Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE SYN 1/4 TUB 8H

Facility

$315.25

Hospital Charge Code	270604321
Hospital Revenue Code	278
Min. Negotiated Rate	$47.29
Max. Negotiated Rate	$76.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$69.36
Rate for Payer: Qualcare PPO/HMO/WC	$47.29

PLATE SYN 1/4 TUB 8H

Facility

$315.25

Hospital Charge Code	270604321
Hospital Revenue Code	278
Min. Negotiated Rate	$7.60
Max. Negotiated Rate	$157.62
Rate for Payer: Aetna Commercial	$119.80
Rate for Payer: Aetna Medicare Advantage	$94.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.39
Rate for Payer: Cigna Commercial	$157.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$69.36
Rate for Payer: Qualcare PPO/HMO/WC	$47.29
Rate for Payer: UnitedHealthcare Community & State	$7.60
Rate for Payer: Wellpoint Medicaid Managed Care	$8.35

PLATE SYN 1/4 TUB TT 3H

Facility

$289.65

Hospital Charge Code	270603408
Hospital Revenue Code	278
Min. Negotiated Rate	$43.45
Max. Negotiated Rate	$70.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$63.72
Rate for Payer: Qualcare PPO/HMO/WC	$43.45

PLATE SYN 1/4 TUB TT 3H

Facility

$289.65

Hospital Charge Code	270603408
Hospital Revenue Code	278
Min. Negotiated Rate	$6.98
Max. Negotiated Rate	$144.82
Rate for Payer: Aetna Commercial	$110.07
Rate for Payer: Aetna Medicare Advantage	$86.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.86
Rate for Payer: Cigna Commercial	$144.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$63.72
Rate for Payer: Qualcare PPO/HMO/WC	$43.45
Rate for Payer: UnitedHealthcare Community & State	$6.98
Rate for Payer: Wellpoint Medicaid Managed Care	$7.68

PLATE SYN 1/4 TUB TT 4H

Facility

$307.25

Hospital Charge Code	270604067
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 1/4 TUB TT 4H

Facility

$307.25

Hospital Charge Code	270604067
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 1/4 TUB TT 5H

Facility

$323.25

Hospital Charge Code	270604070
Hospital Revenue Code	278
Min. Negotiated Rate	$48.49
Max. Negotiated Rate	$78.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$71.11
Rate for Payer: Qualcare PPO/HMO/WC	$48.49

PLATE SYN 1/4 TUB TT 5H

Facility

$323.25

Hospital Charge Code	270604070
Hospital Revenue Code	278
Min. Negotiated Rate	$7.79
Max. Negotiated Rate	$161.62
Rate for Payer: Aetna Commercial	$122.83
Rate for Payer: Aetna Medicare Advantage	$96.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.43
Rate for Payer: Cigna Commercial	$161.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$71.11
Rate for Payer: Qualcare PPO/HMO/WC	$48.49
Rate for Payer: UnitedHealthcare Community & State	$7.79
Rate for Payer: Wellpoint Medicaid Managed Care	$8.57

PLATE SYN 1/4 TUB TT 6H

Facility

$348.85

Hospital Charge Code	270604071
Hospital Revenue Code	278
Min. Negotiated Rate	$52.33
Max. Negotiated Rate	$84.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$76.75
Rate for Payer: Qualcare PPO/HMO/WC	$52.33

PLATE SYN 1/4 TUB TT 6H

Facility

$348.85

Hospital Charge Code	270604071
Hospital Revenue Code	278
Min. Negotiated Rate	$8.41
Max. Negotiated Rate	$174.43
Rate for Payer: Aetna Commercial	$132.56
Rate for Payer: Aetna Medicare Advantage	$104.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.96
Rate for Payer: Cigna Commercial	$174.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$76.75
Rate for Payer: Qualcare PPO/HMO/WC	$52.33
Rate for Payer: UnitedHealthcare Community & State	$8.41
Rate for Payer: Wellpoint Medicaid Managed Care	$9.24

PLATE SYN 1/4 TUB TT 7H

Facility

$307.25

Hospital Charge Code	270603412
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 1/4 TUB TT 7H

Facility

$307.25

Hospital Charge Code	270603412
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 1/4 TUB TT 7H

Facility

$374.45

Hospital Charge Code	270604072
Hospital Revenue Code	278
Min. Negotiated Rate	$9.02
Max. Negotiated Rate	$187.22
Rate for Payer: Aetna Commercial	$142.29
Rate for Payer: Aetna Medicare Advantage	$112.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.48
Rate for Payer: Cigna Commercial	$187.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.38
Rate for Payer: Qualcare PPO/HMO/WC	$56.17
Rate for Payer: UnitedHealthcare Community & State	$9.02
Rate for Payer: Wellpoint Medicaid Managed Care	$9.92

PLATE SYN 1/4 TUB TT 7H

Facility

$374.45

Hospital Charge Code	270604072
Hospital Revenue Code	278
Min. Negotiated Rate	$56.17
Max. Negotiated Rate	$90.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.38
Rate for Payer: Qualcare PPO/HMO/WC	$56.17

PLATE SYN 1/4 TUB TT 8H

Facility

$388.85

Hospital Charge Code	270604073
Hospital Revenue Code	278
Min. Negotiated Rate	$9.37
Max. Negotiated Rate	$194.43
Rate for Payer: Aetna Commercial	$147.76
Rate for Payer: Aetna Medicare Advantage	$116.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.16
Rate for Payer: Cigna Commercial	$194.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$85.55
Rate for Payer: Qualcare PPO/HMO/WC	$58.33
Rate for Payer: UnitedHealthcare Community & State	$9.37
Rate for Payer: Wellpoint Medicaid Managed Care	$10.30

PLATE SYN 1/4 TUB TT 8H

Facility

$388.85

Hospital Charge Code	270604073
Hospital Revenue Code	278
Min. Negotiated Rate	$58.33
Max. Negotiated Rate	$94.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$85.55
Rate for Payer: Qualcare PPO/HMO/WC	$58.33

PLATE SYN 1/4 TUB TT 8H

Facility

$315.25

Hospital Charge Code	270603413
Hospital Revenue Code	278
Min. Negotiated Rate	$7.60
Max. Negotiated Rate	$157.62
Rate for Payer: Aetna Commercial	$119.80
Rate for Payer: Aetna Medicare Advantage	$94.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.39
Rate for Payer: Cigna Commercial	$157.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$69.36
Rate for Payer: Qualcare PPO/HMO/WC	$47.29
Rate for Payer: UnitedHealthcare Community & State	$7.60
Rate for Payer: Wellpoint Medicaid Managed Care	$8.35

PLATE SYN 1/4 TUB TT 8H

Facility

$315.25

Hospital Charge Code	270603413
Hospital Revenue Code	278
Min. Negotiated Rate	$47.29
Max. Negotiated Rate	$76.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$69.36
Rate for Payer: Qualcare PPO/HMO/WC	$47.29

PLATE SYN 3.5 10H

Facility

$715.25

Hospital Charge Code	270601899
Hospital Revenue Code	278
Min. Negotiated Rate	$17.24
Max. Negotiated Rate	$357.62
Rate for Payer: Aetna Commercial	$271.80
Rate for Payer: Aetna Medicare Advantage	$214.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.39
Rate for Payer: Cigna Commercial	$357.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$157.35
Rate for Payer: Qualcare PPO/HMO/WC	$107.29
Rate for Payer: UnitedHealthcare Community & State	$17.24
Rate for Payer: Wellpoint Medicaid Managed Care	$18.95

PLATE SYN 3.5 10H

Facility

$715.25

Hospital Charge Code	270601899
Hospital Revenue Code	278
Min. Negotiated Rate	$107.29
Max. Negotiated Rate	$173.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$157.35
Rate for Payer: Qualcare PPO/HMO/WC	$107.29

PLATE SYN 3.5 10 HL

Facility

$414.00

Hospital Charge Code	1603794
Hospital Revenue Code	274
Min. Negotiated Rate	$62.10
Max. Negotiated Rate	$100.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$91.08
Rate for Payer: Qualcare PPO/HMO/WC	$62.10

PLATE SYN 3.5 10 HL

Facility

$414.00

Hospital Charge Code	1603794
Hospital Revenue Code	274
Min. Negotiated Rate	$9.98
Max. Negotiated Rate	$207.00
Rate for Payer: Aetna Commercial	$157.32
Rate for Payer: Aetna Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.57
Rate for Payer: Cigna Commercial	$207.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$91.08
Rate for Payer: Qualcare PPO/HMO/WC	$62.10
Rate for Payer: UnitedHealthcare Community & State	$9.98
Rate for Payer: Wellpoint Medicaid Managed Care	$10.97

PLATE SYN 3.5 6 HL 423.56

Facility

$349.00

Hospital Charge Code	1603752
Hospital Revenue Code	274
Min. Negotiated Rate	$8.41
Max. Negotiated Rate	$174.50
Rate for Payer: Aetna Commercial	$132.62
Rate for Payer: Aetna Medicare Advantage	$104.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.00
Rate for Payer: Cigna Commercial	$174.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$76.78
Rate for Payer: Qualcare PPO/HMO/WC	$52.35
Rate for Payer: UnitedHealthcare Community & State	$8.41
Rate for Payer: Wellpoint Medicaid Managed Care	$9.25

PLATE SYN 3.5 6 HL 423.56

Facility

$349.00

Hospital Charge Code	1603752
Hospital Revenue Code	274
Min. Negotiated Rate	$52.35
Max. Negotiated Rate	$84.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$76.78
Rate for Payer: Qualcare PPO/HMO/WC	$52.35

PLATE SYN 3.5 7 HL 423.57

Facility

$369.00

Hospital Charge Code	1603760
Hospital Revenue Code	274
Min. Negotiated Rate	$55.35
Max. Negotiated Rate	$89.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$81.18
Rate for Payer: Qualcare PPO/HMO/WC	$55.35

Know your out-of-pocket cost for care.

All Charges