Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PACK ANTERIOR VITRECTOMY

Facility

$830.00

Hospital Charge Code	270653347
Hospital Revenue Code	270
Min. Negotiated Rate	$124.50
Max. Negotiated Rate	$124.50
Rate for Payer: Qualcare PPO/HMO/WC	$124.50

PACK AUTOGRAFT GRAFTLINK CONV

Facility

$3,400.00

Hospital Charge Code	270676748
Hospital Revenue Code	272
Min. Negotiated Rate	$81.94
Max. Negotiated Rate	$1,700.00
Rate for Payer: Aetna Commercial	$1,292.00
Rate for Payer: Aetna Medicare Advantage	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$867.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$867.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$867.00
Rate for Payer: Cigna Commercial	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,020.00
Rate for Payer: Oxford Commercial	$680.00
Rate for Payer: Qualcare PPO/HMO/WC	$510.00
Rate for Payer: UnitedHealthcare Commercial	$680.00
Rate for Payer: UnitedHealthcare Community & State	$81.94
Rate for Payer: Wellpoint Medicaid Managed Care	$90.10

PACK AUTOGRAFT GRAFTLINK CONV

Facility

$3,400.00

Hospital Charge Code	270676748
Hospital Revenue Code	272
Min. Negotiated Rate	$510.00
Max. Negotiated Rate	$510.00
Rate for Payer: Qualcare PPO/HMO/WC	$510.00

PACK AUTOLOGUE PLATELET CONCE

Facility

$4,005.00

Hospital Charge Code	270656948
Hospital Revenue Code	278
Min. Negotiated Rate	$600.75
Max. Negotiated Rate	$969.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$801.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$969.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$881.10
Rate for Payer: Qualcare PPO/HMO/WC	$600.75

PACK AUTOLOGUE PLATELET CONCE

Facility

$4,005.00

Hospital Charge Code	270656948
Hospital Revenue Code	278
Min. Negotiated Rate	$96.52
Max. Negotiated Rate	$2,002.50
Rate for Payer: Aetna Commercial	$1,521.90
Rate for Payer: Aetna Medicare Advantage	$1,201.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,021.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,021.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$801.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,021.27
Rate for Payer: Cigna Commercial	$2,002.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$969.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$881.10
Rate for Payer: Qualcare PPO/HMO/WC	$600.75
Rate for Payer: UnitedHealthcare Community & State	$96.52
Rate for Payer: Wellpoint Medicaid Managed Care	$106.13

PACK A.V. FISTULA

Facility

$390.10

Hospital Charge Code	270653789
Hospital Revenue Code	270
Min. Negotiated Rate	$58.52
Max. Negotiated Rate	$58.52
Rate for Payer: Qualcare PPO/HMO/WC	$58.52

PACK A.V. FISTULA

Facility

$390.10

Hospital Charge Code	270653789
Hospital Revenue Code	270
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.05
Rate for Payer: Aetna Commercial	$148.24
Rate for Payer: Aetna Medicare Advantage	$117.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.48
Rate for Payer: Cigna Commercial	$195.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.03
Rate for Payer: Oxford Commercial	$78.02
Rate for Payer: Qualcare PPO/HMO/WC	$58.52
Rate for Payer: UnitedHealthcare Commercial	$78.02
Rate for Payer: UnitedHealthcare Community & State	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

PACK BASIC LINEN 88132

Facility

$56.00

Hospital Charge Code	270609199
Hospital Revenue Code	272
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

PACK BASIC LINEN 88132

Facility

$56.00

Hospital Charge Code	270609199
Hospital Revenue Code	272
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$28.00
Rate for Payer: Aetna Commercial	$21.28
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.28
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.80
Rate for Payer: Oxford Commercial	$11.20
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$11.20
Rate for Payer: UnitedHealthcare Community & State	$1.35
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

PACK BREAST TRAY

Facility

$333.98

Hospital Charge Code	270671833
Hospital Revenue Code	272
Min. Negotiated Rate	$50.10
Max. Negotiated Rate	$50.10
Rate for Payer: Qualcare PPO/HMO/WC	$50.10

PACK BREAST TRAY

Facility

$333.98

Hospital Charge Code	270671833
Hospital Revenue Code	272
Min. Negotiated Rate	$8.05
Max. Negotiated Rate	$166.99
Rate for Payer: Aetna Commercial	$126.91
Rate for Payer: Aetna Medicare Advantage	$100.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.16
Rate for Payer: Cigna Commercial	$166.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.19
Rate for Payer: Oxford Commercial	$66.80
Rate for Payer: Qualcare PPO/HMO/WC	$50.10
Rate for Payer: UnitedHealthcare Commercial	$66.80
Rate for Payer: UnitedHealthcare Community & State	$8.05
Rate for Payer: Wellpoint Medicaid Managed Care	$8.85

PACK BRONCHOSCOPY

Facility

$69.79

Hospital Charge Code	270653796
Hospital Revenue Code	272
Min. Negotiated Rate	$10.47
Max. Negotiated Rate	$10.47
Rate for Payer: Qualcare PPO/HMO/WC	$10.47

PACK BRONCHOSCOPY

Facility

$69.79

Hospital Charge Code	270653796
Hospital Revenue Code	272
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$34.90
Rate for Payer: Aetna Commercial	$26.52
Rate for Payer: Aetna Medicare Advantage	$20.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.80
Rate for Payer: Cigna Commercial	$34.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.94
Rate for Payer: Oxford Commercial	$13.96
Rate for Payer: Qualcare PPO/HMO/WC	$10.47
Rate for Payer: UnitedHealthcare Commercial	$13.96
Rate for Payer: UnitedHealthcare Community & State	$1.68
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

PACK CATARACT ALCON

Facility

$1,487.50

Hospital Charge Code	270651590
Hospital Revenue Code	272
Min. Negotiated Rate	$35.85
Max. Negotiated Rate	$743.75
Rate for Payer: Aetna Commercial	$565.25
Rate for Payer: Aetna Medicare Advantage	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$379.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$379.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$379.31
Rate for Payer: Cigna Commercial	$743.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$446.25
Rate for Payer: Oxford Commercial	$297.50
Rate for Payer: Qualcare PPO/HMO/WC	$223.12
Rate for Payer: UnitedHealthcare Commercial	$297.50
Rate for Payer: UnitedHealthcare Community & State	$35.85
Rate for Payer: Wellpoint Medicaid Managed Care	$39.42

PACK CATARACT ALCON

Facility

$1,487.50

Hospital Charge Code	270651590
Hospital Revenue Code	272
Min. Negotiated Rate	$223.12
Max. Negotiated Rate	$223.12
Rate for Payer: Qualcare PPO/HMO/WC	$223.12

PACK CATARACT AS4544

Facility

$446.90

Hospital Charge Code	270651299
Hospital Revenue Code	272
Min. Negotiated Rate	$10.77
Max. Negotiated Rate	$223.45
Rate for Payer: Aetna Commercial	$169.82
Rate for Payer: Aetna Medicare Advantage	$134.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.96
Rate for Payer: Cigna Commercial	$223.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.07
Rate for Payer: Oxford Commercial	$89.38
Rate for Payer: Qualcare PPO/HMO/WC	$67.03
Rate for Payer: UnitedHealthcare Commercial	$89.38
Rate for Payer: UnitedHealthcare Community & State	$10.77
Rate for Payer: Wellpoint Medicaid Managed Care	$11.84

PACK CATARACT AS4544

Facility

$446.90

Hospital Charge Code	270651299
Hospital Revenue Code	272
Min. Negotiated Rate	$67.03
Max. Negotiated Rate	$67.03
Rate for Payer: Qualcare PPO/HMO/WC	$67.03

PACK CATARACT EXTRACTION

Facility

$742.65

Hospital Charge Code	270651297
Hospital Revenue Code	272
Min. Negotiated Rate	$17.90
Max. Negotiated Rate	$371.32
Rate for Payer: Aetna Commercial	$282.21
Rate for Payer: Aetna Medicare Advantage	$222.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.38
Rate for Payer: Cigna Commercial	$371.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.79
Rate for Payer: Oxford Commercial	$148.53
Rate for Payer: Qualcare PPO/HMO/WC	$111.40
Rate for Payer: UnitedHealthcare Commercial	$148.53
Rate for Payer: UnitedHealthcare Community & State	$17.90
Rate for Payer: Wellpoint Medicaid Managed Care	$19.68

PACK CATARACT EXTRACTION

Facility

$742.65

Hospital Charge Code	270651297
Hospital Revenue Code	272
Min. Negotiated Rate	$111.40
Max. Negotiated Rate	$111.40
Rate for Payer: Qualcare PPO/HMO/WC	$111.40

PACK CATH LAB CUSTOM

Facility

$226.45

Hospital Charge Code	270600699
Hospital Revenue Code	272
Min. Negotiated Rate	$5.46
Max. Negotiated Rate	$113.22
Rate for Payer: Aetna Commercial	$86.05
Rate for Payer: Aetna Medicare Advantage	$67.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.74
Rate for Payer: Cigna Commercial	$113.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.94
Rate for Payer: Oxford Commercial	$45.29
Rate for Payer: Qualcare PPO/HMO/WC	$33.97
Rate for Payer: UnitedHealthcare Commercial	$45.29
Rate for Payer: UnitedHealthcare Community & State	$5.46
Rate for Payer: Wellpoint Medicaid Managed Care	$6.00

PACK CATH LAB CUSTOM

Facility

$226.45

Hospital Charge Code	270600699
Hospital Revenue Code	272
Min. Negotiated Rate	$33.97
Max. Negotiated Rate	$33.97
Rate for Payer: Qualcare PPO/HMO/WC	$33.97

PACK CELL SAVER 125CC HAE241

Facility

$340.00

Hospital Charge Code	270605801
Hospital Revenue Code	272
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$129.20
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.00
Rate for Payer: Oxford Commercial	$68.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Commercial	$68.00
Rate for Payer: UnitedHealthcare Community & State	$8.19
Rate for Payer: Wellpoint Medicaid Managed Care	$9.01

PACK CELL SAVER 125CC HAE241

Facility

$340.00

Hospital Charge Code	270605801
Hospital Revenue Code	272
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

PACK CELL SAVER 125ml SOR125

Facility

$363.75

Hospital Charge Code	270616337
Hospital Revenue Code	272
Min. Negotiated Rate	$8.77
Max. Negotiated Rate	$181.88
Rate for Payer: Aetna Commercial	$138.22
Rate for Payer: Aetna Medicare Advantage	$109.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.76
Rate for Payer: Cigna Commercial	$181.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.12
Rate for Payer: Oxford Commercial	$72.75
Rate for Payer: Qualcare PPO/HMO/WC	$54.56
Rate for Payer: UnitedHealthcare Commercial	$72.75
Rate for Payer: UnitedHealthcare Community & State	$8.77
Rate for Payer: Wellpoint Medicaid Managed Care	$9.64

PACK CELL SAVER 125ml SOR125

Facility

$363.75

Hospital Charge Code	270616337
Hospital Revenue Code	272
Min. Negotiated Rate	$54.56
Max. Negotiated Rate	$54.56
Rate for Payer: Qualcare PPO/HMO/WC	$54.56

Know your out-of-pocket cost for care.

All Charges