Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SIZE E RIGHT LPS-FLEX

Facility

$11,724.30

Hospital Charge Code	270657113
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 F LEFT GSF LPS-FLEX

Facility

$12,166.15

Hospital Charge Code	270657116
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 F LEFT GSF LPS-FLEX

Facility

$12,166.15

Hospital Charge Code	270657116
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 F RIGHT LPS-FLEX

Facility

$11,724.30

Hospital Charge Code	270657117
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 F RIGHT LPS-FLEX

Facility

$11,724.30

Hospital Charge Code	270657117
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

SIZER CIRCULAR 25/29/33MM

Facility

$822.65

Hospital Charge Code	270608835
Hospital Revenue Code	272
Min. Negotiated Rate	$19.83
Max. Negotiated Rate	$411.32
Rate for Payer: Aetna Commercial	$312.61
Rate for Payer: Aetna Medicare Advantage	$246.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.78
Rate for Payer: Cigna Commercial	$411.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.79
Rate for Payer: Oxford Commercial	$164.53
Rate for Payer: Qualcare PPO/HMO/WC	$123.40
Rate for Payer: UnitedHealthcare Commercial	$164.53
Rate for Payer: UnitedHealthcare Community & State	$19.83
Rate for Payer: Wellpoint Medicaid Managed Care	$21.80

SIZER CIRCULAR 25/29/33MM

Facility

$822.65

Hospital Charge Code	270608835
Hospital Revenue Code	272
Min. Negotiated Rate	$123.40
Max. Negotiated Rate	$123.40
Rate for Payer: Qualcare PPO/HMO/WC	$123.40

SIZER CNTR VOL 550cc 350-0714S

Facility

$223.25

Hospital Charge Code	270619649
Hospital Revenue Code	272
Min. Negotiated Rate	$5.38
Max. Negotiated Rate	$111.62
Rate for Payer: Aetna Commercial	$84.83
Rate for Payer: Aetna Medicare Advantage	$66.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.93
Rate for Payer: Cigna Commercial	$111.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.97
Rate for Payer: Oxford Commercial	$44.65
Rate for Payer: Qualcare PPO/HMO/WC	$33.49
Rate for Payer: UnitedHealthcare Commercial	$44.65
Rate for Payer: UnitedHealthcare Community & State	$5.38
Rate for Payer: Wellpoint Medicaid Managed Care	$5.92

SIZER CNTR VOL 550cc 350-0714S

Facility

$223.25

Hospital Charge Code	270619649
Hospital Revenue Code	272
Min. Negotiated Rate	$33.49
Max. Negotiated Rate	$33.49
Rate for Payer: Qualcare PPO/HMO/WC	$33.49

SIZER CONTOUR 125CC 350-125S

Facility

$414.45

Hospital Charge Code	270615792
Hospital Revenue Code	272
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

SIZER CONTOUR 125CC 350-125S

Facility

$414.45

Hospital Charge Code	270615792
Hospital Revenue Code	272
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$207.22
Rate for Payer: Aetna Commercial	$157.49
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.68
Rate for Payer: Cigna Commercial	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.33
Rate for Payer: Oxford Commercial	$82.89
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$82.89
Rate for Payer: UnitedHealthcare Community & State	$9.99
Rate for Payer: Wellpoint Medicaid Managed Care	$10.98

SIZER CONTOUR 175CC 350-175S

Facility

$414.45

Hospital Charge Code	270615793
Hospital Revenue Code	272
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

SIZER CONTOUR 175CC 350-175S

Facility

$414.45

Hospital Charge Code	270615793
Hospital Revenue Code	272
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$207.22
Rate for Payer: Aetna Commercial	$157.49
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.68
Rate for Payer: Cigna Commercial	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.33
Rate for Payer: Oxford Commercial	$82.89
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$82.89
Rate for Payer: UnitedHealthcare Community & State	$9.99
Rate for Payer: Wellpoint Medicaid Managed Care	$10.98

SIZER CONTOUR 350CC 350-0172S

Facility

$346.45

Hospital Charge Code	270614002
Hospital Revenue Code	272
Min. Negotiated Rate	$8.35
Max. Negotiated Rate	$173.22
Rate for Payer: Aetna Commercial	$131.65
Rate for Payer: Aetna Medicare Advantage	$103.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.34
Rate for Payer: Cigna Commercial	$173.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.94
Rate for Payer: Oxford Commercial	$69.29
Rate for Payer: Qualcare PPO/HMO/WC	$51.97
Rate for Payer: UnitedHealthcare Commercial	$69.29
Rate for Payer: UnitedHealthcare Community & State	$8.35
Rate for Payer: Wellpoint Medicaid Managed Care	$9.18

SIZER CONTOUR 350CC 350-0172S

Facility

$346.45

Hospital Charge Code	270614002
Hospital Revenue Code	272
Min. Negotiated Rate	$51.97
Max. Negotiated Rate	$51.97
Rate for Payer: Qualcare PPO/HMO/WC	$51.97

SIZER CONTOUR CC 350-0711S

Facility

$231.25

Hospital Charge Code	270613848
Hospital Revenue Code	272
Min. Negotiated Rate	$5.57
Max. Negotiated Rate	$115.62
Rate for Payer: Aetna Commercial	$87.88
Rate for Payer: Aetna Medicare Advantage	$69.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.97
Rate for Payer: Cigna Commercial	$115.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.38
Rate for Payer: Oxford Commercial	$46.25
Rate for Payer: Qualcare PPO/HMO/WC	$34.69
Rate for Payer: UnitedHealthcare Commercial	$46.25
Rate for Payer: UnitedHealthcare Community & State	$5.57
Rate for Payer: Wellpoint Medicaid Managed Care	$6.13

SIZER CONTOUR CC 350-0711S

Facility

$231.25

Hospital Charge Code	270613848
Hospital Revenue Code	272
Min. Negotiated Rate	$34.69
Max. Negotiated Rate	$34.69
Rate for Payer: Qualcare PPO/HMO/WC	$34.69

SIZER CONTR VOL 450cc 3500713S

Facility

$223.25

Hospital Charge Code	270614097
Hospital Revenue Code	272
Min. Negotiated Rate	$5.38
Max. Negotiated Rate	$111.62
Rate for Payer: Aetna Commercial	$84.83
Rate for Payer: Aetna Medicare Advantage	$66.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.93
Rate for Payer: Cigna Commercial	$111.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.97
Rate for Payer: Oxford Commercial	$44.65
Rate for Payer: Qualcare PPO/HMO/WC	$33.49
Rate for Payer: UnitedHealthcare Commercial	$44.65
Rate for Payer: UnitedHealthcare Community & State	$5.38
Rate for Payer: Wellpoint Medicaid Managed Care	$5.92

SIZER CONTR VOL 450cc 3500713S

Facility

$223.25

Hospital Charge Code	270614097
Hospital Revenue Code	272
Min. Negotiated Rate	$33.49
Max. Negotiated Rate	$33.49
Rate for Payer: Qualcare PPO/HMO/WC	$33.49

SIZER CONTR VOL 550cc 3500714S

Facility

$223.25

Hospital Charge Code	270614649
Hospital Revenue Code	272
Min. Negotiated Rate	$5.38
Max. Negotiated Rate	$111.62
Rate for Payer: Aetna Commercial	$84.83
Rate for Payer: Aetna Medicare Advantage	$66.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.93
Rate for Payer: Cigna Commercial	$111.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.97
Rate for Payer: Oxford Commercial	$44.65
Rate for Payer: Qualcare PPO/HMO/WC	$33.49
Rate for Payer: UnitedHealthcare Commercial	$44.65
Rate for Payer: UnitedHealthcare Community & State	$5.38
Rate for Payer: Wellpoint Medicaid Managed Care	$5.92

SIZER CONTR VOL 550cc 3500714S

Facility

$223.25

Hospital Charge Code	270614649
Hospital Revenue Code	272
Min. Negotiated Rate	$33.49
Max. Negotiated Rate	$33.49
Rate for Payer: Qualcare PPO/HMO/WC	$33.49

SIZER CONTUR VOL 225CC 350225S

Facility

$223.25

Hospital Charge Code	270621088
Hospital Revenue Code	272
Min. Negotiated Rate	$33.49
Max. Negotiated Rate	$33.49
Rate for Payer: Qualcare PPO/HMO/WC	$33.49

SIZER CONTUR VOL 225CC 350225S

Facility

$223.25

Hospital Charge Code	270621088
Hospital Revenue Code	272
Min. Negotiated Rate	$5.38
Max. Negotiated Rate	$111.62
Rate for Payer: Aetna Commercial	$84.83
Rate for Payer: Aetna Medicare Advantage	$66.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.93
Rate for Payer: Cigna Commercial	$111.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.97
Rate for Payer: Oxford Commercial	$44.65
Rate for Payer: Qualcare PPO/HMO/WC	$33.49
Rate for Payer: UnitedHealthcare Commercial	$44.65
Rate for Payer: UnitedHealthcare Community & State	$5.38
Rate for Payer: Wellpoint Medicaid Managed Care	$5.92

SIZER EXTRA HIGH PROFILE 500cc

Facility

$1,000.00

Hospital Charge Code	270673558
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

SIZER EXTRA HIGH PROFILE 500cc

Facility

$1,000.00

Hospital Charge Code	270673558
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

Know your out-of-pocket cost for care.

All Charges