Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SIZE C,D 20MM 1,2 POLY INSERT

Facility

$5,862.10

Hospital Charge Code	270657105
Hospital Revenue Code	278
Min. Negotiated Rate	$141.28
Max. Negotiated Rate	$2,931.05
Rate for Payer: Aetna Commercial	$2,227.60
Rate for Payer: Aetna Medicare Advantage	$1,758.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,494.84
Rate for Payer: Cigna Commercial	$2,931.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,289.66
Rate for Payer: Qualcare PPO/HMO/WC	$879.32
Rate for Payer: UnitedHealthcare Community & State	$141.28
Rate for Payer: Wellpoint Medicaid Managed Care	$155.35

SIZE C,D 20MM 1,2 POLY INSERT

Facility

$5,862.10

Hospital Charge Code	270657105
Hospital Revenue Code	278
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$1,418.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,289.66
Rate for Payer: Qualcare PPO/HMO/WC	$879.32

SIZE C LEFT LPS-FLEX

Facility

$11,724.30

Hospital Charge Code	270657102
Hospital Revenue Code	278
Min. Negotiated Rate	$282.56
Max. Negotiated Rate	$5,862.15
Rate for Payer: Aetna Commercial	$4,455.23
Rate for Payer: Aetna Medicare Advantage	$3,517.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,989.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,989.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,344.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,989.70
Rate for Payer: Cigna Commercial	$5,862.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,837.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,579.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,758.64
Rate for Payer: UnitedHealthcare Community & State	$282.56
Rate for Payer: Wellpoint Medicaid Managed Care	$310.69

SIZE C LEFT LPS-FLEX

Facility

$11,724.30

Hospital Charge Code	270657102
Hospital Revenue Code	278
Min. Negotiated Rate	$1,758.64
Max. Negotiated Rate	$2,837.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,344.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,837.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,579.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,758.64

SIZE C RIGHT 9SF

Facility

$12,166.15

Hospital Charge Code	270657103
Hospital Revenue Code	278
Min. Negotiated Rate	$293.20
Max. Negotiated Rate	$6,083.07
Rate for Payer: Aetna Commercial	$4,623.14
Rate for Payer: Aetna Medicare Advantage	$3,649.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,102.37
Rate for Payer: Cigna Commercial	$6,083.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,676.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92
Rate for Payer: UnitedHealthcare Community & State	$293.20
Rate for Payer: Wellpoint Medicaid Managed Care	$322.40

SIZE C RIGHT 9SF

Facility

$12,166.15

Hospital Charge Code	270657103
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.92
Max. Negotiated Rate	$2,944.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,676.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92

SIZE D LEFT LCCK

Facility

$28,661.45

Hospital Charge Code	270657106
Hospital Revenue Code	278
Min. Negotiated Rate	$690.74
Max. Negotiated Rate	$14,330.73
Rate for Payer: Aetna Commercial	$10,891.35
Rate for Payer: Aetna Medicare Advantage	$8,598.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,308.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,308.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,732.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,308.67
Rate for Payer: Cigna Commercial	$14,330.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,936.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,305.52
Rate for Payer: Qualcare PPO/HMO/WC	$4,299.22
Rate for Payer: UnitedHealthcare Community & State	$690.74
Rate for Payer: Wellpoint Medicaid Managed Care	$759.53

SIZE D LEFT LCCK

Facility

$28,661.45

Hospital Charge Code	270657106
Hospital Revenue Code	278
Min. Negotiated Rate	$4,299.22
Max. Negotiated Rate	$6,936.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,732.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,936.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,305.52
Rate for Payer: Qualcare PPO/HMO/WC	$4,299.22

SIZE D RIGHT 65F

Facility

$12,166.15

Hospital Charge Code	270657107
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.92
Max. Negotiated Rate	$2,944.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,676.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92

SIZE D RIGHT 65F

Facility

$12,166.15

Hospital Charge Code	270657107
Hospital Revenue Code	278
Min. Negotiated Rate	$293.20
Max. Negotiated Rate	$6,083.07
Rate for Payer: Aetna Commercial	$4,623.14
Rate for Payer: Aetna Medicare Advantage	$3,649.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,102.37
Rate for Payer: Cigna Commercial	$6,083.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,676.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92
Rate for Payer: UnitedHealthcare Community & State	$293.20
Rate for Payer: Wellpoint Medicaid Managed Care	$322.40

SIZE D RIGHT LCCK

Facility

$28,661.45

Hospital Charge Code	270657109
Hospital Revenue Code	278
Min. Negotiated Rate	$4,299.22
Max. Negotiated Rate	$6,936.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,732.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,936.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,305.52
Rate for Payer: Qualcare PPO/HMO/WC	$4,299.22

SIZE D RIGHT LCCK

Facility

$28,661.45

Hospital Charge Code	270657109
Hospital Revenue Code	278
Min. Negotiated Rate	$690.74
Max. Negotiated Rate	$14,330.73
Rate for Payer: Aetna Commercial	$10,891.35
Rate for Payer: Aetna Medicare Advantage	$8,598.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,308.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,308.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,732.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,308.67
Rate for Payer: Cigna Commercial	$14,330.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,936.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,305.52
Rate for Payer: Qualcare PPO/HMO/WC	$4,299.22
Rate for Payer: UnitedHealthcare Community & State	$690.74
Rate for Payer: Wellpoint Medicaid Managed Care	$759.53

SIZE D RIGHT LEG FLEX

Facility

$11,724.30

Hospital Charge Code	270657108
Hospital Revenue Code	278
Min. Negotiated Rate	$1,758.64
Max. Negotiated Rate	$2,837.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,344.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,837.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,579.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,758.64

SIZE D RIGHT LEG FLEX

Facility

$11,724.30

Hospital Charge Code	270657108
Hospital Revenue Code	278
Min. Negotiated Rate	$282.56
Max. Negotiated Rate	$5,862.15
Rate for Payer: Aetna Commercial	$4,455.23
Rate for Payer: Aetna Medicare Advantage	$3,517.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,989.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,989.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,344.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,989.70
Rate for Payer: Cigna Commercial	$5,862.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,837.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,579.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,758.64
Rate for Payer: UnitedHealthcare Community & State	$282.56
Rate for Payer: Wellpoint Medicaid Managed Care	$310.69

SIZE EF 12MM POLY LPSFLEX 7-10

Facility

$5,862.10

Hospital Charge Code	270657115
Hospital Revenue Code	278
Min. Negotiated Rate	$141.28
Max. Negotiated Rate	$2,931.05
Rate for Payer: Aetna Commercial	$2,227.60
Rate for Payer: Aetna Medicare Advantage	$1,758.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,494.84
Rate for Payer: Cigna Commercial	$2,931.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,289.66
Rate for Payer: Qualcare PPO/HMO/WC	$879.32
Rate for Payer: UnitedHealthcare Community & State	$141.28
Rate for Payer: Wellpoint Medicaid Managed Care	$155.35

SIZE EF 12MM POLY LPSFLEX 7-10

Facility

$5,862.10

Hospital Charge Code	270657115
Hospital Revenue Code	278
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$1,418.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,289.66
Rate for Payer: Qualcare PPO/HMO/WC	$879.32

SIZE E,F 23MM 7-10

Facility

$5,862.10

Hospital Charge Code	270657114
Hospital Revenue Code	278
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$1,418.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,289.66
Rate for Payer: Qualcare PPO/HMO/WC	$879.32

SIZE E,F 23MM 7-10

Facility

$5,862.10

Hospital Charge Code	270657114
Hospital Revenue Code	278
Min. Negotiated Rate	$141.28
Max. Negotiated Rate	$2,931.05
Rate for Payer: Aetna Commercial	$2,227.60
Rate for Payer: Aetna Medicare Advantage	$1,758.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,494.84
Rate for Payer: Cigna Commercial	$2,931.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,289.66
Rate for Payer: Qualcare PPO/HMO/WC	$879.32
Rate for Payer: UnitedHealthcare Community & State	$141.28
Rate for Payer: Wellpoint Medicaid Managed Care	$155.35

SIZE E LEFT GSF-FLEX

Facility

$12,166.15

Hospital Charge Code	270657110
Hospital Revenue Code	278
Min. Negotiated Rate	$293.20
Max. Negotiated Rate	$6,083.07
Rate for Payer: Aetna Commercial	$4,623.14
Rate for Payer: Aetna Medicare Advantage	$3,649.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,102.37
Rate for Payer: Cigna Commercial	$6,083.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,676.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92
Rate for Payer: UnitedHealthcare Community & State	$293.20
Rate for Payer: Wellpoint Medicaid Managed Care	$322.40

SIZE E LEFT GSF-FLEX

Facility

$12,166.15

Hospital Charge Code	270657110
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.92
Max. Negotiated Rate	$2,944.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,676.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92

SIZE E LEFT LPS-FLEX

Facility

$11,724.30

Hospital Charge Code	270657111
Hospital Revenue Code	278
Min. Negotiated Rate	$282.56
Max. Negotiated Rate	$5,862.15
Rate for Payer: Aetna Commercial	$4,455.23
Rate for Payer: Aetna Medicare Advantage	$3,517.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,989.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,989.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,344.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,989.70
Rate for Payer: Cigna Commercial	$5,862.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,837.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,579.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,758.64
Rate for Payer: UnitedHealthcare Community & State	$282.56
Rate for Payer: Wellpoint Medicaid Managed Care	$310.69

SIZE E LEFT LPS-FLEX

Facility

$11,724.30

Hospital Charge Code	270657111
Hospital Revenue Code	278
Min. Negotiated Rate	$1,758.64
Max. Negotiated Rate	$2,837.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,344.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,837.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,579.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,758.64

SIZE E RIGHT GSF FLEX

Facility

$12,166.15

Hospital Charge Code	270657112
Hospital Revenue Code	278
Min. Negotiated Rate	$293.20
Max. Negotiated Rate	$6,083.07
Rate for Payer: Aetna Commercial	$4,623.14
Rate for Payer: Aetna Medicare Advantage	$3,649.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,102.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,102.37
Rate for Payer: Cigna Commercial	$6,083.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,676.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92
Rate for Payer: UnitedHealthcare Community & State	$293.20
Rate for Payer: Wellpoint Medicaid Managed Care	$322.40

SIZE E RIGHT GSF FLEX

Facility

$12,166.15

Hospital Charge Code	270657112
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.92
Max. Negotiated Rate	$2,944.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,944.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,676.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.92

SIZE E RIGHT LPS-FLEX

Facility

$11,724.30

Hospital Charge Code	270657113
Hospital Revenue Code	278
Min. Negotiated Rate	$282.56
Max. Negotiated Rate	$5,862.15
Rate for Payer: Aetna Commercial	$4,455.23
Rate for Payer: Aetna Medicare Advantage	$3,517.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,989.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,989.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,344.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,989.70
Rate for Payer: Cigna Commercial	$5,862.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,837.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,579.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,758.64
Rate for Payer: UnitedHealthcare Community & State	$282.56
Rate for Payer: Wellpoint Medicaid Managed Care	$310.69

Know your out-of-pocket cost for care.

All Charges