Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK

Facility

$45,996.01

Service Code	APR-DRG 1714
Min. Negotiated Rate	$45,094.13
Max. Negotiated Rate	$45,996.01
Rate for Payer: UnitedHealthcare Community & State	$45,094.13
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$45,996.01
Rate for Payer: Wellpoint Medicaid Managed Care	$45,094.13

PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK

Facility

$19,976.68

Service Code	APR-DRG 1711
Min. Negotiated Rate	$19,584.98
Max. Negotiated Rate	$19,976.68
Rate for Payer: UnitedHealthcare Community & State	$19,584.98
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,976.68
Rate for Payer: Wellpoint Medicaid Managed Care	$19,584.98

PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK

Facility

$22,657.75

Service Code	APR-DRG 1712
Min. Negotiated Rate	$22,213.48
Max. Negotiated Rate	$22,657.75
Rate for Payer: UnitedHealthcare Community & State	$22,213.48
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,657.75
Rate for Payer: Wellpoint Medicaid Managed Care	$22,213.48

PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK

Facility

$29,410.31

Service Code	APR-DRG 1713
Min. Negotiated Rate	$28,833.64
Max. Negotiated Rate	$29,410.31
Rate for Payer: UnitedHealthcare Community & State	$28,833.64
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,410.31
Rate for Payer: Wellpoint Medicaid Managed Care	$28,833.64

PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC

Facility

$60,555.49

Service Code	MSDRG 244
Min. Negotiated Rate	$18,438.37
Max. Negotiated Rate	$60,555.49
Rate for Payer: Aetna Commercial	$41,865.82
Rate for Payer: Aetna Medicare Advantage	$60,555.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42,567.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42,567.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,408.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42,567.63
Rate for Payer: Cigna Commercial	$33,825.56
Rate for Payer: Cigna Medicare Advantage	$19,408.81
Rate for Payer: Clover Medicare Advantage	$18,438.37
Rate for Payer: EmblemHealth Commercial	$58,226.43
Rate for Payer: Humana Medicare Advantage	$19,991.07
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19,408.81
Rate for Payer: Oxford Commercial	$24,310.88
Rate for Payer: UnitedHealthcare Commercial	$42,629.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,408.81
Rate for Payer: Wellcare Medicare Advantage	$19,408.81

PERMANENT NAIL REMOVAL

Facility

$1,287.45

Service Code	HCPCS 11750
Hospital Charge Code	160000199
Hospital Revenue Code	360
Min. Negotiated Rate	$31.03
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.24
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$193.12
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$31.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$34.12

PERMANENT NAIL REMOVAL

Facility

$1,287.45

Service Code	HCPCS 11750
Hospital Charge Code	160000199
Hospital Revenue Code	360
Min. Negotiated Rate	$193.12
Max. Negotiated Rate	$193.12
Rate for Payer: Qualcare PPO/HMO/WC	$193.12

PERMANENT PACEMAKER LEAD

Facility

$313.00

Hospital Charge Code	270331428
Hospital Revenue Code	275
Min. Negotiated Rate	$46.95
Max. Negotiated Rate	$75.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.86
Rate for Payer: Qualcare PPO/HMO/WC	$46.95

PERMANENT PACEMAKER LEAD

Facility

$313.00

Hospital Charge Code	270331428
Hospital Revenue Code	275
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) NJ Health	$62.60
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	$75.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$68.86
Rate for Payer: Qualcare PPO/HMO/WC	$46.95
Rate for Payer: UnitedHealthcare Community & State	$7.54
Rate for Payer: Wellpoint Medicaid Managed Care	$8.29

PERMANENT SLED STERILE BAD

Facility

$75.00

Hospital Charge Code	270703399
Hospital Revenue Code	278
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

PERMANENT SLED STERILE BAD

Facility

$75.00

Hospital Charge Code	270703399
Hospital Revenue Code	278
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

PERMASOFT LAP ABSORB-35 CM

Facility

$124.00

Hospital Charge Code	270335800
Hospital Revenue Code	272
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

PERMASOFT LAP ABSORB-35 CM

Facility

$124.00

Hospital Charge Code	270335800
Hospital Revenue Code	272
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$62.00
Rate for Payer: Aetna Commercial	$47.12
Rate for Payer: Aetna Medicare Advantage	$37.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.62
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.20
Rate for Payer: Oxford Commercial	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$24.80
Rate for Payer: UnitedHealthcare Community & State	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

PERMASOFT LAP FASTENERS 12-35

Facility

$226.00

Hospital Charge Code	270335801
Hospital Revenue Code	272
Min. Negotiated Rate	$33.90
Max. Negotiated Rate	$33.90
Rate for Payer: Qualcare PPO/HMO/WC	$33.90

PERMASOFT LAP FASTENERS 12-35

Facility

$226.00

Hospital Charge Code	270335801
Hospital Revenue Code	272
Min. Negotiated Rate	$5.45
Max. Negotiated Rate	$113.00
Rate for Payer: Aetna Commercial	$85.88
Rate for Payer: Aetna Medicare Advantage	$67.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.63
Rate for Payer: Cigna Commercial	$113.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.80
Rate for Payer: Oxford Commercial	$45.20
Rate for Payer: Qualcare PPO/HMO/WC	$33.90
Rate for Payer: UnitedHealthcare Commercial	$45.20
Rate for Payer: UnitedHealthcare Community & State	$5.45
Rate for Payer: Wellpoint Medicaid Managed Care	$5.99

PERMAX 0.05MG TAB

Facility

$3.00

Hospital Charge Code	60635064
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PERMAX 0.05MG TAB

Facility

$3.00

Hospital Charge Code	60635064
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

PERMAX/0.05MG/TAB

Facility

$3.00

Hospital Charge Code	60633635
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PERMAX/0.05MG/TAB

Facility

$3.00

Hospital Charge Code	60633635
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

PERMAX/0.25MG/TAB

Facility

$3.00

Hospital Charge Code	60633636
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

PERMAX/0.25MG/TAB

Facility

$3.00

Hospital Charge Code	60633636
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PERMAX/1MG/TAB

Facility

$13.00

Hospital Charge Code	60633637
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

PERMAX/1MG/TAB

Facility

$13.00

Hospital Charge Code	60633637
Hospital Revenue Code	250
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

PERM CATHETER

Facility

$574.00

Hospital Charge Code	270332053
Hospital Revenue Code	278
Min. Negotiated Rate	$86.10
Max. Negotiated Rate	$138.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.28
Rate for Payer: Qualcare PPO/HMO/WC	$86.10

PERM CATHETER

Facility

$574.00

Hospital Charge Code	270332053
Hospital Revenue Code	278
Min. Negotiated Rate	$13.83
Max. Negotiated Rate	$287.00
Rate for Payer: Aetna Commercial	$218.12
Rate for Payer: Aetna Medicare Advantage	$172.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.37
Rate for Payer: Cigna Commercial	$287.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.28
Rate for Payer: Qualcare PPO/HMO/WC	$86.10
Rate for Payer: UnitedHealthcare Community & State	$13.83
Rate for Payer: Wellpoint Medicaid Managed Care	$15.21

Know your out-of-pocket cost for care.

All Charges