Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SURFACE ZIM ART P Y10 59823010

Facility

$2,956.00

Hospital Charge Code	270611704
Hospital Revenue Code	278
Min. Negotiated Rate	$443.40
Max. Negotiated Rate	$715.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$591.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$715.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$650.32
Rate for Payer: Qualcare PPO/HMO/WC	$443.40

SURFACE ZIM ART P Y14 59823014

Facility

$2,956.00

Hospital Charge Code	270607659
Hospital Revenue Code	270
Min. Negotiated Rate	$71.24
Max. Negotiated Rate	$1,478.00
Rate for Payer: Aetna Commercial	$1,123.28
Rate for Payer: Aetna Medicare Advantage	$886.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$753.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$753.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$753.78
Rate for Payer: Cigna Commercial	$1,478.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$886.80
Rate for Payer: Oxford Commercial	$591.20
Rate for Payer: Qualcare PPO/HMO/WC	$443.40
Rate for Payer: UnitedHealthcare Commercial	$591.20
Rate for Payer: UnitedHealthcare Community & State	$71.24
Rate for Payer: Wellpoint Medicaid Managed Care	$78.33

SURFACE ZIM ART P Y14 59823014

Facility

$2,956.00

Hospital Charge Code	270607659
Hospital Revenue Code	270
Min. Negotiated Rate	$443.40
Max. Negotiated Rate	$443.40
Rate for Payer: Qualcare PPO/HMO/WC	$443.40

SURFACE ZIM ART Y10 59963210

Facility

$4,672.50

Hospital Charge Code	270628378
Hospital Revenue Code	272
Min. Negotiated Rate	$112.61
Max. Negotiated Rate	$2,336.25
Rate for Payer: Aetna Commercial	$1,775.55
Rate for Payer: Aetna Medicare Advantage	$1,401.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,191.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,191.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,191.49
Rate for Payer: Cigna Commercial	$2,336.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,401.75
Rate for Payer: Oxford Commercial	$934.50
Rate for Payer: Qualcare PPO/HMO/WC	$700.88
Rate for Payer: UnitedHealthcare Commercial	$934.50
Rate for Payer: UnitedHealthcare Community & State	$112.61
Rate for Payer: Wellpoint Medicaid Managed Care	$123.82

SURFACE ZIM ART Y10 59963210

Facility

$4,672.50

Hospital Charge Code	270628378
Hospital Revenue Code	272
Min. Negotiated Rate	$700.88
Max. Negotiated Rate	$700.88
Rate for Payer: Qualcare PPO/HMO/WC	$700.88

SURF ART CD 3-4/YEL145996-3012

Facility

$4,456.95

Hospital Charge Code	270635287
Hospital Revenue Code	272
Min. Negotiated Rate	$668.54
Max. Negotiated Rate	$668.54
Rate for Payer: Qualcare PPO/HMO/WC	$668.54

SURF ART CD 3-4/YEL145996-3012

Facility

$4,456.95

Hospital Charge Code	270635287
Hospital Revenue Code	272
Min. Negotiated Rate	$107.41
Max. Negotiated Rate	$2,228.47
Rate for Payer: Aetna Commercial	$1,693.64
Rate for Payer: Aetna Medicare Advantage	$1,337.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,136.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,136.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,136.52
Rate for Payer: Cigna Commercial	$2,228.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,337.09
Rate for Payer: Oxford Commercial	$891.39
Rate for Payer: Qualcare PPO/HMO/WC	$668.54
Rate for Payer: UnitedHealthcare Commercial	$891.39
Rate for Payer: UnitedHealthcare Community & State	$107.41
Rate for Payer: Wellpoint Medicaid Managed Care	$118.11

SURF ART LPS GH5-6 14m59964214

Facility

$4,456.95

Hospital Charge Code	270635685
Hospital Revenue Code	272
Min. Negotiated Rate	$107.41
Max. Negotiated Rate	$2,228.47
Rate for Payer: Aetna Commercial	$1,693.64
Rate for Payer: Aetna Medicare Advantage	$1,337.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,136.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,136.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,136.52
Rate for Payer: Cigna Commercial	$2,228.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,337.09
Rate for Payer: Oxford Commercial	$891.39
Rate for Payer: Qualcare PPO/HMO/WC	$668.54
Rate for Payer: UnitedHealthcare Commercial	$891.39
Rate for Payer: UnitedHealthcare Community & State	$107.41
Rate for Payer: Wellpoint Medicaid Managed Care	$118.11

SURF ART LPS GH5-6 14m59964214

Facility

$4,456.95

Hospital Charge Code	270635685
Hospital Revenue Code	272
Min. Negotiated Rate	$668.54
Max. Negotiated Rate	$668.54
Rate for Payer: Qualcare PPO/HMO/WC	$668.54

SURFAS WANDS

Facility

$724.00

Hospital Charge Code	270332651
Hospital Revenue Code	272
Min. Negotiated Rate	$17.45
Max. Negotiated Rate	$362.00
Rate for Payer: Aetna Commercial	$275.12
Rate for Payer: Aetna Medicare Advantage	$217.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.62
Rate for Payer: Cigna Commercial	$362.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.20
Rate for Payer: Oxford Commercial	$144.80
Rate for Payer: Qualcare PPO/HMO/WC	$108.60
Rate for Payer: UnitedHealthcare Commercial	$144.80
Rate for Payer: UnitedHealthcare Community & State	$17.45
Rate for Payer: Wellpoint Medicaid Managed Care	$19.19

SURFAS WANDS

Facility

$724.00

Hospital Charge Code	270332651
Hospital Revenue Code	272
Min. Negotiated Rate	$108.60
Max. Negotiated Rate	$108.60
Rate for Payer: Qualcare PPO/HMO/WC	$108.60

SURFCE NXGN LPS NSMRT 59643212

Facility

$9,245.00

Hospital Charge Code	270639736
Hospital Revenue Code	278
Min. Negotiated Rate	$222.80
Max. Negotiated Rate	$4,622.50
Rate for Payer: Aetna Commercial	$3,513.10
Rate for Payer: Aetna Medicare Advantage	$2,773.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,357.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,357.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,849.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,357.47
Rate for Payer: Cigna Commercial	$4,622.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,237.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,033.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,386.75
Rate for Payer: UnitedHealthcare Community & State	$222.80
Rate for Payer: Wellpoint Medicaid Managed Care	$244.99

SURFCE NXGN LPS NSMRT 59643212

Facility

$9,245.00

Hospital Charge Code	270639736
Hospital Revenue Code	278
Min. Negotiated Rate	$1,386.75
Max. Negotiated Rate	$2,237.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,849.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,237.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,033.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,386.75

SUR-FIT NIGHT DRAINAGE

Facility

$207.00

Hospital Charge Code	270331470
Hospital Revenue Code	272
Min. Negotiated Rate	$31.05
Max. Negotiated Rate	$31.05
Rate for Payer: Qualcare PPO/HMO/WC	$31.05

SUR-FIT NIGHT DRAINAGE

Facility

$207.00

Hospital Charge Code	270331470
Hospital Revenue Code	272
Min. Negotiated Rate	$4.99
Max. Negotiated Rate	$103.50
Rate for Payer: Aetna Commercial	$78.66
Rate for Payer: Aetna Medicare Advantage	$62.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.78
Rate for Payer: Cigna Commercial	$103.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.10
Rate for Payer: Oxford Commercial	$41.40
Rate for Payer: Qualcare PPO/HMO/WC	$31.05
Rate for Payer: UnitedHealthcare Commercial	$41.40
Rate for Payer: UnitedHealthcare Community & State	$4.99
Rate for Payer: Wellpoint Medicaid Managed Care	$5.49

SURF ZIM ART NEX Y12 59723012

Facility

$3,900.00

Hospital Charge Code	270607474
Hospital Revenue Code	278
Min. Negotiated Rate	$93.99
Max. Negotiated Rate	$1,950.00
Rate for Payer: Aetna Commercial	$1,482.00
Rate for Payer: Aetna Medicare Advantage	$1,170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$994.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$994.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$994.50
Rate for Payer: Cigna Commercial	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$943.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$858.00
Rate for Payer: Qualcare PPO/HMO/WC	$585.00
Rate for Payer: UnitedHealthcare Community & State	$93.99
Rate for Payer: Wellpoint Medicaid Managed Care	$103.35

SURF ZIM ART NEX Y12 59723012

Facility

$3,900.00

Hospital Charge Code	270607474
Hospital Revenue Code	278
Min. Negotiated Rate	$585.00
Max. Negotiated Rate	$943.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$943.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$858.00
Rate for Payer: Qualcare PPO/HMO/WC	$585.00

SURGERY TIME 1ST HOUR

Facility

$5,093.20

Hospital Charge Code	1600010
Hospital Revenue Code	360
Min. Negotiated Rate	$122.75
Max. Negotiated Rate	$2,546.60
Rate for Payer: Aetna Commercial	$1,935.42
Rate for Payer: Aetna Medicare Advantage	$1,527.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,298.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,298.77
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	$1,298.77
Rate for Payer: Cigna Commercial	$2,546.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,527.96
Rate for Payer: Qualcare PPO/HMO/WC	$763.98
Rate for Payer: UnitedHealthcare Community & State	$122.75
Rate for Payer: Wellpoint Medicaid Managed Care	$134.97

SURGERY TIME 1ST HOUR

Facility

$5,093.20

Hospital Charge Code	1600010
Hospital Revenue Code	360
Min. Negotiated Rate	$763.98
Max. Negotiated Rate	$763.98
Rate for Payer: Qualcare PPO/HMO/WC	$763.98

SURGERY TIME EACH ADDTL 30MIN

Facility

$2,548.00

Hospital Charge Code	1600012
Hospital Revenue Code	360
Min. Negotiated Rate	$61.41
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$968.24
Rate for Payer: Aetna Medicare Advantage	$764.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$649.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$649.74
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	$649.74
Rate for Payer: Cigna Commercial	$1,274.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$764.40
Rate for Payer: Qualcare PPO/HMO/WC	$382.20
Rate for Payer: UnitedHealthcare Community & State	$61.41
Rate for Payer: Wellpoint Medicaid Managed Care	$67.52

SURGERY TIME EACH ADDTL 30MIN

Facility

$2,548.00

Hospital Charge Code	1600012
Hospital Revenue Code	360
Min. Negotiated Rate	$382.20
Max. Negotiated Rate	$382.20
Rate for Payer: Qualcare PPO/HMO/WC	$382.20

SURGI-BRA LARGE LATEX FREE

Facility

$177.95

Hospital Charge Code	270650035
Hospital Revenue Code	270
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$88.97
Rate for Payer: Aetna Commercial	$67.62
Rate for Payer: Aetna Medicare Advantage	$53.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.38
Rate for Payer: Cigna Commercial	$88.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.38
Rate for Payer: Oxford Commercial	$35.59
Rate for Payer: Qualcare PPO/HMO/WC	$26.69
Rate for Payer: UnitedHealthcare Commercial	$35.59
Rate for Payer: UnitedHealthcare Community & State	$4.29
Rate for Payer: Wellpoint Medicaid Managed Care	$4.72

SURGI-BRA LARGE LATEX FREE

Facility

$177.95

Hospital Charge Code	270650035
Hospital Revenue Code	270
Min. Negotiated Rate	$26.69
Max. Negotiated Rate	$26.69
Rate for Payer: Qualcare PPO/HMO/WC	$26.69

SURGI-BRA MEDIUM

Facility

$262.40

Hospital Charge Code	270650034
Hospital Revenue Code	272
Min. Negotiated Rate	$39.36
Max. Negotiated Rate	$39.36
Rate for Payer: Qualcare PPO/HMO/WC	$39.36

SURGI-BRA MEDIUM

Facility

$262.40

Hospital Charge Code	270650034
Hospital Revenue Code	272
Min. Negotiated Rate	$6.32
Max. Negotiated Rate	$131.20
Rate for Payer: Aetna Commercial	$99.71
Rate for Payer: Aetna Medicare Advantage	$78.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.91
Rate for Payer: Cigna Commercial	$131.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.72
Rate for Payer: Oxford Commercial	$52.48
Rate for Payer: Qualcare PPO/HMO/WC	$39.36
Rate for Payer: UnitedHealthcare Commercial	$52.48
Rate for Payer: UnitedHealthcare Community & State	$6.32
Rate for Payer: Wellpoint Medicaid Managed Care	$6.95

Know your out-of-pocket cost for care.

All Charges