Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MARKERBXTITOPHATSMARKCELER122S

Facility

$412.25

Service Code	HCPCS A4648
Hospital Charge Code	270697948
Hospital Revenue Code	278
Min. Negotiated Rate	$9.94
Max. Negotiated Rate	$206.12
Rate for Payer: Aetna Commercial	$156.66
Rate for Payer: Aetna Medicare Advantage	$123.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.12
Rate for Payer: Cigna Commercial	$206.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$90.69
Rate for Payer: Qualcare PPO/HMO/WC	$61.84
Rate for Payer: UnitedHealthcare Community & State	$9.94
Rate for Payer: Wellpoint Medicaid Managed Care	$10.92

MARKER BX TOPHATSMARKEVIVA2ND

Facility

$359.15

Service Code	HCPCS A4648
Hospital Charge Code	270675353R
Hospital Revenue Code	278
Min. Negotiated Rate	$53.87
Max. Negotiated Rate	$86.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.01
Rate for Payer: Qualcare PPO/HMO/WC	$53.87

MARKER BX TOPHATSMARKEVIVA2ND

Facility

$359.15

Service Code	HCPCS A4648
Hospital Charge Code	270675353R
Hospital Revenue Code	278
Min. Negotiated Rate	$8.66
Max. Negotiated Rate	$179.57
Rate for Payer: Aetna Commercial	$136.48
Rate for Payer: Aetna Medicare Advantage	$107.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.58
Rate for Payer: Cigna Commercial	$179.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.01
Rate for Payer: Qualcare PPO/HMO/WC	$53.87
Rate for Payer: UnitedHealthcare Community & State	$8.66
Rate for Payer: Wellpoint Medicaid Managed Care	$9.52

MARKERBXTRIMARKATECTD-2S-13-XX

Facility

$388.00

Service Code	HCPCS A4648
Hospital Charge Code	270679041R
Hospital Revenue Code	278
Min. Negotiated Rate	$9.35
Max. Negotiated Rate	$194.00
Rate for Payer: Aetna Commercial	$147.44
Rate for Payer: Aetna Medicare Advantage	$116.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.94
Rate for Payer: Cigna Commercial	$194.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$85.36
Rate for Payer: Qualcare PPO/HMO/WC	$58.20
Rate for Payer: UnitedHealthcare Community & State	$9.35
Rate for Payer: Wellpoint Medicaid Managed Care	$10.28

MARKERBXTRIMARKATECTD-2S-13-XX

Facility

$388.00

Service Code	HCPCS A4648
Hospital Charge Code	270679041R
Hospital Revenue Code	278
Min. Negotiated Rate	$58.20
Max. Negotiated Rate	$93.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$85.36
Rate for Payer: Qualcare PPO/HMO/WC	$58.20

MARKER BX TRIMARK TI 13CM

Facility

$338.00

Service Code	HCPCS A4648
Hospital Charge Code	270664834R
Hospital Revenue Code	278
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$81.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.36
Rate for Payer: Qualcare PPO/HMO/WC	$50.70

MARKER BX TRIMARK TI 13CM

Facility

$338.00

Service Code	HCPCS A4648
Hospital Charge Code	270664834R
Hospital Revenue Code	278
Min. Negotiated Rate	$8.15
Max. Negotiated Rate	$169.00
Rate for Payer: Aetna Commercial	$128.44
Rate for Payer: Aetna Medicare Advantage	$101.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.19
Rate for Payer: Cigna Commercial	$169.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$74.36
Rate for Payer: Qualcare PPO/HMO/WC	$50.70
Rate for Payer: UnitedHealthcare Community & State	$8.15
Rate for Payer: Wellpoint Medicaid Managed Care	$8.96

MARKER BX TUMARK EVIVA18G120MM

Facility

$437.50

Service Code	HCPCS A4648
Hospital Charge Code	270669921R
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$218.75
Rate for Payer: Aetna Commercial	$166.25
Rate for Payer: Aetna Medicare Advantage	$131.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.56
Rate for Payer: Cigna Commercial	$218.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.25
Rate for Payer: Qualcare PPO/HMO/WC	$65.62
Rate for Payer: UnitedHealthcare Community & State	$10.54
Rate for Payer: Wellpoint Medicaid Managed Care	$11.59

MARKER BX TUMARK EVIVA18G120MM

Facility

$437.50

Service Code	HCPCS A4648
Hospital Charge Code	270669921R
Hospital Revenue Code	278
Min. Negotiated Rate	$65.62
Max. Negotiated Rate	$105.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.25
Rate for Payer: Qualcare PPO/HMO/WC	$65.62

MARKER BX TUMARK EYE 18G12CM

Facility

$412.50

Service Code	HCPCS A4648
Hospital Charge Code	270683012
Hospital Revenue Code	278
Min. Negotiated Rate	$9.94
Max. Negotiated Rate	$206.25
Rate for Payer: Aetna Commercial	$156.75
Rate for Payer: Aetna Medicare Advantage	$123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.19
Rate for Payer: Cigna Commercial	$206.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$61.88
Rate for Payer: UnitedHealthcare Community & State	$9.94
Rate for Payer: Wellpoint Medicaid Managed Care	$10.93

MARKER BX TUMARK EYE 18G12CM

Facility

$412.50

Service Code	HCPCS A4648
Hospital Charge Code	270683012
Hospital Revenue Code	278
Min. Negotiated Rate	$61.88
Max. Negotiated Rate	$99.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$61.88

MARKERBXTUMARKEYESHAPE18G12CM

Facility

$437.50

Service Code	HCPCS A4648
Hospital Charge Code	270683827R
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$218.75
Rate for Payer: Aetna Commercial	$166.25
Rate for Payer: Aetna Medicare Advantage	$131.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.56
Rate for Payer: Cigna Commercial	$218.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.25
Rate for Payer: Qualcare PPO/HMO/WC	$65.62
Rate for Payer: UnitedHealthcare Community & State	$10.54
Rate for Payer: Wellpoint Medicaid Managed Care	$11.59

MARKERBXTUMARKEYESHAPE18G12CM

Facility

$437.50

Service Code	HCPCS A4648
Hospital Charge Code	270683827R
Hospital Revenue Code	278
Min. Negotiated Rate	$65.62
Max. Negotiated Rate	$105.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.25
Rate for Payer: Qualcare PPO/HMO/WC	$65.62

MARKER BX TUMARK Q SHAPE 10CM

Facility

$412.25

Service Code	HCPCS A4648
Hospital Charge Code	270697945
Hospital Revenue Code	278
Min. Negotiated Rate	$9.94
Max. Negotiated Rate	$206.12
Rate for Payer: Aetna Commercial	$156.66
Rate for Payer: Aetna Medicare Advantage	$123.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.12
Rate for Payer: Cigna Commercial	$206.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$90.69
Rate for Payer: Qualcare PPO/HMO/WC	$61.84
Rate for Payer: UnitedHealthcare Community & State	$9.94
Rate for Payer: Wellpoint Medicaid Managed Care	$10.92

MARKER BX TUMARK Q SHAPE 10CM

Facility

$412.25

Service Code	HCPCS A4648
Hospital Charge Code	270697945
Hospital Revenue Code	278
Min. Negotiated Rate	$61.84
Max. Negotiated Rate	$99.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$90.69
Rate for Payer: Qualcare PPO/HMO/WC	$61.84

MARKER BX TUMARK VISION 10CM

Facility

$412.25

Service Code	HCPCS A4648
Hospital Charge Code	270697946
Hospital Revenue Code	278
Min. Negotiated Rate	$9.94
Max. Negotiated Rate	$206.12
Rate for Payer: Aetna Commercial	$156.66
Rate for Payer: Aetna Medicare Advantage	$123.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.12
Rate for Payer: Cigna Commercial	$206.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$90.69
Rate for Payer: Qualcare PPO/HMO/WC	$61.84
Rate for Payer: UnitedHealthcare Community & State	$9.94
Rate for Payer: Wellpoint Medicaid Managed Care	$10.92

MARKER BX TUMARK VISION 10CM

Facility

$412.25

Service Code	HCPCS A4648
Hospital Charge Code	270697946
Hospital Revenue Code	278
Min. Negotiated Rate	$61.84
Max. Negotiated Rate	$99.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$90.69
Rate for Payer: Qualcare PPO/HMO/WC	$61.84

MARKER BX TUMARK X SHAPE 10CM

Facility

$412.25

Service Code	HCPCS A4648
Hospital Charge Code	270697944
Hospital Revenue Code	278
Min. Negotiated Rate	$9.94
Max. Negotiated Rate	$206.12
Rate for Payer: Aetna Commercial	$156.66
Rate for Payer: Aetna Medicare Advantage	$123.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.12
Rate for Payer: Cigna Commercial	$206.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$90.69
Rate for Payer: Qualcare PPO/HMO/WC	$61.84
Rate for Payer: UnitedHealthcare Community & State	$9.94
Rate for Payer: Wellpoint Medicaid Managed Care	$10.92

MARKER BX TUMARK X SHAPE 10CM

Facility

$412.25

Service Code	HCPCS A4648
Hospital Charge Code	270697944
Hospital Revenue Code	278
Min. Negotiated Rate	$61.84
Max. Negotiated Rate	$99.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$90.69
Rate for Payer: Qualcare PPO/HMO/WC	$61.84

MARKER EVIVA 13MM SHAPE 1 BUCK

Facility

$359.13

Hospital Charge Code	270675352N
Hospital Revenue Code	272
Min. Negotiated Rate	$53.87
Max. Negotiated Rate	$53.87
Rate for Payer: Qualcare PPO/HMO/WC	$53.87

MARKER EVIVA 13MM SHAPE 1 BUCK

Facility

$359.13

Hospital Charge Code	270675352N
Hospital Revenue Code	272
Min. Negotiated Rate	$8.66
Max. Negotiated Rate	$179.56
Rate for Payer: Aetna Commercial	$136.47
Rate for Payer: Aetna Medicare Advantage	$107.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.58
Rate for Payer: Cigna Commercial	$179.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.74
Rate for Payer: Oxford Commercial	$71.83
Rate for Payer: Qualcare PPO/HMO/WC	$53.87
Rate for Payer: UnitedHealthcare Commercial	$71.83
Rate for Payer: UnitedHealthcare Community & State	$8.66
Rate for Payer: Wellpoint Medicaid Managed Care	$9.52

MARKER EVIVA 13MM SHAPE 1 BUCK

Facility

$359.15

Service Code	HCPCS A4648
Hospital Charge Code	270675352
Hospital Revenue Code	278
Min. Negotiated Rate	$8.66
Max. Negotiated Rate	$179.57
Rate for Payer: Aetna Commercial	$136.48
Rate for Payer: Aetna Medicare Advantage	$107.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.58
Rate for Payer: Cigna Commercial	$179.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.01
Rate for Payer: Qualcare PPO/HMO/WC	$53.87
Rate for Payer: UnitedHealthcare Community & State	$8.66
Rate for Payer: Wellpoint Medicaid Managed Care	$9.52

MARKER EVIVA 13MM SHAPE 1 BUCK

Facility

$359.15

Service Code	HCPCS A4648
Hospital Charge Code	270675352
Hospital Revenue Code	278
Min. Negotiated Rate	$53.87
Max. Negotiated Rate	$86.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$79.01
Rate for Payer: Qualcare PPO/HMO/WC	$53.87

MARKER LEADING RADIO 5FR 7 CM

Facility

$385.00

Service Code	HCPCS C2617
Hospital Charge Code	270679134
Hospital Revenue Code	278
Min. Negotiated Rate	$57.75
Max. Negotiated Rate	$93.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.70
Rate for Payer: Qualcare PPO/HMO/WC	$57.75

MARKER LEADING RADIO 5FR 7 CM

Facility

$385.00

Service Code	HCPCS C2617
Hospital Charge Code	270679134
Hospital Revenue Code	278
Min. Negotiated Rate	$9.28
Max. Negotiated Rate	$192.50
Rate for Payer: Aetna Commercial	$146.30
Rate for Payer: Aetna Medicare Advantage	$115.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.17
Rate for Payer: Cigna Commercial	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.70
Rate for Payer: Qualcare PPO/HMO/WC	$57.75
Rate for Payer: UnitedHealthcare Community & State	$9.28
Rate for Payer: Wellpoint Medicaid Managed Care	$10.20

Know your out-of-pocket cost for care.

All Charges