Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC

Facility

$79,615.54

Service Code	MSDRG 330
Min. Negotiated Rate	$24,241.91
Max. Negotiated Rate	$79,615.54
Rate for Payer: Aetna Commercial	$54,962.28
Rate for Payer: Aetna Medicare Advantage	$79,615.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25,517.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55,128.57
Rate for Payer: Cigna Commercial	$44,861.20
Rate for Payer: Cigna Medicare Advantage	$25,517.80
Rate for Payer: Clover Medicare Advantage	$24,241.91
Rate for Payer: EmblemHealth Commercial	$76,553.40
Rate for Payer: Humana Medicare Advantage	$26,283.33
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25,517.80
Rate for Payer: Oxford Commercial	$32,242.34
Rate for Payer: UnitedHealthcare Commercial	$56,537.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$25,517.80
Rate for Payer: Wellcare Medicare Advantage	$25,517.80

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC

Facility

$150,700.56

Service Code	MSDRG 329
Min. Negotiated Rate	$45,886.39
Max. Negotiated Rate	$150,700.56
Rate for Payer: Aetna Commercial	$103,805.78
Rate for Payer: Aetna Medicare Advantage	$150,700.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105,139.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105,139.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$48,301.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105,139.72
Rate for Payer: Cigna Commercial	$86,018.90
Rate for Payer: Cigna Medicare Advantage	$48,301.46
Rate for Payer: Clover Medicare Advantage	$45,886.39
Rate for Payer: EmblemHealth Commercial	$144,904.38
Rate for Payer: Humana Medicare Advantage	$49,750.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$48,301.46
Rate for Payer: Oxford Commercial	$61,822.93
Rate for Payer: UnitedHealthcare Commercial	$108,408.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$48,301.46
Rate for Payer: Wellcare Medicare Advantage	$48,301.46

MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC

Facility

$56,528.19

Service Code	MSDRG 331
Min. Negotiated Rate	$17,212.11
Max. Negotiated Rate	$56,528.19
Rate for Payer: Aetna Commercial	$39,098.63
Rate for Payer: Aetna Medicare Advantage	$56,528.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38,845.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38,845.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,118.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38,845.87
Rate for Payer: Cigna Commercial	$31,493.79
Rate for Payer: Cigna Medicare Advantage	$18,118.01
Rate for Payer: Clover Medicare Advantage	$17,212.11
Rate for Payer: EmblemHealth Commercial	$54,354.03
Rate for Payer: Humana Medicare Advantage	$18,661.55
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,118.01
Rate for Payer: Oxford Commercial	$22,635.01
Rate for Payer: UnitedHealthcare Commercial	$39,691.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,118.01
Rate for Payer: Wellcare Medicare Advantage	$18,118.01

MAJOR SMALL BOWEL PROCEDURES

Facility

$16,440.18

Service Code	APR-DRG 2301
Min. Negotiated Rate	$16,117.82
Max. Negotiated Rate	$16,440.18
Rate for Payer: UnitedHealthcare Community & State	$16,117.82
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,440.18
Rate for Payer: Wellpoint Medicaid Managed Care	$16,117.82

MAJOR SMALL BOWEL PROCEDURES

Facility

$22,502.04

Service Code	APR-DRG 2302
Min. Negotiated Rate	$22,060.82
Max. Negotiated Rate	$22,502.04
Rate for Payer: UnitedHealthcare Community & State	$22,060.82
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,502.04
Rate for Payer: Wellpoint Medicaid Managed Care	$22,060.82

MAJOR SMALL BOWEL PROCEDURES

Facility

$58,325.21

Service Code	APR-DRG 2304
Min. Negotiated Rate	$57,181.58
Max. Negotiated Rate	$58,325.21
Rate for Payer: UnitedHealthcare Community & State	$57,181.58
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$58,325.21
Rate for Payer: Wellpoint Medicaid Managed Care	$57,181.58

MAJOR SMALL BOWEL PROCEDURES

Facility

$32,706.71

Service Code	APR-DRG 2303
Min. Negotiated Rate	$32,065.40
Max. Negotiated Rate	$32,706.71
Rate for Payer: UnitedHealthcare Community & State	$32,065.40
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$32,706.71
Rate for Payer: Wellpoint Medicaid Managed Care	$32,065.40

MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$69,317.67

Service Code	APR-DRG 2204
Min. Negotiated Rate	$67,958.50
Max. Negotiated Rate	$69,317.67
Rate for Payer: UnitedHealthcare Community & State	$67,958.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$69,317.67
Rate for Payer: Wellpoint Medicaid Managed Care	$67,958.50

MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$17,774.34

Service Code	APR-DRG 2201
Min. Negotiated Rate	$17,425.82
Max. Negotiated Rate	$17,774.34
Rate for Payer: UnitedHealthcare Community & State	$17,425.82
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,774.34
Rate for Payer: Wellpoint Medicaid Managed Care	$17,425.82

MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$24,834.55

Service Code	APR-DRG 2202
Min. Negotiated Rate	$24,347.60
Max. Negotiated Rate	$24,834.55
Rate for Payer: UnitedHealthcare Community & State	$24,347.60
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,834.55
Rate for Payer: Wellpoint Medicaid Managed Care	$24,347.60

MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES

Facility

$37,264.60

Service Code	APR-DRG 2203
Min. Negotiated Rate	$36,533.92
Max. Negotiated Rate	$37,264.60
Rate for Payer: UnitedHealthcare Community & State	$36,533.92
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$37,264.60
Rate for Payer: Wellpoint Medicaid Managed Care	$36,533.92

MAJOR THUMB OR JOINT PROCEDURES

Facility

$45,742.44

Service Code	MSDRG 506
Min. Negotiated Rate	$13,927.99
Max. Negotiated Rate	$45,742.44
Rate for Payer: Aetna Commercial	$31,687.59
Rate for Payer: Aetna Medicare Advantage	$45,742.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,961.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,961.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,661.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33,961.06
Rate for Payer: Cigna Commercial	$22,449.31
Rate for Payer: Cigna Medicare Advantage	$14,661.04
Rate for Payer: Clover Medicare Advantage	$13,927.99
Rate for Payer: EmblemHealth Commercial	$43,983.12
Rate for Payer: Humana Medicare Advantage	$15,100.87
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,661.04
Rate for Payer: Oxford Commercial	$16,134.62
Rate for Payer: UnitedHealthcare Commercial	$28,292.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,661.04
Rate for Payer: Wellcare Medicare Advantage	$14,661.04

MAKO BLADE SAGITTAL NARROW

Facility

$1,525.00

Hospital Charge Code	270690810
Hospital Revenue Code	272
Min. Negotiated Rate	$228.75
Max. Negotiated Rate	$228.75
Rate for Payer: Qualcare PPO/HMO/WC	$228.75

MAKO BLADE SAGITTAL NARROW

Facility

$1,525.00

Hospital Charge Code	270690810
Hospital Revenue Code	272
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$762.50
Rate for Payer: Aetna Commercial	$579.50
Rate for Payer: Aetna Medicare Advantage	$457.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.88
Rate for Payer: Cigna Commercial	$762.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.50
Rate for Payer: Oxford Commercial	$305.00
Rate for Payer: Qualcare PPO/HMO/WC	$228.75
Rate for Payer: UnitedHealthcare Commercial	$305.00
Rate for Payer: UnitedHealthcare Community & State	$36.75
Rate for Payer: Wellpoint Medicaid Managed Care	$40.41

MAKO BLADE SAGITTAL ST

Facility

$1,525.00

Hospital Charge Code	270690809
Hospital Revenue Code	272
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$762.50
Rate for Payer: Aetna Commercial	$579.50
Rate for Payer: Aetna Medicare Advantage	$457.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.88
Rate for Payer: Cigna Commercial	$762.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.50
Rate for Payer: Oxford Commercial	$305.00
Rate for Payer: Qualcare PPO/HMO/WC	$228.75
Rate for Payer: UnitedHealthcare Commercial	$305.00
Rate for Payer: UnitedHealthcare Community & State	$36.75
Rate for Payer: Wellpoint Medicaid Managed Care	$40.41

MAKO BLADE SAGITTAL ST

Facility

$1,525.00

Hospital Charge Code	270690809
Hospital Revenue Code	272
Min. Negotiated Rate	$228.75
Max. Negotiated Rate	$228.75
Rate for Payer: Qualcare PPO/HMO/WC	$228.75

MAKOPLASTY HIP CONSUMABLES

Facility

$5,150.00

Hospital Charge Code	270668072
Hospital Revenue Code	278
Min. Negotiated Rate	$124.11
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,957.00
Rate for Payer: Aetna Medicare Advantage	$1,545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,313.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,313.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,030.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,313.25
Rate for Payer: Cigna Commercial	$2,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,246.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,133.00
Rate for Payer: Qualcare PPO/HMO/WC	$772.50
Rate for Payer: UnitedHealthcare Community & State	$124.11
Rate for Payer: Wellpoint Medicaid Managed Care	$136.47

MAKOPLASTY HIP CONSUMABLES

Facility

$5,150.00

Hospital Charge Code	270668072
Hospital Revenue Code	278
Min. Negotiated Rate	$772.50
Max. Negotiated Rate	$1,246.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,030.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,246.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,133.00
Rate for Payer: Qualcare PPO/HMO/WC	$772.50

MAKO X3 UNI ONLAY TIBIAL INSER

Facility

$4,223.20

Service Code	HCPCS C1713
Hospital Charge Code	270704053
Hospital Revenue Code	278
Min. Negotiated Rate	$101.78
Max. Negotiated Rate	$2,111.60
Rate for Payer: Aetna Commercial	$1,604.82
Rate for Payer: Aetna Medicare Advantage	$1,266.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,076.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,076.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$844.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,076.92
Rate for Payer: Cigna Commercial	$2,111.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,022.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$929.10
Rate for Payer: Qualcare PPO/HMO/WC	$633.48
Rate for Payer: UnitedHealthcare Community & State	$101.78
Rate for Payer: Wellpoint Medicaid Managed Care	$111.91

MAKO X3 UNI ONLAY TIBIAL INSER

Facility

$4,324.70

Service Code	HCPCS C1789
Hospital Charge Code	270706170
Hospital Revenue Code	278
Min. Negotiated Rate	$104.23
Max. Negotiated Rate	$2,162.35
Rate for Payer: Aetna Commercial	$1,643.39
Rate for Payer: Aetna Medicare Advantage	$1,297.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,102.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,102.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$864.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,102.80
Rate for Payer: Cigna Commercial	$2,162.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,046.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$951.43
Rate for Payer: Qualcare PPO/HMO/WC	$648.71
Rate for Payer: UnitedHealthcare Community & State	$104.23
Rate for Payer: Wellpoint Medicaid Managed Care	$114.60

MAKO X3 UNI ONLAY TIBIAL INSER

Facility

$4,223.20

Service Code	HCPCS C1713
Hospital Charge Code	270704053
Hospital Revenue Code	278
Min. Negotiated Rate	$633.48
Max. Negotiated Rate	$1,022.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$844.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,022.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$929.10
Rate for Payer: Qualcare PPO/HMO/WC	$633.48

MAKO X3 UNI ONLAY TIBIAL INSER

Facility

$4,324.70

Service Code	HCPCS C1789
Hospital Charge Code	270706170
Hospital Revenue Code	278
Min. Negotiated Rate	$648.71
Max. Negotiated Rate	$1,046.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$864.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,046.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$951.43
Rate for Payer: Qualcare PPO/HMO/WC	$648.71

MALARIA SMEAR

Facility

$133.65

Service Code	HCPCS 87207
Hospital Charge Code	3000189
Hospital Revenue Code	309
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$20.05
Rate for Payer: Qualcare PPO/HMO/WC	$20.05

MALARIA SMEAR

Facility

$146.00

Service Code	HCPCS 87207
Hospital Charge Code	38473021
Hospital Revenue Code	309
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

MALARIA SMEAR

Facility

$146.00

Service Code	HCPCS 87207
Hospital Charge Code	38473021
Hospital Revenue Code	309
Min. Negotiated Rate	$3.87
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$16.29
Rate for Payer: Aetna Medicare Advantage	$19.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.62
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$5.69
Rate for Payer: EmblemHealth Commercial	$17.97
Rate for Payer: Humana Medicare Advantage	$6.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.99
Rate for Payer: Wellcare Medicare Advantage	$5.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.87

Know your out-of-pocket cost for care.

All Charges