Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE DHS 38mm 4HOLE 135

Facility

$2,208.00

Hospital Charge Code	270603807
Hospital Revenue Code	278
Min. Negotiated Rate	$331.20
Max. Negotiated Rate	$534.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$441.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$534.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$485.76
Rate for Payer: Qualcare PPO/HMO/WC	$331.20

PLATE DHS 38MM 5H 140 DEG****

Facility

$2,300.00

Hospital Charge Code	27060318
Hospital Revenue Code	274
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$506.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

PLATE DHS 38MM 5H 140 DEG****

Facility

$2,300.00

Hospital Charge Code	27060318
Hospital Revenue Code	274
Min. Negotiated Rate	$55.43
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$874.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$506.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00
Rate for Payer: UnitedHealthcare Community & State	$55.43
Rate for Payer: Wellpoint Medicaid Managed Care	$60.95

PLATE DHS 38MM 5 HL 135 DEG

Facility

$1,932.00

Hospital Charge Code	270603808
Hospital Revenue Code	278
Min. Negotiated Rate	$289.80
Max. Negotiated Rate	$467.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80

PLATE DHS 38MM 5 HL 135 DEG

Facility

$1,932.00

Hospital Charge Code	270603808
Hospital Revenue Code	278
Min. Negotiated Rate	$46.56
Max. Negotiated Rate	$966.00
Rate for Payer: Aetna Commercial	$734.16
Rate for Payer: Aetna Medicare Advantage	$579.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.66
Rate for Payer: Cigna Commercial	$966.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80
Rate for Payer: UnitedHealthcare Community & State	$46.56
Rate for Payer: Wellpoint Medicaid Managed Care	$51.20

PLATE DHS 38MM 5 HL 145 DEG

Facility

$1,932.00

Hospital Charge Code	270603822
Hospital Revenue Code	278
Min. Negotiated Rate	$46.56
Max. Negotiated Rate	$966.00
Rate for Payer: Aetna Commercial	$734.16
Rate for Payer: Aetna Medicare Advantage	$579.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.66
Rate for Payer: Cigna Commercial	$966.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80
Rate for Payer: UnitedHealthcare Community & State	$46.56
Rate for Payer: Wellpoint Medicaid Managed Care	$51.20

PLATE DHS 38MM 5 HL 145 DEG

Facility

$1,932.00

Hospital Charge Code	270603822
Hospital Revenue Code	278
Min. Negotiated Rate	$289.80
Max. Negotiated Rate	$467.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80

PLATE DHS 38MM 5 HL 150 DEG

Facility

$1,932.00

Hospital Charge Code	270603826
Hospital Revenue Code	278
Min. Negotiated Rate	$46.56
Max. Negotiated Rate	$966.00
Rate for Payer: Aetna Commercial	$734.16
Rate for Payer: Aetna Medicare Advantage	$579.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.66
Rate for Payer: Cigna Commercial	$966.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80
Rate for Payer: UnitedHealthcare Community & State	$46.56
Rate for Payer: Wellpoint Medicaid Managed Care	$51.20

PLATE DHS 38MM 5 HL 150 DEG

Facility

$1,932.00

Hospital Charge Code	270603826
Hospital Revenue Code	278
Min. Negotiated Rate	$289.80
Max. Negotiated Rate	$467.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80

PLATE DHS 38MM 6 HL 140 DEG

Facility

$1,932.00

Hospital Charge Code	270603820
Hospital Revenue Code	278
Min. Negotiated Rate	$289.80
Max. Negotiated Rate	$467.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80

PLATE DHS 38MM 6 HL 140 DEG

Facility

$1,932.00

Hospital Charge Code	270603820
Hospital Revenue Code	278
Min. Negotiated Rate	$46.56
Max. Negotiated Rate	$966.00
Rate for Payer: Aetna Commercial	$734.16
Rate for Payer: Aetna Medicare Advantage	$579.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.66
Rate for Payer: Cigna Commercial	$966.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80
Rate for Payer: UnitedHealthcare Community & State	$46.56
Rate for Payer: Wellpoint Medicaid Managed Care	$51.20

PLATE DHS 38MM 6 HL 145 DEG

Facility

$1,932.00

Hospital Charge Code	270603823
Hospital Revenue Code	278
Min. Negotiated Rate	$46.56
Max. Negotiated Rate	$966.00
Rate for Payer: Aetna Commercial	$734.16
Rate for Payer: Aetna Medicare Advantage	$579.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.66
Rate for Payer: Cigna Commercial	$966.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80
Rate for Payer: UnitedHealthcare Community & State	$46.56
Rate for Payer: Wellpoint Medicaid Managed Care	$51.20

PLATE DHS 38MM 6 HL 145 DEG

Facility

$1,932.00

Hospital Charge Code	270603823
Hospital Revenue Code	278
Min. Negotiated Rate	$289.80
Max. Negotiated Rate	$467.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80

PLATE DHS 38MM 6 HL 150 DEG

Facility

$1,932.00

Hospital Charge Code	270603827
Hospital Revenue Code	278
Min. Negotiated Rate	$46.56
Max. Negotiated Rate	$966.00
Rate for Payer: Aetna Commercial	$734.16
Rate for Payer: Aetna Medicare Advantage	$579.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.66
Rate for Payer: Cigna Commercial	$966.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80
Rate for Payer: UnitedHealthcare Community & State	$46.56
Rate for Payer: Wellpoint Medicaid Managed Care	$51.20

PLATE DHS 38MM 6 HL 150 DEG

Facility

$1,932.00

Hospital Charge Code	270603827
Hospital Revenue Code	278
Min. Negotiated Rate	$289.80
Max. Negotiated Rate	$467.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80

PLATE DHS 38MM 8 HL 135 DEG

Facility

$2,591.25

Hospital Charge Code	270603810
Hospital Revenue Code	278
Min. Negotiated Rate	$62.45
Max. Negotiated Rate	$1,295.62
Rate for Payer: Aetna Commercial	$984.67
Rate for Payer: Aetna Medicare Advantage	$777.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$660.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$660.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$518.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$660.77
Rate for Payer: Cigna Commercial	$1,295.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$627.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$570.08
Rate for Payer: Qualcare PPO/HMO/WC	$388.69
Rate for Payer: UnitedHealthcare Community & State	$62.45
Rate for Payer: Wellpoint Medicaid Managed Care	$68.67

PLATE DHS 38MM 8 HL 135 DEG

Facility

$2,591.25

Hospital Charge Code	270603810
Hospital Revenue Code	278
Min. Negotiated Rate	$388.69
Max. Negotiated Rate	$627.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$518.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$627.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$570.08
Rate for Payer: Qualcare PPO/HMO/WC	$388.69

PLATE DHS 38MM 8 HL 150 DEG

Facility

$2,591.25

Hospital Charge Code	270603828
Hospital Revenue Code	278
Min. Negotiated Rate	$62.45
Max. Negotiated Rate	$1,295.62
Rate for Payer: Aetna Commercial	$984.67
Rate for Payer: Aetna Medicare Advantage	$777.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$660.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$660.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$518.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$660.77
Rate for Payer: Cigna Commercial	$1,295.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$627.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$570.08
Rate for Payer: Qualcare PPO/HMO/WC	$388.69
Rate for Payer: UnitedHealthcare Community & State	$62.45
Rate for Payer: Wellpoint Medicaid Managed Care	$68.67

PLATE DHS 38MM 8 HL 150 DEG

Facility

$2,591.25

Hospital Charge Code	270603828
Hospital Revenue Code	278
Min. Negotiated Rate	$388.69
Max. Negotiated Rate	$627.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$518.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$627.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$570.08
Rate for Payer: Qualcare PPO/HMO/WC	$388.69

PLATE DHS 4 HL 135 DEG

Facility

$2,000.85

Hospital Charge Code	270607094
Hospital Revenue Code	278
Min. Negotiated Rate	$300.13
Max. Negotiated Rate	$484.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.19
Rate for Payer: Qualcare PPO/HMO/WC	$300.13

PLATE DHS 4 HL 135 DEG

Facility

$2,000.85

Hospital Charge Code	270607094
Hospital Revenue Code	278
Min. Negotiated Rate	$48.22
Max. Negotiated Rate	$1,000.42
Rate for Payer: Aetna Commercial	$760.32
Rate for Payer: Aetna Medicare Advantage	$600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.22
Rate for Payer: Cigna Commercial	$1,000.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.19
Rate for Payer: Qualcare PPO/HMO/WC	$300.13
Rate for Payer: UnitedHealthcare Community & State	$48.22
Rate for Payer: Wellpoint Medicaid Managed Care	$53.02

PLATE DHS ST BAR 2 HL 135 DEG

Facility

$2,576.00

Hospital Charge Code	270603806
Hospital Revenue Code	278
Min. Negotiated Rate	$386.40
Max. Negotiated Rate	$623.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$515.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$623.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$566.72
Rate for Payer: Qualcare PPO/HMO/WC	$386.40

PLATE DHS ST BAR 2 HL 135 DEG

Facility

$2,576.00

Hospital Charge Code	270603806
Hospital Revenue Code	278
Min. Negotiated Rate	$62.08
Max. Negotiated Rate	$1,288.00
Rate for Payer: Aetna Commercial	$978.88
Rate for Payer: Aetna Medicare Advantage	$772.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$656.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$656.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$515.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$656.88
Rate for Payer: Cigna Commercial	$1,288.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$623.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$566.72
Rate for Payer: Qualcare PPO/HMO/WC	$386.40
Rate for Payer: UnitedHealthcare Community & State	$62.08
Rate for Payer: Wellpoint Medicaid Managed Care	$68.26

PLATE DHS ST BAR 4 HL 130 DEG

Facility

$1,932.00

Hospital Charge Code	270603803
Hospital Revenue Code	278
Min. Negotiated Rate	$46.56
Max. Negotiated Rate	$966.00
Rate for Payer: Aetna Commercial	$734.16
Rate for Payer: Aetna Medicare Advantage	$579.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.66
Rate for Payer: Cigna Commercial	$966.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80
Rate for Payer: UnitedHealthcare Community & State	$46.56
Rate for Payer: Wellpoint Medicaid Managed Care	$51.20

PLATE DHS ST BAR 4 HL 130 DEG

Facility

$1,932.00

Hospital Charge Code	270603803
Hospital Revenue Code	278
Min. Negotiated Rate	$289.80
Max. Negotiated Rate	$467.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$425.04
Rate for Payer: Qualcare PPO/HMO/WC	$289.80

Know your out-of-pocket cost for care.

All Charges