Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SICKLE CELL ANEMIA CRISIS

Facility

$12,378.95

Service Code	APR-DRG 6623
Min. Negotiated Rate	$12,136.23
Max. Negotiated Rate	$12,378.95
Rate for Payer: UnitedHealthcare Community & State	$12,136.23
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,378.95
Rate for Payer: Wellpoint Medicaid Managed Care	$12,136.23

SICKLE CELL ANEMIA CRISIS

Facility

$8,583.31

Service Code	APR-DRG 6622
Min. Negotiated Rate	$8,415.01
Max. Negotiated Rate	$8,583.31
Rate for Payer: UnitedHealthcare Community & State	$8,415.01
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,583.31
Rate for Payer: Wellpoint Medicaid Managed Care	$8,415.01

SICKLE CELL SCREEN

Facility

$390.00

Service Code	HCPCS 85660
Hospital Charge Code	39900182
Hospital Revenue Code	305
Min. Negotiated Rate	$4.41
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.99
Rate for Payer: Aetna Medicare Advantage	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.89
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.51
Rate for Payer: Clover Medicare Advantage	$5.23
Rate for Payer: EmblemHealth Commercial	$16.53
Rate for Payer: Humana Medicare Advantage	$5.68
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.51
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	$4.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.51
Rate for Payer: Wellcare Medicare Advantage	$5.51
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

SICKLE CELL SCREEN

Facility

$390.00

Service Code	HCPCS 85660
Hospital Charge Code	39900182
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SICKLE CELL SCREEN

Facility

$109.25

Service Code	HCPCS 85660
Hospital Charge Code	3003621
Hospital Revenue Code	305
Min. Negotiated Rate	$16.39
Max. Negotiated Rate	$16.39
Rate for Payer: Qualcare PPO/HMO/WC	$16.39

SICKLE CELL SCREEN

Facility

$109.25

Service Code	HCPCS 85660
Hospital Charge Code	3003621
Hospital Revenue Code	305
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.99
Rate for Payer: Aetna Medicare Advantage	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.89
Rate for Payer: Cigna Commercial	$54.62
Rate for Payer: Cigna Medicare Advantage	$5.51
Rate for Payer: Clover Medicare Advantage	$5.23
Rate for Payer: EmblemHealth Commercial	$16.53
Rate for Payer: Humana Medicare Advantage	$5.68
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.39
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.51
Rate for Payer: Wellcare Medicare Advantage	$5.51
Rate for Payer: Wellpoint Medicaid Managed Care	$2.90

SICKLING OF RBC, REDUCTION

Facility

$109.25

Service Code	HCPCS 85660
Hospital Charge Code	3001519B
Hospital Revenue Code	305
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.99
Rate for Payer: Aetna Medicare Advantage	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.89
Rate for Payer: Cigna Commercial	$54.62
Rate for Payer: Cigna Medicare Advantage	$5.51
Rate for Payer: Clover Medicare Advantage	$5.23
Rate for Payer: EmblemHealth Commercial	$16.53
Rate for Payer: Humana Medicare Advantage	$5.68
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.39
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.51
Rate for Payer: Wellcare Medicare Advantage	$5.51
Rate for Payer: Wellpoint Medicaid Managed Care	$2.90

SICKLING OF RBC, REDUCTION

Facility

$109.25

Service Code	HCPCS 85660
Hospital Charge Code	3001519B
Hospital Revenue Code	305
Min. Negotiated Rate	$16.39
Max. Negotiated Rate	$16.39
Rate for Payer: Qualcare PPO/HMO/WC	$16.39

S&I COR/SVG/IMA/AO

Facility

$3,410.45

Service Code	HCPCS 93568
Hospital Charge Code	74110015
Hospital Revenue Code	481
Min. Negotiated Rate	$82.19
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$1,295.97
Rate for Payer: Aetna Medicare Advantage	$1,023.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$869.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$869.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$869.66
Rate for Payer: Cigna Commercial	$1,705.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,023.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$511.57
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$82.19
Rate for Payer: Wellpoint Medicaid Managed Care	$90.38

S&I COR/SVG/IMA/AO

Facility

$3,410.45

Service Code	HCPCS 93568
Hospital Charge Code	5100110
Hospital Revenue Code	481
Min. Negotiated Rate	$511.57
Max. Negotiated Rate	$511.57
Rate for Payer: Qualcare PPO/HMO/WC	$511.57

S&I COR/SVG/IMA/AO

Facility

$3,410.45

Service Code	HCPCS 93568
Hospital Charge Code	74110015
Hospital Revenue Code	481
Min. Negotiated Rate	$511.57
Max. Negotiated Rate	$511.57
Rate for Payer: Qualcare PPO/HMO/WC	$511.57

S&I COR/SVG/IMA/AO

Facility

$3,410.45

Service Code	HCPCS 93568
Hospital Charge Code	5100110
Hospital Revenue Code	481
Min. Negotiated Rate	$82.19
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$1,295.97
Rate for Payer: Aetna Medicare Advantage	$1,023.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$869.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$869.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$869.66
Rate for Payer: Cigna Commercial	$1,705.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,023.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$511.57
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$82.19
Rate for Payer: Wellpoint Medicaid Managed Care	$90.38

SIDE CUTTER (ADULT)

Facility

$191.00

Hospital Charge Code	270335569
Hospital Revenue Code	272
Min. Negotiated Rate	$4.60
Max. Negotiated Rate	$95.50
Rate for Payer: Aetna Commercial	$72.58
Rate for Payer: Aetna Medicare Advantage	$57.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.70
Rate for Payer: Cigna Commercial	$95.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.30
Rate for Payer: Oxford Commercial	$38.20
Rate for Payer: Qualcare PPO/HMO/WC	$28.65
Rate for Payer: UnitedHealthcare Commercial	$38.20
Rate for Payer: UnitedHealthcare Community & State	$4.60
Rate for Payer: Wellpoint Medicaid Managed Care	$5.06

SIDE CUTTER (ADULT)

Facility

$191.00

Hospital Charge Code	270335569
Hospital Revenue Code	272
Min. Negotiated Rate	$28.65
Max. Negotiated Rate	$28.65
Rate for Payer: Qualcare PPO/HMO/WC	$28.65

SIDE CUTTER BUR AM-10

Facility

$310.00

Hospital Charge Code	270335564
Hospital Revenue Code	272
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$46.50
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

SIDE CUTTER BUR AM-10

Facility

$310.00

Hospital Charge Code	270335564
Hospital Revenue Code	272
Min. Negotiated Rate	$7.47
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$117.80
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.00
Rate for Payer: Oxford Commercial	$62.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Commercial	$62.00
Rate for Payer: UnitedHealthcare Community & State	$7.47
Rate for Payer: Wellpoint Medicaid Managed Care	$8.21

SIDE CUTTER BUR TU-10

Facility

$321.00

Hospital Charge Code	270335563
Hospital Revenue Code	272
Min. Negotiated Rate	$48.15
Max. Negotiated Rate	$48.15
Rate for Payer: Qualcare PPO/HMO/WC	$48.15

SIDE CUTTER BUR TU-10

Facility

$321.00

Hospital Charge Code	270335563
Hospital Revenue Code	272
Min. Negotiated Rate	$7.74
Max. Negotiated Rate	$160.50
Rate for Payer: Aetna Commercial	$121.98
Rate for Payer: Aetna Medicare Advantage	$96.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.86
Rate for Payer: Cigna Commercial	$160.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.30
Rate for Payer: Oxford Commercial	$64.20
Rate for Payer: Qualcare PPO/HMO/WC	$48.15
Rate for Payer: UnitedHealthcare Commercial	$64.20
Rate for Payer: UnitedHealthcare Community & State	$7.74
Rate for Payer: Wellpoint Medicaid Managed Care	$8.51

SIDE CUTTER CRANIOTOME

Facility

$186.00

Hospital Charge Code	270335568
Hospital Revenue Code	272
Min. Negotiated Rate	$27.90
Max. Negotiated Rate	$27.90
Rate for Payer: Qualcare PPO/HMO/WC	$27.90

SIDE CUTTER CRANIOTOME

Facility

$186.00

Hospital Charge Code	270335568
Hospital Revenue Code	272
Min. Negotiated Rate	$4.48
Max. Negotiated Rate	$93.00
Rate for Payer: Aetna Commercial	$70.68
Rate for Payer: Aetna Medicare Advantage	$55.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.43
Rate for Payer: Cigna Commercial	$93.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.80
Rate for Payer: Oxford Commercial	$37.20
Rate for Payer: Qualcare PPO/HMO/WC	$27.90
Rate for Payer: UnitedHealthcare Commercial	$37.20
Rate for Payer: UnitedHealthcare Community & State	$4.48
Rate for Payer: Wellpoint Medicaid Managed Care	$4.93

SIDE CUTTING BUR 1.5 X7.5

Facility

$208.00

Hospital Charge Code	270332569
Hospital Revenue Code	272
Min. Negotiated Rate	$5.01
Max. Negotiated Rate	$104.00
Rate for Payer: Aetna Commercial	$79.04
Rate for Payer: Aetna Medicare Advantage	$62.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.04
Rate for Payer: Cigna Commercial	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.40
Rate for Payer: Oxford Commercial	$41.60
Rate for Payer: Qualcare PPO/HMO/WC	$31.20
Rate for Payer: UnitedHealthcare Commercial	$41.60
Rate for Payer: UnitedHealthcare Community & State	$5.01
Rate for Payer: Wellpoint Medicaid Managed Care	$5.51

SIDE CUTTING BUR 1.5 X7.5

Facility

$208.00

Hospital Charge Code	270332569
Hospital Revenue Code	272
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$31.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.20

SIDE CUTTING BUR 2 X 19

Facility

$248.00

Hospital Charge Code	270332570
Hospital Revenue Code	272
Min. Negotiated Rate	$5.98
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$94.24
Rate for Payer: Aetna Medicare Advantage	$74.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.24
Rate for Payer: Cigna Commercial	$124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.40
Rate for Payer: Oxford Commercial	$49.60
Rate for Payer: Qualcare PPO/HMO/WC	$37.20
Rate for Payer: UnitedHealthcare Commercial	$49.60
Rate for Payer: UnitedHealthcare Community & State	$5.98
Rate for Payer: Wellpoint Medicaid Managed Care	$6.57

SIDE CUTTING BUR 2 X 19

Facility

$248.00

Hospital Charge Code	270332570
Hospital Revenue Code	272
Min. Negotiated Rate	$37.20
Max. Negotiated Rate	$37.20
Rate for Payer: Qualcare PPO/HMO/WC	$37.20

SIGMA SHIM

Facility

$2,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270703545
Hospital Revenue Code	278
Min. Negotiated Rate	$442.50
Max. Negotiated Rate	$713.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$713.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$649.00
Rate for Payer: Qualcare PPO/HMO/WC	$442.50

Know your out-of-pocket cost for care.

All Charges