Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE DCP TT 2.7MM 2H

Facility

$1,035.25

Hospital Charge Code	270604089
Hospital Revenue Code	278
Min. Negotiated Rate	$24.95
Max. Negotiated Rate	$517.62
Rate for Payer: Aetna Commercial	$393.39
Rate for Payer: Aetna Medicare Advantage	$310.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$207.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.99
Rate for Payer: Cigna Commercial	$517.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.75
Rate for Payer: Qualcare PPO/HMO/WC	$155.29
Rate for Payer: UnitedHealthcare Community & State	$24.95
Rate for Payer: Wellpoint Medicaid Managed Care	$27.43

PLATE DCP TT 2.7MM 2H

Facility

$1,035.25

Hospital Charge Code	270604089
Hospital Revenue Code	278
Min. Negotiated Rate	$155.29
Max. Negotiated Rate	$250.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$207.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$227.75
Rate for Payer: Qualcare PPO/HMO/WC	$155.29

PLATE DCP TT 2.7MM 4H

Facility

$1,242.45

Hospital Charge Code	270604081
Hospital Revenue Code	278
Min. Negotiated Rate	$186.37
Max. Negotiated Rate	$300.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.34
Rate for Payer: Qualcare PPO/HMO/WC	$186.37

PLATE DCP TT 2.7MM 4H

Facility

$1,242.45

Hospital Charge Code	270604081
Hospital Revenue Code	278
Min. Negotiated Rate	$29.94
Max. Negotiated Rate	$621.23
Rate for Payer: Aetna Commercial	$472.13
Rate for Payer: Aetna Medicare Advantage	$372.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.82
Rate for Payer: Cigna Commercial	$621.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.34
Rate for Payer: Qualcare PPO/HMO/WC	$186.37
Rate for Payer: UnitedHealthcare Community & State	$29.94
Rate for Payer: Wellpoint Medicaid Managed Care	$32.92

PLATE DCP TT 2.7MM 7H

Facility

$1,693.65

Hospital Charge Code	270604084
Hospital Revenue Code	278
Min. Negotiated Rate	$40.82
Max. Negotiated Rate	$846.83
Rate for Payer: Aetna Commercial	$643.59
Rate for Payer: Aetna Medicare Advantage	$508.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$431.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$431.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$338.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$431.88
Rate for Payer: Cigna Commercial	$846.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$409.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$372.60
Rate for Payer: Qualcare PPO/HMO/WC	$254.05
Rate for Payer: UnitedHealthcare Community & State	$40.82
Rate for Payer: Wellpoint Medicaid Managed Care	$44.88

PLATE DCP TT 2.7MM 7H

Facility

$1,693.65

Hospital Charge Code	270604084
Hospital Revenue Code	278
Min. Negotiated Rate	$254.05
Max. Negotiated Rate	$409.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$338.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$409.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$372.60
Rate for Payer: Qualcare PPO/HMO/WC	$254.05

PLATE DCP TT 2.7MM 8H

Facility

$1,771.25

Hospital Charge Code	270604085
Hospital Revenue Code	278
Min. Negotiated Rate	$265.69
Max. Negotiated Rate	$428.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$354.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$389.68
Rate for Payer: Qualcare PPO/HMO/WC	$265.69

PLATE DCP TT 2.7MM 8H

Facility

$1,771.25

Hospital Charge Code	270604085
Hospital Revenue Code	278
Min. Negotiated Rate	$42.69
Max. Negotiated Rate	$885.62
Rate for Payer: Aetna Commercial	$673.08
Rate for Payer: Aetna Medicare Advantage	$531.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$451.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$451.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$354.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$451.67
Rate for Payer: Cigna Commercial	$885.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$389.68
Rate for Payer: Qualcare PPO/HMO/WC	$265.69
Rate for Payer: UnitedHealthcare Community & State	$42.69
Rate for Payer: Wellpoint Medicaid Managed Care	$46.94

PLATE DCS 95 25MM 10H

Facility

$3,218.45

Hospital Charge Code	270603848
Hospital Revenue Code	278
Min. Negotiated Rate	$77.56
Max. Negotiated Rate	$1,609.22
Rate for Payer: Aetna Commercial	$1,223.01
Rate for Payer: Aetna Medicare Advantage	$965.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$820.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$820.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$820.70
Rate for Payer: Cigna Commercial	$1,609.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$708.06
Rate for Payer: Qualcare PPO/HMO/WC	$482.77
Rate for Payer: UnitedHealthcare Community & State	$77.56
Rate for Payer: Wellpoint Medicaid Managed Care	$85.29

PLATE DCS 95 25MM 10H

Facility

$3,218.45

Hospital Charge Code	270603848
Hospital Revenue Code	278
Min. Negotiated Rate	$482.77
Max. Negotiated Rate	$778.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$708.06
Rate for Payer: Qualcare PPO/HMO/WC	$482.77

PLATE DCS 95 25MM 12H

Facility

$3,218.45

Hospital Charge Code	270603849
Hospital Revenue Code	278
Min. Negotiated Rate	$77.56
Max. Negotiated Rate	$1,609.22
Rate for Payer: Aetna Commercial	$1,223.01
Rate for Payer: Aetna Medicare Advantage	$965.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$820.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$820.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$820.70
Rate for Payer: Cigna Commercial	$1,609.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$708.06
Rate for Payer: Qualcare PPO/HMO/WC	$482.77
Rate for Payer: UnitedHealthcare Community & State	$77.56
Rate for Payer: Wellpoint Medicaid Managed Care	$85.29

PLATE DCS 95 25MM 12H

Facility

$3,218.45

Hospital Charge Code	270603849
Hospital Revenue Code	278
Min. Negotiated Rate	$482.77
Max. Negotiated Rate	$778.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$708.06
Rate for Payer: Qualcare PPO/HMO/WC	$482.77

PLATE DCS 95 25MM 14H

Facility

$3,218.45

Hospital Charge Code	270603850
Hospital Revenue Code	278
Min. Negotiated Rate	$77.56
Max. Negotiated Rate	$1,609.22
Rate for Payer: Aetna Commercial	$1,223.01
Rate for Payer: Aetna Medicare Advantage	$965.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$820.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$820.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$820.70
Rate for Payer: Cigna Commercial	$1,609.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$708.06
Rate for Payer: Qualcare PPO/HMO/WC	$482.77
Rate for Payer: UnitedHealthcare Community & State	$77.56
Rate for Payer: Wellpoint Medicaid Managed Care	$85.29

PLATE DCS 95 25MM 14H

Facility

$3,218.45

Hospital Charge Code	270603850
Hospital Revenue Code	278
Min. Negotiated Rate	$482.77
Max. Negotiated Rate	$778.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$708.06
Rate for Payer: Qualcare PPO/HMO/WC	$482.77

PLATE DCS 95 25MM 16H

Facility

$3,877.65

Hospital Charge Code	270603851
Hospital Revenue Code	278
Min. Negotiated Rate	$581.65
Max. Negotiated Rate	$938.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$938.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$853.08
Rate for Payer: Qualcare PPO/HMO/WC	$581.65

PLATE DCS 95 25MM 16H

Facility

$3,877.65

Hospital Charge Code	270603851
Hospital Revenue Code	278
Min. Negotiated Rate	$93.45
Max. Negotiated Rate	$1,938.83
Rate for Payer: Aetna Commercial	$1,473.51
Rate for Payer: Aetna Medicare Advantage	$1,163.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.80
Rate for Payer: Cigna Commercial	$1,938.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$938.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$853.08
Rate for Payer: Qualcare PPO/HMO/WC	$581.65
Rate for Payer: UnitedHealthcare Community & State	$93.45
Rate for Payer: Wellpoint Medicaid Managed Care	$102.76

PLATE DCS 95 25MM 6H

Facility

$3,218.45

Hospital Charge Code	270603846
Hospital Revenue Code	278
Min. Negotiated Rate	$77.56
Max. Negotiated Rate	$1,609.22
Rate for Payer: Aetna Commercial	$1,223.01
Rate for Payer: Aetna Medicare Advantage	$965.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$820.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$820.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$820.70
Rate for Payer: Cigna Commercial	$1,609.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$708.06
Rate for Payer: Qualcare PPO/HMO/WC	$482.77
Rate for Payer: UnitedHealthcare Community & State	$77.56
Rate for Payer: Wellpoint Medicaid Managed Care	$85.29

PLATE DCS 95 25MM 6H

Facility

$3,218.45

Hospital Charge Code	270603846
Hospital Revenue Code	278
Min. Negotiated Rate	$482.77
Max. Negotiated Rate	$778.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$708.06
Rate for Payer: Qualcare PPO/HMO/WC	$482.77

PLATE DCS 95 25MM 8H

Facility

$3,218.45

Hospital Charge Code	270603847
Hospital Revenue Code	278
Min. Negotiated Rate	$77.56
Max. Negotiated Rate	$1,609.22
Rate for Payer: Aetna Commercial	$1,223.01
Rate for Payer: Aetna Medicare Advantage	$965.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$820.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$820.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$820.70
Rate for Payer: Cigna Commercial	$1,609.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$708.06
Rate for Payer: Qualcare PPO/HMO/WC	$482.77
Rate for Payer: UnitedHealthcare Community & State	$77.56
Rate for Payer: Wellpoint Medicaid Managed Care	$85.29

PLATE DCS 95 25MM 8H

Facility

$3,218.45

Hospital Charge Code	270603847
Hospital Revenue Code	278
Min. Negotiated Rate	$482.77
Max. Negotiated Rate	$778.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$708.06
Rate for Payer: Qualcare PPO/HMO/WC	$482.77

PLATE DHS 135 DEG 10H/174MM

Facility

$3,229.05

Service Code	HCPCS C1713
Hospital Charge Code	270651718
Hospital Revenue Code	278
Min. Negotiated Rate	$484.36
Max. Negotiated Rate	$781.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$645.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$710.39
Rate for Payer: Qualcare PPO/HMO/WC	$484.36

PLATE DHS 135 DEG 10H/174MM

Facility

$3,229.05

Service Code	HCPCS C1713
Hospital Charge Code	270651718
Hospital Revenue Code	278
Min. Negotiated Rate	$77.82
Max. Negotiated Rate	$1,614.53
Rate for Payer: Aetna Commercial	$1,227.04
Rate for Payer: Aetna Medicare Advantage	$968.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$823.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$823.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$645.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$823.41
Rate for Payer: Cigna Commercial	$1,614.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$710.39
Rate for Payer: Qualcare PPO/HMO/WC	$484.36
Rate for Payer: UnitedHealthcare Community & State	$77.82
Rate for Payer: Wellpoint Medicaid Managed Care	$85.57

PLATE DHS 135 DEG 4H/78MM

Facility

$2,274.25

Service Code	HCPCS C1713
Hospital Charge Code	270603833
Hospital Revenue Code	278
Min. Negotiated Rate	$341.14
Max. Negotiated Rate	$550.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$454.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$500.33
Rate for Payer: Qualcare PPO/HMO/WC	$341.14

PLATE DHS 135 DEG 4H/78MM

Facility

$2,274.25

Service Code	HCPCS C1713
Hospital Charge Code	270603833
Hospital Revenue Code	278
Min. Negotiated Rate	$54.81
Max. Negotiated Rate	$1,137.12
Rate for Payer: Aetna Commercial	$864.22
Rate for Payer: Aetna Medicare Advantage	$682.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$579.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$579.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$454.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$579.93
Rate for Payer: Cigna Commercial	$1,137.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$500.33
Rate for Payer: Qualcare PPO/HMO/WC	$341.14
Rate for Payer: UnitedHealthcare Community & State	$54.81
Rate for Payer: Wellpoint Medicaid Managed Care	$60.27

PLATE DHS 135 DEG 5H/94MM

Facility

$2,274.25

Service Code	HCPCS C1713
Hospital Charge Code	270651719
Hospital Revenue Code	278
Min. Negotiated Rate	$54.81
Max. Negotiated Rate	$1,137.12
Rate for Payer: Aetna Commercial	$864.22
Rate for Payer: Aetna Medicare Advantage	$682.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$579.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$579.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$454.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$579.93
Rate for Payer: Cigna Commercial	$1,137.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$500.33
Rate for Payer: Qualcare PPO/HMO/WC	$341.14
Rate for Payer: UnitedHealthcare Community & State	$54.81
Rate for Payer: Wellpoint Medicaid Managed Care	$60.27

Know your out-of-pocket cost for care.

All Charges