Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

*****OR MAJOR 6 TO 7 HOURS

Facility

$6,303.00

Hospital Charge Code	1600071
Hospital Revenue Code	361
Min. Negotiated Rate	$945.45
Max. Negotiated Rate	$945.45
Rate for Payer: Qualcare PPO/HMO/WC	$945.45

*****OR MAJOR 6 TO 7 HOURS

Facility

$6,303.00

Hospital Charge Code	1600071
Hospital Revenue Code	361
Min. Negotiated Rate	$151.90
Max. Negotiated Rate	$3,151.50
Rate for Payer: Aetna Commercial	$2,395.14
Rate for Payer: Aetna Medicare Advantage	$1,890.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,607.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,607.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,607.27
Rate for Payer: Cigna Commercial	$3,151.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,890.90
Rate for Payer: Qualcare PPO/HMO/WC	$945.45
Rate for Payer: UnitedHealthcare Community & State	$151.90
Rate for Payer: Wellpoint Medicaid Managed Care	$167.03

*****OR MAJOR 7 TO 8 HOURS

Facility

$7,129.00

Hospital Charge Code	1600089
Hospital Revenue Code	361
Min. Negotiated Rate	$1,069.35
Max. Negotiated Rate	$1,069.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,069.35

*****OR MAJOR 7 TO 8 HOURS

Facility

$7,129.00

Hospital Charge Code	1600089
Hospital Revenue Code	361
Min. Negotiated Rate	$171.81
Max. Negotiated Rate	$3,564.50
Rate for Payer: Aetna Commercial	$2,709.02
Rate for Payer: Aetna Medicare Advantage	$2,138.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,817.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,817.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,817.89
Rate for Payer: Cigna Commercial	$3,564.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,138.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,069.35
Rate for Payer: UnitedHealthcare Community & State	$171.81
Rate for Payer: Wellpoint Medicaid Managed Care	$188.92

OR MAJOR EACH ADD'L HOUR

Facility

$2,211.34

Hospital Charge Code	1600097
Hospital Revenue Code	360
Min. Negotiated Rate	$53.29
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$840.31
Rate for Payer: Aetna Medicare Advantage	$663.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$563.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$563.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$563.89
Rate for Payer: Cigna Commercial	$1,105.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.40
Rate for Payer: Qualcare PPO/HMO/WC	$331.70
Rate for Payer: UnitedHealthcare Community & State	$53.29
Rate for Payer: Wellpoint Medicaid Managed Care	$58.60

OR MAJOR EACH ADD'L HOUR

Facility

$2,211.34

Hospital Charge Code	1600097
Hospital Revenue Code	360
Min. Negotiated Rate	$331.70
Max. Negotiated Rate	$331.70
Rate for Payer: Qualcare PPO/HMO/WC	$331.70

*****OR MINOR 1 1/2 TO 2 HRS

Facility

$1,631.00

Hospital Charge Code	1600139
Hospital Revenue Code	361
Min. Negotiated Rate	$39.31
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$619.78
Rate for Payer: Aetna Medicare Advantage	$489.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$415.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$415.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$415.90
Rate for Payer: Cigna Commercial	$815.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$489.30
Rate for Payer: Qualcare PPO/HMO/WC	$244.65
Rate for Payer: UnitedHealthcare Community & State	$39.31
Rate for Payer: Wellpoint Medicaid Managed Care	$43.22

*****OR MINOR 1 1/2 TO 2 HRS

Facility

$1,631.00

Hospital Charge Code	1600139
Hospital Revenue Code	361
Min. Negotiated Rate	$244.65
Max. Negotiated Rate	$244.65
Rate for Payer: Qualcare PPO/HMO/WC	$244.65

*****OR MINOR 1/2 TO 1 HOUR

Facility

$1,027.00

Hospital Charge Code	1600113
Hospital Revenue Code	361
Min. Negotiated Rate	$154.05
Max. Negotiated Rate	$154.05
Rate for Payer: Qualcare PPO/HMO/WC	$154.05

*****OR MINOR 1/2 TO 1 HOUR

Facility

$1,027.00

Hospital Charge Code	1600113
Hospital Revenue Code	361
Min. Negotiated Rate	$24.75
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$390.26
Rate for Payer: Aetna Medicare Advantage	$308.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.88
Rate for Payer: Cigna Commercial	$513.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.10
Rate for Payer: Qualcare PPO/HMO/WC	$154.05
Rate for Payer: UnitedHealthcare Community & State	$24.75
Rate for Payer: Wellpoint Medicaid Managed Care	$27.22

*****OR MINOR 1 TO 1 1/2 HR

Facility

$1,446.00

Hospital Charge Code	1600121
Hospital Revenue Code	361
Min. Negotiated Rate	$216.90
Max. Negotiated Rate	$216.90
Rate for Payer: Qualcare PPO/HMO/WC	$216.90

*****OR MINOR 1 TO 1 1/2 HR

Facility

$1,446.00

Hospital Charge Code	1600121
Hospital Revenue Code	361
Min. Negotiated Rate	$34.85
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$549.48
Rate for Payer: Aetna Medicare Advantage	$433.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$368.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$368.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$368.73
Rate for Payer: Cigna Commercial	$723.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.80
Rate for Payer: Qualcare PPO/HMO/WC	$216.90
Rate for Payer: UnitedHealthcare Community & State	$34.85
Rate for Payer: Wellpoint Medicaid Managed Care	$38.32

***OR MINOR OVER 2 TO 2 1/2 HR

Facility

$2,105.00

Hospital Charge Code	1600147
Hospital Revenue Code	361
Min. Negotiated Rate	$315.75
Max. Negotiated Rate	$315.75
Rate for Payer: Qualcare PPO/HMO/WC	$315.75

***OR MINOR OVER 2 TO 2 1/2 HR

Facility

$2,105.00

Hospital Charge Code	1600147
Hospital Revenue Code	361
Min. Negotiated Rate	$50.73
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$799.90
Rate for Payer: Aetna Medicare Advantage	$631.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.77
Rate for Payer: Cigna Commercial	$1,052.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$631.50
Rate for Payer: Qualcare PPO/HMO/WC	$315.75
Rate for Payer: UnitedHealthcare Community & State	$50.73
Rate for Payer: Wellpoint Medicaid Managed Care	$55.78

ORNADE 75-12/CAP

Facility

$6.00

Hospital Charge Code	60633584
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

ORNADE 75-12/CAP

Facility

$6.00

Hospital Charge Code	60633583
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

ORNADE 75-12/CAP

Facility

$6.00

Hospital Charge Code	60633584
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

ORNADE 75-12/CAP

Facility

$6.00

Hospital Charge Code	60633583
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

ORNADE 75-12/CAP

Facility

$6.00

Hospital Charge Code	60633585
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

ORNADE 75-12/CAP

Facility

$6.00

Hospital Charge Code	60633585
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

ORNEX/TAB

Facility

$3.00

Hospital Charge Code	60633586
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

ORNEX/TAB

Facility

$3.00

Hospital Charge Code	60633586
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ORPHENADRINE 100 MG ER

Facility

$12.85

Hospital Charge Code	6010037
Hospital Revenue Code	251
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.42
Rate for Payer: Aetna Commercial	$4.88
Rate for Payer: Aetna Medicare Advantage	$3.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.28
Rate for Payer: Cigna Commercial	$6.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.85
Rate for Payer: Oxford Commercial	$2.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.93
Rate for Payer: UnitedHealthcare Commercial	$2.57
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

ORPHENADRINE 100 MG ER

Facility

$12.85

Hospital Charge Code	6010037
Hospital Revenue Code	251
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.93

OR PLASTIC SURGERY HOUR CHARGE

Facility

$960.00

Hospital Charge Code	1600172
Hospital Revenue Code	360
Min. Negotiated Rate	$23.14
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$364.80
Rate for Payer: Aetna Medicare Advantage	$288.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.80
Rate for Payer: Cigna Commercial	$480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$288.00
Rate for Payer: Qualcare PPO/HMO/WC	$144.00
Rate for Payer: UnitedHealthcare Community & State	$23.14
Rate for Payer: Wellpoint Medicaid Managed Care	$25.44

Know your out-of-pocket cost for care.

All Charges