Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE SYN 1/3 TUB 6H

Facility

$240.85

Hospital Charge Code	270604303
Hospital Revenue Code	278
Min. Negotiated Rate	$36.13
Max. Negotiated Rate	$58.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.99
Rate for Payer: Qualcare PPO/HMO/WC	$36.13

PLATE SYN 1/3 TUB 7H

Facility

$240.85

Hospital Charge Code	270604304
Hospital Revenue Code	278
Min. Negotiated Rate	$36.13
Max. Negotiated Rate	$58.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.99
Rate for Payer: Qualcare PPO/HMO/WC	$36.13

PLATE SYN 1/3 TUB 7H

Facility

$240.85

Hospital Charge Code	270604304
Hospital Revenue Code	278
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$120.42
Rate for Payer: Aetna Commercial	$91.52
Rate for Payer: Aetna Medicare Advantage	$72.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.42
Rate for Payer: Cigna Commercial	$120.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.99
Rate for Payer: Qualcare PPO/HMO/WC	$36.13
Rate for Payer: UnitedHealthcare Community & State	$5.80
Rate for Payer: Wellpoint Medicaid Managed Care	$6.38

PLATE SYN 1/3 TUB 8H

Facility

$248.85

Hospital Charge Code	270604305
Hospital Revenue Code	278
Min. Negotiated Rate	$37.33
Max. Negotiated Rate	$60.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.75
Rate for Payer: Qualcare PPO/HMO/WC	$37.33

PLATE SYN 1/3 TUB 8H

Facility

$248.85

Hospital Charge Code	270604305
Hospital Revenue Code	278
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$124.42
Rate for Payer: Aetna Commercial	$94.56
Rate for Payer: Aetna Medicare Advantage	$74.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.46
Rate for Payer: Cigna Commercial	$124.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.75
Rate for Payer: Qualcare PPO/HMO/WC	$37.33
Rate for Payer: UnitedHealthcare Community & State	$6.00
Rate for Payer: Wellpoint Medicaid Managed Care	$6.59

PLATE SYN 1/3 TUB 8H 236108

Facility

$222.30

Service Code	HCPCS C1713
Hospital Charge Code	270607164
Hospital Revenue Code	278
Min. Negotiated Rate	$5.36
Max. Negotiated Rate	$111.15
Rate for Payer: Aetna Commercial	$84.47
Rate for Payer: Aetna Medicare Advantage	$66.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.69
Rate for Payer: Cigna Commercial	$111.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$48.91
Rate for Payer: Qualcare PPO/HMO/WC	$33.34
Rate for Payer: UnitedHealthcare Community & State	$5.36
Rate for Payer: Wellpoint Medicaid Managed Care	$5.89

PLATE SYN 1/3 TUB 8H 236108

Facility

$222.30

Service Code	HCPCS C1713
Hospital Charge Code	270607164
Hospital Revenue Code	278
Min. Negotiated Rate	$33.34
Max. Negotiated Rate	$53.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$48.91
Rate for Payer: Qualcare PPO/HMO/WC	$33.34

PLATE SYN 1/3 TUB 9H

Facility

$248.85

Hospital Charge Code	270604306
Hospital Revenue Code	278
Min. Negotiated Rate	$37.33
Max. Negotiated Rate	$60.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.75
Rate for Payer: Qualcare PPO/HMO/WC	$37.33

PLATE SYN 1/3 TUB 9H

Facility

$307.25

Hospital Charge Code	270601909
Hospital Revenue Code	278
Min. Negotiated Rate	$7.40
Max. Negotiated Rate	$153.62
Rate for Payer: Aetna Commercial	$116.75
Rate for Payer: Aetna Medicare Advantage	$92.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.35
Rate for Payer: Cigna Commercial	$153.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.59
Rate for Payer: Qualcare PPO/HMO/WC	$46.09
Rate for Payer: UnitedHealthcare Community & State	$7.40
Rate for Payer: Wellpoint Medicaid Managed Care	$8.14

PLATE SYN 1/3 TUB 9H

Facility

$307.25

Hospital Charge Code	270601909
Hospital Revenue Code	278
Min. Negotiated Rate	$46.09
Max. Negotiated Rate	$74.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.59
Rate for Payer: Qualcare PPO/HMO/WC	$46.09

PLATE SYN 1/3 TUB 9H

Facility

$248.85

Hospital Charge Code	270604306
Hospital Revenue Code	278
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$124.42
Rate for Payer: Aetna Commercial	$94.56
Rate for Payer: Aetna Medicare Advantage	$74.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.46
Rate for Payer: Cigna Commercial	$124.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.22
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$54.75
Rate for Payer: Qualcare PPO/HMO/WC	$37.33
Rate for Payer: UnitedHealthcare Community & State	$6.00
Rate for Payer: Wellpoint Medicaid Managed Care	$6.59

PLATE SYN 1/3 TUBL 3 HL

Facility

$54.95

Hospital Charge Code	1602903
Hospital Revenue Code	274
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$27.48
Rate for Payer: Aetna Commercial	$20.88
Rate for Payer: Aetna Medicare Advantage	$16.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.01
Rate for Payer: Cigna Commercial	$27.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.09
Rate for Payer: Qualcare PPO/HMO/WC	$8.24
Rate for Payer: UnitedHealthcare Community & State	$1.32
Rate for Payer: Wellpoint Medicaid Managed Care	$1.46

PLATE SYN 1/3 TUBL 3 HL

Facility

$54.95

Hospital Charge Code	1602903
Hospital Revenue Code	274
Min. Negotiated Rate	$8.24
Max. Negotiated Rate	$13.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.09
Rate for Payer: Qualcare PPO/HMO/WC	$8.24

PLATE SYN 1/3 TUBL 4 HL

Facility

$61.15

Hospital Charge Code	1602911
Hospital Revenue Code	274
Min. Negotiated Rate	$9.17
Max. Negotiated Rate	$14.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.17

PLATE SYN 1/3 TUBL 4 HL

Facility

$61.15

Hospital Charge Code	1602911
Hospital Revenue Code	274
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$30.57
Rate for Payer: Aetna Commercial	$23.24
Rate for Payer: Aetna Medicare Advantage	$18.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.59
Rate for Payer: Cigna Commercial	$30.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.17
Rate for Payer: UnitedHealthcare Community & State	$1.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.62

PLATE SYN 1/3 TUBL 5 HL

Facility

$64.25

Hospital Charge Code	1602929
Hospital Revenue Code	274
Min. Negotiated Rate	$1.55
Max. Negotiated Rate	$32.12
Rate for Payer: Aetna Commercial	$24.41
Rate for Payer: Aetna Medicare Advantage	$19.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.38
Rate for Payer: Cigna Commercial	$32.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.13
Rate for Payer: Qualcare PPO/HMO/WC	$9.64
Rate for Payer: UnitedHealthcare Community & State	$1.55
Rate for Payer: Wellpoint Medicaid Managed Care	$1.70

PLATE SYN 1/3 TUBL 5 HL

Facility

$64.25

Hospital Charge Code	1602929
Hospital Revenue Code	274
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.13
Rate for Payer: Qualcare PPO/HMO/WC	$9.64

PLATE SYN 1/3 TUBL 6 HL

Facility

$66.35

Hospital Charge Code	1602937
Hospital Revenue Code	274
Min. Negotiated Rate	$9.95
Max. Negotiated Rate	$16.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.95

PLATE SYN 1/3 TUBL 6 HL

Facility

$66.35

Hospital Charge Code	1602937
Hospital Revenue Code	274
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$33.17
Rate for Payer: Aetna Commercial	$25.21
Rate for Payer: Aetna Medicare Advantage	$19.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.92
Rate for Payer: Cigna Commercial	$33.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.95
Rate for Payer: UnitedHealthcare Community & State	$1.60
Rate for Payer: Wellpoint Medicaid Managed Care	$1.76

PLATE SYN 1/3 TUBL 7&8 HL

Facility

$73.85

Hospital Charge Code	1602945
Hospital Revenue Code	274
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$17.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.08

PLATE SYN 1/3 TUBL 7&8 HL

Facility

$73.85

Hospital Charge Code	1602945
Hospital Revenue Code	274
Min. Negotiated Rate	$1.78
Max. Negotiated Rate	$36.92
Rate for Payer: Aetna Commercial	$28.06
Rate for Payer: Aetna Medicare Advantage	$22.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.83
Rate for Payer: Cigna Commercial	$36.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$16.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.08
Rate for Payer: UnitedHealthcare Community & State	$1.78
Rate for Payer: Wellpoint Medicaid Managed Care	$1.96

PLATE SYN 1/4 TUB 4H

Facility

$240.85

Hospital Charge Code	270604317
Hospital Revenue Code	278
Min. Negotiated Rate	$36.13
Max. Negotiated Rate	$58.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.99
Rate for Payer: Qualcare PPO/HMO/WC	$36.13

PLATE SYN 1/4 TUB 4H

Facility

$240.85

Hospital Charge Code	270604317
Hospital Revenue Code	278
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$120.42
Rate for Payer: Aetna Commercial	$91.52
Rate for Payer: Aetna Medicare Advantage	$72.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.42
Rate for Payer: Cigna Commercial	$120.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.99
Rate for Payer: Qualcare PPO/HMO/WC	$36.13
Rate for Payer: UnitedHealthcare Community & State	$5.80
Rate for Payer: Wellpoint Medicaid Managed Care	$6.38

PLATE SYN 1/4 TUB 5H

Facility

$259.25

Hospital Charge Code	270604318
Hospital Revenue Code	278
Min. Negotiated Rate	$38.89
Max. Negotiated Rate	$62.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$57.03
Rate for Payer: Qualcare PPO/HMO/WC	$38.89

PLATE SYN 1/4 TUB 5H

Facility

$259.25

Hospital Charge Code	270604318
Hospital Revenue Code	278
Min. Negotiated Rate	$6.25
Max. Negotiated Rate	$129.62
Rate for Payer: Aetna Commercial	$98.52
Rate for Payer: Aetna Medicare Advantage	$77.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.11
Rate for Payer: Cigna Commercial	$129.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$57.03
Rate for Payer: Qualcare PPO/HMO/WC	$38.89
Rate for Payer: UnitedHealthcare Community & State	$6.25
Rate for Payer: Wellpoint Medicaid Managed Care	$6.87

Know your out-of-pocket cost for care.

All Charges