Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PACKED CELLS

Facility

$330.90

Hospital Charge Code	3100039
Hospital Revenue Code	390
Min. Negotiated Rate	$7.97
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$125.74
Rate for Payer: Aetna Medicare Advantage	$99.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.38
Rate for Payer: Cigna Commercial	$165.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.27
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.63
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$7.97
Rate for Payer: Wellpoint Medicaid Managed Care	$8.77

PACKED CELLS

Facility

$330.90

Hospital Charge Code	3100039
Hospital Revenue Code	390
Min. Negotiated Rate	$49.63
Max. Negotiated Rate	$49.63
Rate for Payer: Qualcare PPO/HMO/WC	$49.63

PACK EENT 88037

Facility

$104.85

Hospital Charge Code	270609213
Hospital Revenue Code	272
Min. Negotiated Rate	$15.73
Max. Negotiated Rate	$15.73
Rate for Payer: Qualcare PPO/HMO/WC	$15.73

PACK EENT 88037

Facility

$104.85

Hospital Charge Code	270609213
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$52.42
Rate for Payer: Aetna Commercial	$39.84
Rate for Payer: Aetna Medicare Advantage	$31.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.74
Rate for Payer: Cigna Commercial	$52.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.45
Rate for Payer: Oxford Commercial	$20.97
Rate for Payer: Qualcare PPO/HMO/WC	$15.73
Rate for Payer: UnitedHealthcare Commercial	$20.97
Rate for Payer: UnitedHealthcare Community & State	$2.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

PACKER CELL CHA-010

Facility

$100.00

Hospital Charge Code	270622963
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

PACKER CELL CHA-010

Facility

$100.00

Hospital Charge Code	270622963
Hospital Revenue Code	272
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

PACK EXTREMITY LOWER III

Facility

$517.68

Hospital Charge Code	270653807
Hospital Revenue Code	272
Min. Negotiated Rate	$12.48
Max. Negotiated Rate	$258.84
Rate for Payer: Aetna Commercial	$196.72
Rate for Payer: Aetna Medicare Advantage	$155.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.01
Rate for Payer: Cigna Commercial	$258.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.30
Rate for Payer: Oxford Commercial	$103.54
Rate for Payer: Qualcare PPO/HMO/WC	$77.65
Rate for Payer: UnitedHealthcare Commercial	$103.54
Rate for Payer: UnitedHealthcare Community & State	$12.48
Rate for Payer: Wellpoint Medicaid Managed Care	$13.72

PACK EXTREMITY LOWER III

Facility

$517.68

Hospital Charge Code	270653807
Hospital Revenue Code	272
Min. Negotiated Rate	$77.65
Max. Negotiated Rate	$77.65
Rate for Payer: Qualcare PPO/HMO/WC	$77.65

PACK GYN LAPAROSCOPY III

Facility

$226.24

Hospital Charge Code	270653801
Hospital Revenue Code	272
Min. Negotiated Rate	$33.94
Max. Negotiated Rate	$33.94
Rate for Payer: Qualcare PPO/HMO/WC	$33.94

PACK GYN LAPAROSCOPY III

Facility

$226.24

Hospital Charge Code	270653801
Hospital Revenue Code	272
Min. Negotiated Rate	$5.45
Max. Negotiated Rate	$113.12
Rate for Payer: Aetna Commercial	$85.97
Rate for Payer: Aetna Medicare Advantage	$67.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.69
Rate for Payer: Cigna Commercial	$113.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.87
Rate for Payer: Oxford Commercial	$45.25
Rate for Payer: Qualcare PPO/HMO/WC	$33.94
Rate for Payer: UnitedHealthcare Commercial	$45.25
Rate for Payer: UnitedHealthcare Community & State	$5.45
Rate for Payer: Wellpoint Medicaid Managed Care	$6.00

PACK HEAD AND NECK

Facility

$52.78

Hospital Charge Code	270653742
Hospital Revenue Code	272
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$26.39
Rate for Payer: Aetna Commercial	$20.06
Rate for Payer: Aetna Medicare Advantage	$15.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.46
Rate for Payer: Cigna Commercial	$26.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.83
Rate for Payer: Oxford Commercial	$10.56
Rate for Payer: Qualcare PPO/HMO/WC	$7.92
Rate for Payer: UnitedHealthcare Commercial	$10.56
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

PACK HEAD AND NECK

Facility

$52.78

Hospital Charge Code	270653742
Hospital Revenue Code	272
Min. Negotiated Rate	$7.92
Max. Negotiated Rate	$7.92
Rate for Payer: Qualcare PPO/HMO/WC	$7.92

PACK HIP PINNING

Facility

$474.08

Hospital Charge Code	270653806
Hospital Revenue Code	272
Min. Negotiated Rate	$11.43
Max. Negotiated Rate	$237.04
Rate for Payer: Aetna Commercial	$180.15
Rate for Payer: Aetna Medicare Advantage	$142.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.89
Rate for Payer: Cigna Commercial	$237.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.22
Rate for Payer: Oxford Commercial	$94.82
Rate for Payer: Qualcare PPO/HMO/WC	$71.11
Rate for Payer: UnitedHealthcare Commercial	$94.82
Rate for Payer: UnitedHealthcare Community & State	$11.43
Rate for Payer: Wellpoint Medicaid Managed Care	$12.56

PACK HIP PINNING

Facility

$474.08

Hospital Charge Code	270653806
Hospital Revenue Code	272
Min. Negotiated Rate	$71.11
Max. Negotiated Rate	$71.11
Rate for Payer: Qualcare PPO/HMO/WC	$71.11

PACK HOT

Facility

$36.00

Hospital Charge Code	8200214
Hospital Revenue Code	271
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

PACK HOT

Facility

$36.00

Hospital Charge Code	8200214
Hospital Revenue Code	271
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$18.00
Rate for Payer: Aetna Commercial	$13.68
Rate for Payer: Aetna Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.18
Rate for Payer: Cigna Commercial	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.80
Rate for Payer: Oxford Commercial	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$5.40
Rate for Payer: UnitedHealthcare Commercial	$7.20
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

PACK I &A

Facility

$313.00

Hospital Charge Code	270331453
Hospital Revenue Code	272
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$156.50
Rate for Payer: Aetna Commercial	$118.94
Rate for Payer: Aetna Medicare Advantage	$93.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.81
Rate for Payer: Cigna Commercial	$156.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.90
Rate for Payer: Oxford Commercial	$62.60
Rate for Payer: Qualcare PPO/HMO/WC	$46.95
Rate for Payer: UnitedHealthcare Commercial	$62.60
Rate for Payer: UnitedHealthcare Community & State	$7.54
Rate for Payer: Wellpoint Medicaid Managed Care	$8.29

PACK I &A

Facility

$313.00

Hospital Charge Code	270331453
Hospital Revenue Code	272
Min. Negotiated Rate	$46.95
Max. Negotiated Rate	$46.95
Rate for Payer: Qualcare PPO/HMO/WC	$46.95

PACK ICE - ALL SIZES

Facility

$16.85

Hospital Charge Code	270301283
Hospital Revenue Code	270
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

PACK ICE - ALL SIZES

Facility

$16.85

Hospital Charge Code	270301283
Hospital Revenue Code	270
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$6.40
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.05
Rate for Payer: Oxford Commercial	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$3.37
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

PACK ICE - ALL SIZES****

Facility

$7.72

Hospital Charge Code	207301283
Hospital Revenue Code	271
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

PACK ICE - ALL SIZES****

Facility

$7.72

Hospital Charge Code	207301283
Hospital Revenue Code	271
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.86
Rate for Payer: Aetna Commercial	$2.93
Rate for Payer: Aetna Medicare Advantage	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.97
Rate for Payer: Cigna Commercial	$3.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.32
Rate for Payer: Oxford Commercial	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$1.54
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

PACK ICE DISP **********

Facility

$13.00

Hospital Charge Code	8002990
Hospital Revenue Code	279
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

PACK ICE DISP **********

Facility

$13.00

Hospital Charge Code	8002990
Hospital Revenue Code	279
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

PACK ICE KWIK KOLD PAK

Facility

$24.20

Hospital Charge Code	270651596
Hospital Revenue Code	270
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$12.10
Rate for Payer: Aetna Commercial	$9.20
Rate for Payer: Aetna Medicare Advantage	$7.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.17
Rate for Payer: Cigna Commercial	$12.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.26
Rate for Payer: Oxford Commercial	$4.84
Rate for Payer: Qualcare PPO/HMO/WC	$3.63
Rate for Payer: UnitedHealthcare Commercial	$4.84
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

Know your out-of-pocket cost for care.

All Charges