Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BAL MAV MONO 3.0x20m 389282030

Facility

$1,036.00

Hospital Charge Code	270639397C
Hospital Revenue Code	272
Min. Negotiated Rate	$24.97
Max. Negotiated Rate	$518.00
Rate for Payer: Aetna Commercial	$393.68
Rate for Payer: Aetna Medicare Advantage	$310.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$264.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$264.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$264.18
Rate for Payer: Cigna Commercial	$518.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.80
Rate for Payer: Oxford Commercial	$207.20
Rate for Payer: Qualcare PPO/HMO/WC	$155.40
Rate for Payer: UnitedHealthcare Commercial	$207.20
Rate for Payer: UnitedHealthcare Community & State	$24.97
Rate for Payer: Wellpoint Medicaid Managed Care	$27.45

BAL MAV MONO 3.0x9m 389280930

Facility

$1,295.00

Hospital Charge Code	270637972
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV MONO 3.0x9m 389280930

Facility

$1,295.00

Hospital Charge Code	270637972
Hospital Revenue Code	278
Min. Negotiated Rate	$31.21
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$492.10
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Community & State	$31.21
Rate for Payer: Wellpoint Medicaid Managed Care	$34.32

BAL MAV MONO 3.5x12m 389281235

Facility

$1,295.00

Hospital Charge Code	270638018
Hospital Revenue Code	278
Min. Negotiated Rate	$31.21
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$492.10
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Community & State	$31.21
Rate for Payer: Wellpoint Medicaid Managed Care	$34.32

BAL MAV MONO 3.5x12m 389281235

Facility

$1,295.00

Hospital Charge Code	270638018
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV MONO 3.5x15m 389281535

Facility

$1,295.00

Hospital Charge Code	270639279
Hospital Revenue Code	278
Min. Negotiated Rate	$31.21
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$492.10
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Community & State	$31.21
Rate for Payer: Wellpoint Medicaid Managed Care	$34.32

BAL MAV MONO 3.5x15m 389281535

Facility

$1,295.00

Hospital Charge Code	270639279
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV MONO 3.75x12 389281237

Facility

$1,295.00

Hospital Charge Code	270638237
Hospital Revenue Code	278
Min. Negotiated Rate	$31.21
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$492.10
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Community & State	$31.21
Rate for Payer: Wellpoint Medicaid Managed Care	$34.32

BAL MAV MONO 3.75x12 389281237

Facility

$1,295.00

Hospital Charge Code	270638237
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 1.5X15M 206201515

Facility

$1,295.00

Hospital Charge Code	270636797
Hospital Revenue Code	278
Min. Negotiated Rate	$31.21
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$492.10
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Community & State	$31.21
Rate for Payer: Wellpoint Medicaid Managed Care	$34.32

BAL MAV OTW 1.5X15M 206201515

Facility

$1,295.00

Hospital Charge Code	270636797
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 1.5x20m 206202015

Facility

$1,295.00

Hospital Charge Code	270637713
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 1.5x20m 206202015

Facility

$1,295.00

Hospital Charge Code	270637713
Hospital Revenue Code	278
Min. Negotiated Rate	$31.21
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$492.10
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Community & State	$31.21
Rate for Payer: Wellpoint Medicaid Managed Care	$34.32

BAL MAV OTW 1.5x9mm 206200915

Facility

$1,295.00

Hospital Charge Code	270639413
Hospital Revenue Code	278
Min. Negotiated Rate	$31.21
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$492.10
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Community & State	$31.21
Rate for Payer: Wellpoint Medicaid Managed Care	$34.32

BAL MAV OTW 1.5x9mm 206200915

Facility

$1,295.00

Hospital Charge Code	270639413
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 2.0X12M 206201220

Facility

$1,284.70

Hospital Charge Code	270636612
Hospital Revenue Code	278
Min. Negotiated Rate	$192.71
Max. Negotiated Rate	$310.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$282.63
Rate for Payer: Qualcare PPO/HMO/WC	$192.71

BAL MAV OTW 2.0X12M 206201220

Facility

$1,284.70

Hospital Charge Code	270636612
Hospital Revenue Code	278
Min. Negotiated Rate	$30.96
Max. Negotiated Rate	$642.35
Rate for Payer: Aetna Commercial	$488.19
Rate for Payer: Aetna Medicare Advantage	$385.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$327.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$327.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$327.60
Rate for Payer: Cigna Commercial	$642.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$282.63
Rate for Payer: Qualcare PPO/HMO/WC	$192.71
Rate for Payer: UnitedHealthcare Community & State	$30.96
Rate for Payer: Wellpoint Medicaid Managed Care	$34.04

BAL MAV OTW 2.0X15M 206201520

Facility

$1,284.70

Hospital Charge Code	270636795
Hospital Revenue Code	278
Min. Negotiated Rate	$192.71
Max. Negotiated Rate	$310.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$282.63
Rate for Payer: Qualcare PPO/HMO/WC	$192.71

BAL MAV OTW 2.0X15M 206201520

Facility

$1,284.70

Hospital Charge Code	270636795
Hospital Revenue Code	278
Min. Negotiated Rate	$30.96
Max. Negotiated Rate	$642.35
Rate for Payer: Aetna Commercial	$488.19
Rate for Payer: Aetna Medicare Advantage	$385.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$327.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$327.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$327.60
Rate for Payer: Cigna Commercial	$642.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$282.63
Rate for Payer: Qualcare PPO/HMO/WC	$192.71
Rate for Payer: UnitedHealthcare Community & State	$30.96
Rate for Payer: Wellpoint Medicaid Managed Care	$34.04

BAL MAV OTW 2.0x20m 206202020

Facility

$1,295.00

Hospital Charge Code	270637780
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 2.0x20m 206202020

Facility

$1,295.00

Hospital Charge Code	270637780
Hospital Revenue Code	278
Min. Negotiated Rate	$31.21
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$492.10
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Community & State	$31.21
Rate for Payer: Wellpoint Medicaid Managed Care	$34.32

BAL MAV OTW 2.0x9m 206200920

Facility

$1,295.00

Hospital Charge Code	270637315
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 2.0x9m 206200920

Facility

$1,295.00

Hospital Charge Code	270637315
Hospital Revenue Code	278
Min. Negotiated Rate	$31.21
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$492.10
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Community & State	$31.21
Rate for Payer: Wellpoint Medicaid Managed Care	$34.32

BAL MAV OTW 2.25X12 206201222

Facility

$1,295.00

Hospital Charge Code	270637188
Hospital Revenue Code	278
Min. Negotiated Rate	$31.21
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$492.10
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Community & State	$31.21
Rate for Payer: Wellpoint Medicaid Managed Care	$34.32

BAL MAV OTW 2.25X12 206201222

Facility

$1,295.00

Hospital Charge Code	270637188
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.90
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

Know your out-of-pocket cost for care.

All Charges