Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PACK CUSTOM TOTAL JOINT

Facility

$739.25

Hospital Charge Code	270619915
Hospital Revenue Code	272
Min. Negotiated Rate	$17.82
Max. Negotiated Rate	$369.62
Rate for Payer: Aetna Commercial	$280.92
Rate for Payer: Aetna Medicare Advantage	$221.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.51
Rate for Payer: Cigna Commercial	$369.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.78
Rate for Payer: Oxford Commercial	$147.85
Rate for Payer: Qualcare PPO/HMO/WC	$110.89
Rate for Payer: UnitedHealthcare Commercial	$147.85
Rate for Payer: UnitedHealthcare Community & State	$17.82
Rate for Payer: Wellpoint Medicaid Managed Care	$19.59

PACK CUSTOM TOTAL JOINT

Facility

$739.25

Hospital Charge Code	270619915
Hospital Revenue Code	272
Min. Negotiated Rate	$110.89
Max. Negotiated Rate	$110.89
Rate for Payer: Qualcare PPO/HMO/WC	$110.89

PACK CUSTOM TOTAL JOINT

Facility

$898.15

Hospital Charge Code	270653777
Hospital Revenue Code	272
Min. Negotiated Rate	$21.65
Max. Negotiated Rate	$449.07
Rate for Payer: Aetna Commercial	$341.30
Rate for Payer: Aetna Medicare Advantage	$269.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.03
Rate for Payer: Cigna Commercial	$449.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$269.44
Rate for Payer: Oxford Commercial	$179.63
Rate for Payer: Qualcare PPO/HMO/WC	$134.72
Rate for Payer: UnitedHealthcare Commercial	$179.63
Rate for Payer: UnitedHealthcare Community & State	$21.65
Rate for Payer: Wellpoint Medicaid Managed Care	$23.80

PACK CUSTOM VASC AVIBMBM014-09

Facility

$292.10

Hospital Charge Code	270642271
Hospital Revenue Code	272
Min. Negotiated Rate	$43.81
Max. Negotiated Rate	$43.81
Rate for Payer: Qualcare PPO/HMO/WC	$43.81

PACK CUSTOM VASC AVIBMBM014-09

Facility

$292.10

Hospital Charge Code	270642271
Hospital Revenue Code	272
Min. Negotiated Rate	$7.04
Max. Negotiated Rate	$146.05
Rate for Payer: Aetna Commercial	$111.00
Rate for Payer: Aetna Medicare Advantage	$87.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.49
Rate for Payer: Cigna Commercial	$146.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.63
Rate for Payer: Oxford Commercial	$58.42
Rate for Payer: Qualcare PPO/HMO/WC	$43.81
Rate for Payer: UnitedHealthcare Commercial	$58.42
Rate for Payer: UnitedHealthcare Community & State	$7.04
Rate for Payer: Wellpoint Medicaid Managed Care	$7.74

PACK CUSTOM VASCULAR

Facility

$292.10

Hospital Charge Code	270642271C
Hospital Revenue Code	272
Min. Negotiated Rate	$43.81
Max. Negotiated Rate	$43.81
Rate for Payer: Qualcare PPO/HMO/WC	$43.81

PACK CUSTOM VASCULAR

Facility

$292.10

Hospital Charge Code	270642271C
Hospital Revenue Code	272
Min. Negotiated Rate	$7.04
Max. Negotiated Rate	$146.05
Rate for Payer: Aetna Commercial	$111.00
Rate for Payer: Aetna Medicare Advantage	$87.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.49
Rate for Payer: Cigna Commercial	$146.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.63
Rate for Payer: Oxford Commercial	$58.42
Rate for Payer: Qualcare PPO/HMO/WC	$43.81
Rate for Payer: UnitedHealthcare Commercial	$58.42
Rate for Payer: UnitedHealthcare Community & State	$7.04
Rate for Payer: Wellpoint Medicaid Managed Care	$7.74

PACK CYSTO 3 K/C

Facility

$100.00

Hospital Charge Code	270654020
Hospital Revenue Code	272
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$38.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.00
Rate for Payer: Oxford Commercial	$20.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$20.00
Rate for Payer: UnitedHealthcare Community & State	$2.41
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

PACK CYSTO 3 K/C

Facility

$100.00

Hospital Charge Code	270654020
Hospital Revenue Code	272
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

PACK CYSTO DISP 88631

Facility

$139.25

Hospital Charge Code	270600149
Hospital Revenue Code	272
Min. Negotiated Rate	$3.36
Max. Negotiated Rate	$69.62
Rate for Payer: Aetna Commercial	$52.91
Rate for Payer: Aetna Medicare Advantage	$41.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.51
Rate for Payer: Cigna Commercial	$69.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.77
Rate for Payer: Oxford Commercial	$27.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.89
Rate for Payer: UnitedHealthcare Commercial	$27.85
Rate for Payer: UnitedHealthcare Community & State	$3.36
Rate for Payer: Wellpoint Medicaid Managed Care	$3.69

PACK CYSTO DISP 88631

Facility

$139.25

Hospital Charge Code	270600149
Hospital Revenue Code	272
Min. Negotiated Rate	$20.89
Max. Negotiated Rate	$20.89
Rate for Payer: Qualcare PPO/HMO/WC	$20.89

PACK CYSTO III K/C

Facility

$91.67

Hospital Charge Code	270653791
Hospital Revenue Code	272
Min. Negotiated Rate	$13.75
Max. Negotiated Rate	$13.75
Rate for Payer: Qualcare PPO/HMO/WC	$13.75

PACK CYSTO III K/C

Facility

$91.67

Hospital Charge Code	270653791
Hospital Revenue Code	272
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$45.84
Rate for Payer: Aetna Commercial	$34.83
Rate for Payer: Aetna Medicare Advantage	$27.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.38
Rate for Payer: Cigna Commercial	$45.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.50
Rate for Payer: Oxford Commercial	$18.33
Rate for Payer: Qualcare PPO/HMO/WC	$13.75
Rate for Payer: UnitedHealthcare Commercial	$18.33
Rate for Payer: UnitedHealthcare Community & State	$2.21
Rate for Payer: Wellpoint Medicaid Managed Care	$2.43

PACK CYSTOSCOPY ***********

Facility

$55.00

Hospital Charge Code	1607092
Hospital Revenue Code	251
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$20.90
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.50
Rate for Payer: Oxford Commercial	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$11.00
Rate for Payer: UnitedHealthcare Community & State	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$1.46

PACK CYSTOSCOPY ***********

Facility

$55.00

Hospital Charge Code	1607092
Hospital Revenue Code	251
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

PACK CYSTOSCOPY IV 88618

Facility

$24.90

Hospital Charge Code	270609204
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

PACK CYSTOSCOPY IV 88618

Facility

$24.90

Hospital Charge Code	270609204
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.45
Rate for Payer: Aetna Commercial	$9.46
Rate for Payer: Aetna Medicare Advantage	$7.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.35
Rate for Payer: Cigna Commercial	$12.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.47
Rate for Payer: Oxford Commercial	$4.98
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$4.98
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

PACK D & C HYSTEROSCOPY

Facility

$111.10

Hospital Charge Code	270653804
Hospital Revenue Code	272
Min. Negotiated Rate	$16.66
Max. Negotiated Rate	$16.66
Rate for Payer: Qualcare PPO/HMO/WC	$16.66

PACK D & C HYSTEROSCOPY

Facility

$111.10

Hospital Charge Code	270653804
Hospital Revenue Code	272
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$55.55
Rate for Payer: Aetna Commercial	$42.22
Rate for Payer: Aetna Medicare Advantage	$33.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.33
Rate for Payer: Cigna Commercial	$55.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.33
Rate for Payer: Oxford Commercial	$22.22
Rate for Payer: Qualcare PPO/HMO/WC	$16.66
Rate for Payer: UnitedHealthcare Commercial	$22.22
Rate for Payer: UnitedHealthcare Community & State	$2.68
Rate for Payer: Wellpoint Medicaid Managed Care	$2.94

PACK DELIVERY OBM090B

Facility

$396.00

Hospital Charge Code	270600576
Hospital Revenue Code	272
Min. Negotiated Rate	$59.40
Max. Negotiated Rate	$59.40
Rate for Payer: Qualcare PPO/HMO/WC	$59.40

PACK DELIVERY OBM090B

Facility

$396.00

Hospital Charge Code	270600576
Hospital Revenue Code	272
Min. Negotiated Rate	$9.54
Max. Negotiated Rate	$198.00
Rate for Payer: Aetna Commercial	$150.48
Rate for Payer: Aetna Medicare Advantage	$118.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.98
Rate for Payer: Cigna Commercial	$198.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.80
Rate for Payer: Oxford Commercial	$79.20
Rate for Payer: Qualcare PPO/HMO/WC	$59.40
Rate for Payer: UnitedHealthcare Commercial	$79.20
Rate for Payer: UnitedHealthcare Community & State	$9.54
Rate for Payer: Wellpoint Medicaid Managed Care	$10.49

PACK DIAGNOSTIC CATH LAB (4CS)

Facility

$340.47

Hospital Charge Code	2707500026
Hospital Revenue Code	272
Min. Negotiated Rate	$8.21
Max. Negotiated Rate	$170.24
Rate for Payer: Aetna Commercial	$129.38
Rate for Payer: Aetna Medicare Advantage	$102.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.82
Rate for Payer: Cigna Commercial	$170.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.14
Rate for Payer: Oxford Commercial	$68.09
Rate for Payer: Qualcare PPO/HMO/WC	$51.07
Rate for Payer: UnitedHealthcare Commercial	$68.09
Rate for Payer: UnitedHealthcare Community & State	$8.21
Rate for Payer: Wellpoint Medicaid Managed Care	$9.02

PACK DIAGNOSTIC CATH LAB (4CS)

Facility

$340.47

Hospital Charge Code	2707500026
Hospital Revenue Code	272
Min. Negotiated Rate	$51.07
Max. Negotiated Rate	$51.07
Rate for Payer: Qualcare PPO/HMO/WC	$51.07

PACK DIAGNOSTIC CATH LAB(4CS)

Facility

$364.25

Hospital Charge Code	270653723
Hospital Revenue Code	272
Min. Negotiated Rate	$54.64
Max. Negotiated Rate	$54.64
Rate for Payer: Qualcare PPO/HMO/WC	$54.64

PACK DIAGNOSTIC CATH LAB(4CS)

Facility

$364.25

Hospital Charge Code	270653723
Hospital Revenue Code	272
Min. Negotiated Rate	$8.78
Max. Negotiated Rate	$182.12
Rate for Payer: Aetna Commercial	$138.41
Rate for Payer: Aetna Medicare Advantage	$109.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.88
Rate for Payer: Cigna Commercial	$182.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.28
Rate for Payer: Oxford Commercial	$72.85
Rate for Payer: Qualcare PPO/HMO/WC	$54.64
Rate for Payer: UnitedHealthcare Commercial	$72.85
Rate for Payer: UnitedHealthcare Community & State	$8.78
Rate for Payer: Wellpoint Medicaid Managed Care	$9.65

Know your out-of-pocket cost for care.

All Charges