Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LOAD UNIT ENDOWRIST 30MM GRAY

Facility

$10,250.00

Hospital Charge Code	270677911
Hospital Revenue Code	272
Min. Negotiated Rate	$247.03
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,895.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,075.00
Rate for Payer: Oxford Commercial	$2,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50
Rate for Payer: UnitedHealthcare Commercial	$2,050.00
Rate for Payer: UnitedHealthcare Community & State	$247.03
Rate for Payer: Wellpoint Medicaid Managed Care	$271.62

LOAD UNIT ENDOWRIST 30MM GRAY

Facility

$10,250.00

Hospital Charge Code	270677911
Hospital Revenue Code	272
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$1,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

LOAD UNIT ENDOWRIST 30MM GREEN

Facility

$854.17

Hospital Charge Code	270677824
Hospital Revenue Code	272
Min. Negotiated Rate	$128.13
Max. Negotiated Rate	$128.13
Rate for Payer: Qualcare PPO/HMO/WC	$128.13

LOAD UNIT ENDOWRIST 30MM GREEN

Facility

$854.17

Hospital Charge Code	270677824
Hospital Revenue Code	272
Min. Negotiated Rate	$20.59
Max. Negotiated Rate	$427.08
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	$427.08
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	$128.13
Rate for Payer: UnitedHealthcare Commercial	$170.83
Rate for Payer: UnitedHealthcare Community & State	$20.59
Rate for Payer: Wellpoint Medicaid Managed Care	$22.64

LOAD UNIT ENDOWRIST 30MM WHITE

Facility

$854.17

Hospital Charge Code	270677823
Hospital Revenue Code	272
Min. Negotiated Rate	$128.13
Max. Negotiated Rate	$128.13
Rate for Payer: Qualcare PPO/HMO/WC	$128.13

LOAD UNIT ENDOWRIST 30MM WHITE

Facility

$854.17

Hospital Charge Code	270677823
Hospital Revenue Code	272
Min. Negotiated Rate	$20.59
Max. Negotiated Rate	$427.08
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	$427.08
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	$128.13
Rate for Payer: UnitedHealthcare Commercial	$170.83
Rate for Payer: UnitedHealthcare Community & State	$20.59
Rate for Payer: Wellpoint Medicaid Managed Care	$22.64

LOAD UNIT EN GIA 30 2.5 030418

Facility

$443.78

Hospital Charge Code	270621873
Hospital Revenue Code	270
Min. Negotiated Rate	$10.70
Max. Negotiated Rate	$221.89
Rate for Payer: Aetna Commercial	$168.64
Rate for Payer: Aetna Medicare Advantage	$133.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.16
Rate for Payer: Cigna Commercial	$221.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.13
Rate for Payer: Oxford Commercial	$88.76
Rate for Payer: Qualcare PPO/HMO/WC	$66.57
Rate for Payer: UnitedHealthcare Commercial	$88.76
Rate for Payer: UnitedHealthcare Community & State	$10.70
Rate for Payer: Wellpoint Medicaid Managed Care	$11.76

LOAD UNIT EN GIA 30 2.5 030418

Facility

$443.78

Hospital Charge Code	270621873
Hospital Revenue Code	270
Min. Negotiated Rate	$66.57
Max. Negotiated Rate	$66.57
Rate for Payer: Qualcare PPO/HMO/WC	$66.57

LOAD UNIT EN TA 60 4.8 010320

Facility

$241.65

Hospital Charge Code	270615081
Hospital Revenue Code	272
Min. Negotiated Rate	$5.82
Max. Negotiated Rate	$120.83
Rate for Payer: Aetna Commercial	$91.83
Rate for Payer: Aetna Medicare Advantage	$72.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.62
Rate for Payer: Cigna Commercial	$120.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.50
Rate for Payer: Oxford Commercial	$48.33
Rate for Payer: Qualcare PPO/HMO/WC	$36.25
Rate for Payer: UnitedHealthcare Commercial	$48.33
Rate for Payer: UnitedHealthcare Community & State	$5.82
Rate for Payer: Wellpoint Medicaid Managed Care	$6.40

LOAD UNIT EN TA 60 4.8 010320

Facility

$241.65

Hospital Charge Code	270615081
Hospital Revenue Code	272
Min. Negotiated Rate	$36.25
Max. Negotiated Rate	$36.25
Rate for Payer: Qualcare PPO/HMO/WC	$36.25

LOAD UNIT GIA 60-3.8 SINGLE US

Facility

$236.54

Hospital Charge Code	270600047
Hospital Revenue Code	272
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$118.27
Rate for Payer: Aetna Commercial	$89.89
Rate for Payer: Aetna Medicare Advantage	$70.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.32
Rate for Payer: Cigna Commercial	$118.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.96
Rate for Payer: Oxford Commercial	$47.31
Rate for Payer: Qualcare PPO/HMO/WC	$35.48
Rate for Payer: UnitedHealthcare Commercial	$47.31
Rate for Payer: UnitedHealthcare Community & State	$5.70
Rate for Payer: Wellpoint Medicaid Managed Care	$6.27

LOAD UNIT GIA 60-3.8 SINGLE US

Facility

$236.54

Hospital Charge Code	270600047
Hospital Revenue Code	272
Min. Negotiated Rate	$35.48
Max. Negotiated Rate	$35.48
Rate for Payer: Qualcare PPO/HMO/WC	$35.48

LOAD UNIT GIA 60-4.8 SINGLE

Facility

$233.07

Hospital Charge Code	270659453
Hospital Revenue Code	272
Min. Negotiated Rate	$34.96
Max. Negotiated Rate	$34.96
Rate for Payer: Qualcare PPO/HMO/WC	$34.96

LOAD UNIT GIA 60-4.8 SINGLE

Facility

$233.07

Hospital Charge Code	270659453
Hospital Revenue Code	272
Min. Negotiated Rate	$5.62
Max. Negotiated Rate	$116.53
Rate for Payer: Aetna Commercial	$88.57
Rate for Payer: Aetna Medicare Advantage	$69.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.43
Rate for Payer: Cigna Commercial	$116.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.92
Rate for Payer: Oxford Commercial	$46.61
Rate for Payer: Qualcare PPO/HMO/WC	$34.96
Rate for Payer: UnitedHealthcare Commercial	$46.61
Rate for Payer: UnitedHealthcare Community & State	$5.62
Rate for Payer: Wellpoint Medicaid Managed Care	$6.18

LOAD UNIT GIA 80-3.8 SINGLE

Facility

$345.78

Hospital Charge Code	270656101
Hospital Revenue Code	272
Min. Negotiated Rate	$8.33
Max. Negotiated Rate	$172.89
Rate for Payer: Aetna Commercial	$131.40
Rate for Payer: Aetna Medicare Advantage	$103.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.17
Rate for Payer: Cigna Commercial	$172.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.73
Rate for Payer: Oxford Commercial	$69.16
Rate for Payer: Qualcare PPO/HMO/WC	$51.87
Rate for Payer: UnitedHealthcare Commercial	$69.16
Rate for Payer: UnitedHealthcare Community & State	$8.33
Rate for Payer: Wellpoint Medicaid Managed Care	$9.16

LOAD UNIT GIA 80-3.8 SINGLE

Facility

$345.78

Hospital Charge Code	270656101
Hospital Revenue Code	272
Min. Negotiated Rate	$51.87
Max. Negotiated Rate	$51.87
Rate for Payer: Qualcare PPO/HMO/WC	$51.87

LOAD UNIT GIA 80-4.8 SINGLE

Facility

$345.78

Hospital Charge Code	270630399
Hospital Revenue Code	272
Min. Negotiated Rate	$51.87
Max. Negotiated Rate	$51.87
Rate for Payer: Qualcare PPO/HMO/WC	$51.87

LOAD UNIT GIA 80-4.8 SINGLE

Facility

$345.78

Hospital Charge Code	270630399
Hospital Revenue Code	272
Min. Negotiated Rate	$8.33
Max. Negotiated Rate	$172.89
Rate for Payer: Aetna Commercial	$131.40
Rate for Payer: Aetna Medicare Advantage	$103.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.17
Rate for Payer: Cigna Commercial	$172.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.73
Rate for Payer: Oxford Commercial	$69.16
Rate for Payer: Qualcare PPO/HMO/WC	$51.87
Rate for Payer: UnitedHealthcare Commercial	$69.16
Rate for Payer: UnitedHealthcare Community & State	$8.33
Rate for Payer: Wellpoint Medicaid Managed Care	$9.16

LOAD UNIT MULTI 30 BL XR30B

Facility

$685.65

Hospital Charge Code	270608648
Hospital Revenue Code	272
Min. Negotiated Rate	$102.85
Max. Negotiated Rate	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$102.85

LOAD UNIT MULTI 30 BL XR30B

Facility

$685.65

Hospital Charge Code	270608648
Hospital Revenue Code	272
Min. Negotiated Rate	$16.52
Max. Negotiated Rate	$342.82
Rate for Payer: Aetna Commercial	$260.55
Rate for Payer: Aetna Medicare Advantage	$205.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.84
Rate for Payer: Cigna Commercial	$342.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.69
Rate for Payer: Oxford Commercial	$137.13
Rate for Payer: Qualcare PPO/HMO/WC	$102.85
Rate for Payer: UnitedHealthcare Commercial	$137.13
Rate for Payer: UnitedHealthcare Community & State	$16.52
Rate for Payer: Wellpoint Medicaid Managed Care	$18.17

LOAD UNIT MULTI 30 GN XR30G

Facility

$685.65

Hospital Charge Code	270608650
Hospital Revenue Code	272
Min. Negotiated Rate	$102.85
Max. Negotiated Rate	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$102.85

LOAD UNIT MULTI 30 GN XR30G

Facility

$685.65

Hospital Charge Code	270608650
Hospital Revenue Code	272
Min. Negotiated Rate	$16.52
Max. Negotiated Rate	$342.82
Rate for Payer: Aetna Commercial	$260.55
Rate for Payer: Aetna Medicare Advantage	$205.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.84
Rate for Payer: Cigna Commercial	$342.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.69
Rate for Payer: Oxford Commercial	$137.13
Rate for Payer: Qualcare PPO/HMO/WC	$102.85
Rate for Payer: UnitedHealthcare Commercial	$137.13
Rate for Payer: UnitedHealthcare Community & State	$16.52
Rate for Payer: Wellpoint Medicaid Managed Care	$18.17

LOAD UNIT MULTI 60 3.8BL XR60B

Facility

$737.65

Hospital Charge Code	270608642
Hospital Revenue Code	272
Min. Negotiated Rate	$17.78
Max. Negotiated Rate	$368.82
Rate for Payer: Aetna Commercial	$280.31
Rate for Payer: Aetna Medicare Advantage	$221.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.10
Rate for Payer: Cigna Commercial	$368.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.29
Rate for Payer: Oxford Commercial	$147.53
Rate for Payer: Qualcare PPO/HMO/WC	$110.65
Rate for Payer: UnitedHealthcare Commercial	$147.53
Rate for Payer: UnitedHealthcare Community & State	$17.78
Rate for Payer: Wellpoint Medicaid Managed Care	$19.55

LOAD UNIT MULTI 60 3.8BL XR60B

Facility

$737.65

Hospital Charge Code	270608642
Hospital Revenue Code	272
Min. Negotiated Rate	$110.65
Max. Negotiated Rate	$110.65
Rate for Payer: Qualcare PPO/HMO/WC	$110.65

LOAD UNIT MULTI 90 TRH90

Facility

$844.00

Hospital Charge Code	270608646
Hospital Revenue Code	272
Min. Negotiated Rate	$20.34
Max. Negotiated Rate	$422.00
Rate for Payer: Aetna Commercial	$320.72
Rate for Payer: Aetna Medicare Advantage	$253.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$215.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$215.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$215.22
Rate for Payer: Cigna Commercial	$422.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.20
Rate for Payer: Oxford Commercial	$168.80
Rate for Payer: Qualcare PPO/HMO/WC	$126.60
Rate for Payer: UnitedHealthcare Commercial	$168.80
Rate for Payer: UnitedHealthcare Community & State	$20.34
Rate for Payer: Wellpoint Medicaid Managed Care	$22.37

Know your out-of-pocket cost for care.

All Charges