Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

No.3 Knife Handle

Facility

$19.20

Hospital Charge Code	270607725
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.60
Rate for Payer: Aetna Commercial	$7.30
Rate for Payer: Aetna Medicare Advantage	$5.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.90
Rate for Payer: Cigna Commercial	$9.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.76
Rate for Payer: Oxford Commercial	$3.84
Rate for Payer: Qualcare PPO/HMO/WC	$2.88
Rate for Payer: UnitedHealthcare Commercial	$3.84
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

No.3 Knife Handle

Facility

$19.20

Hospital Charge Code	270607725
Hospital Revenue Code	272
Min. Negotiated Rate	$2.88
Max. Negotiated Rate	$2.88
Rate for Payer: Qualcare PPO/HMO/WC	$2.88

NOLVADEX/10MG/TAB

Facility

$7.00

Hospital Charge Code	60633540
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

NOLVADEX/10MG/TAB

Facility

$7.00

Hospital Charge Code	60633540
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.66
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.40
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC

Facility

$76,309.05

Service Code	MSDRG 098
Min. Negotiated Rate	$23,235.13
Max. Negotiated Rate	$76,309.05
Rate for Payer: Aetna Medicare Advantage	$76,309.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50,011.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50,011.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24,458.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50,011.15
Rate for Payer: Cigna Commercial	$42,946.76
Rate for Payer: Cigna Medicare Advantage	$24,458.03
Rate for Payer: Clover Medicare Advantage	$23,235.13
Rate for Payer: EmblemHealth Commercial	$73,374.09
Rate for Payer: Humana Medicare Advantage	$25,191.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24,458.03
Rate for Payer: Oxford Commercial	$30,866.40
Rate for Payer: UnitedHealthcare Commercial	$54,125.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$24,458.03
Rate for Payer: Wellcare Medicare Advantage	$24,458.03

NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC

Facility

$118,873.40

Service Code	MSDRG 097
Min. Negotiated Rate	$36,195.43
Max. Negotiated Rate	$118,873.40
Rate for Payer: Aetna Medicare Advantage	$118,873.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84,670.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84,670.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$38,100.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84,670.04
Rate for Payer: Cigna Commercial	$67,591.23
Rate for Payer: Cigna Medicare Advantage	$38,100.45
Rate for Payer: Clover Medicare Advantage	$36,195.43
Rate for Payer: EmblemHealth Commercial	$114,301.35
Rate for Payer: Humana Medicare Advantage	$39,243.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$38,100.45
Rate for Payer: Oxford Commercial	$48,578.71
Rate for Payer: UnitedHealthcare Commercial	$85,184.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$38,100.45
Rate for Payer: Wellcare Medicare Advantage	$38,100.45

NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC

Facility

$46,169.10

Service Code	MSDRG 099
Min. Negotiated Rate	$14,057.90
Max. Negotiated Rate	$46,169.10
Rate for Payer: Aetna Medicare Advantage	$46,169.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,704.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,704.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,797.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30,704.52
Rate for Payer: Cigna Commercial	$25,495.95
Rate for Payer: Cigna Medicare Advantage	$14,797.79
Rate for Payer: Clover Medicare Advantage	$14,057.90
Rate for Payer: EmblemHealth Commercial	$44,393.37
Rate for Payer: Humana Medicare Advantage	$15,241.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,797.79
Rate for Payer: Oxford Commercial	$18,324.28
Rate for Payer: UnitedHealthcare Commercial	$32,132.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,797.79
Rate for Payer: Wellcare Medicare Advantage	$14,797.79

NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS

Facility

$44,329.91

Service Code	APR-DRG 0504
Min. Negotiated Rate	$43,460.70
Max. Negotiated Rate	$44,329.91
Rate for Payer: UnitedHealthcare Community & State	$43,460.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$44,329.91
Rate for Payer: Wellpoint Medicaid Managed Care	$43,460.70

NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS

Facility

$8,409.66

Service Code	APR-DRG 0501
Min. Negotiated Rate	$8,244.76
Max. Negotiated Rate	$8,409.66
Rate for Payer: UnitedHealthcare Community & State	$8,244.76
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,409.66
Rate for Payer: Wellpoint Medicaid Managed Care	$8,244.76

NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS

Facility

$22,456.04

Service Code	APR-DRG 0503
Min. Negotiated Rate	$22,015.73
Max. Negotiated Rate	$22,456.04
Rate for Payer: UnitedHealthcare Community & State	$22,015.73
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,456.04
Rate for Payer: Wellpoint Medicaid Managed Care	$22,015.73

NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS

Facility

$14,212.36

Service Code	APR-DRG 0502
Min. Negotiated Rate	$13,933.69
Max. Negotiated Rate	$14,212.36
Rate for Payer: UnitedHealthcare Community & State	$13,933.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,212.36
Rate for Payer: Wellpoint Medicaid Managed Care	$13,933.69

NON-BLADED TROCAR 10MM

Facility

$115.00

Hospital Charge Code	270335695
Hospital Revenue Code	272
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

NON-BLADED TROCAR 10MM

Facility

$115.00

Hospital Charge Code	270335695
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$57.50
Rate for Payer: Aetna Commercial	$43.70
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.50
Rate for Payer: Oxford Commercial	$23.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Commercial	$23.00
Rate for Payer: UnitedHealthcare Community & State	$2.77
Rate for Payer: Wellpoint Medicaid Managed Care	$3.05

NON-BLADED TROCAR 5MM

Facility

$94.00

Hospital Charge Code	270335694
Hospital Revenue Code	272
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$47.00
Rate for Payer: Aetna Commercial	$35.72
Rate for Payer: Aetna Medicare Advantage	$28.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.97
Rate for Payer: Cigna Commercial	$47.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.20
Rate for Payer: Oxford Commercial	$18.80
Rate for Payer: Qualcare PPO/HMO/WC	$14.10
Rate for Payer: UnitedHealthcare Commercial	$18.80
Rate for Payer: UnitedHealthcare Community & State	$2.27
Rate for Payer: Wellpoint Medicaid Managed Care	$2.49

NON-BLADED TROCAR 5MM

Facility

$94.00

Hospital Charge Code	270335694
Hospital Revenue Code	272
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$14.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.10

NON CHEMO-IV START 2 HRS

Facility

$613.00

Service Code	HCPCS 96366
Hospital Charge Code	93500043
Hospital Revenue Code	260
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$151.31
Rate for Payer: Aetna Medicare Advantage	$180.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.81
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: Cigna Medicare Advantage	$55.63
Rate for Payer: Clover Medicare Advantage	$52.85
Rate for Payer: EmblemHealth Commercial	$166.89
Rate for Payer: Humana Medicare Advantage	$57.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.90
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.95
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$14.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$55.63
Rate for Payer: Wellcare Medicare Advantage	$55.63
Rate for Payer: Wellpoint Medicaid Managed Care	$16.24

NON CHEMO-IV START 2 HRS

Facility

$613.00

Service Code	HCPCS 96366
Hospital Charge Code	93500043
Hospital Revenue Code	260
Min. Negotiated Rate	$91.95
Max. Negotiated Rate	$91.95
Rate for Payer: Qualcare PPO/HMO/WC	$91.95

NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT

Facility

$23,366.32

Service Code	APR-DRG 3232
Min. Negotiated Rate	$22,908.16
Max. Negotiated Rate	$23,366.32
Rate for Payer: UnitedHealthcare Community & State	$22,908.16
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,366.32
Rate for Payer: Wellpoint Medicaid Managed Care	$22,908.16

NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT

Facility

$31,229.62

Service Code	APR-DRG 3233
Min. Negotiated Rate	$30,617.27
Max. Negotiated Rate	$31,229.62
Rate for Payer: UnitedHealthcare Community & State	$30,617.27
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$31,229.62
Rate for Payer: Wellpoint Medicaid Managed Care	$30,617.27

NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT

Facility

$20,802.72

Service Code	APR-DRG 3231
Min. Negotiated Rate	$20,394.82
Max. Negotiated Rate	$20,802.72
Rate for Payer: UnitedHealthcare Community & State	$20,394.82
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,802.72
Rate for Payer: Wellpoint Medicaid Managed Care	$20,394.82

NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT

Facility

$43,944.36

Service Code	APR-DRG 3234
Min. Negotiated Rate	$43,082.71
Max. Negotiated Rate	$43,944.36
Rate for Payer: UnitedHealthcare Community & State	$43,082.71
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$43,944.36
Rate for Payer: Wellpoint Medicaid Managed Care	$43,082.71

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility

$25,600.56

Service Code	APR-DRG 3251
Min. Negotiated Rate	$25,098.59
Max. Negotiated Rate	$25,600.56
Rate for Payer: UnitedHealthcare Community & State	$25,098.59
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$25,600.56
Rate for Payer: Wellpoint Medicaid Managed Care	$25,098.59

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility

$54,666.16

Service Code	APR-DRG 3254
Min. Negotiated Rate	$53,594.27
Max. Negotiated Rate	$54,666.16
Rate for Payer: UnitedHealthcare Community & State	$53,594.27
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$54,666.16
Rate for Payer: Wellpoint Medicaid Managed Care	$53,594.27

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility

$39,013.68

Service Code	APR-DRG 3253
Min. Negotiated Rate	$38,248.71
Max. Negotiated Rate	$39,013.68
Rate for Payer: UnitedHealthcare Community & State	$38,248.71
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$39,013.68
Rate for Payer: Wellpoint Medicaid Managed Care	$38,248.71

NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT

Facility

$29,466.42

Service Code	APR-DRG 3252
Min. Negotiated Rate	$28,888.65
Max. Negotiated Rate	$29,466.42
Rate for Payer: UnitedHealthcare Community & State	$28,888.65
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,466.42
Rate for Payer: Wellpoint Medicaid Managed Care	$28,888.65

Know your out-of-pocket cost for care.

All Charges