Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PACK PTCA CODE HEART

Facility

$659.15

Hospital Charge Code	270658335
Hospital Revenue Code	272
Min. Negotiated Rate	$15.89
Max. Negotiated Rate	$329.57
Rate for Payer: Aetna Commercial	$250.48
Rate for Payer: Aetna Medicare Advantage	$197.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.08
Rate for Payer: Cigna Commercial	$329.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$197.75
Rate for Payer: Oxford Commercial	$131.83
Rate for Payer: Qualcare PPO/HMO/WC	$98.87
Rate for Payer: UnitedHealthcare Commercial	$131.83
Rate for Payer: UnitedHealthcare Community & State	$15.89
Rate for Payer: Wellpoint Medicaid Managed Care	$17.47

PACK PTCA CODE HEART

Facility

$659.15

Hospital Charge Code	270658335
Hospital Revenue Code	272
Min. Negotiated Rate	$98.87
Max. Negotiated Rate	$98.87
Rate for Payer: Qualcare PPO/HMO/WC	$98.87

PACK SET UP

Facility

$24.03

Hospital Charge Code	270651631
Hospital Revenue Code	270
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$12.02
Rate for Payer: Aetna Commercial	$9.13
Rate for Payer: Aetna Medicare Advantage	$7.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.13
Rate for Payer: Cigna Commercial	$12.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.21
Rate for Payer: Oxford Commercial	$4.81
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$4.81
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

PACK SET UP

Facility

$24.03

Hospital Charge Code	270651631
Hospital Revenue Code	270
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

PACK SHOULDER EXTREMITY

Facility

$608.63

Hospital Charge Code	270653810
Hospital Revenue Code	272
Min. Negotiated Rate	$14.67
Max. Negotiated Rate	$304.31
Rate for Payer: Aetna Commercial	$231.28
Rate for Payer: Aetna Medicare Advantage	$182.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.20
Rate for Payer: Cigna Commercial	$304.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.59
Rate for Payer: Oxford Commercial	$121.73
Rate for Payer: Qualcare PPO/HMO/WC	$91.29
Rate for Payer: UnitedHealthcare Commercial	$121.73
Rate for Payer: UnitedHealthcare Community & State	$14.67
Rate for Payer: Wellpoint Medicaid Managed Care	$16.13

PACK SHOULDER EXTREMITY

Facility

$608.63

Hospital Charge Code	270653810
Hospital Revenue Code	272
Min. Negotiated Rate	$91.29
Max. Negotiated Rate	$91.29
Rate for Payer: Qualcare PPO/HMO/WC	$91.29

PACK SHOULDER PIN MEDACTA

Facility

$500.00

Hospital Charge Code	270693365
Hospital Revenue Code	270
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

PACK SHOULDER PIN MEDACTA

Facility

$500.00

Hospital Charge Code	270693365
Hospital Revenue Code	270
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

PACK STERILE GENERAL DELIVERY

Facility

$576.80

Hospital Charge Code	270651632
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 STERILE GENERAL DELIVERY

Facility

$576.80

Hospital Charge Code	270651632
Hospital Revenue Code	272
Min. Negotiated Rate	$86.52
Max. Negotiated Rate	$86.52
Rate for Payer: Qualcare PPO/HMO/WC	$86.52

PACK SUTURE

Facility

$128.00

Hospital Charge Code	1801034
Hospital Revenue Code	272
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$64.00
Rate for Payer: Aetna Commercial	$48.64
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$25.60
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$25.60
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

PACK SUTURE

Facility

$128.00

Hospital Charge Code	1801034
Hospital Revenue Code	272
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

PACK T AND A

Facility

$106.40

Hospital Charge Code	270653799
Hospital Revenue Code	272
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$53.20
Rate for Payer: Aetna Commercial	$40.43
Rate for Payer: Aetna Medicare Advantage	$31.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.13
Rate for Payer: Cigna Commercial	$53.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.92
Rate for Payer: Oxford Commercial	$21.28
Rate for Payer: Qualcare PPO/HMO/WC	$15.96
Rate for Payer: UnitedHealthcare Commercial	$21.28
Rate for Payer: UnitedHealthcare Community & State	$2.56
Rate for Payer: Wellpoint Medicaid Managed Care	$2.82

PACK T AND A

Facility

$106.40

Hospital Charge Code	270653799
Hospital Revenue Code	272
Min. Negotiated Rate	$15.96
Max. Negotiated Rate	$15.96
Rate for Payer: Qualcare PPO/HMO/WC	$15.96

PACK TENODESIS SURGICAL DISP

Facility

$2,350.00

Hospital Charge Code	270700353
Hospital Revenue Code	272
Min. Negotiated Rate	$56.63
Max. Negotiated Rate	$1,175.00
Rate for Payer: Aetna Commercial	$893.00
Rate for Payer: Aetna Medicare Advantage	$705.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$599.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$599.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$599.25
Rate for Payer: Cigna Commercial	$1,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$705.00
Rate for Payer: Oxford Commercial	$470.00
Rate for Payer: Qualcare PPO/HMO/WC	$352.50
Rate for Payer: UnitedHealthcare Commercial	$470.00
Rate for Payer: UnitedHealthcare Community & State	$56.63
Rate for Payer: Wellpoint Medicaid Managed Care	$62.27

PACK TENODESIS SURGICAL DISP

Facility

$2,350.00

Hospital Charge Code	270700353
Hospital Revenue Code	272
Min. Negotiated Rate	$352.50
Max. Negotiated Rate	$352.50
Rate for Payer: Qualcare PPO/HMO/WC	$352.50

PACK TX BONE SINGLE TXB

Facility

$6,475.00

Hospital Charge Code	270693668
Hospital Revenue Code	270
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$971.25
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

PACK TX BONE SINGLE TXB

Facility

$6,475.00

Hospital Charge Code	270693668
Hospital Revenue Code	270
Min. Negotiated Rate	$156.05
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$2,460.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,942.50
Rate for Payer: Oxford Commercial	$1,295.00
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Commercial	$1,295.00
Rate for Payer: UnitedHealthcare Community & State	$156.05
Rate for Payer: Wellpoint Medicaid Managed Care	$171.59

PACK UNIVERSAL DISP 29107

Facility

$234.45

Hospital Charge Code	270600158
Hospital Revenue Code	272
Min. Negotiated Rate	$35.17
Max. Negotiated Rate	$35.17
Rate for Payer: Qualcare PPO/HMO/WC	$35.17

PACK UNIVERSAL DISP 29107

Facility

$234.45

Hospital Charge Code	270600158
Hospital Revenue Code	272
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$117.22
Rate for Payer: Aetna Commercial	$89.09
Rate for Payer: Aetna Medicare Advantage	$70.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.78
Rate for Payer: Cigna Commercial	$117.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.33
Rate for Payer: Oxford Commercial	$46.89
Rate for Payer: Qualcare PPO/HMO/WC	$35.17
Rate for Payer: UnitedHealthcare Commercial	$46.89
Rate for Payer: UnitedHealthcare Community & State	$5.65
Rate for Payer: Wellpoint Medicaid Managed Care	$6.21

PACK UNIVERSAL LINEN *********

Facility

$148.00

Hospital Charge Code	1607084
Hospital Revenue Code	272
Min. Negotiated Rate	$22.20
Max. Negotiated Rate	$22.20
Rate for Payer: Qualcare PPO/HMO/WC	$22.20

PACK UNIVERSAL LINEN *********

Facility

$148.00

Hospital Charge Code	1607084
Hospital Revenue Code	272
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$74.00
Rate for Payer: Aetna Commercial	$56.24
Rate for Payer: Aetna Medicare Advantage	$44.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.74
Rate for Payer: Cigna Commercial	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.40
Rate for Payer: Oxford Commercial	$29.60
Rate for Payer: Qualcare PPO/HMO/WC	$22.20
Rate for Payer: UnitedHealthcare Commercial	$29.60
Rate for Payer: UnitedHealthcare Community & State	$3.57
Rate for Payer: Wellpoint Medicaid Managed Care	$3.92

PACK UPPER EXTREMITY III

Facility

$306.80

Hospital Charge Code	270653811
Hospital Revenue Code	272
Min. Negotiated Rate	$7.39
Max. Negotiated Rate	$153.40
Rate for Payer: Aetna Commercial	$116.58
Rate for Payer: Aetna Medicare Advantage	$92.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.23
Rate for Payer: Cigna Commercial	$153.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.04
Rate for Payer: Oxford Commercial	$61.36
Rate for Payer: Qualcare PPO/HMO/WC	$46.02
Rate for Payer: UnitedHealthcare Commercial	$61.36
Rate for Payer: UnitedHealthcare Community & State	$7.39
Rate for Payer: Wellpoint Medicaid Managed Care	$8.13

PACK UPPER EXTREMITY III

Facility

$306.80

Hospital Charge Code	270653811
Hospital Revenue Code	272
Min. Negotiated Rate	$46.02
Max. Negotiated Rate	$46.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.02

PACK VAGINAL DELIVERY

Facility

$150.45

Hospital Charge Code	1801042
Hospital Revenue Code	272
Min. Negotiated Rate	$22.57
Max. Negotiated Rate	$22.57
Rate for Payer: Qualcare PPO/HMO/WC	$22.57

Know your out-of-pocket cost for care.

All Charges