Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE FRLOK COMP 3 HL 145 DEG

Facility

$1,075.00

Hospital Charge Code	1605344
Hospital Revenue Code	274
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.50
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

PLATE FRLOK COMP 3 HL 150 DEG

Facility

$723.00

Hospital Charge Code	1605302
Hospital Revenue Code	274
Min. Negotiated Rate	$17.42
Max. Negotiated Rate	$361.50
Rate for Payer: Aetna Commercial	$274.74
Rate for Payer: Aetna Medicare Advantage	$216.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.37
Rate for Payer: Cigna Commercial	$361.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.06
Rate for Payer: Qualcare PPO/HMO/WC	$108.45
Rate for Payer: UnitedHealthcare Community & State	$17.42
Rate for Payer: Wellpoint Medicaid Managed Care	$19.16

PLATE FRLOK COMP 3 HL 150 DEG

Facility

$723.00

Hospital Charge Code	1605302
Hospital Revenue Code	274
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$174.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.06
Rate for Payer: Qualcare PPO/HMO/WC	$108.45

PLATE FRLOK COMP 5 HL 130 DEG

Facility

$1,146.00

Hospital Charge Code	1605435
Hospital Revenue Code	274
Min. Negotiated Rate	$27.62
Max. Negotiated Rate	$573.00
Rate for Payer: Aetna Commercial	$435.48
Rate for Payer: Aetna Medicare Advantage	$343.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.23
Rate for Payer: Cigna Commercial	$573.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.12
Rate for Payer: Qualcare PPO/HMO/WC	$171.90
Rate for Payer: UnitedHealthcare Community & State	$27.62
Rate for Payer: Wellpoint Medicaid Managed Care	$30.37

PLATE FRLOK COMP 5 HL 130 DEG

Facility

$1,146.00

Hospital Charge Code	1605435
Hospital Revenue Code	274
Min. Negotiated Rate	$171.90
Max. Negotiated Rate	$277.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.12
Rate for Payer: Qualcare PPO/HMO/WC	$171.90

PLATE FRLOK COMP 5 HL 135 DEG

Facility

$1,146.00

Hospital Charge Code	1605401
Hospital Revenue Code	274
Min. Negotiated Rate	$171.90
Max. Negotiated Rate	$277.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.12
Rate for Payer: Qualcare PPO/HMO/WC	$171.90

PLATE FRLOK COMP 5 HL 135 DEG

Facility

$1,146.00

Hospital Charge Code	1605401
Hospital Revenue Code	274
Min. Negotiated Rate	$27.62
Max. Negotiated Rate	$573.00
Rate for Payer: Aetna Commercial	$435.48
Rate for Payer: Aetna Medicare Advantage	$343.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.23
Rate for Payer: Cigna Commercial	$573.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.12
Rate for Payer: Qualcare PPO/HMO/WC	$171.90
Rate for Payer: UnitedHealthcare Community & State	$27.62
Rate for Payer: Wellpoint Medicaid Managed Care	$30.37

PLATE FRLOK COMP 5 HL 145 DEG

Facility

$1,146.00

Hospital Charge Code	1605328
Hospital Revenue Code	274
Min. Negotiated Rate	$171.90
Max. Negotiated Rate	$277.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.12
Rate for Payer: Qualcare PPO/HMO/WC	$171.90

PLATE FRLOK COMP 5 HL 145 DEG

Facility

$1,146.00

Hospital Charge Code	1605328
Hospital Revenue Code	274
Min. Negotiated Rate	$27.62
Max. Negotiated Rate	$573.00
Rate for Payer: Aetna Commercial	$435.48
Rate for Payer: Aetna Medicare Advantage	$343.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.23
Rate for Payer: Cigna Commercial	$573.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.12
Rate for Payer: Qualcare PPO/HMO/WC	$171.90
Rate for Payer: UnitedHealthcare Community & State	$27.62
Rate for Payer: Wellpoint Medicaid Managed Care	$30.37

PLATE FRLOK COMP 5 HL 145 DEG

Facility

$1,146.00

Hospital Charge Code	1605377
Hospital Revenue Code	274
Min. Negotiated Rate	$27.62
Max. Negotiated Rate	$573.00
Rate for Payer: Aetna Commercial	$435.48
Rate for Payer: Aetna Medicare Advantage	$343.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.23
Rate for Payer: Cigna Commercial	$573.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.12
Rate for Payer: Qualcare PPO/HMO/WC	$171.90
Rate for Payer: UnitedHealthcare Community & State	$27.62
Rate for Payer: Wellpoint Medicaid Managed Care	$30.37

PLATE FRLOK COMP 5 HL 145 DEG

Facility

$1,146.00

Hospital Charge Code	1605377
Hospital Revenue Code	274
Min. Negotiated Rate	$171.90
Max. Negotiated Rate	$277.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.12
Rate for Payer: Qualcare PPO/HMO/WC	$171.90

PLATE FRLOK COMP 5 HL 150 DEG

Facility

$723.00

Hospital Charge Code	1605294
Hospital Revenue Code	274
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$174.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.06
Rate for Payer: Qualcare PPO/HMO/WC	$108.45

PLATE FRLOK COMP 5 HL 150 DEG

Facility

$723.00

Hospital Charge Code	1605294
Hospital Revenue Code	274
Min. Negotiated Rate	$17.42
Max. Negotiated Rate	$361.50
Rate for Payer: Aetna Commercial	$274.74
Rate for Payer: Aetna Medicare Advantage	$216.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.37
Rate for Payer: Cigna Commercial	$361.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.06
Rate for Payer: Qualcare PPO/HMO/WC	$108.45
Rate for Payer: UnitedHealthcare Community & State	$17.42
Rate for Payer: Wellpoint Medicaid Managed Care	$19.16

PLATE FRLOK COMP 6 HL 130 DEG

Facility

$1,146.00

Hospital Charge Code	1605427
Hospital Revenue Code	274
Min. Negotiated Rate	$27.62
Max. Negotiated Rate	$573.00
Rate for Payer: Aetna Commercial	$435.48
Rate for Payer: Aetna Medicare Advantage	$343.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.23
Rate for Payer: Cigna Commercial	$573.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.12
Rate for Payer: Qualcare PPO/HMO/WC	$171.90
Rate for Payer: UnitedHealthcare Community & State	$27.62
Rate for Payer: Wellpoint Medicaid Managed Care	$30.37

PLATE FRLOK COMP 6 HL 130 DEG

Facility

$1,146.00

Hospital Charge Code	1605427
Hospital Revenue Code	274
Min. Negotiated Rate	$171.90
Max. Negotiated Rate	$277.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.12
Rate for Payer: Qualcare PPO/HMO/WC	$171.90

PLATE FRLOK COMP 6 HL 140 DEG

Facility

$1,146.00

Hospital Charge Code	1605369
Hospital Revenue Code	274
Min. Negotiated Rate	$27.62
Max. Negotiated Rate	$573.00
Rate for Payer: Aetna Commercial	$435.48
Rate for Payer: Aetna Medicare Advantage	$343.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.23
Rate for Payer: Cigna Commercial	$573.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.12
Rate for Payer: Qualcare PPO/HMO/WC	$171.90
Rate for Payer: UnitedHealthcare Community & State	$27.62
Rate for Payer: Wellpoint Medicaid Managed Care	$30.37

PLATE FRLOK COMP 6 HL 140 DEG

Facility

$1,146.00

Hospital Charge Code	1605369
Hospital Revenue Code	274
Min. Negotiated Rate	$171.90
Max. Negotiated Rate	$277.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.12
Rate for Payer: Qualcare PPO/HMO/WC	$171.90

PLATE FRLOK COMP 6 HL 145 DEG

Facility

$1,146.00

Hospital Charge Code	1605336
Hospital Revenue Code	274
Min. Negotiated Rate	$171.90
Max. Negotiated Rate	$277.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.12
Rate for Payer: Qualcare PPO/HMO/WC	$171.90

PLATE FRLOK COMP 6 HL 145 DEG

Facility

$1,146.00

Hospital Charge Code	1605336
Hospital Revenue Code	274
Min. Negotiated Rate	$27.62
Max. Negotiated Rate	$573.00
Rate for Payer: Aetna Commercial	$435.48
Rate for Payer: Aetna Medicare Advantage	$343.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.23
Rate for Payer: Cigna Commercial	$573.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.12
Rate for Payer: Qualcare PPO/HMO/WC	$171.90
Rate for Payer: UnitedHealthcare Community & State	$27.62
Rate for Payer: Wellpoint Medicaid Managed Care	$30.37

PLATE FRLOK COMP 6 HL 160 DEG

Facility

$723.00

Hospital Charge Code	1605252
Hospital Revenue Code	274
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$174.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.06
Rate for Payer: Qualcare PPO/HMO/WC	$108.45

PLATE FRLOK COMP 6 HL 160 DEG

Facility

$723.00

Hospital Charge Code	1605252
Hospital Revenue Code	274
Min. Negotiated Rate	$17.42
Max. Negotiated Rate	$361.50
Rate for Payer: Aetna Commercial	$274.74
Rate for Payer: Aetna Medicare Advantage	$216.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.37
Rate for Payer: Cigna Commercial	$361.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.06
Rate for Payer: Qualcare PPO/HMO/WC	$108.45
Rate for Payer: UnitedHealthcare Community & State	$17.42
Rate for Payer: Wellpoint Medicaid Managed Care	$19.16

PLATE FRLOK COMP 8 HL 130 DEG

Facility

$1,146.00

Hospital Charge Code	1605419
Hospital Revenue Code	274
Min. Negotiated Rate	$27.62
Max. Negotiated Rate	$573.00
Rate for Payer: Aetna Commercial	$435.48
Rate for Payer: Aetna Medicare Advantage	$343.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.23
Rate for Payer: Cigna Commercial	$573.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.12
Rate for Payer: Qualcare PPO/HMO/WC	$171.90
Rate for Payer: UnitedHealthcare Community & State	$27.62
Rate for Payer: Wellpoint Medicaid Managed Care	$30.37

PLATE FRLOK COMP 8 HL 130 DEG

Facility

$1,146.00

Hospital Charge Code	1605419
Hospital Revenue Code	274
Min. Negotiated Rate	$171.90
Max. Negotiated Rate	$277.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$252.12
Rate for Payer: Qualcare PPO/HMO/WC	$171.90

PLATE FRLOK COMP 8 HL 140 DEG

Facility

$1,371.00

Hospital Charge Code	1605351
Hospital Revenue Code	274
Min. Negotiated Rate	$205.65
Max. Negotiated Rate	$331.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$301.62
Rate for Payer: Qualcare PPO/HMO/WC	$205.65

PLATE FRLOK COMP 8 HL 140 DEG

Facility

$1,371.00

Hospital Charge Code	1605351
Hospital Revenue Code	274
Min. Negotiated Rate	$33.04
Max. Negotiated Rate	$685.50
Rate for Payer: Aetna Commercial	$520.98
Rate for Payer: Aetna Medicare Advantage	$411.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.61
Rate for Payer: Cigna Commercial	$685.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$301.62
Rate for Payer: Qualcare PPO/HMO/WC	$205.65
Rate for Payer: UnitedHealthcare Community & State	$33.04
Rate for Payer: Wellpoint Medicaid Managed Care	$36.33

Know your out-of-pocket cost for care.

All Charges