Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ROOM & BOARD CCIS - ISOLATION

Facility

$18,000.00

Hospital Charge Code	100803
Hospital Revenue Code	164
Min. Negotiated Rate	$2,700.00
Max. Negotiated Rate	$6,764.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,764.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.00

ROOM & BOARD CCU

Facility

$20,000.00

Hospital Charge Code	100149
Hospital Revenue Code	219
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$6,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD CRITICAL CAR 9E

Facility

$18,000.00

Hospital Charge Code	100931
Hospital Revenue Code	211
Min. Negotiated Rate	$2,700.00
Max. Negotiated Rate	$6,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.00

ROOM & BOARD ENDOSCOPY

Facility

$2,236.00

Hospital Charge Code	100156
Hospital Revenue Code	499
Min. Negotiated Rate	$53.89
Max. Negotiated Rate	$1,118.00
Rate for Payer: Aetna Commercial	$849.68
Rate for Payer: Aetna Medicare Advantage	$670.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.18
Rate for Payer: Cigna Commercial	$1,118.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$670.80
Rate for Payer: Qualcare PPO/HMO/WC	$335.40
Rate for Payer: UnitedHealthcare Community & State	$53.89
Rate for Payer: Wellpoint Medicaid Managed Care	$59.25

ROOM & BOARD ENDOSCOPY

Facility

$2,236.00

Hospital Charge Code	100156
Hospital Revenue Code	499
Min. Negotiated Rate	$335.40
Max. Negotiated Rate	$335.40
Rate for Payer: Qualcare PPO/HMO/WC	$335.40

ROOM & BOARD ER

Facility

$18,000.00

Hospital Charge Code	100131
Hospital Revenue Code	121
Min. Negotiated Rate	$2,312.00
Max. Negotiated Rate	$6,764.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,312.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,764.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.00

ROOM & BOARD ERH-SEMI PRIVATE

Facility

$18,000.00

Hospital Charge Code	100804
Hospital Revenue Code	169
Min. Negotiated Rate	$2,700.00
Max. Negotiated Rate	$6,764.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,764.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,700.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100952
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100968
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100943
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100963
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100944
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100950
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100947
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100948
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100949
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100966
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100946
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100953
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100956
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100962
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100958
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100957
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100961
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

ROOM & BOARD ICU

Facility

$20,000.00

Hospital Charge Code	100960
Hospital Revenue Code	200
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$8,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,793.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

Know your out-of-pocket cost for care.

All Charges