Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PACK NASAL/FESS

Facility

$200.95

Hospital Charge Code	270653797
Hospital Revenue Code	272
Min. Negotiated Rate	$4.84
Max. Negotiated Rate	$100.47
Rate for Payer: Aetna Commercial	$76.36
Rate for Payer: Aetna Medicare Advantage	$60.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.24
Rate for Payer: Cigna Commercial	$100.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.28
Rate for Payer: Oxford Commercial	$40.19
Rate for Payer: Qualcare PPO/HMO/WC	$30.14
Rate for Payer: UnitedHealthcare Commercial	$40.19
Rate for Payer: UnitedHealthcare Community & State	$4.84
Rate for Payer: Wellpoint Medicaid Managed Care	$5.33

PACK NASAL/FESS

Facility

$200.95

Hospital Charge Code	270653797
Hospital Revenue Code	272
Min. Negotiated Rate	$30.14
Max. Negotiated Rate	$30.14
Rate for Payer: Qualcare PPO/HMO/WC	$30.14

PACK ORTHO 2 UPPER EXTREMITY

Facility

$115.98

Hospital Charge Code	270688553
Hospital Revenue Code	272
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$57.99
Rate for Payer: Aetna Commercial	$44.07
Rate for Payer: Aetna Medicare Advantage	$34.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.57
Rate for Payer: Cigna Commercial	$57.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.79
Rate for Payer: Oxford Commercial	$23.20
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$23.20
Rate for Payer: UnitedHealthcare Community & State	$2.80
Rate for Payer: Wellpoint Medicaid Managed Care	$3.07

PACK ORTHO 2 UPPER EXTREMITY

Facility

$115.98

Hospital Charge Code	270688553
Hospital Revenue Code	272
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

PACK ORTHO I MAJOR 88411

Facility

$110.45

Hospital Charge Code	270609201
Hospital Revenue Code	272
Min. Negotiated Rate	$16.57
Max. Negotiated Rate	$16.57
Rate for Payer: Qualcare PPO/HMO/WC	$16.57

PACK ORTHO I MAJOR 88411

Facility

$110.45

Hospital Charge Code	270609201
Hospital Revenue Code	272
Min. Negotiated Rate	$2.66
Max. Negotiated Rate	$55.23
Rate for Payer: Aetna Commercial	$41.97
Rate for Payer: Aetna Medicare Advantage	$33.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.16
Rate for Payer: Cigna Commercial	$55.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.13
Rate for Payer: Oxford Commercial	$22.09
Rate for Payer: Qualcare PPO/HMO/WC	$16.57
Rate for Payer: UnitedHealthcare Commercial	$22.09
Rate for Payer: UnitedHealthcare Community & State	$2.66
Rate for Payer: Wellpoint Medicaid Managed Care	$2.93

PACK ORTHO VI EXTREMITY *****

Facility

$1,063.00

Hospital Charge Code	1607050
Hospital Revenue Code	272
Min. Negotiated Rate	$159.45
Max. Negotiated Rate	$159.45
Rate for Payer: Qualcare PPO/HMO/WC	$159.45

PACK ORTHO VI EXTREMITY *****

Facility

$1,063.00

Hospital Charge Code	1607050
Hospital Revenue Code	272
Min. Negotiated Rate	$25.62
Max. Negotiated Rate	$531.50
Rate for Payer: Aetna Commercial	$403.94
Rate for Payer: Aetna Medicare Advantage	$318.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.06
Rate for Payer: Cigna Commercial	$531.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.90
Rate for Payer: Oxford Commercial	$212.60
Rate for Payer: Qualcare PPO/HMO/WC	$159.45
Rate for Payer: UnitedHealthcare Commercial	$212.60
Rate for Payer: UnitedHealthcare Community & State	$25.62
Rate for Payer: Wellpoint Medicaid Managed Care	$28.17

PACK ORTHO VI EXTREMITY 88461

Facility

$268.00

Hospital Charge Code	270600164
Hospital Revenue Code	272
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$134.00
Rate for Payer: Aetna Commercial	$101.84
Rate for Payer: Aetna Medicare Advantage	$80.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.34
Rate for Payer: Cigna Commercial	$134.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.40
Rate for Payer: Oxford Commercial	$53.60
Rate for Payer: Qualcare PPO/HMO/WC	$40.20
Rate for Payer: UnitedHealthcare Commercial	$53.60
Rate for Payer: UnitedHealthcare Community & State	$6.46
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

PACK ORTHO VI EXTREMITY 88461

Facility

$268.00

Hospital Charge Code	270600164
Hospital Revenue Code	272
Min. Negotiated Rate	$40.20
Max. Negotiated Rate	$40.20
Rate for Payer: Qualcare PPO/HMO/WC	$40.20

PACK PACEMAKER

Facility

$373.20

Hospital Charge Code	270658353S
Hospital Revenue Code	272
Min. Negotiated Rate	$8.99
Max. Negotiated Rate	$186.60
Rate for Payer: Aetna Commercial	$141.82
Rate for Payer: Aetna Medicare Advantage	$111.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.17
Rate for Payer: Cigna Commercial	$186.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.96
Rate for Payer: Oxford Commercial	$74.64
Rate for Payer: Qualcare PPO/HMO/WC	$55.98
Rate for Payer: UnitedHealthcare Commercial	$74.64
Rate for Payer: UnitedHealthcare Community & State	$8.99
Rate for Payer: Wellpoint Medicaid Managed Care	$9.89

PACK PACEMAKER

Facility

$373.20

Hospital Charge Code	270658353S
Hospital Revenue Code	272
Min. Negotiated Rate	$55.98
Max. Negotiated Rate	$55.98
Rate for Payer: Qualcare PPO/HMO/WC	$55.98

PACK PACEMAKER

Facility

$373.20

Hospital Charge Code	270658353
Hospital Revenue Code	272
Min. Negotiated Rate	$55.98
Max. Negotiated Rate	$55.98
Rate for Payer: Qualcare PPO/HMO/WC	$55.98

PACK PACEMAKER

Facility

$372.20

Hospital Charge Code	270658353N
Hospital Revenue Code	272
Min. Negotiated Rate	$8.97
Max. Negotiated Rate	$186.10
Rate for Payer: Aetna Commercial	$141.44
Rate for Payer: Aetna Medicare Advantage	$111.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.91
Rate for Payer: Cigna Commercial	$186.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.66
Rate for Payer: Oxford Commercial	$74.44
Rate for Payer: Qualcare PPO/HMO/WC	$55.83
Rate for Payer: UnitedHealthcare Commercial	$74.44
Rate for Payer: UnitedHealthcare Community & State	$8.97
Rate for Payer: Wellpoint Medicaid Managed Care	$9.86

PACK PACEMAKER

Facility

$372.20

Hospital Charge Code	270658353N
Hospital Revenue Code	272
Min. Negotiated Rate	$55.83
Max. Negotiated Rate	$55.83
Rate for Payer: Qualcare PPO/HMO/WC	$55.83

PACK PACEMAKER

Facility

$373.20

Hospital Charge Code	270658353
Hospital Revenue Code	272
Min. Negotiated Rate	$8.99
Max. Negotiated Rate	$186.60
Rate for Payer: Aetna Commercial	$141.82
Rate for Payer: Aetna Medicare Advantage	$111.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.17
Rate for Payer: Cigna Commercial	$186.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.96
Rate for Payer: Oxford Commercial	$74.64
Rate for Payer: Qualcare PPO/HMO/WC	$55.98
Rate for Payer: UnitedHealthcare Commercial	$74.64
Rate for Payer: UnitedHealthcare Community & State	$8.99
Rate for Payer: Wellpoint Medicaid Managed Care	$9.89

PACK PACEMAKER (4/CS)

Facility

$397.80

Hospital Charge Code	2707500028
Hospital Revenue Code	272
Min. Negotiated Rate	$59.67
Max. Negotiated Rate	$59.67
Rate for Payer: Qualcare PPO/HMO/WC	$59.67

PACK PACEMAKER (4/CS)

Facility

$397.80

Hospital Charge Code	2707500028
Hospital Revenue Code	272
Min. Negotiated Rate	$9.59
Max. Negotiated Rate	$198.90
Rate for Payer: Aetna Commercial	$151.16
Rate for Payer: Aetna Medicare Advantage	$119.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.44
Rate for Payer: Cigna Commercial	$198.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.34
Rate for Payer: Oxford Commercial	$79.56
Rate for Payer: Qualcare PPO/HMO/WC	$59.67
Rate for Payer: UnitedHealthcare Commercial	$79.56
Rate for Payer: UnitedHealthcare Community & State	$9.59
Rate for Payer: Wellpoint Medicaid Managed Care	$10.54

PACK PBDS CYSTO

Facility

$111.30

Hospital Charge Code	270651597
Hospital Revenue Code	272
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$55.65
Rate for Payer: Aetna Commercial	$42.29
Rate for Payer: Aetna Medicare Advantage	$33.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.38
Rate for Payer: Cigna Commercial	$55.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.39
Rate for Payer: Oxford Commercial	$22.26
Rate for Payer: Qualcare PPO/HMO/WC	$16.70
Rate for Payer: UnitedHealthcare Commercial	$22.26
Rate for Payer: UnitedHealthcare Community & State	$2.68
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

PACK PBDS CYSTO

Facility

$111.30

Hospital Charge Code	270651597
Hospital Revenue Code	272
Min. Negotiated Rate	$16.70
Max. Negotiated Rate	$16.70
Rate for Payer: Qualcare PPO/HMO/WC	$16.70

PACK PBDS EENT

Facility

$295.25

Hospital Charge Code	270651598
Hospital Revenue Code	272
Min. Negotiated Rate	$44.29
Max. Negotiated Rate	$44.29
Rate for Payer: Qualcare PPO/HMO/WC	$44.29

PACK PBDS EENT

Facility

$295.25

Hospital Charge Code	270651598
Hospital Revenue Code	272
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$147.62
Rate for Payer: Aetna Commercial	$112.19
Rate for Payer: Aetna Medicare Advantage	$88.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.29
Rate for Payer: Cigna Commercial	$147.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.58
Rate for Payer: Oxford Commercial	$59.05
Rate for Payer: Qualcare PPO/HMO/WC	$44.29
Rate for Payer: UnitedHealthcare Commercial	$59.05
Rate for Payer: UnitedHealthcare Community & State	$7.12
Rate for Payer: Wellpoint Medicaid Managed Care	$7.82

PACK PBDS KIT ARTHRO

Facility

$309.00

Hospital Charge Code	270651600
Hospital Revenue Code	272
Min. Negotiated Rate	$7.45
Max. Negotiated Rate	$154.50
Rate for Payer: Aetna Commercial	$117.42
Rate for Payer: Aetna Medicare Advantage	$92.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.80
Rate for Payer: Cigna Commercial	$154.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.70
Rate for Payer: Oxford Commercial	$61.80
Rate for Payer: Qualcare PPO/HMO/WC	$46.35
Rate for Payer: UnitedHealthcare Commercial	$61.80
Rate for Payer: UnitedHealthcare Community & State	$7.45
Rate for Payer: Wellpoint Medicaid Managed Care	$8.19

PACK PBDS KIT ARTHRO

Facility

$309.00

Hospital Charge Code	270651600
Hospital Revenue Code	272
Min. Negotiated Rate	$46.35
Max. Negotiated Rate	$46.35
Rate for Payer: Qualcare PPO/HMO/WC	$46.35

PACK PBDS KIT GEN LAP

Facility

$381.10

Hospital Charge Code	270651601
Hospital Revenue Code	272
Min. Negotiated Rate	$9.18
Max. Negotiated Rate	$190.55
Rate for Payer: Aetna Commercial	$144.82
Rate for Payer: Aetna Medicare Advantage	$114.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.18
Rate for Payer: Cigna Commercial	$190.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.33
Rate for Payer: Oxford Commercial	$76.22
Rate for Payer: Qualcare PPO/HMO/WC	$57.16
Rate for Payer: UnitedHealthcare Commercial	$76.22
Rate for Payer: UnitedHealthcare Community & State	$9.18
Rate for Payer: Wellpoint Medicaid Managed Care	$10.10

Know your out-of-pocket cost for care.

All Charges