Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS

Facility

$6,689.96

Service Code	APR-DRG 4252
Min. Negotiated Rate	$6,558.78
Max. Negotiated Rate	$6,689.96
Rate for Payer: UnitedHealthcare Community & State	$6,558.78
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,689.96
Rate for Payer: Wellpoint Medicaid Managed Care	$6,558.78

OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS

Facility

$20,205.19

Service Code	APR-DRG 4254
Min. Negotiated Rate	$19,809.01
Max. Negotiated Rate	$20,205.19
Rate for Payer: UnitedHealthcare Community & State	$19,809.01
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,205.19
Rate for Payer: Wellpoint Medicaid Managed Care	$19,809.01

OTHER OPEN CRANIOTOMY

Facility

$37,104.98

Service Code	APR-DRG 0273
Min. Negotiated Rate	$36,377.43
Max. Negotiated Rate	$37,104.98
Rate for Payer: UnitedHealthcare Community & State	$36,377.43
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$37,104.98
Rate for Payer: Wellpoint Medicaid Managed Care	$36,377.43

OTHER OPEN CRANIOTOMY

Facility

$23,691.92

Service Code	APR-DRG 0272
Min. Negotiated Rate	$23,227.37
Max. Negotiated Rate	$23,691.92
Rate for Payer: UnitedHealthcare Community & State	$23,227.37
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,691.92
Rate for Payer: Wellpoint Medicaid Managed Care	$23,227.37

OTHER OPEN CRANIOTOMY

Facility

$21,270.00

Service Code	APR-DRG 0271
Min. Negotiated Rate	$20,852.94
Max. Negotiated Rate	$21,270.00
Rate for Payer: UnitedHealthcare Community & State	$20,852.94
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,270.00
Rate for Payer: Wellpoint Medicaid Managed Care	$20,852.94

OTHER OPEN CRANIOTOMY

Facility

$63,800.99

Service Code	APR-DRG 0274
Min. Negotiated Rate	$62,549.99
Max. Negotiated Rate	$63,800.99
Rate for Payer: UnitedHealthcare Community & State	$62,549.99
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$63,800.99
Rate for Payer: Wellpoint Medicaid Managed Care	$62,549.99

OTHER O.R. PROCEDURES FOR INJURIES WITH CC

Facility

$66,622.23

Service Code	MSDRG 908
Min. Negotiated Rate	$20,285.62
Max. Negotiated Rate	$66,622.23
Rate for Payer: Aetna Commercial	$46,034.40
Rate for Payer: Aetna Medicare Advantage	$66,622.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46,522.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46,522.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,353.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46,522.00
Rate for Payer: Cigna Commercial	$37,338.17
Rate for Payer: Cigna Medicare Advantage	$21,353.28
Rate for Payer: Clover Medicare Advantage	$20,285.62
Rate for Payer: EmblemHealth Commercial	$64,059.84
Rate for Payer: Humana Medicare Advantage	$21,993.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,353.28
Rate for Payer: Oxford Commercial	$26,835.44
Rate for Payer: UnitedHealthcare Commercial	$47,056.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,353.28
Rate for Payer: Wellcare Medicare Advantage	$21,353.28

OTHER O.R. PROCEDURES FOR INJURIES WITH MCC

Facility

$126,226.62

Service Code	MSDRG 907
Min. Negotiated Rate	$38,434.39
Max. Negotiated Rate	$126,226.62
Rate for Payer: Aetna Commercial	$86,989.42
Rate for Payer: Aetna Medicare Advantage	$126,226.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86,530.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86,530.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$40,457.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86,530.92
Rate for Payer: Cigna Commercial	$71,848.66
Rate for Payer: Cigna Medicare Advantage	$40,457.25
Rate for Payer: Clover Medicare Advantage	$38,434.39
Rate for Payer: EmblemHealth Commercial	$121,371.75
Rate for Payer: Humana Medicare Advantage	$41,670.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$40,457.25
Rate for Payer: Oxford Commercial	$51,638.58
Rate for Payer: UnitedHealthcare Commercial	$90,549.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$40,457.25
Rate for Payer: Wellcare Medicare Advantage	$40,457.25

OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC

Facility

$44,562.71

Service Code	MSDRG 909
Min. Negotiated Rate	$13,568.77
Max. Negotiated Rate	$44,562.71
Rate for Payer: Aetna Commercial	$30,876.98
Rate for Payer: Aetna Medicare Advantage	$44,562.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,634.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,634.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,282.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,634.96
Rate for Payer: Cigna Commercial	$24,565.87
Rate for Payer: Cigna Medicare Advantage	$14,282.92
Rate for Payer: Clover Medicare Advantage	$13,568.77
Rate for Payer: EmblemHealth Commercial	$42,848.76
Rate for Payer: Humana Medicare Advantage	$14,711.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,282.92
Rate for Payer: Oxford Commercial	$17,655.81
Rate for Payer: UnitedHealthcare Commercial	$30,960.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,282.92
Rate for Payer: Wellcare Medicare Advantage	$14,282.92

OTHERO.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$14,477.86

Service Code	APR-DRG 6811
Min. Negotiated Rate	$14,193.98
Max. Negotiated Rate	$14,477.86
Rate for Payer: UnitedHealthcare Community & State	$14,193.98
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,477.86
Rate for Payer: Wellpoint Medicaid Managed Care	$14,193.98

OTHERO.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$69,339.38

Service Code	APR-DRG 6814
Min. Negotiated Rate	$67,979.78
Max. Negotiated Rate	$69,339.38
Rate for Payer: UnitedHealthcare Community & State	$67,979.78
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$69,339.38
Rate for Payer: Wellpoint Medicaid Managed Care	$67,979.78

OTHERO.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$30,629.51

Service Code	APR-DRG 6813
Min. Negotiated Rate	$30,028.93
Max. Negotiated Rate	$30,629.51
Rate for Payer: UnitedHealthcare Community & State	$30,028.93
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$30,629.51
Rate for Payer: Wellpoint Medicaid Managed Care	$30,028.93

OTHERO.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS

Facility

$18,734.44

Service Code	APR-DRG 6812
Min. Negotiated Rate	$18,367.10
Max. Negotiated Rate	$18,734.44
Rate for Payer: UnitedHealthcare Community & State	$18,367.10
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,734.44
Rate for Payer: Wellpoint Medicaid Managed Care	$18,367.10

OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC

Facility

$138,334.28

Service Code	MSDRG 958
Min. Negotiated Rate	$42,121.01
Max. Negotiated Rate	$138,334.28
Rate for Payer: Aetna Commercial	$95,308.74
Rate for Payer: Aetna Medicare Advantage	$138,334.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93,974.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93,974.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44,337.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93,974.44
Rate for Payer: Cigna Commercial	$78,858.92
Rate for Payer: Cigna Medicare Advantage	$44,337.91
Rate for Payer: Clover Medicare Advantage	$42,121.01
Rate for Payer: EmblemHealth Commercial	$133,013.73
Rate for Payer: Humana Medicare Advantage	$45,668.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44,337.91
Rate for Payer: Oxford Commercial	$56,676.96
Rate for Payer: UnitedHealthcare Commercial	$99,384.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$44,337.91
Rate for Payer: Wellcare Medicare Advantage	$44,337.91

OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC

Facility

$248,421.83

Service Code	MSDRG 957
Min. Negotiated Rate	$75,641.26
Max. Negotiated Rate	$248,421.83
Rate for Payer: Aetna Commercial	$170,951.43
Rate for Payer: Aetna Medicare Advantage	$248,421.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168,177.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168,177.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$79,622.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168,177.03
Rate for Payer: Cigna Commercial	$142,598.81
Rate for Payer: Cigna Medicare Advantage	$79,622.38
Rate for Payer: Clover Medicare Advantage	$75,641.26
Rate for Payer: EmblemHealth Commercial	$238,867.14
Rate for Payer: Humana Medicare Advantage	$82,011.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$79,622.38
Rate for Payer: Oxford Commercial	$102,487.65
Rate for Payer: UnitedHealthcare Commercial	$179,715.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$79,622.38
Rate for Payer: Wellcare Medicare Advantage	$79,622.38

OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC

Facility

$97,292.24

Service Code	MSDRG 959
Min. Negotiated Rate	$29,624.24
Max. Negotiated Rate	$97,292.24
Rate for Payer: Aetna Commercial	$67,108.20
Rate for Payer: Aetna Medicare Advantage	$97,292.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58,850.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58,850.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$31,183.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58,850.33
Rate for Payer: Cigna Commercial	$55,095.89
Rate for Payer: Cigna Medicare Advantage	$31,183.41
Rate for Payer: Clover Medicare Advantage	$29,624.24
Rate for Payer: EmblemHealth Commercial	$93,550.23
Rate for Payer: Humana Medicare Advantage	$32,118.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$31,183.41
Rate for Payer: Oxford Commercial	$39,598.14
Rate for Payer: UnitedHealthcare Commercial	$69,436.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$31,183.41
Rate for Payer: Wellcare Medicare Advantage	$31,183.41

OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC

Facility

$62,216.86

Service Code	MSDRG 803
Min. Negotiated Rate	$18,944.24
Max. Negotiated Rate	$62,216.86
Rate for Payer: Aetna Commercial	$43,007.40
Rate for Payer: Aetna Medicare Advantage	$62,216.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43,265.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43,265.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,941.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43,265.46
Rate for Payer: Cigna Commercial	$34,787.45
Rate for Payer: Cigna Medicare Advantage	$19,941.30
Rate for Payer: Clover Medicare Advantage	$18,944.24
Rate for Payer: EmblemHealth Commercial	$59,823.90
Rate for Payer: Humana Medicare Advantage	$20,539.54
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19,941.30
Rate for Payer: Oxford Commercial	$25,002.21
Rate for Payer: UnitedHealthcare Commercial	$43,842.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,941.30
Rate for Payer: Wellcare Medicare Advantage	$19,941.30

OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC

Facility

$130,906.78

Service Code	MSDRG 802
Min. Negotiated Rate	$39,859.43
Max. Negotiated Rate	$130,906.78
Rate for Payer: Aetna Commercial	$90,205.19
Rate for Payer: Aetna Medicare Advantage	$130,906.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79,785.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79,785.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41,957.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79,785.23
Rate for Payer: Cigna Commercial	$74,558.45
Rate for Payer: Cigna Medicare Advantage	$41,957.30
Rate for Payer: Clover Medicare Advantage	$39,859.43
Rate for Payer: EmblemHealth Commercial	$125,871.90
Rate for Payer: Humana Medicare Advantage	$43,216.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$41,957.30
Rate for Payer: Oxford Commercial	$53,586.14
Rate for Payer: UnitedHealthcare Commercial	$93,965.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$41,957.30
Rate for Payer: Wellcare Medicare Advantage	$41,957.30

OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC

Facility

$45,962.22

Service Code	MSDRG 804
Min. Negotiated Rate	$13,994.91
Max. Negotiated Rate	$45,962.22
Rate for Payer: Aetna Commercial	$31,838.64
Rate for Payer: Aetna Medicare Advantage	$45,962.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,145.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,145.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,731.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28,145.81
Rate for Payer: Cigna Commercial	$25,376.18
Rate for Payer: Cigna Medicare Advantage	$14,731.48
Rate for Payer: Clover Medicare Advantage	$13,994.91
Rate for Payer: EmblemHealth Commercial	$44,194.44
Rate for Payer: Humana Medicare Advantage	$15,173.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,731.48
Rate for Payer: Oxford Commercial	$18,238.20
Rate for Payer: UnitedHealthcare Commercial	$31,981.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,731.48
Rate for Payer: Wellcare Medicare Advantage	$14,731.48

OTHER OT CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8990GO
Hospital Charge Code	9109152
Hospital Revenue Code	430
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

OTHER OT CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8990GO
Hospital Charge Code	9109152
Hospital Revenue Code	430
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

OTHER OT D/C STATUS

Facility

$0.01

Service Code	HCPCS G8992GO
Hospital Charge Code	9109154
Hospital Revenue Code	430
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

OTHER OT D/C STATUS

Facility

$0.01

Service Code	HCPCS G8992GO
Hospital Charge Code	9109154
Hospital Revenue Code	430
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

OTHER OT GOAL STATUS

Facility

$0.01

Service Code	HCPCS G8991GO
Hospital Charge Code	9109153
Hospital Revenue Code	430
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

OTHER OT GOAL STATUS

Facility

$0.01

Service Code	HCPCS G8991GO
Hospital Charge Code	9109153
Hospital Revenue Code	430
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

Know your out-of-pocket cost for care.

All Charges