Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PACK PBDS KIT GEN LAP

Facility

$381.10

Hospital Charge Code	270651601
Hospital Revenue Code	272
Min. Negotiated Rate	$57.16
Max. Negotiated Rate	$57.16
Rate for Payer: Qualcare PPO/HMO/WC	$57.16

PACK PBDS KIT MAJOR PROC NDRAP

Facility

$576.80

Hospital Charge Code	270651613
Hospital Revenue Code	272
Min. Negotiated Rate	$13.90
Max. Negotiated Rate	$288.40
Rate for Payer: Aetna Commercial	$219.18
Rate for Payer: Aetna Medicare Advantage	$173.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.08
Rate for Payer: Cigna Commercial	$288.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.04
Rate for Payer: Oxford Commercial	$115.36
Rate for Payer: Qualcare PPO/HMO/WC	$86.52
Rate for Payer: UnitedHealthcare Commercial	$115.36
Rate for Payer: UnitedHealthcare Community & State	$13.90
Rate for Payer: Wellpoint Medicaid Managed Care	$15.29

PACK PBDS KIT MAJOR PROC NDRAP

Facility

$576.80

Hospital Charge Code	270651613
Hospital Revenue Code	272
Min. Negotiated Rate	$86.52
Max. Negotiated Rate	$86.52
Rate for Payer: Qualcare PPO/HMO/WC	$86.52

PACK PBDS KIT PODIATRY

Facility

$308.40

Hospital Charge Code	270651616
Hospital Revenue Code	272
Min. Negotiated Rate	$46.26
Max. Negotiated Rate	$46.26
Rate for Payer: Qualcare PPO/HMO/WC	$46.26

PACK PBDS KIT PODIATRY

Facility

$308.40

Hospital Charge Code	270651616
Hospital Revenue Code	272
Min. Negotiated Rate	$7.43
Max. Negotiated Rate	$154.20
Rate for Payer: Aetna Commercial	$117.19
Rate for Payer: Aetna Medicare Advantage	$92.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.64
Rate for Payer: Cigna Commercial	$154.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.52
Rate for Payer: Oxford Commercial	$61.68
Rate for Payer: Qualcare PPO/HMO/WC	$46.26
Rate for Payer: UnitedHealthcare Commercial	$61.68
Rate for Payer: UnitedHealthcare Community & State	$7.43
Rate for Payer: Wellpoint Medicaid Managed Care	$8.17

PACK PBDS KIT SHOULDER ARTHRO

Facility

$417.15

Hospital Charge Code	270651618
Hospital Revenue Code	272
Min. Negotiated Rate	$62.57
Max. Negotiated Rate	$62.57
Rate for Payer: Qualcare PPO/HMO/WC	$62.57

PACK PBDS KIT SHOULDER ARTHRO

Facility

$417.15

Hospital Charge Code	270651618
Hospital Revenue Code	272
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$208.57
Rate for Payer: Aetna Commercial	$158.52
Rate for Payer: Aetna Medicare Advantage	$125.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.37
Rate for Payer: Cigna Commercial	$208.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.14
Rate for Payer: Oxford Commercial	$83.43
Rate for Payer: Qualcare PPO/HMO/WC	$62.57
Rate for Payer: UnitedHealthcare Commercial	$83.43
Rate for Payer: UnitedHealthcare Community & State	$10.05
Rate for Payer: Wellpoint Medicaid Managed Care	$11.05

PACK PBDS KIT TOTAL HIP

Facility

$996.25

Hospital Charge Code	270651619
Hospital Revenue Code	272
Min. Negotiated Rate	$149.44
Max. Negotiated Rate	$149.44
Rate for Payer: Qualcare PPO/HMO/WC	$149.44

PACK PBDS KIT TOTAL HIP

Facility

$996.25

Hospital Charge Code	270651619
Hospital Revenue Code	272
Min. Negotiated Rate	$24.01
Max. Negotiated Rate	$498.12
Rate for Payer: Aetna Commercial	$378.57
Rate for Payer: Aetna Medicare Advantage	$298.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.04
Rate for Payer: Cigna Commercial	$498.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$298.88
Rate for Payer: Oxford Commercial	$199.25
Rate for Payer: Qualcare PPO/HMO/WC	$149.44
Rate for Payer: UnitedHealthcare Commercial	$199.25
Rate for Payer: UnitedHealthcare Community & State	$24.01
Rate for Payer: Wellpoint Medicaid Managed Care	$26.40

PACK PBDS KIT TOTAL KNEE

Facility

$571.65

Hospital Charge Code	270651621
Hospital Revenue Code	272
Min. Negotiated Rate	$85.75
Max. Negotiated Rate	$85.75
Rate for Payer: Qualcare PPO/HMO/WC	$85.75

PACK PBDS KIT TOTAL KNEE

Facility

$571.65

Hospital Charge Code	270651621
Hospital Revenue Code	272
Min. Negotiated Rate	$13.78
Max. Negotiated Rate	$285.82
Rate for Payer: Aetna Commercial	$217.23
Rate for Payer: Aetna Medicare Advantage	$171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.77
Rate for Payer: Cigna Commercial	$285.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.50
Rate for Payer: Oxford Commercial	$114.33
Rate for Payer: Qualcare PPO/HMO/WC	$85.75
Rate for Payer: UnitedHealthcare Commercial	$114.33
Rate for Payer: UnitedHealthcare Community & State	$13.78
Rate for Payer: Wellpoint Medicaid Managed Care	$15.15

PACK PBDS KIT VASCULAR NODRAPE

Facility

$925.65

Hospital Charge Code	270651623
Hospital Revenue Code	272
Min. Negotiated Rate	$22.31
Max. Negotiated Rate	$462.82
Rate for Payer: Aetna Commercial	$351.75
Rate for Payer: Aetna Medicare Advantage	$277.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$236.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$236.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$236.04
Rate for Payer: Cigna Commercial	$462.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.69
Rate for Payer: Oxford Commercial	$185.13
Rate for Payer: Qualcare PPO/HMO/WC	$138.85
Rate for Payer: UnitedHealthcare Commercial	$185.13
Rate for Payer: UnitedHealthcare Community & State	$22.31
Rate for Payer: Wellpoint Medicaid Managed Care	$24.53

PACK PBDS KIT VASCULAR NODRAPE

Facility

$925.65

Hospital Charge Code	270651623
Hospital Revenue Code	272
Min. Negotiated Rate	$138.85
Max. Negotiated Rate	$138.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.85

PACK PBDS LOCAL

Facility

$163.35

Hospital Charge Code	270651626
Hospital Revenue Code	272
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$24.50
Rate for Payer: Qualcare PPO/HMO/WC	$24.50

PACK PBDS LOCAL

Facility

$163.35

Hospital Charge Code	270651626
Hospital Revenue Code	272
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$81.67
Rate for Payer: Aetna Commercial	$62.07
Rate for Payer: Aetna Medicare Advantage	$49.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.65
Rate for Payer: Cigna Commercial	$81.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.01
Rate for Payer: Oxford Commercial	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$24.50
Rate for Payer: UnitedHealthcare Commercial	$32.67
Rate for Payer: UnitedHealthcare Community & State	$3.94
Rate for Payer: Wellpoint Medicaid Managed Care	$4.33

PACK PBDS PER GYN

Facility

$135.05

Hospital Charge Code	270651627
Hospital Revenue Code	272
Min. Negotiated Rate	$20.26
Max. Negotiated Rate	$20.26
Rate for Payer: Qualcare PPO/HMO/WC	$20.26

PACK PBDS PER GYN

Facility

$135.05

Hospital Charge Code	270651627
Hospital Revenue Code	272
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$67.53
Rate for Payer: Aetna Commercial	$51.32
Rate for Payer: Aetna Medicare Advantage	$40.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.44
Rate for Payer: Cigna Commercial	$67.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.52
Rate for Payer: Oxford Commercial	$27.01
Rate for Payer: Qualcare PPO/HMO/WC	$20.26
Rate for Payer: UnitedHealthcare Commercial	$27.01
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

PACK PBDS T&A

Facility

$210.60

Hospital Charge Code	270651628
Hospital Revenue Code	272
Min. Negotiated Rate	$31.59
Max. Negotiated Rate	$31.59
Rate for Payer: Qualcare PPO/HMO/WC	$31.59

PACK PBDS T&A

Facility

$210.60

Hospital Charge Code	270651628
Hospital Revenue Code	272
Min. Negotiated Rate	$5.08
Max. Negotiated Rate	$105.30
Rate for Payer: Aetna Commercial	$80.03
Rate for Payer: Aetna Medicare Advantage	$63.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.70
Rate for Payer: Cigna Commercial	$105.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.18
Rate for Payer: Oxford Commercial	$42.12
Rate for Payer: Qualcare PPO/HMO/WC	$31.59
Rate for Payer: UnitedHealthcare Commercial	$42.12
Rate for Payer: UnitedHealthcare Community & State	$5.08
Rate for Payer: Wellpoint Medicaid Managed Care	$5.58

PACK PERIPHERAL VASCULAR

Facility

$448.90

Hospital Charge Code	270653778
Hospital Revenue Code	272
Min. Negotiated Rate	$67.33
Max. Negotiated Rate	$67.33
Rate for Payer: Qualcare PPO/HMO/WC	$67.33

PACK PERIPHERAL VASCULAR

Facility

$448.90

Hospital Charge Code	270653778
Hospital Revenue Code	272
Min. Negotiated Rate	$10.82
Max. Negotiated Rate	$224.45
Rate for Payer: Aetna Commercial	$170.58
Rate for Payer: Aetna Medicare Advantage	$134.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.47
Rate for Payer: Cigna Commercial	$224.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.67
Rate for Payer: Oxford Commercial	$89.78
Rate for Payer: Qualcare PPO/HMO/WC	$67.33
Rate for Payer: UnitedHealthcare Commercial	$89.78
Rate for Payer: UnitedHealthcare Community & State	$10.82
Rate for Payer: Wellpoint Medicaid Managed Care	$11.90

PACK PODIATRY CUSTOMIZED

Facility

$260.30

Hospital Charge Code	270653809
Hospital Revenue Code	272
Min. Negotiated Rate	$39.05
Max. Negotiated Rate	$39.05
Rate for Payer: Qualcare PPO/HMO/WC	$39.05

PACK PODIATRY CUSTOMIZED

Facility

$260.30

Hospital Charge Code	270653809
Hospital Revenue Code	272
Min. Negotiated Rate	$6.27
Max. Negotiated Rate	$130.15
Rate for Payer: Aetna Commercial	$98.91
Rate for Payer: Aetna Medicare Advantage	$78.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.38
Rate for Payer: Cigna Commercial	$130.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.09
Rate for Payer: Oxford Commercial	$52.06
Rate for Payer: Qualcare PPO/HMO/WC	$39.05
Rate for Payer: UnitedHealthcare Commercial	$52.06
Rate for Payer: UnitedHealthcare Community & State	$6.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.90

PACK PTCA CODE CODE HEART(4/CS

Facility

$728.45

Hospital Charge Code	2707500027
Hospital Revenue Code	272
Min. Negotiated Rate	$109.27
Max. Negotiated Rate	$109.27
Rate for Payer: Qualcare PPO/HMO/WC	$109.27

PACK PTCA CODE CODE HEART(4/CS

Facility

$728.45

Hospital Charge Code	2707500027
Hospital Revenue Code	272
Min. Negotiated Rate	$17.56
Max. Negotiated Rate	$364.23
Rate for Payer: Aetna Commercial	$276.81
Rate for Payer: Aetna Medicare Advantage	$218.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.75
Rate for Payer: Cigna Commercial	$364.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.53
Rate for Payer: Oxford Commercial	$145.69
Rate for Payer: Qualcare PPO/HMO/WC	$109.27
Rate for Payer: UnitedHealthcare Commercial	$145.69
Rate for Payer: UnitedHealthcare Community & State	$17.56
Rate for Payer: Wellpoint Medicaid Managed Care	$19.30

Know your out-of-pocket cost for care.

All Charges