Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BASKET GEMINI

Facility

$1,315.00

Hospital Charge Code	270651472
Hospital Revenue Code	278
Min. Negotiated Rate	$197.25
Max. Negotiated Rate	$318.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.30
Rate for Payer: Qualcare PPO/HMO/WC	$197.25

BASKET GEMINI

Facility

$1,315.00

Hospital Charge Code	270651472
Hospital Revenue Code	278
Min. Negotiated Rate	$31.69
Max. Negotiated Rate	$657.50
Rate for Payer: Aetna Commercial	$499.70
Rate for Payer: Aetna Medicare Advantage	$394.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.32
Rate for Payer: Cigna Commercial	$657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.30
Rate for Payer: Qualcare PPO/HMO/WC	$197.25
Rate for Payer: UnitedHealthcare Community & State	$31.69
Rate for Payer: Wellpoint Medicaid Managed Care	$34.85

BASKET GRASPIT GEMINI

Facility

$1,488.75

Hospital Charge Code	270651298
Hospital Revenue Code	270
Min. Negotiated Rate	$223.31
Max. Negotiated Rate	$223.31
Rate for Payer: Qualcare PPO/HMO/WC	$223.31

BASKET GRASPIT GEMINI

Facility

$1,488.75

Hospital Charge Code	270651298
Hospital Revenue Code	270
Min. Negotiated Rate	$35.88
Max. Negotiated Rate	$744.38
Rate for Payer: Aetna Commercial	$565.73
Rate for Payer: Aetna Medicare Advantage	$446.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$379.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$379.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$379.63
Rate for Payer: Cigna Commercial	$744.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$446.62
Rate for Payer: Oxford Commercial	$297.75
Rate for Payer: Qualcare PPO/HMO/WC	$223.31
Rate for Payer: UnitedHealthcare Commercial	$297.75
Rate for Payer: UnitedHealthcare Community & State	$35.88
Rate for Payer: Wellpoint Medicaid Managed Care	$39.45

BASKET LARGE 9040-08

Facility

$2,010.00

Hospital Charge Code	270638008
Hospital Revenue Code	278
Min. Negotiated Rate	$301.50
Max. Negotiated Rate	$486.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$402.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$486.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$442.20
Rate for Payer: Qualcare PPO/HMO/WC	$301.50

BASKET LARGE 9040-08

Facility

$2,010.00

Hospital Charge Code	270638008
Hospital Revenue Code	278
Min. Negotiated Rate	$48.44
Max. Negotiated Rate	$1,005.00
Rate for Payer: Aetna Commercial	$763.80
Rate for Payer: Aetna Medicare Advantage	$603.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$512.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$512.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$402.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$512.55
Rate for Payer: Cigna Commercial	$1,005.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$486.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$442.20
Rate for Payer: Qualcare PPO/HMO/WC	$301.50
Rate for Payer: UnitedHealthcare Community & State	$48.44
Rate for Payer: Wellpoint Medicaid Managed Care	$53.27

BASKET MCV COLON 1058

Facility

$1,168.85

Hospital Charge Code	270606079
Hospital Revenue Code	272
Min. Negotiated Rate	$28.17
Max. Negotiated Rate	$584.42
Rate for Payer: Aetna Commercial	$444.16
Rate for Payer: Aetna Medicare Advantage	$350.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$298.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$298.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$298.06
Rate for Payer: Cigna Commercial	$584.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.65
Rate for Payer: Oxford Commercial	$233.77
Rate for Payer: Qualcare PPO/HMO/WC	$175.33
Rate for Payer: UnitedHealthcare Commercial	$233.77
Rate for Payer: UnitedHealthcare Community & State	$28.17
Rate for Payer: Wellpoint Medicaid Managed Care	$30.97

BASKET MCV COLON 1058

Facility

$1,168.85

Hospital Charge Code	270606079
Hospital Revenue Code	272
Min. Negotiated Rate	$175.33
Max. Negotiated Rate	$175.33
Rate for Payer: Qualcare PPO/HMO/WC	$175.33

BASKET MCV FLT STN RTR 130530

Facility

$1,940.00

Hospital Charge Code	270606027
Hospital Revenue Code	272
Min. Negotiated Rate	$46.75
Max. Negotiated Rate	$970.00
Rate for Payer: Aetna Commercial	$737.20
Rate for Payer: Aetna Medicare Advantage	$582.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$494.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$494.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$494.70
Rate for Payer: Cigna Commercial	$970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$582.00
Rate for Payer: Oxford Commercial	$388.00
Rate for Payer: Qualcare PPO/HMO/WC	$291.00
Rate for Payer: UnitedHealthcare Commercial	$388.00
Rate for Payer: UnitedHealthcare Community & State	$46.75
Rate for Payer: Wellpoint Medicaid Managed Care	$51.41

BASKET MCV FLT STN RTR 130530

Facility

$1,940.00

Hospital Charge Code	270606027
Hospital Revenue Code	272
Min. Negotiated Rate	$291.00
Max. Negotiated Rate	$291.00
Rate for Payer: Qualcare PPO/HMO/WC	$291.00

BASKET MCV HEL 1.9FR ******

Facility

$812.00

Hospital Charge Code	1604479
Hospital Revenue Code	272
Min. Negotiated Rate	$121.80
Max. Negotiated Rate	$121.80
Rate for Payer: Qualcare PPO/HMO/WC	$121.80

BASKET MCV HEL 1.9FR ******

Facility

$812.00

Hospital Charge Code	1604479
Hospital Revenue Code	272
Min. Negotiated Rate	$19.57
Max. Negotiated Rate	$406.00
Rate for Payer: Aetna Commercial	$308.56
Rate for Payer: Aetna Medicare Advantage	$243.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.06
Rate for Payer: Cigna Commercial	$406.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.60
Rate for Payer: Oxford Commercial	$162.40
Rate for Payer: Qualcare PPO/HMO/WC	$121.80
Rate for Payer: UnitedHealthcare Commercial	$162.40
Rate for Payer: UnitedHealthcare Community & State	$19.57
Rate for Payer: Wellpoint Medicaid Managed Care	$21.52

BASKET MCV HEL 1.9FR 340121

Facility

$1,382.45

Hospital Charge Code	270601035
Hospital Revenue Code	272
Min. Negotiated Rate	$207.37
Max. Negotiated Rate	$207.37
Rate for Payer: Qualcare PPO/HMO/WC	$207.37

BASKET MCV HEL 1.9FR 340121

Facility

$1,382.45

Hospital Charge Code	270601035
Hospital Revenue Code	272
Min. Negotiated Rate	$33.32
Max. Negotiated Rate	$691.23
Rate for Payer: Aetna Commercial	$525.33
Rate for Payer: Aetna Medicare Advantage	$414.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$352.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$352.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$352.52
Rate for Payer: Cigna Commercial	$691.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$414.74
Rate for Payer: Oxford Commercial	$276.49
Rate for Payer: Qualcare PPO/HMO/WC	$207.37
Rate for Payer: UnitedHealthcare Commercial	$276.49
Rate for Payer: UnitedHealthcare Community & State	$33.32
Rate for Payer: Wellpoint Medicaid Managed Care	$36.63

BASKET MCV HEL 3W BGLY 340122

Facility

$1,791.25

Hospital Charge Code	270606030
Hospital Revenue Code	272
Min. Negotiated Rate	$43.17
Max. Negotiated Rate	$895.62
Rate for Payer: Aetna Commercial	$680.67
Rate for Payer: Aetna Medicare Advantage	$537.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$456.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$456.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$456.77
Rate for Payer: Cigna Commercial	$895.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$537.38
Rate for Payer: Oxford Commercial	$358.25
Rate for Payer: Qualcare PPO/HMO/WC	$268.69
Rate for Payer: UnitedHealthcare Commercial	$358.25
Rate for Payer: UnitedHealthcare Community & State	$43.17
Rate for Payer: Wellpoint Medicaid Managed Care	$47.47

BASKET MCV HEL 3W BGLY 340122

Facility

$1,791.25

Hospital Charge Code	270606030
Hospital Revenue Code	272
Min. Negotiated Rate	$268.69
Max. Negotiated Rate	$268.69
Rate for Payer: Qualcare PPO/HMO/WC	$268.69

BASKET MCV HEL 4W 4.8FR *****

Facility

$763.00

Hospital Charge Code	1605120
Hospital Revenue Code	272
Min. Negotiated Rate	$114.45
Max. Negotiated Rate	$114.45
Rate for Payer: Qualcare PPO/HMO/WC	$114.45

BASKET MCV HEL 4W 4.8FR *****

Facility

$763.00

Hospital Charge Code	1605120
Hospital Revenue Code	272
Min. Negotiated Rate	$18.39
Max. Negotiated Rate	$381.50
Rate for Payer: Aetna Commercial	$289.94
Rate for Payer: Aetna Medicare Advantage	$228.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$194.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$194.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$194.56
Rate for Payer: Cigna Commercial	$381.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.90
Rate for Payer: Oxford Commercial	$152.60
Rate for Payer: Qualcare PPO/HMO/WC	$114.45
Rate for Payer: UnitedHealthcare Commercial	$152.60
Rate for Payer: UnitedHealthcare Community & State	$18.39
Rate for Payer: Wellpoint Medicaid Managed Care	$20.22

BASKET MCV HEL 4W 4.8FR 340100

Facility

$1,175.25

Hospital Charge Code	270601034
Hospital Revenue Code	272
Min. Negotiated Rate	$176.29
Max. Negotiated Rate	$176.29
Rate for Payer: Qualcare PPO/HMO/WC	$176.29

BASKET MCV HEL 4W 4.8FR 340100

Facility

$1,175.25

Hospital Charge Code	270601034
Hospital Revenue Code	272
Min. Negotiated Rate	$28.32
Max. Negotiated Rate	$587.62
Rate for Payer: Aetna Commercial	$446.60
Rate for Payer: Aetna Medicare Advantage	$352.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.69
Rate for Payer: Cigna Commercial	$587.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.57
Rate for Payer: Oxford Commercial	$235.05
Rate for Payer: Qualcare PPO/HMO/WC	$176.29
Rate for Payer: UnitedHealthcare Commercial	$235.05
Rate for Payer: UnitedHealthcare Community & State	$28.32
Rate for Payer: Wellpoint Medicaid Managed Care	$31.14

BASKET MCV SEQUIRA MINI *****

Facility

$768.00

Hospital Charge Code	1604230
Hospital Revenue Code	272
Min. Negotiated Rate	$18.51
Max. Negotiated Rate	$384.00
Rate for Payer: Aetna Commercial	$291.84
Rate for Payer: Aetna Medicare Advantage	$230.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.84
Rate for Payer: Cigna Commercial	$384.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.40
Rate for Payer: Oxford Commercial	$153.60
Rate for Payer: Qualcare PPO/HMO/WC	$115.20
Rate for Payer: UnitedHealthcare Commercial	$153.60
Rate for Payer: UnitedHealthcare Community & State	$18.51
Rate for Payer: Wellpoint Medicaid Managed Care	$20.35

BASKET MCV SEQUIRA MINI *****

Facility

$768.00

Hospital Charge Code	1604230
Hospital Revenue Code	272
Min. Negotiated Rate	$115.20
Max. Negotiated Rate	$115.20
Rate for Payer: Qualcare PPO/HMO/WC	$115.20

BASKET MCV SEQUIRA MINI 310105

Facility

$1,299.25

Hospital Charge Code	270601038
Hospital Revenue Code	272
Min. Negotiated Rate	$31.31
Max. Negotiated Rate	$649.62
Rate for Payer: Aetna Commercial	$493.71
Rate for Payer: Aetna Medicare Advantage	$389.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.31
Rate for Payer: Cigna Commercial	$649.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.77
Rate for Payer: Oxford Commercial	$259.85
Rate for Payer: Qualcare PPO/HMO/WC	$194.89
Rate for Payer: UnitedHealthcare Commercial	$259.85
Rate for Payer: UnitedHealthcare Community & State	$31.31
Rate for Payer: Wellpoint Medicaid Managed Care	$34.43

BASKET MCV SEQUIRA MINI 310105

Facility

$1,299.25

Hospital Charge Code	270601038
Hospital Revenue Code	272
Min. Negotiated Rate	$194.89
Max. Negotiated Rate	$194.89
Rate for Payer: Qualcare PPO/HMO/WC	$194.89

BASKET RETRIEVAL FB 00711152

Facility

$525.00

Hospital Charge Code	270637475
Hospital Revenue Code	272
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.50
Rate for Payer: Oxford Commercial	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Commercial	$105.00
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

Know your out-of-pocket cost for care.

All Charges