Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PERI VBAC

Facility

$5,539.00

Service Code	HCPCS 59612
Hospital Charge Code	74308075
Hospital Revenue Code	722
Min. Negotiated Rate	$133.49
Max. Negotiated Rate	$13,882.15
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,882.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,882.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$774.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,882.15
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,661.70
Rate for Payer: Oxford Commercial	$2,624.00
Rate for Payer: Qualcare PPO/HMO/WC	$830.85
Rate for Payer: UnitedHealthcare Commercial	$4,601.00
Rate for Payer: UnitedHealthcare Community & State	$133.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$146.78

PERI VENIPUNCTURE

Facility

$135.80

Service Code	HCPCS 36415
Hospital Charge Code	74308005
Hospital Revenue Code	300
Min. Negotiated Rate	$20.37
Max. Negotiated Rate	$20.37
Rate for Payer: Qualcare PPO/HMO/WC	$20.37

PERI VENIPUNCTURE

Facility

$135.80

Service Code	HCPCS 36415
Hospital Charge Code	74308005
Hospital Revenue Code	300
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$25.40
Rate for Payer: Aetna Medicare Advantage	$30.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.71
Rate for Payer: Cigna Commercial	$67.90
Rate for Payer: Cigna Medicare Advantage	$9.34
Rate for Payer: Clover Medicare Advantage	$8.87
Rate for Payer: EmblemHealth Commercial	$28.02
Rate for Payer: Humana Medicare Advantage	$9.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.37
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.34
Rate for Payer: Wellcare Medicare Advantage	$9.34
Rate for Payer: Wellpoint Medicaid Managed Care	$3.60

PERLA 5.5X45MM ROD

Facility

$1,750.00

Hospital Charge Code	270702842
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$385.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

PERLA 5.5X45MM ROD

Facility

$1,750.00

Hospital Charge Code	270702842
Hospital Revenue Code	278
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$385.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

PERLA CORTICAL 6.5X45MM SCREW

Facility

$3,125.00

Hospital Charge Code	270702838
Hospital Revenue Code	278
Min. Negotiated Rate	$75.31
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$75.31
Rate for Payer: Wellpoint Medicaid Managed Care	$82.81

PERLA CORTICAL 6.5X45MM SCREW

Facility

$3,125.00

Hospital Charge Code	270702838
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

PERLA CORTICAL 7.5X40MM SCREW

Facility

$3,125.00

Hospital Charge Code	270702839
Hospital Revenue Code	278
Min. Negotiated Rate	$75.31
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$75.31
Rate for Payer: Wellpoint Medicaid Managed Care	$82.81

PERLA CORTICAL 7.5X40MM SCREW

Facility

$3,125.00

Hospital Charge Code	270702839
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

PERLA SET SCREW

Facility

$500.00

Hospital Charge Code	270702841
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

PERLA SET SCREW

Facility

$500.00

Hospital Charge Code	270702841
Hospital Revenue Code	278
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) NJ Health	$100.00
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	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

PERMA CATH DUAL LUMEN 36 CM

Facility

$1,102.50

Hospital Charge Code	270650810
Hospital Revenue Code	272
Min. Negotiated Rate	$26.57
Max. Negotiated Rate	$551.25
Rate for Payer: Aetna Commercial	$418.95
Rate for Payer: Aetna Medicare Advantage	$330.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$281.14
Rate for Payer: Cigna Commercial	$551.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.75
Rate for Payer: Oxford Commercial	$220.50
Rate for Payer: Qualcare PPO/HMO/WC	$165.38
Rate for Payer: UnitedHealthcare Commercial	$220.50
Rate for Payer: UnitedHealthcare Community & State	$26.57
Rate for Payer: Wellpoint Medicaid Managed Care	$29.22

PERMA CATH DUAL LUMEN 36 CM

Facility

$1,102.50

Hospital Charge Code	270650810
Hospital Revenue Code	272
Min. Negotiated Rate	$165.38
Max. Negotiated Rate	$165.38
Rate for Payer: Qualcare PPO/HMO/WC	$165.38

PERMA CATH DUAL LUMEN 40CM

Facility

$1,320.50

Hospital Charge Code	270650811
Hospital Revenue Code	272
Min. Negotiated Rate	$31.82
Max. Negotiated Rate	$660.25
Rate for Payer: Aetna Commercial	$501.79
Rate for Payer: Aetna Medicare Advantage	$396.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$336.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$336.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$336.73
Rate for Payer: Cigna Commercial	$660.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.15
Rate for Payer: Oxford Commercial	$264.10
Rate for Payer: Qualcare PPO/HMO/WC	$198.07
Rate for Payer: UnitedHealthcare Commercial	$264.10
Rate for Payer: UnitedHealthcare Community & State	$31.82
Rate for Payer: Wellpoint Medicaid Managed Care	$34.99

PERMA CATH DUAL LUMEN 40CM

Facility

$1,320.50

Hospital Charge Code	270650811
Hospital Revenue Code	272
Min. Negotiated Rate	$198.07
Max. Negotiated Rate	$198.07
Rate for Payer: Qualcare PPO/HMO/WC	$198.07

PERMA CATH DUAL LUMEN 45cm

Facility

$1,146.50

Hospital Charge Code	270655918
Hospital Revenue Code	271
Min. Negotiated Rate	$27.63
Max. Negotiated Rate	$573.25
Rate for Payer: Aetna Commercial	$435.67
Rate for Payer: Aetna Medicare Advantage	$343.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.36
Rate for Payer: Cigna Commercial	$573.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.95
Rate for Payer: Oxford Commercial	$229.30
Rate for Payer: Qualcare PPO/HMO/WC	$171.97
Rate for Payer: UnitedHealthcare Commercial	$229.30
Rate for Payer: UnitedHealthcare Community & State	$27.63
Rate for Payer: Wellpoint Medicaid Managed Care	$30.38

PERMA CATH DUAL LUMEN 45cm

Facility

$1,146.50

Hospital Charge Code	270655918
Hospital Revenue Code	271
Min. Negotiated Rate	$171.97
Max. Negotiated Rate	$171.97
Rate for Payer: Qualcare PPO/HMO/WC	$171.97

PERMACOL 10 X 10 X 1.50

Facility

$11,490.00

Service Code	HCPCS C1781
Hospital Charge Code	270665982
Hospital Revenue Code	278
Min. Negotiated Rate	$276.91
Max. Negotiated Rate	$5,745.00
Rate for Payer: Aetna Commercial	$4,366.20
Rate for Payer: Aetna Medicare Advantage	$3,447.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,929.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,929.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,298.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,929.95
Rate for Payer: Cigna Commercial	$5,745.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,780.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,527.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,723.50
Rate for Payer: UnitedHealthcare Community & State	$276.91
Rate for Payer: Wellpoint Medicaid Managed Care	$304.49

PERMACOL 10 X 10 X 1.50

Facility

$11,490.00

Service Code	HCPCS C1781
Hospital Charge Code	270665982
Hospital Revenue Code	278
Min. Negotiated Rate	$1,723.50
Max. Negotiated Rate	$2,780.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,298.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,780.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,527.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,723.50

PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK

Facility

$29,064.26

Service Code	APR-DRG 1702
Min. Negotiated Rate	$28,494.37
Max. Negotiated Rate	$29,064.26
Rate for Payer: UnitedHealthcare Community & State	$28,494.37
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,064.26
Rate for Payer: Wellpoint Medicaid Managed Care	$28,494.37

PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK

Facility

$54,818.09

Service Code	APR-DRG 1704
Min. Negotiated Rate	$53,743.23
Max. Negotiated Rate	$54,818.09
Rate for Payer: UnitedHealthcare Community & State	$53,743.23
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$54,818.09
Rate for Payer: Wellpoint Medicaid Managed Care	$53,743.23

PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK

Facility

$39,032.81

Service Code	APR-DRG 1703
Min. Negotiated Rate	$38,267.46
Max. Negotiated Rate	$39,032.81
Rate for Payer: UnitedHealthcare Community & State	$38,267.46
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$39,032.81
Rate for Payer: Wellpoint Medicaid Managed Care	$38,267.46

PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK

Facility

$28,005.87

Service Code	APR-DRG 1701
Min. Negotiated Rate	$27,456.74
Max. Negotiated Rate	$28,005.87
Rate for Payer: UnitedHealthcare Community & State	$27,456.74
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$28,005.87
Rate for Payer: Wellpoint Medicaid Managed Care	$27,456.74

PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC

Facility

$71,008.24

Service Code	MSDRG 243
Min. Negotiated Rate	$21,621.10
Max. Negotiated Rate	$71,008.24
Rate for Payer: Aetna Commercial	$49,048.07
Rate for Payer: Aetna Medicare Advantage	$71,008.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53,035.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53,035.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,759.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53,035.08
Rate for Payer: Cigna Commercial	$39,877.66
Rate for Payer: Cigna Medicare Advantage	$22,759.05
Rate for Payer: Clover Medicare Advantage	$21,621.10
Rate for Payer: EmblemHealth Commercial	$68,277.15
Rate for Payer: Humana Medicare Advantage	$23,441.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22,759.05
Rate for Payer: Oxford Commercial	$28,660.60
Rate for Payer: UnitedHealthcare Commercial	$50,257.28
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,759.05
Rate for Payer: Wellcare Medicare Advantage	$22,759.05

PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC

Facility

$105,330.70

Service Code	MSDRG 242
Min. Negotiated Rate	$32,071.85
Max. Negotiated Rate	$105,330.70
Rate for Payer: Aetna Commercial	$72,631.52
Rate for Payer: Aetna Medicare Advantage	$105,330.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80,483.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80,483.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$33,759.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80,483.06
Rate for Payer: Cigna Commercial	$59,750.06
Rate for Payer: Cigna Medicare Advantage	$33,759.84
Rate for Payer: Clover Medicare Advantage	$32,071.85
Rate for Payer: EmblemHealth Commercial	$101,279.52
Rate for Payer: Humana Medicare Advantage	$34,772.64
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$33,759.84
Rate for Payer: Oxford Commercial	$42,943.16
Rate for Payer: UnitedHealthcare Commercial	$75,302.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$33,759.84
Rate for Payer: Wellcare Medicare Advantage	$33,759.84

Know your out-of-pocket cost for care.

All Charges