Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NEONATAL PULSE OXIMETER SENSOR

Facility

$31.25

Hospital Charge Code	270652478
Hospital Revenue Code	270
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$15.62
Rate for Payer: Aetna Commercial	$11.88
Rate for Payer: Aetna Medicare Advantage	$9.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.97
Rate for Payer: Cigna Commercial	$15.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.38
Rate for Payer: Oxford Commercial	$6.25
Rate for Payer: Qualcare PPO/HMO/WC	$4.69
Rate for Payer: UnitedHealthcare Commercial	$6.25
Rate for Payer: UnitedHealthcare Community & State	$0.75
Rate for Payer: Wellpoint Medicaid Managed Care	$0.83

NEONATAL PULSE OXIMETER SENSOR

Facility

$31.25

Hospital Charge Code	270652478
Hospital Revenue Code	270
Min. Negotiated Rate	$4.69
Max. Negotiated Rate	$4.69
Rate for Payer: Qualcare PPO/HMO/WC	$4.69

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$1,892.10

Service Code	APR-DRG 6031
Min. Negotiated Rate	$1,855.00
Max. Negotiated Rate	$1,892.10
Rate for Payer: UnitedHealthcare Community & State	$1,855.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,892.10
Rate for Payer: Wellpoint Medicaid Managed Care	$1,855.00

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$39,475.88

Service Code	APR-DRG 6032
Min. Negotiated Rate	$38,701.84
Max. Negotiated Rate	$39,475.88
Rate for Payer: UnitedHealthcare Community & State	$38,701.84
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$39,475.88
Rate for Payer: Wellpoint Medicaid Managed Care	$38,701.84

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$163,005.12

Service Code	APR-DRG 6034
Min. Negotiated Rate	$159,808.94
Max. Negotiated Rate	$163,005.12
Rate for Payer: UnitedHealthcare Community & State	$159,808.94
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$163,005.12
Rate for Payer: Wellpoint Medicaid Managed Care	$159,808.94

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$78,710.40

Service Code	APR-DRG 6033
Min. Negotiated Rate	$77,167.06
Max. Negotiated Rate	$78,710.40
Rate for Payer: UnitedHealthcare Community & State	$77,167.06
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$78,710.40
Rate for Payer: Wellpoint Medicaid Managed Care	$77,167.06

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$118,450.53

Service Code	APR-DRG 6023
Min. Negotiated Rate	$116,127.97
Max. Negotiated Rate	$118,450.53
Rate for Payer: UnitedHealthcare Community & State	$116,127.97
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$118,450.53
Rate for Payer: Wellpoint Medicaid Managed Care	$116,127.97

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$156,799.06

Service Code	APR-DRG 6024
Min. Negotiated Rate	$153,724.57
Max. Negotiated Rate	$156,799.06
Rate for Payer: UnitedHealthcare Community & State	$153,724.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$156,799.06
Rate for Payer: Wellpoint Medicaid Managed Care	$153,724.57

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$91,892.43

Service Code	APR-DRG 6022
Min. Negotiated Rate	$90,090.62
Max. Negotiated Rate	$91,892.43
Rate for Payer: UnitedHealthcare Community & State	$90,090.62
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$91,892.43
Rate for Payer: Wellpoint Medicaid Managed Care	$90,090.62

NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$14,613.20

Service Code	APR-DRG 6021
Min. Negotiated Rate	$14,326.67
Max. Negotiated Rate	$14,613.20
Rate for Payer: UnitedHealthcare Community & State	$14,326.67
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,613.20
Rate for Payer: Wellpoint Medicaid Managed Care	$14,326.67

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$66,567.64

Service Code	APR-DRG 6084
Min. Negotiated Rate	$65,262.39
Max. Negotiated Rate	$66,567.64
Rate for Payer: UnitedHealthcare Community & State	$65,262.39
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$66,567.64
Rate for Payer: Wellpoint Medicaid Managed Care	$65,262.39

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$46,801.60

Service Code	APR-DRG 6082
Min. Negotiated Rate	$45,883.92
Max. Negotiated Rate	$46,801.60
Rate for Payer: UnitedHealthcare Community & State	$45,883.92
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$46,801.60
Rate for Payer: Wellpoint Medicaid Managed Care	$45,883.92

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$9,316.17

Service Code	APR-DRG 6081
Min. Negotiated Rate	$9,133.50
Max. Negotiated Rate	$9,316.17
Rate for Payer: UnitedHealthcare Community & State	$9,133.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,316.17
Rate for Payer: Wellpoint Medicaid Managed Care	$9,133.50

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION

Facility

$65,082.79

Service Code	APR-DRG 6083
Min. Negotiated Rate	$63,806.66
Max. Negotiated Rate	$65,082.79
Rate for Payer: UnitedHealthcare Community & State	$63,806.66
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$65,082.79
Rate for Payer: Wellpoint Medicaid Managed Care	$63,806.66

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$66,731.02

Service Code	APR-DRG 6072
Min. Negotiated Rate	$65,422.57
Max. Negotiated Rate	$66,731.02
Rate for Payer: UnitedHealthcare Community & State	$65,422.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$66,731.02
Rate for Payer: Wellpoint Medicaid Managed Care	$65,422.57

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$91,722.62

Service Code	APR-DRG 6073
Min. Negotiated Rate	$89,924.14
Max. Negotiated Rate	$91,722.62
Rate for Payer: UnitedHealthcare Community & State	$89,924.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$91,722.62
Rate for Payer: Wellpoint Medicaid Managed Care	$89,924.14

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$27,073.89

Service Code	APR-DRG 6071
Min. Negotiated Rate	$26,543.03
Max. Negotiated Rate	$27,073.89
Rate for Payer: UnitedHealthcare Community & State	$26,543.03
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27,073.89
Rate for Payer: Wellpoint Medicaid Managed Care	$26,543.03

NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY

Facility

$121,888.76

Service Code	APR-DRG 6074
Min. Negotiated Rate	$119,498.78
Max. Negotiated Rate	$121,888.76
Rate for Payer: UnitedHealthcare Community & State	$119,498.78
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$121,888.76
Rate for Payer: Wellpoint Medicaid Managed Care	$119,498.78

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$75,316.92

Service Code	APR-DRG 6134
Min. Negotiated Rate	$73,840.12
Max. Negotiated Rate	$75,316.92
Rate for Payer: UnitedHealthcare Community & State	$73,840.12
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$75,316.92
Rate for Payer: Wellpoint Medicaid Managed Care	$73,840.12

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$19,647.31

Service Code	APR-DRG 6131
Min. Negotiated Rate	$19,262.07
Max. Negotiated Rate	$19,647.31
Rate for Payer: UnitedHealthcare Community & State	$19,262.07
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,647.31
Rate for Payer: Wellpoint Medicaid Managed Care	$19,262.07

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$30,513.37

Service Code	APR-DRG 6132
Min. Negotiated Rate	$29,915.07
Max. Negotiated Rate	$30,513.37
Rate for Payer: UnitedHealthcare Community & State	$29,915.07
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$30,513.37
Rate for Payer: Wellpoint Medicaid Managed Care	$29,915.07

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION

Facility

$54,037.99

Service Code	APR-DRG 6133
Min. Negotiated Rate	$52,978.42
Max. Negotiated Rate	$54,037.99
Rate for Payer: UnitedHealthcare Community & State	$52,978.42
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$54,037.99
Rate for Payer: Wellpoint Medicaid Managed Care	$52,978.42

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$55,464.06

Service Code	APR-DRG 6113
Min. Negotiated Rate	$54,376.53
Max. Negotiated Rate	$55,464.06
Rate for Payer: UnitedHealthcare Community & State	$54,376.53
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$55,464.06
Rate for Payer: Wellpoint Medicaid Managed Care	$54,376.53

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$13,831.90

Service Code	APR-DRG 6111
Min. Negotiated Rate	$13,560.69
Max. Negotiated Rate	$13,831.90
Rate for Payer: UnitedHealthcare Community & State	$13,560.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,831.90
Rate for Payer: Wellpoint Medicaid Managed Care	$13,560.69

NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY

Facility

$92,445.22

Service Code	APR-DRG 6114
Min. Negotiated Rate	$90,632.57
Max. Negotiated Rate	$92,445.22
Rate for Payer: UnitedHealthcare Community & State	$90,632.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$92,445.22
Rate for Payer: Wellpoint Medicaid Managed Care	$90,632.57

Know your out-of-pocket cost for care.

All Charges