Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SHELL BMT ACET 25 60MM 107060

Facility

$5,139.25

Hospital Charge Code	270625256
Hospital Revenue Code	278
Min. Negotiated Rate	$123.86
Max. Negotiated Rate	$2,569.62
Rate for Payer: Aetna Commercial	$1,952.91
Rate for Payer: Aetna Medicare Advantage	$1,541.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,310.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,310.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,027.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,310.51
Rate for Payer: Cigna Commercial	$2,569.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,243.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,130.63
Rate for Payer: Qualcare PPO/HMO/WC	$770.89
Rate for Payer: UnitedHealthcare Community & State	$123.86
Rate for Payer: Wellpoint Medicaid Managed Care	$136.19

SHELL BMT ACET 38 58MM 118858

Facility

$13,178.75

Hospital Charge Code	270628144
Hospital Revenue Code	278
Min. Negotiated Rate	$317.61
Max. Negotiated Rate	$6,589.38
Rate for Payer: Aetna Commercial	$5,007.93
Rate for Payer: Aetna Medicare Advantage	$3,953.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,360.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,360.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,635.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,360.58
Rate for Payer: Cigna Commercial	$6,589.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,189.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,899.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,976.81
Rate for Payer: UnitedHealthcare Community & State	$317.61
Rate for Payer: Wellpoint Medicaid Managed Care	$349.24

SHELL BMT ACET 38 58MM 118858

Facility

$13,178.75

Hospital Charge Code	270628144
Hospital Revenue Code	278
Min. Negotiated Rate	$1,976.81
Max. Negotiated Rate	$3,189.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,635.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,189.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,899.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,976.81

SHELL BMT ACET 38 60MM 118860

Facility

$14,071.25

Hospital Charge Code	270628618
Hospital Revenue Code	278
Min. Negotiated Rate	$339.12
Max. Negotiated Rate	$7,035.62
Rate for Payer: Aetna Commercial	$5,347.07
Rate for Payer: Aetna Medicare Advantage	$4,221.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,588.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,588.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,814.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,588.17
Rate for Payer: Cigna Commercial	$7,035.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,405.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,095.68
Rate for Payer: Qualcare PPO/HMO/WC	$2,110.69
Rate for Payer: UnitedHealthcare Community & State	$339.12
Rate for Payer: Wellpoint Medicaid Managed Care	$372.89

SHELL BMT ACET 38 60MM 118860

Facility

$14,071.25

Hospital Charge Code	270628618
Hospital Revenue Code	278
Min. Negotiated Rate	$2,110.69
Max. Negotiated Rate	$3,405.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,814.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,405.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,095.68
Rate for Payer: Qualcare PPO/HMO/WC	$2,110.69

SHELL BMT ACET 52MM 106052

Facility

$7,765.00

Hospital Charge Code	270606920
Hospital Revenue Code	278
Min. Negotiated Rate	$187.14
Max. Negotiated Rate	$3,882.50
Rate for Payer: Aetna Commercial	$2,950.70
Rate for Payer: Aetna Medicare Advantage	$2,329.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,980.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,980.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,553.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,980.08
Rate for Payer: Cigna Commercial	$3,882.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,879.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,708.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,164.75
Rate for Payer: UnitedHealthcare Community & State	$187.14
Rate for Payer: Wellpoint Medicaid Managed Care	$205.77

SHELL BMT ACET 52MM 106052

Facility

$7,765.00

Hospital Charge Code	270606920
Hospital Revenue Code	278
Min. Negotiated Rate	$1,164.75
Max. Negotiated Rate	$1,879.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,553.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,879.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,708.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,164.75

SHELL BMT ACET 52MM 107052

Facility

$3,759.25

Hospital Charge Code	270617008
Hospital Revenue Code	278
Min. Negotiated Rate	$563.89
Max. Negotiated Rate	$909.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$751.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$909.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$827.03
Rate for Payer: Qualcare PPO/HMO/WC	$563.89

SHELL BMT ACET 52MM 107052

Facility

$3,759.25

Hospital Charge Code	270617008
Hospital Revenue Code	278
Min. Negotiated Rate	$90.60
Max. Negotiated Rate	$1,879.62
Rate for Payer: Aetna Commercial	$1,428.52
Rate for Payer: Aetna Medicare Advantage	$1,127.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$958.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$958.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$751.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$958.61
Rate for Payer: Cigna Commercial	$1,879.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$909.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$827.03
Rate for Payer: Qualcare PPO/HMO/WC	$563.89
Rate for Payer: UnitedHealthcare Community & State	$90.60
Rate for Payer: Wellpoint Medicaid Managed Care	$99.62

SHELL BMT ACET 54MM 106054

Facility

$3,759.25

Hospital Charge Code	270614514
Hospital Revenue Code	278
Min. Negotiated Rate	$563.89
Max. Negotiated Rate	$909.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$751.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$909.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$827.03
Rate for Payer: Qualcare PPO/HMO/WC	$563.89

SHELL BMT ACET 54MM 106054

Facility

$3,759.25

Hospital Charge Code	270614514
Hospital Revenue Code	278
Min. Negotiated Rate	$90.60
Max. Negotiated Rate	$1,879.62
Rate for Payer: Aetna Commercial	$1,428.52
Rate for Payer: Aetna Medicare Advantage	$1,127.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$958.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$958.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$751.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$958.61
Rate for Payer: Cigna Commercial	$1,879.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$909.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$827.03
Rate for Payer: Qualcare PPO/HMO/WC	$563.89
Rate for Payer: UnitedHealthcare Community & State	$90.60
Rate for Payer: Wellpoint Medicaid Managed Care	$99.62

SHELL BMT ACET 56MM 107056

Facility

$3,540.85

Hospital Charge Code	270607005
Hospital Revenue Code	278
Min. Negotiated Rate	$85.33
Max. Negotiated Rate	$1,770.42
Rate for Payer: Aetna Commercial	$1,345.52
Rate for Payer: Aetna Medicare Advantage	$1,062.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$902.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$902.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$708.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$902.92
Rate for Payer: Cigna Commercial	$1,770.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$778.99
Rate for Payer: Qualcare PPO/HMO/WC	$531.13
Rate for Payer: UnitedHealthcare Community & State	$85.33
Rate for Payer: Wellpoint Medicaid Managed Care	$93.83

SHELL BMT ACET 56MM 107056

Facility

$3,540.85

Hospital Charge Code	270607005
Hospital Revenue Code	278
Min. Negotiated Rate	$531.13
Max. Negotiated Rate	$856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$708.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$778.99
Rate for Payer: Qualcare PPO/HMO/WC	$531.13

SHELL BMT ACET 58MM 107058

Facility

$5,139.25

Hospital Charge Code	270625649
Hospital Revenue Code	278
Min. Negotiated Rate	$770.89
Max. Negotiated Rate	$1,243.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,027.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,243.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,130.63
Rate for Payer: Qualcare PPO/HMO/WC	$770.89

SHELL BMT ACET 58MM 107058

Facility

$5,139.25

Hospital Charge Code	270625649
Hospital Revenue Code	278
Min. Negotiated Rate	$123.86
Max. Negotiated Rate	$2,569.62
Rate for Payer: Aetna Commercial	$1,952.91
Rate for Payer: Aetna Medicare Advantage	$1,541.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,310.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,310.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,027.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,310.51
Rate for Payer: Cigna Commercial	$2,569.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,243.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,130.63
Rate for Payer: Qualcare PPO/HMO/WC	$770.89
Rate for Payer: UnitedHealthcare Community & State	$123.86
Rate for Payer: Wellpoint Medicaid Managed Care	$136.19

SHELL BMT ACET 60MM 135260

Facility

$3,779.25

Hospital Charge Code	270612162
Hospital Revenue Code	278
Min. Negotiated Rate	$566.89
Max. Negotiated Rate	$914.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$755.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$914.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$831.43
Rate for Payer: Qualcare PPO/HMO/WC	$566.89

SHELL BMT ACET 60MM 135260

Facility

$3,779.25

Hospital Charge Code	270612162
Hospital Revenue Code	278
Min. Negotiated Rate	$91.08
Max. Negotiated Rate	$1,889.62
Rate for Payer: Aetna Commercial	$1,436.12
Rate for Payer: Aetna Medicare Advantage	$1,133.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$963.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$963.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$755.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$963.71
Rate for Payer: Cigna Commercial	$1,889.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$914.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$831.43
Rate for Payer: Qualcare PPO/HMO/WC	$566.89
Rate for Payer: UnitedHealthcare Community & State	$91.08
Rate for Payer: Wellpoint Medicaid Managed Care	$100.15

SHELL BMT ACET 62MM 106062

Facility

$3,540.85

Hospital Charge Code	270609081
Hospital Revenue Code	278
Min. Negotiated Rate	$531.13
Max. Negotiated Rate	$856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$708.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$778.99
Rate for Payer: Qualcare PPO/HMO/WC	$531.13

SHELL BMT ACET 62MM 106062

Facility

$3,540.85

Hospital Charge Code	270609081
Hospital Revenue Code	278
Min. Negotiated Rate	$85.33
Max. Negotiated Rate	$1,770.42
Rate for Payer: Aetna Commercial	$1,345.52
Rate for Payer: Aetna Medicare Advantage	$1,062.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$902.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$902.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$708.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$902.92
Rate for Payer: Cigna Commercial	$1,770.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$778.99
Rate for Payer: Qualcare PPO/HMO/WC	$531.13
Rate for Payer: UnitedHealthcare Community & State	$85.33
Rate for Payer: Wellpoint Medicaid Managed Care	$93.83

SHELL BMT ACETAB 60 106060

Facility

$5,139.25

Hospital Charge Code	270626542
Hospital Revenue Code	278
Min. Negotiated Rate	$123.86
Max. Negotiated Rate	$2,569.62
Rate for Payer: Aetna Commercial	$1,952.91
Rate for Payer: Aetna Medicare Advantage	$1,541.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,310.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,310.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,027.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,310.51
Rate for Payer: Cigna Commercial	$2,569.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,243.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,130.63
Rate for Payer: Qualcare PPO/HMO/WC	$770.89
Rate for Payer: UnitedHealthcare Community & State	$123.86
Rate for Payer: Wellpoint Medicaid Managed Care	$136.19

SHELL BMT ACETAB 60 106060

Facility

$5,139.25

Hospital Charge Code	270626542
Hospital Revenue Code	278
Min. Negotiated Rate	$770.89
Max. Negotiated Rate	$1,243.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,027.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,243.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,130.63
Rate for Payer: Qualcare PPO/HMO/WC	$770.89

SHELL BMT MZA RAD 56 15-104056

Facility

$7,156.00

Hospital Charge Code	270622515
Hospital Revenue Code	278
Min. Negotiated Rate	$172.46
Max. Negotiated Rate	$3,578.00
Rate for Payer: Aetna Commercial	$2,719.28
Rate for Payer: Aetna Medicare Advantage	$2,146.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,824.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,824.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,431.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,824.78
Rate for Payer: Cigna Commercial	$3,578.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,731.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,574.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,073.40
Rate for Payer: UnitedHealthcare Community & State	$172.46
Rate for Payer: Wellpoint Medicaid Managed Care	$189.63

SHELL BMT MZA RAD 56 15-104056

Facility

$7,156.00

Hospital Charge Code	270622515
Hospital Revenue Code	278
Min. Negotiated Rate	$1,073.40
Max. Negotiated Rate	$1,731.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,431.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,731.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,574.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,073.40

SHELL CEMENTLESS SZ G

Facility

$9,500.00

Hospital Charge Code	270703303
Hospital Revenue Code	278
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$2,299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,090.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

SHELL CEMENTLESS SZ G

Facility

$9,500.00

Hospital Charge Code	270703303
Hospital Revenue Code	278
Min. Negotiated Rate	$228.95
Max. Negotiated Rate	$4,750.00
Rate for Payer: Aetna Commercial	$3,610.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$4,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,090.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Community & State	$228.95
Rate for Payer: Wellpoint Medicaid Managed Care	$251.75

Know your out-of-pocket cost for care.

All Charges