Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES

Facility

$16,953.39

Service Code	APR-DRG 3611
Min. Negotiated Rate	$16,620.97
Max. Negotiated Rate	$16,953.39
Rate for Payer: UnitedHealthcare Community & State	$16,620.97
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,953.39
Rate for Payer: Wellpoint Medicaid Managed Care	$16,620.97

SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES

Facility

$31,684.13

Service Code	APR-DRG 3613
Min. Negotiated Rate	$31,062.87
Max. Negotiated Rate	$31,684.13
Rate for Payer: UnitedHealthcare Community & State	$31,062.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$31,684.13
Rate for Payer: Wellpoint Medicaid Managed Care	$31,062.87

SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES

Facility

$21,349.15

Service Code	APR-DRG 3612
Min. Negotiated Rate	$20,930.54
Max. Negotiated Rate	$21,349.15
Rate for Payer: UnitedHealthcare Community & State	$20,930.54
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,349.15
Rate for Payer: Wellpoint Medicaid Managed Care	$20,930.54

SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES

Facility

$66,762.99

Service Code	APR-DRG 3614
Min. Negotiated Rate	$65,453.91
Max. Negotiated Rate	$66,762.99
Rate for Payer: UnitedHealthcare Community & State	$65,453.91
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$66,762.99
Rate for Payer: Wellpoint Medicaid Managed Care	$65,453.91

SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC

Facility

$114,335.49

Service Code	MSDRG 574
Min. Negotiated Rate	$34,813.69
Max. Negotiated Rate	$114,335.49
Rate for Payer: Aetna Commercial	$78,818.85
Rate for Payer: Aetna Medicare Advantage	$114,335.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79,320.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79,320.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$36,645.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79,320.01
Rate for Payer: Cigna Commercial	$64,963.78
Rate for Payer: Cigna Medicare Advantage	$36,645.99
Rate for Payer: Clover Medicare Advantage	$34,813.69
Rate for Payer: EmblemHealth Commercial	$109,937.97
Rate for Payer: Humana Medicare Advantage	$37,745.37
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$36,645.99
Rate for Payer: Oxford Commercial	$46,690.33
Rate for Payer: UnitedHealthcare Commercial	$81,872.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$36,645.99
Rate for Payer: Wellcare Medicare Advantage	$36,645.99

SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC

Facility

$213,886.17

Service Code	MSDRG 573
Min. Negotiated Rate	$65,125.60
Max. Negotiated Rate	$213,886.17
Rate for Payer: Aetna Commercial	$147,221.50
Rate for Payer: Aetna Medicare Advantage	$213,886.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144,683.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144,683.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$68,553.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144,683.42
Rate for Payer: Cigna Commercial	$122,602.90
Rate for Payer: Cigna Medicare Advantage	$68,553.26
Rate for Payer: Clover Medicare Advantage	$65,125.60
Rate for Payer: EmblemHealth Commercial	$205,659.78
Rate for Payer: Humana Medicare Advantage	$70,609.86
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$68,553.26
Rate for Payer: Oxford Commercial	$88,116.33
Rate for Payer: UnitedHealthcare Commercial	$154,514.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$68,553.26
Rate for Payer: Wellcare Medicare Advantage	$68,553.26

SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC

Facility

$60,216.06

Service Code	MSDRG 575
Min. Negotiated Rate	$18,335.02
Max. Negotiated Rate	$60,216.06
Rate for Payer: Aetna Commercial	$41,632.62
Rate for Payer: Aetna Medicare Advantage	$60,216.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47,685.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47,685.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,300.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47,685.05
Rate for Payer: Cigna Commercial	$30,571.19
Rate for Payer: Cigna Medicare Advantage	$19,300.02
Rate for Payer: Clover Medicare Advantage	$18,335.02
Rate for Payer: EmblemHealth Commercial	$57,900.06
Rate for Payer: Humana Medicare Advantage	$19,879.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19,300.02
Rate for Payer: Oxford Commercial	$21,971.92
Rate for Payer: UnitedHealthcare Commercial	$38,528.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,300.02
Rate for Payer: Wellcare Medicare Advantage	$19,300.02

SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC

Facility

$60,115.91

Service Code	MSDRG 623
Min. Negotiated Rate	$18,304.52
Max. Negotiated Rate	$60,115.91
Rate for Payer: Aetna Commercial	$41,563.80
Rate for Payer: Aetna Medicare Advantage	$60,115.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43,265.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43,265.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,267.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43,265.46
Rate for Payer: Cigna Commercial	$33,571.04
Rate for Payer: Cigna Medicare Advantage	$19,267.92
Rate for Payer: Clover Medicare Advantage	$18,304.52
Rate for Payer: EmblemHealth Commercial	$57,803.76
Rate for Payer: Humana Medicare Advantage	$19,845.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19,267.92
Rate for Payer: Oxford Commercial	$24,127.96
Rate for Payer: UnitedHealthcare Commercial	$42,309.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,267.92
Rate for Payer: Wellcare Medicare Advantage	$19,267.92

SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC

Facility

$117,173.25

Service Code	MSDRG 622
Min. Negotiated Rate	$35,677.75
Max. Negotiated Rate	$117,173.25
Rate for Payer: Aetna Commercial	$80,768.72
Rate for Payer: Aetna Medicare Advantage	$117,173.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89,089.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89,089.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37,555.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89,089.63
Rate for Payer: Cigna Commercial	$66,606.87
Rate for Payer: Cigna Medicare Advantage	$37,555.53
Rate for Payer: Clover Medicare Advantage	$35,677.75
Rate for Payer: EmblemHealth Commercial	$112,666.59
Rate for Payer: Humana Medicare Advantage	$38,682.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$37,555.53
Rate for Payer: Oxford Commercial	$47,871.24
Rate for Payer: UnitedHealthcare Commercial	$83,943.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$37,555.53
Rate for Payer: Wellcare Medicare Advantage	$37,555.53

SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC

Facility

$42,597.55

Service Code	MSDRG 624
Min. Negotiated Rate	$12,970.41
Max. Negotiated Rate	$42,597.55
Rate for Payer: Aetna Commercial	$29,526.69
Rate for Payer: Aetna Medicare Advantage	$42,597.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,819.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,819.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,653.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,819.71
Rate for Payer: Cigna Commercial	$23,428.06
Rate for Payer: Cigna Medicare Advantage	$13,653.06
Rate for Payer: Clover Medicare Advantage	$12,970.41
Rate for Payer: EmblemHealth Commercial	$40,959.18
Rate for Payer: Humana Medicare Advantage	$14,062.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,653.06
Rate for Payer: Oxford Commercial	$16,838.06
Rate for Payer: UnitedHealthcare Commercial	$29,526.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,653.06
Rate for Payer: Wellcare Medicare Advantage	$13,653.06

SKIN GRAFTS FOR INJURIES WITH CC/MCC

Facility

$120,854.70

Service Code	MSDRG 904
Min. Negotiated Rate	$36,798.71
Max. Negotiated Rate	$120,854.70
Rate for Payer: Aetna Commercial	$83,298.27
Rate for Payer: Aetna Medicare Advantage	$120,854.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75,830.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75,830.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$38,735.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75,830.86
Rate for Payer: Cigna Commercial	$68,738.39
Rate for Payer: Cigna Medicare Advantage	$38,735.48
Rate for Payer: Clover Medicare Advantage	$36,798.71
Rate for Payer: EmblemHealth Commercial	$116,206.44
Rate for Payer: Humana Medicare Advantage	$39,897.54
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$38,735.48
Rate for Payer: Oxford Commercial	$49,403.19
Rate for Payer: UnitedHealthcare Commercial	$86,630.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$38,735.48
Rate for Payer: Wellcare Medicare Advantage	$38,735.48

SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC

Facility

$50,079.99

Service Code	MSDRG 905
Min. Negotiated Rate	$15,248.72
Max. Negotiated Rate	$50,079.99
Rate for Payer: Aetna Commercial	$34,667.99
Rate for Payer: Aetna Medicare Advantage	$50,079.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36,752.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36,752.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,051.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36,752.38
Rate for Payer: Cigna Commercial	$26,794.71
Rate for Payer: Cigna Medicare Advantage	$16,051.28
Rate for Payer: Clover Medicare Advantage	$15,248.72
Rate for Payer: EmblemHealth Commercial	$48,153.84
Rate for Payer: Humana Medicare Advantage	$16,532.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,051.28
Rate for Payer: Oxford Commercial	$19,257.71
Rate for Payer: UnitedHealthcare Commercial	$33,769.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,051.28
Rate for Payer: Wellcare Medicare Advantage	$16,051.28

SKIN HOOK JOSEPH DOUBLE 6 IN

Facility

$492.55

Hospital Charge Code	270684791
Hospital Revenue Code	272
Min. Negotiated Rate	$11.87
Max. Negotiated Rate	$246.28
Rate for Payer: Aetna Commercial	$187.17
Rate for Payer: Aetna Medicare Advantage	$147.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.60
Rate for Payer: Cigna Commercial	$246.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.76
Rate for Payer: Oxford Commercial	$98.51
Rate for Payer: Qualcare PPO/HMO/WC	$73.88
Rate for Payer: UnitedHealthcare Commercial	$98.51
Rate for Payer: UnitedHealthcare Community & State	$11.87
Rate for Payer: Wellpoint Medicaid Managed Care	$13.05

SKIN HOOK JOSEPH DOUBLE 6 IN

Facility

$492.55

Hospital Charge Code	270684791
Hospital Revenue Code	272
Min. Negotiated Rate	$73.88
Max. Negotiated Rate	$73.88
Rate for Payer: Qualcare PPO/HMO/WC	$73.88

SKIN LOTION

Facility

$67.25

Hospital Charge Code	60628457
Hospital Revenue Code	250
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$10.09
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SKIN LOTION

Facility

$53.80

Hospital Charge Code	60628458
Hospital Revenue Code	250
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

SKIN LOTION

Facility

$67.25

Hospital Charge Code	60628457
Hospital Revenue Code	250
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$33.62
Rate for Payer: Aetna Commercial	$25.55
Rate for Payer: Aetna Medicare Advantage	$20.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$33.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.18
Rate for Payer: Oxford Commercial	$13.45
Rate for Payer: Qualcare PPO/HMO/WC	$10.09
Rate for Payer: UnitedHealthcare Commercial	$13.45
Rate for Payer: UnitedHealthcare Community & State	$1.62
Rate for Payer: Wellpoint Medicaid Managed Care	$1.78

SKIN LOTION

Facility

$53.80

Hospital Charge Code	60628458
Hospital Revenue Code	250
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$26.90
Rate for Payer: Aetna Commercial	$20.44
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.14
Rate for Payer: Oxford Commercial	$10.76
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$10.76
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

SKIN LOTION

Facility

$26.90

Hospital Charge Code	60628456
Hospital Revenue Code	250
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$4.04
Rate for Payer: Qualcare PPO/HMO/WC	$4.04

SKIN LOTION

Facility

$26.90

Hospital Charge Code	60628456
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$13.45
Rate for Payer: Aetna Commercial	$10.22
Rate for Payer: Aetna Medicare Advantage	$8.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.86
Rate for Payer: Cigna Commercial	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.07
Rate for Payer: Oxford Commercial	$5.38
Rate for Payer: Qualcare PPO/HMO/WC	$4.04
Rate for Payer: UnitedHealthcare Commercial	$5.38
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

SKIN OIL 120ML

Facility

$21.15

Hospital Charge Code	6009971
Hospital Revenue Code	250
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

SKIN OIL 120ML

Facility

$21.15

Hospital Charge Code	6009971
Hospital Revenue Code	250
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$10.57
Rate for Payer: Aetna Commercial	$8.04
Rate for Payer: Aetna Medicare Advantage	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.39
Rate for Payer: Cigna Commercial	$10.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.34
Rate for Payer: Oxford Commercial	$4.23
Rate for Payer: Qualcare PPO/HMO/WC	$3.17
Rate for Payer: UnitedHealthcare Commercial	$4.23
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

SKIN PARTIAL THICK,ABRASION

Facility

$1,050.00

Service Code	HCPCS 11040
Hospital Charge Code	1600000376
Hospital Revenue Code	360
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$315.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Community & State	$25.30
Rate for Payer: Wellpoint Medicaid Managed Care	$27.82

SKIN PARTIAL THICK,ABRASION

Facility

$1,050.00

Service Code	HCPCS 11040
Hospital Charge Code	1600000376
Hospital Revenue Code	360
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$157.50
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SKIN PREP BOX ******

Facility

$95.00

Hospital Charge Code	8001554
Hospital Revenue Code	279
Min. Negotiated Rate	$14.25
Max. Negotiated Rate	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$14.25

Know your out-of-pocket cost for care.

All Charges