Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCW SLD SHT BLNT TIP 5.5X46MM

Facility

$3,231.25

Hospital Charge Code	270701726
Hospital Revenue Code	278
Min. Negotiated Rate	$77.87
Max. Negotiated Rate	$1,615.62
Rate for Payer: Aetna Commercial	$1,227.88
Rate for Payer: Aetna Medicare Advantage	$969.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$823.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$823.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$823.97
Rate for Payer: Cigna Commercial	$1,615.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$710.88
Rate for Payer: Qualcare PPO/HMO/WC	$484.69
Rate for Payer: UnitedHealthcare Community & State	$77.87
Rate for Payer: Wellpoint Medicaid Managed Care	$85.63

SCW SLD SHT BLNT TIP 5.5X46MM

Facility

$3,231.25

Hospital Charge Code	270701726
Hospital Revenue Code	278
Min. Negotiated Rate	$484.69
Max. Negotiated Rate	$781.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$710.88
Rate for Payer: Qualcare PPO/HMO/WC	$484.69

SDS BEDSIDE PROCEDURE

Facility

$2,230.00

Hospital Charge Code	1001190
Hospital Revenue Code	361
Min. Negotiated Rate	$53.74
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$847.40
Rate for Payer: Aetna Medicare Advantage	$669.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$568.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$568.65
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	$568.65
Rate for Payer: Cigna Commercial	$1,115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$669.00
Rate for Payer: Qualcare PPO/HMO/WC	$334.50
Rate for Payer: UnitedHealthcare Community & State	$53.74
Rate for Payer: Wellpoint Medicaid Managed Care	$59.09

SDS BEDSIDE PROCEDURE

Facility

$2,230.00

Hospital Charge Code	1001190
Hospital Revenue Code	361
Min. Negotiated Rate	$334.50
Max. Negotiated Rate	$334.50
Rate for Payer: Qualcare PPO/HMO/WC	$334.50

SD SCREW 12MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703901
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SD SCREW 12MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703901
Hospital Revenue Code	278
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

SD SCREW 3.5X16MM

Facility

$1,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270704127
Hospital Revenue Code	278
Min. Negotiated Rate	$40.97
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$646.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$374.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Community & State	$40.97
Rate for Payer: Wellpoint Medicaid Managed Care	$45.05

SD SCREW 3.5X16MM

Facility

$1,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270704127
Hospital Revenue Code	278
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$411.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$374.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00

SDS GLUCOSE CAPILLARY FINGERST

Facility

$390.00

Service Code	HCPCS 82948
Hospital Charge Code	1001182
Hospital Revenue Code	301
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$13.71
Rate for Payer: Aetna Medicare Advantage	$16.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.19
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.04
Rate for Payer: Clover Medicare Advantage	$4.79
Rate for Payer: EmblemHealth Commercial	$15.12
Rate for Payer: Humana Medicare Advantage	$5.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.04
Rate for Payer: Wellcare Medicare Advantage	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

SDS GLUCOSE CAPILLARY FINGERST

Facility

$390.00

Service Code	HCPCS 82948
Hospital Charge Code	1001182
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SDS HEMOGLOBIN HGB

Facility

$390.00

Service Code	HCPCS 85018
Hospital Charge Code	1001181
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SDS HEMOGLOBIN HGB

Facility

$390.00

Service Code	HCPCS 85018
Hospital Charge Code	1001181
Hospital Revenue Code	305
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$6.45
Rate for Payer: Aetna Medicare Advantage	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.55
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$2.37
Rate for Payer: Clover Medicare Advantage	$2.25
Rate for Payer: EmblemHealth Commercial	$7.11
Rate for Payer: Humana Medicare Advantage	$2.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.37
Rate for Payer: Wellcare Medicare Advantage	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

SDS INJ BEDSIDE PAIN MANGEMENT

Facility

$1,590.00

Hospital Charge Code	1001167
Hospital Revenue Code	360
Min. Negotiated Rate	$38.32
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$604.20
Rate for Payer: Aetna Medicare Advantage	$477.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$405.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$405.45
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	$405.45
Rate for Payer: Cigna Commercial	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.00
Rate for Payer: Qualcare PPO/HMO/WC	$238.50
Rate for Payer: UnitedHealthcare Community & State	$38.32
Rate for Payer: Wellpoint Medicaid Managed Care	$42.13

SDS INJ BEDSIDE PAIN MANGEMENT

Facility

$1,590.00

Hospital Charge Code	1001167
Hospital Revenue Code	360
Min. Negotiated Rate	$238.50
Max. Negotiated Rate	$238.50
Rate for Payer: Qualcare PPO/HMO/WC	$238.50

SDS IV SOL 1000CC

Facility

$120.00

Hospital Charge Code	1001187
Hospital Revenue Code	258
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$45.60
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.00
Rate for Payer: Oxford Commercial	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$24.00
Rate for Payer: UnitedHealthcare Community & State	$2.89
Rate for Payer: Wellpoint Medicaid Managed Care	$3.18

SDS IV SOL 1000CC

Facility

$120.00

Hospital Charge Code	1001187
Hospital Revenue Code	258
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

SDS IV SOL 100CC

Facility

$81.00

Hospital Charge Code	1001185
Hospital Revenue Code	258
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$12.15
Rate for Payer: Qualcare PPO/HMO/WC	$12.15

SDS IV SOL 100CC

Facility

$81.00

Hospital Charge Code	1001185
Hospital Revenue Code	258
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$40.50
Rate for Payer: Aetna Commercial	$30.78
Rate for Payer: Aetna Medicare Advantage	$24.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.66
Rate for Payer: Cigna Commercial	$40.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.30
Rate for Payer: Oxford Commercial	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$12.15
Rate for Payer: UnitedHealthcare Commercial	$16.20
Rate for Payer: UnitedHealthcare Community & State	$1.95
Rate for Payer: Wellpoint Medicaid Managed Care	$2.15

SDS IV SOL 500 CC

Facility

$120.00

Hospital Charge Code	1001186
Hospital Revenue Code	258
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

SDS IV SOL 500 CC

Facility

$120.00

Hospital Charge Code	1001186
Hospital Revenue Code	258
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$45.60
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.00
Rate for Payer: Oxford Commercial	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$24.00
Rate for Payer: UnitedHealthcare Community & State	$2.89
Rate for Payer: Wellpoint Medicaid Managed Care	$3.18

SDS JELCO QUICKCATH (IV CATH)

Facility

$17.00

Hospital Charge Code	1001184
Hospital Revenue Code	272
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

SDS JELCO QUICKCATH (IV CATH)

Facility

$17.00

Hospital Charge Code	1001184
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.50
Rate for Payer: Aetna Commercial	$6.46
Rate for Payer: Aetna Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.33
Rate for Payer: Cigna Commercial	$8.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.10
Rate for Payer: Oxford Commercial	$3.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$3.40
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

SDS OBSERVATION EA ADD'L 2 HRS

Facility

$270.00

Service Code	HCPCS 99218
Hospital Charge Code	83034001
Hospital Revenue Code	762
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

SDS OBSERVATION EA ADD'L 2 HRS

Facility

$270.00

Service Code	HCPCS 99218
Hospital Charge Code	83034001
Hospital Revenue Code	762
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$10,384.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Commercial	$10,384.00
Rate for Payer: UnitedHealthcare Community & State	$6.51
Rate for Payer: Wellpoint Medicaid Managed Care	$50.00

SDS PHASE II RECOV < 1 HOUR

Facility

$800.00

Hospital Charge Code	1000042
Hospital Revenue Code	710
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

Know your out-of-pocket cost for care.

All Charges