare PPO/HMO/WC	$65.92
Rate for Payer: UnitedHealthcare Commercial	$87.89
Rate for Payer: UnitedHealthcare Community & State	$10.59
Rate for Payer: Wellpoint Medicaid Managed Care	$11.65

LOAD UNIT ENDO GIA II 30-3.5

Facility

$439.47

Hospital Charge Code	270621874
Hospital Revenue Code	272
Min. Negotiated Rate	$65.92
Max. Negotiated Rate	$65.92
Rate for Payer: Qualcare PPO/HMO/WC	$65.92

LOAD UNIT ENDO GIA II 45-3.5

Facility

$439.47

Hospital Charge Code	270608866
Hospital Revenue Code	272
Min. Negotiated Rate	$10.59
Max. Negotiated Rate	$219.74
Rate for Payer: Aetna Commercial	$167.00
Rate for Payer: Aetna Medicare Advantage	$131.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.06
Rate for Payer: Cigna Commercial	$219.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.84
Rate for Payer: Oxford Commercial	$87.89
Rate for Payer: Qualcare PPO/HMO/WC	$65.92
Rate for Payer: UnitedHealthcare Commercial	$87.89
Rate for Payer: UnitedHealthcare Community & State	$10.59
Rate for Payer: Wellpoint Medicaid Managed Care	$11.65

LOAD UNIT ENDO GIA II 45-3.5

Facility

$439.47

Hospital Charge Code	270608866
Hospital Revenue Code	272
Min. Negotiated Rate	$65.92
Max. Negotiated Rate	$65.92
Rate for Payer: Qualcare PPO/HMO/WC	$65.92

LOAD UNIT ENDOWRIST 30MM BLUE

Facility

$854.15

Hospital Charge Code	270677822
Hospital Revenue Code	272
Min. Negotiated Rate	$128.12
Max. Negotiated Rate	$128.12
Rate for Payer: Qualcare PPO/HMO/WC	$128.12

LOAD UNIT ENDOWRIST 30MM BLUE

Facility

$854.15

Hospital Charge Code	270677822
Hospital Revenue Code	272
Min. Negotiated Rate	$20.59
Max. Negotiated Rate	$427.07
Rate for Payer: Aetna Commercial	$324.58
Rate for Payer: Aetna Medicare Advantage	$256.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.81
Rate for Payer: Cigna Commercial	$427.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.25
Rate for Payer: Oxford Commercial	$170.83
Rate for Payer: Qualcare PPO/HMO/WC	$128.12
Rate for Payer: UnitedHealthcare Commercial	$170.83
Rate for Payer: UnitedHealthcare Community & State	$20.59
Rate for Payer: Wellpoint Medicaid Managed Care	$22.63

Know your out-of-pocket cost for care.

All Charges