Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$113,802.04

Service Code	APR-DRG 5932
Min. Negotiated Rate	$111,570.63
Max. Negotiated Rate	$113,802.04
Rate for Payer: UnitedHealthcare Community & State	$111,570.63
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$113,802.04
Rate for Payer: Wellpoint Medicaid Managed Care	$111,570.63

NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE

Facility

$2,211.28

Service Code	APR-DRG 5931
Min. Negotiated Rate	$2,167.92
Max. Negotiated Rate	$2,211.28
Rate for Payer: UnitedHealthcare Community & State	$2,167.92
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$2,211.28
Rate for Payer: Wellpoint Medicaid Managed Care	$2,167.92

NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY

Facility

$60,384.20

Service Code	MSDRG 789
Min. Negotiated Rate	$3,028.00
Max. Negotiated Rate	$60,384.20
Rate for Payer: Aetna Commercial	$41,748.16
Rate for Payer: Aetna Medicare Advantage	$60,384.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42,335.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42,335.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,353.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42,335.02
Rate for Payer: Cigna Commercial	$33,726.37
Rate for Payer: Cigna Medicare Advantage	$19,353.91
Rate for Payer: Clover Medicare Advantage	$18,386.21
Rate for Payer: EmblemHealth Commercial	$58,061.73
Rate for Payer: Humana Medicare Advantage	$19,934.53
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19,353.91
Rate for Payer: Oxford Commercial	$3,028.00
Rate for Payer: UnitedHealthcare Commercial	$5,309.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,353.91
Rate for Payer: Wellcare Medicare Advantage	$19,353.91

NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$1,954.64

Service Code	APR-DRG 5812
Min. Negotiated Rate	$1,916.31
Max. Negotiated Rate	$1,954.64
Rate for Payer: UnitedHealthcare Community & State	$1,916.31
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,954.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1,916.31

NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$1,302.25

Service Code	APR-DRG 5811
Min. Negotiated Rate	$1,276.72
Max. Negotiated Rate	$1,302.25
Rate for Payer: UnitedHealthcare Community & State	$1,276.72
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,302.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1,276.72

NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$4,938.28

Service Code	APR-DRG 5814
Min. Negotiated Rate	$4,841.45
Max. Negotiated Rate	$4,938.28
Rate for Payer: UnitedHealthcare Community & State	$4,841.45
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,938.28
Rate for Payer: Wellpoint Medicaid Managed Care	$4,841.45

NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE

Facility

$2,950.49

Service Code	APR-DRG 5813
Min. Negotiated Rate	$2,892.64
Max. Negotiated Rate	$2,950.49
Rate for Payer: UnitedHealthcare Community & State	$2,892.64
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$2,950.49
Rate for Payer: Wellpoint Medicaid Managed Care	$2,892.64

NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE

Facility

$7,515.99

Service Code	APR-DRG 5803
Min. Negotiated Rate	$7,368.62
Max. Negotiated Rate	$7,515.99
Rate for Payer: UnitedHealthcare Community & State	$7,368.62
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,515.99
Rate for Payer: Wellpoint Medicaid Managed Care	$7,368.62

NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE

Facility

$5,150.26

Service Code	APR-DRG 5802
Min. Negotiated Rate	$5,049.27
Max. Negotiated Rate	$5,150.26
Rate for Payer: UnitedHealthcare Community & State	$5,049.27
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,150.26
Rate for Payer: Wellpoint Medicaid Managed Care	$5,049.27

NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE

Facility

$3,720.34

Service Code	APR-DRG 5801
Min. Negotiated Rate	$3,647.39
Max. Negotiated Rate	$3,720.34
Rate for Payer: UnitedHealthcare Community & State	$3,647.39
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$3,720.34
Rate for Payer: Wellpoint Medicaid Managed Care	$3,647.39

NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE

Facility

$13,160.33

Service Code	APR-DRG 5804
Min. Negotiated Rate	$12,902.28
Max. Negotiated Rate	$13,160.33
Rate for Payer: UnitedHealthcare Community & State	$12,902.28
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,160.33
Rate for Payer: Wellpoint Medicaid Managed Care	$12,902.28

NEONATE WITH ECMO

Facility

$242,189.22

Service Code	APR-DRG 5832
Min. Negotiated Rate	$237,440.41
Max. Negotiated Rate	$242,189.22
Rate for Payer: UnitedHealthcare Community & State	$237,440.41
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$242,189.22
Rate for Payer: Wellpoint Medicaid Managed Care	$237,440.41

NEONATE WITH ECMO

Facility

$385,944.10

Service Code	APR-DRG 5833
Min. Negotiated Rate	$378,376.57
Max. Negotiated Rate	$385,944.10
Rate for Payer: UnitedHealthcare Community & State	$378,376.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$385,944.10
Rate for Payer: Wellpoint Medicaid Managed Care	$378,376.57

NEONATE WITH ECMO

Facility

$196,128.09

Service Code	APR-DRG 5831
Min. Negotiated Rate	$192,282.44
Max. Negotiated Rate	$196,128.09
Rate for Payer: UnitedHealthcare Community & State	$192,282.44
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$196,128.09
Rate for Payer: Wellpoint Medicaid Managed Care	$192,282.44

NEONATE WITH ECMO

Facility

$443,170.09

Service Code	APR-DRG 5834
Min. Negotiated Rate	$434,480.48
Max. Negotiated Rate	$443,170.09
Rate for Payer: UnitedHealthcare Community & State	$434,480.48
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$443,170.09
Rate for Payer: Wellpoint Medicaid Managed Care	$434,480.48

NEONATE WITH OTHER SIGNIFICANT PROBLEMS

Facility

$49,837.66

Service Code	MSDRG 794
Min. Negotiated Rate	$3,028.00
Max. Negotiated Rate	$49,837.66
Rate for Payer: Aetna Commercial	$34,501.47
Rate for Payer: Aetna Medicare Advantage	$49,837.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34,658.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34,658.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,973.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34,658.89
Rate for Payer: Cigna Commercial	$27,619.99
Rate for Payer: Cigna Medicare Advantage	$15,973.61
Rate for Payer: Clover Medicare Advantage	$15,174.93
Rate for Payer: EmblemHealth Commercial	$47,920.83
Rate for Payer: Humana Medicare Advantage	$16,452.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,973.61
Rate for Payer: Oxford Commercial	$3,028.00
Rate for Payer: UnitedHealthcare Commercial	$5,309.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,973.61
Rate for Payer: Wellcare Medicare Advantage	$15,973.61

NEO/POLY/BACI OINT

Facility

$28.48

Service Code	NDC 45802014301
Hospital Charge Code	6063943347
Hospital Revenue Code	250
Min. Negotiated Rate	$4.27
Max. Negotiated Rate	$4.27
Rate for Payer: Qualcare PPO/HMO/WC	$4.27

NEO/POLY/BACI OINT

Facility

$28.48

Service Code	NDC 45802014301
Hospital Charge Code	6063943347
Hospital Revenue Code	250
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$14.24
Rate for Payer: Aetna Commercial	$10.82
Rate for Payer: Aetna Medicare Advantage	$8.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.26
Rate for Payer: Cigna Commercial	$14.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.54
Rate for Payer: Oxford Commercial	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$4.27
Rate for Payer: UnitedHealthcare Commercial	$5.70
Rate for Payer: UnitedHealthcare Community & State	$0.69
Rate for Payer: Wellpoint Medicaid Managed Care	$0.75

NEORAL ORAL LIQ 50ML

Facility

$1,657.00

Hospital Charge Code	60635069
Hospital Revenue Code	636
Min. Negotiated Rate	$39.93
Max. Negotiated Rate	$828.50
Rate for Payer: Aetna Commercial	$629.66
Rate for Payer: Aetna Medicare Advantage	$497.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$422.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$422.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$422.54
Rate for Payer: Cigna Commercial	$828.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$400.99
Rate for Payer: Qualcare PPO/HMO/WC	$248.55
Rate for Payer: UnitedHealthcare Community & State	$39.93
Rate for Payer: Wellpoint Medicaid Managed Care	$43.91

NEORAL ORAL LIQ 50ML

Facility

$1,657.00

Hospital Charge Code	60635069
Hospital Revenue Code	636
Min. Negotiated Rate	$248.55
Max. Negotiated Rate	$400.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$400.99
Rate for Payer: Qualcare PPO/HMO/WC	$248.55

NEOSPORIN G.U. IRRIGANT

Facility

$860.95

Service Code	NDC 61570004710
Hospital Charge Code	60633525
Hospital Revenue Code	250
Min. Negotiated Rate	$129.14
Max. Negotiated Rate	$129.14
Rate for Payer: Qualcare PPO/HMO/WC	$129.14

NEOSPORIN G.U. IRRIGANT

Facility

$860.95

Service Code	NDC 61570004710
Hospital Charge Code	60633525
Hospital Revenue Code	250
Min. Negotiated Rate	$20.75
Max. Negotiated Rate	$430.48
Rate for Payer: Aetna Commercial	$327.16
Rate for Payer: Aetna Medicare Advantage	$258.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.54
Rate for Payer: Cigna Commercial	$430.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.29
Rate for Payer: Oxford Commercial	$172.19
Rate for Payer: Qualcare PPO/HMO/WC	$129.14
Rate for Payer: UnitedHealthcare Commercial	$172.19
Rate for Payer: UnitedHealthcare Community & State	$20.75
Rate for Payer: Wellpoint Medicaid Managed Care	$22.82

NEOSPORIN OPHTH SOLN/10ML

Facility

$80.00

Hospital Charge Code	60634570
Hospital Revenue Code	250
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

NEOSPORIN OPHTH SOLN/10ML

Facility

$80.00

Hospital Charge Code	60634570
Hospital Revenue Code	250
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$30.40
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.00
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Commercial	$16.00
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

NEOSPORIN OPTH OINT/1/8OZ

Facility

$71.00

Hospital Charge Code	60634598
Hospital Revenue Code	250
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

Know your out-of-pocket cost for care.

All Charges