Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PROCARDIA XL/60MG/TAB

Facility

$13.00

Hospital Charge Code	60635878
Hospital Revenue Code	259
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

PROCARDIA XL/60MG/TAB

Facility

$18.00

Hospital Charge Code	60633742
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

PROCARDIA XL/60MG/TAB

Facility

$18.00

Hospital Charge Code	60633742
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

PROCARDIA XL/60MG/TAB

Facility

$13.00

Hospital Charge Code	60635878
Hospital Revenue Code	259
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

PROCARDIA XL/90MG/TAB

Facility

$18.00

Hospital Charge Code	60633743
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

PROCARDIA XL/90MG/TAB

Facility

$18.00

Hospital Charge Code	60633743
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

PROCEDURE FOOT ANKLE

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270690331
Hospital Revenue Code	278
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Community & State	$180.75
Rate for Payer: Wellpoint Medicaid Managed Care	$198.75

PROCEDURE FOOT ANKLE

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270690331
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

PROCEDURE PLATELET SEALANT

Facility

$2,340.00

Hospital Charge Code	270646504
Hospital Revenue Code	272
Min. Negotiated Rate	$351.00
Max. Negotiated Rate	$351.00
Rate for Payer: Qualcare PPO/HMO/WC	$351.00

PROCEDURE PLATELET SEALANT

Facility

$2,340.00

Hospital Charge Code	270646504
Hospital Revenue Code	272
Min. Negotiated Rate	$56.39
Max. Negotiated Rate	$1,170.00
Rate for Payer: Aetna Commercial	$889.20
Rate for Payer: Aetna Medicare Advantage	$702.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$596.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$596.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$596.70
Rate for Payer: Cigna Commercial	$1,170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$702.00
Rate for Payer: Oxford Commercial	$468.00
Rate for Payer: Qualcare PPO/HMO/WC	$351.00
Rate for Payer: UnitedHealthcare Commercial	$468.00
Rate for Payer: UnitedHealthcare Community & State	$56.39
Rate for Payer: Wellpoint Medicaid Managed Care	$62.01

PROCEDURE SCREW KIT

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270701838
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

PROCEDURE SCREW KIT

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270701838
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

PROCEDURES FOR OBESITY

Facility

$24,099.18

Service Code	APR-DRG 4033
Min. Negotiated Rate	$23,626.65
Max. Negotiated Rate	$24,099.18
Rate for Payer: UnitedHealthcare Community & State	$23,626.65
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,099.18
Rate for Payer: Wellpoint Medicaid Managed Care	$23,626.65

PROCEDURES FOR OBESITY

Facility

$16,211.67

Service Code	APR-DRG 4032
Min. Negotiated Rate	$15,893.79
Max. Negotiated Rate	$16,211.67
Rate for Payer: UnitedHealthcare Community & State	$15,893.79
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,211.67
Rate for Payer: Wellpoint Medicaid Managed Care	$15,893.79

PROCEDURES FOR OBESITY

Facility

$14,129.38

Service Code	APR-DRG 4031
Min. Negotiated Rate	$13,852.33
Max. Negotiated Rate	$14,129.38
Rate for Payer: UnitedHealthcare Community & State	$13,852.33
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,129.38
Rate for Payer: Wellpoint Medicaid Managed Care	$13,852.33

PROCEDURES FOR OBESITY

Facility

$52,343.83

Service Code	APR-DRG 4034
Min. Negotiated Rate	$51,317.48
Max. Negotiated Rate	$52,343.83
Rate for Payer: UnitedHealthcare Community & State	$51,317.48
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$52,343.83
Rate for Payer: Wellpoint Medicaid Managed Care	$51,317.48

PROCEDURE TRACHEA BRONCHI UNL

Facility

$3,260.14

Service Code	HCPCS 31899
Hospital Charge Code	1600000407
Hospital Revenue Code	360
Min. Negotiated Rate	$78.57
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$645.02
Rate for Payer: Aetna Medicare Advantage	$768.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$237.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$856.00
Rate for Payer: Cigna Commercial	$475.34
Rate for Payer: Cigna Medicare Advantage	$237.14
Rate for Payer: Clover Medicare Advantage	$225.28
Rate for Payer: EmblemHealth Commercial	$711.42
Rate for Payer: Humana Medicare Advantage	$244.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$237.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$978.04
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$489.02
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$78.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$237.14
Rate for Payer: Wellcare Medicare Advantage	$237.14
Rate for Payer: Wellpoint Medicaid Managed Care	$86.39

PROCEDURE TRACHEA BRONCHI UNL

Facility

$3,260.14

Service Code	HCPCS 31899
Hospital Charge Code	1600000407
Hospital Revenue Code	360
Min. Negotiated Rate	$489.02
Max. Negotiated Rate	$489.02
Rate for Payer: Qualcare PPO/HMO/WC	$489.02

PROCEDURE TRACHEA BRONCHI UNL

Facility

$3,260.14

Service Code	HCPCS 31899
Hospital Charge Code	16000925
Hospital Revenue Code	360
Min. Negotiated Rate	$489.02
Max. Negotiated Rate	$489.02
Rate for Payer: Qualcare PPO/HMO/WC	$489.02

PROCEDURE TRACHEA BRONCHI UNL

Facility

$3,260.14

Service Code	HCPCS 31899
Hospital Charge Code	16000925
Hospital Revenue Code	360
Min. Negotiated Rate	$78.57
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$645.02
Rate for Payer: Aetna Medicare Advantage	$768.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$237.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$856.00
Rate for Payer: Cigna Commercial	$475.34
Rate for Payer: Cigna Medicare Advantage	$237.14
Rate for Payer: Clover Medicare Advantage	$225.28
Rate for Payer: EmblemHealth Commercial	$711.42
Rate for Payer: Humana Medicare Advantage	$244.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$237.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$978.04
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$489.02
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$78.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$237.14
Rate for Payer: Wellcare Medicare Advantage	$237.14
Rate for Payer: Wellpoint Medicaid Managed Care	$86.39

PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES

Facility

$77,221.79

Service Code	APR-DRG 8504
Min. Negotiated Rate	$75,707.64
Max. Negotiated Rate	$77,221.79
Rate for Payer: UnitedHealthcare Community & State	$75,707.64
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$77,221.79
Rate for Payer: Wellpoint Medicaid Managed Care	$75,707.64

PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES

Facility

$34,487.76

Service Code	APR-DRG 8503
Min. Negotiated Rate	$33,811.53
Max. Negotiated Rate	$34,487.76
Rate for Payer: UnitedHealthcare Community & State	$33,811.53
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$34,487.76
Rate for Payer: Wellpoint Medicaid Managed Care	$33,811.53

PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES

Facility

$27,685.44

Service Code	APR-DRG 8502
Min. Negotiated Rate	$27,142.59
Max. Negotiated Rate	$27,685.44
Rate for Payer: UnitedHealthcare Community & State	$27,142.59
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27,685.44
Rate for Payer: Wellpoint Medicaid Managed Care	$27,142.59

PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES

Facility

$20,823.17

Service Code	APR-DRG 8501
Min. Negotiated Rate	$20,414.87
Max. Negotiated Rate	$20,823.17
Rate for Payer: UnitedHealthcare Community & State	$20,414.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,823.17
Rate for Payer: Wellpoint Medicaid Managed Care	$20,414.87

PROCELLERA DRESSING 1.5X 10

Facility

$187.50

Hospital Charge Code	270332707
Hospital Revenue Code	272
Min. Negotiated Rate	$28.12
Max. Negotiated Rate	$28.12
Rate for Payer: Qualcare PPO/HMO/WC	$28.12

Know your out-of-pocket cost for care.

All Charges