Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BAL MAV OTW 2.25X15M 206201522

Facility

$1,284.70

Hospital Charge Code	270636693
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 2.25X15M 206201522

Facility

$1,284.70

Hospital Charge Code	270636693
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 2.25X20M 206202022

Facility

$1,295.00

Hospital Charge Code	270637338
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 2.25X20M 206202022

Facility

$1,295.00

Hospital Charge Code	270637338
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 2.25x9m 206200922

Facility

$1,295.00

Hospital Charge Code	270637308
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 2.25x9m 206200922

Facility

$1,295.00

Hospital Charge Code	270637308
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 2.5X12M 206201225

Facility

$1,284.70

Hospital Charge Code	270636579
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 2.5X12M 206201225

Facility

$1,284.70

Hospital Charge Code	270636579
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 2.5X15M 206201525

Facility

$1,295.00

Hospital Charge Code	270637117
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 2.5X15M 206201525

Facility

$1,295.00

Hospital Charge Code	270637117
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 2.5x20m 206202025

Facility

$1,295.00

Hospital Charge Code	270637470V
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 2.5x20m 206202025

Facility

$1,295.00

Hospital Charge Code	270637470V
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 2.5X20M 206202025

Facility

$1,295.00

Hospital Charge Code	270637470
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 2.5X20M 206202025

Facility

$1,295.00

Hospital Charge Code	270637470
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 2.5X9m 206200925

Facility

$1,295.00

Hospital Charge Code	270638503
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 2.5X9m 206200925

Facility

$1,295.00

Hospital Charge Code	270638503
Hospital Revenue Code	272
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) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$388.50
Rate for Payer: Oxford Commercial	$259.00
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Commercial	$259.00
Rate for Payer: UnitedHealthcare Community & State	$31.21
Rate for Payer: Wellpoint Medicaid Managed Care	$34.32

BAL MAV OTW 2.75x12m 206201227

Facility

$1,295.00

Hospital Charge Code	270637650
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 2.75x12m 206201227

Facility

$1,295.00

Hospital Charge Code	270637650
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 2.75X15M 206201527

Facility

$1,284.70

Hospital Charge Code	270636611
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 2.75X15M 206201527

Facility

$1,284.70

Hospital Charge Code	270636611
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 2.75x9m 206200927

Facility

$1,295.00

Hospital Charge Code	270637877
Hospital Revenue Code	272
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

BAL MAV OTW 2.75x9m 206200927

Facility

$1,295.00

Hospital Charge Code	270637877
Hospital Revenue Code	272
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) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$388.50
Rate for Payer: Oxford Commercial	$259.00
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Commercial	$259.00
Rate for Payer: UnitedHealthcare Community & State	$31.21
Rate for Payer: Wellpoint Medicaid Managed Care	$34.32

BAL MAV OTW 3.0X12M 206201230

Facility

$1,295.00

Hospital Charge Code	270636597
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 3.0X12M 206201230

Facility

$1,295.00

Hospital Charge Code	270636597
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 3.0X15M 206201530

Facility

$1,284.70

Hospital Charge Code	270636765
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

Know your out-of-pocket cost for care.

All Charges