Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SEAT TOILET RAISED SPECIAL NVC

Facility

$203.25

Hospital Charge Code	270624860
Hospital Revenue Code	270
Min. Negotiated Rate	$4.90
Max. Negotiated Rate	$101.62
Rate for Payer: Aetna Commercial	$77.23
Rate for Payer: Aetna Medicare Advantage	$60.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.83
Rate for Payer: Cigna Commercial	$101.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.98
Rate for Payer: Oxford Commercial	$40.65
Rate for Payer: Qualcare PPO/HMO/WC	$30.49
Rate for Payer: UnitedHealthcare Commercial	$40.65
Rate for Payer: UnitedHealthcare Community & State	$4.90
Rate for Payer: Wellpoint Medicaid Managed Care	$5.39

SEAT TOILET RAISED SPECIAL NVC

Facility

$203.25

Hospital Charge Code	270624860
Hospital Revenue Code	270
Min. Negotiated Rate	$30.49
Max. Negotiated Rate	$30.49
Rate for Payer: Qualcare PPO/HMO/WC	$30.49

SEC ANT LUM CAGE H18 10DEG

Facility

$25,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270703855
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

SEC ANT LUM CAGE H18 10DEG

Facility

$25,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270703855
Hospital Revenue Code	278
Min. Negotiated Rate	$602.50
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$602.50
Rate for Payer: Wellpoint Medicaid Managed Care	$662.50

SEC FT MX 127DEG STEM 10X35

Facility

$11,937.80

Service Code	HCPCS C1776
Hospital Charge Code	270691174
Hospital Revenue Code	278
Min. Negotiated Rate	$287.70
Max. Negotiated Rate	$5,968.90
Rate for Payer: Aetna Commercial	$4,536.36
Rate for Payer: Aetna Medicare Advantage	$3,581.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,044.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,044.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,387.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,044.14
Rate for Payer: Cigna Commercial	$5,968.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,626.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,790.67
Rate for Payer: UnitedHealthcare Community & State	$287.70
Rate for Payer: Wellpoint Medicaid Managed Care	$316.35

SEC FT MX 127DEG STEM 10X35

Facility

$11,937.80

Service Code	HCPCS C1776
Hospital Charge Code	270691174
Hospital Revenue Code	278
Min. Negotiated Rate	$1,790.67
Max. Negotiated Rate	$2,888.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,387.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,626.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,790.67

SECFTMX127DEGSTEMSZ9NK35MMCTPR

Facility

$11,937.80

Service Code	HCPCS C1776
Hospital Charge Code	270691183
Hospital Revenue Code	278
Min. Negotiated Rate	$1,790.67
Max. Negotiated Rate	$2,888.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,387.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,626.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,790.67

SECFTMX127DEGSTEMSZ9NK35MMCTPR

Facility

$11,937.80

Service Code	HCPCS C1776
Hospital Charge Code	270691183
Hospital Revenue Code	278
Min. Negotiated Rate	$287.70
Max. Negotiated Rate	$5,968.90
Rate for Payer: Aetna Commercial	$4,536.36
Rate for Payer: Aetna Medicare Advantage	$3,581.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,044.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,044.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,387.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,044.14
Rate for Payer: Cigna Commercial	$5,968.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,626.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,790.67
Rate for Payer: UnitedHealthcare Community & State	$287.70
Rate for Payer: Wellpoint Medicaid Managed Care	$316.35

SEC LUM ANT CAGE MED H16 10DEG

Facility

$25,000.00

Service Code	HCPCS C1889
Hospital Charge Code	2703855
Hospital Revenue Code	278
Min. Negotiated Rate	$602.50
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$602.50
Rate for Payer: Wellpoint Medicaid Managed Care	$662.50

SEC LUM ANT CAGE MED H16 10DEG

Facility

$25,000.00

Service Code	HCPCS C1889
Hospital Charge Code	2703855
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

SEC LUM ANT CAGE MEDIUM

Facility

$25,000.00

Hospital Charge Code	270702843
Hospital Revenue Code	278
Min. Negotiated Rate	$602.50
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$602.50
Rate for Payer: Wellpoint Medicaid Managed Care	$662.50

SEC LUM ANT CAGE MEDIUM

Facility

$25,000.00

Hospital Charge Code	270702843
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

SEC LUM ANT CAGE SM H14 10DEG

Facility

$25,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270703792
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

SEC LUM ANT CAGE SM H14 10DEG

Facility

$25,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270703792
Hospital Revenue Code	278
Min. Negotiated Rate	$602.50
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$602.50
Rate for Payer: Wellpoint Medicaid Managed Care	$662.50

SEC LUM ANT CAGE SM H16 15D

Facility

$25,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270703793
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

SEC LUM ANT CAGE SM H16 15D

Facility

$25,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270703793
Hospital Revenue Code	278
Min. Negotiated Rate	$602.50
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$602.50
Rate for Payer: Wellpoint Medicaid Managed Care	$662.50

SECOBARBITAL CAP 100MG

Facility

$4.00

Hospital Charge Code	60627838
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

SECOBARBITAL CAP 100MG

Facility

$4.00

Hospital Charge Code	60627838
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

SECOBARBITAL INJ/100MG

Facility

$152.00

Hospital Charge Code	60634343
Hospital Revenue Code	250
Min. Negotiated Rate	$3.66
Max. Negotiated Rate	$76.00
Rate for Payer: Aetna Commercial	$57.76
Rate for Payer: Aetna Medicare Advantage	$45.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.76
Rate for Payer: Cigna Commercial	$76.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.60
Rate for Payer: Oxford Commercial	$30.40
Rate for Payer: Qualcare PPO/HMO/WC	$22.80
Rate for Payer: UnitedHealthcare Commercial	$30.40
Rate for Payer: UnitedHealthcare Community & State	$3.66
Rate for Payer: Wellpoint Medicaid Managed Care	$4.03

SECOBARBITAL INJ/100MG

Facility

$152.00

Hospital Charge Code	60634343
Hospital Revenue Code	250
Min. Negotiated Rate	$22.80
Max. Negotiated Rate	$22.80
Rate for Payer: Qualcare PPO/HMO/WC	$22.80

SECONAL/100MG/CAP

Facility

$3.00

Hospital Charge Code	60634412
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

SECONAL/100MG/CAP

Facility

$3.00

Hospital Charge Code	60634412
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

SECOND CHANCE PROGRAM ADULT

Facility

$665.50

Service Code	HCPCS 99213
Hospital Charge Code	485099218
Hospital Revenue Code	919
Min. Negotiated Rate	$16.04
Max. Negotiated Rate	$332.75
Rate for Payer: Aetna Commercial	$252.89
Rate for Payer: Aetna Medicare Advantage	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.70
Rate for Payer: Cigna Commercial	$332.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$99.83
Rate for Payer: UnitedHealthcare Community & State	$16.04
Rate for Payer: Wellpoint Medicaid Managed Care	$17.64

SECOND CHANCE PROGRAM ADULT

Facility

$665.50

Service Code	HCPCS 99213
Hospital Charge Code	485099218
Hospital Revenue Code	919
Min. Negotiated Rate	$99.83
Max. Negotiated Rate	$99.83
Rate for Payer: Qualcare PPO/HMO/WC	$99.83

SECOND LEVEL CER DISKECTOMY AD

Facility

$6,238.00

Service Code	HCPCS 22858
Hospital Charge Code	1600000582
Hospital Revenue Code	360
Min. Negotiated Rate	$935.70
Max. Negotiated Rate	$935.70
Rate for Payer: Qualcare PPO/HMO/WC	$935.70

Know your out-of-pocket cost for care.

All Charges