Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCRW BNE LOCK 14Mx2.7M 5227014

Facility

$450.00

Hospital Charge Code	270640884
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SCRW BNE LOCK 14Mx2.7M 5227614

Facility

$525.00

Hospital Charge Code	270640887
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

SCRW BNE LOCK 14Mx2.7M 5227614

Facility

$525.00

Hospital Charge Code	270640887
Hospital Revenue Code	278
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

SCRW BNE LOCK 16Mx2.7M 5220616

Facility

$450.00

Hospital Charge Code	270640889
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SCRW BNE LOCK 16Mx2.7M 5220616

Facility

$450.00

Hospital Charge Code	270640889
Hospital Revenue Code	278
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Community & State	$10.85
Rate for Payer: Wellpoint Medicaid Managed Care	$11.93

SCRW BNE LOCK 16Mx2.7M 5227616

Facility

$525.00

Hospital Charge Code	270640886
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

SCRW BNE LOCK 16Mx2.7M 5227616

Facility

$525.00

Hospital Charge Code	270640886
Hospital Revenue Code	278
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

SCRW BNE LOCK 18Mx2.7M 5220618

Facility

$450.00

Hospital Charge Code	270640891
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SCRW BNE LOCK 18Mx2.7M 5220618

Facility

$450.00

Hospital Charge Code	270640891
Hospital Revenue Code	278
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Community & State	$10.85
Rate for Payer: Wellpoint Medicaid Managed Care	$11.93

SCRW BNE LOCK 18Mx2.7M 5227618

Facility

$450.00

Hospital Charge Code	270640888
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SCRW BNE LOCK 18Mx2.7M 5227618

Facility

$450.00

Hospital Charge Code	270640888
Hospital Revenue Code	278
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Community & State	$10.85
Rate for Payer: Wellpoint Medicaid Managed Care	$11.93

SCRW BON CORT 130x40HAB6013040

Facility

$808.50

Hospital Charge Code	270635001
Hospital Revenue Code	278
Min. Negotiated Rate	$19.48
Max. Negotiated Rate	$404.25
Rate for Payer: Aetna Commercial	$307.23
Rate for Payer: Aetna Medicare Advantage	$242.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$161.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.17
Rate for Payer: Cigna Commercial	$404.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$177.87
Rate for Payer: Qualcare PPO/HMO/WC	$121.28
Rate for Payer: UnitedHealthcare Community & State	$19.48
Rate for Payer: Wellpoint Medicaid Managed Care	$21.43

SCRW BON CORT 130x40HAB6013040

Facility

$808.50

Hospital Charge Code	270635001
Hospital Revenue Code	278
Min. Negotiated Rate	$121.28
Max. Negotiated Rate	$195.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$161.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$177.87
Rate for Payer: Qualcare PPO/HMO/WC	$121.28

SCRW CANC FT 4.0 X 65MM NS

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270704929
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCRW CANC FT 4.0 X 65MM NS

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270704929
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

SCRW CANLTD 2.3mmx11mm 2642311

Facility

$575.00

Hospital Charge Code	270643919
Hospital Revenue Code	278
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Community & State	$13.86
Rate for Payer: Wellpoint Medicaid Managed Care	$15.24

SCRW CANLTD 2.3mmx11mm 2642311

Facility

$575.00

Hospital Charge Code	270643919
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

SCRW CANLTD 2.3mmx18mm 2642318

Facility

$575.00

Hospital Charge Code	270643920
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

SCRW CANLTD 2.3mmx18mm 2642318

Facility

$575.00

Hospital Charge Code	270643920
Hospital Revenue Code	278
Min. Negotiated Rate	$13.86
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Community & State	$13.86
Rate for Payer: Wellpoint Medicaid Managed Care	$15.24

SCRW CANN MATRIX 6.0MM 35MM

Facility

$9,715.00

Hospital Charge Code	270656696
Hospital Revenue Code	278
Min. Negotiated Rate	$234.13
Max. Negotiated Rate	$4,857.50
Rate for Payer: Aetna Commercial	$3,691.70
Rate for Payer: Aetna Medicare Advantage	$2,914.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,477.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,477.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,943.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,477.32
Rate for Payer: Cigna Commercial	$4,857.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,351.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,137.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,457.25
Rate for Payer: UnitedHealthcare Community & State	$234.13
Rate for Payer: Wellpoint Medicaid Managed Care	$257.45

SCRW CANN MATRIX 6.0MM 35MM

Facility

$9,715.00

Hospital Charge Code	270656696
Hospital Revenue Code	278
Min. Negotiated Rate	$1,457.25
Max. Negotiated Rate	$2,351.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,943.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,351.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,137.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,457.25

SCRW CAN PRT THD 5X28 11425128

Facility

$568.60

Hospital Charge Code	270635956
Hospital Revenue Code	278
Min. Negotiated Rate	$85.29
Max. Negotiated Rate	$137.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.09
Rate for Payer: Qualcare PPO/HMO/WC	$85.29

SCRW CAN PRT THD 5X28 11425128

Facility

$568.60

Hospital Charge Code	270635956
Hospital Revenue Code	278
Min. Negotiated Rate	$13.70
Max. Negotiated Rate	$284.30
Rate for Payer: Aetna Commercial	$216.07
Rate for Payer: Aetna Medicare Advantage	$170.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.99
Rate for Payer: Cigna Commercial	$284.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.09
Rate for Payer: Qualcare PPO/HMO/WC	$85.29
Rate for Payer: UnitedHealthcare Community & State	$13.70
Rate for Payer: Wellpoint Medicaid Managed Care	$15.07

SCRW CAN PRT THD 5X30 11425130

Facility

$568.60

Hospital Charge Code	270635957
Hospital Revenue Code	272
Min. Negotiated Rate	$85.29
Max. Negotiated Rate	$85.29
Rate for Payer: Qualcare PPO/HMO/WC	$85.29

SCRW CAN PRT THD 5X30 11425130

Facility

$568.60

Hospital Charge Code	270635957
Hospital Revenue Code	272
Min. Negotiated Rate	$13.70
Max. Negotiated Rate	$284.30
Rate for Payer: Aetna Commercial	$216.07
Rate for Payer: Aetna Medicare Advantage	$170.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.99
Rate for Payer: Cigna Commercial	$284.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.58
Rate for Payer: Oxford Commercial	$113.72
Rate for Payer: Qualcare PPO/HMO/WC	$85.29
Rate for Payer: UnitedHealthcare Commercial	$113.72
Rate for Payer: UnitedHealthcare Community & State	$13.70
Rate for Payer: Wellpoint Medicaid Managed Care	$15.07

Know your out-of-pocket cost for care.

All Charges