Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BI-METRIC POR FMRL 9.0X250MMR

Facility

$42,630.00

Service Code	HCPCS C1776
Hospital Charge Code	270688751
Hospital Revenue Code	278
Min. Negotiated Rate	$1,027.38
Max. Negotiated Rate	$21,315.00
Rate for Payer: Aetna Commercial	$16,199.40
Rate for Payer: Aetna Medicare Advantage	$12,789.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,870.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,870.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,526.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,870.65
Rate for Payer: Cigna Commercial	$21,315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,316.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,378.60
Rate for Payer: Qualcare PPO/HMO/WC	$6,394.50
Rate for Payer: UnitedHealthcare Community & State	$1,027.38
Rate for Payer: Wellpoint Medicaid Managed Care	$1,129.69

BI-METRIC POR FMRL 9.0X250MMR

Facility

$42,630.00

Service Code	HCPCS C1776
Hospital Charge Code	270688751
Hospital Revenue Code	278
Min. Negotiated Rate	$6,394.50
Max. Negotiated Rate	$10,316.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,526.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,316.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,378.60
Rate for Payer: Qualcare PPO/HMO/WC	$6,394.50

BIMTRC STEM 13X34-150 12162382

Facility

$20,955.00

Hospital Charge Code	270639189
Hospital Revenue Code	278
Min. Negotiated Rate	$3,143.25
Max. Negotiated Rate	$5,071.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,191.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,071.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,610.10
Rate for Payer: Qualcare PPO/HMO/WC	$3,143.25

BIMTRC STEM 13X34-150 12162382

Facility

$20,955.00

Hospital Charge Code	270639189
Hospital Revenue Code	278
Min. Negotiated Rate	$505.02
Max. Negotiated Rate	$10,477.50
Rate for Payer: Aetna Commercial	$7,962.90
Rate for Payer: Aetna Medicare Advantage	$6,286.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,343.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,343.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,191.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,343.52
Rate for Payer: Cigna Commercial	$10,477.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,071.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,610.10
Rate for Payer: Qualcare PPO/HMO/WC	$3,143.25
Rate for Payer: UnitedHealthcare Community & State	$505.02
Rate for Payer: Wellpoint Medicaid Managed Care	$555.31

BINAXNOW COVID19 ANTIGEN POC

Facility

$206.90

Service Code	HCPCS 87811
Hospital Charge Code	401187811
Hospital Revenue Code	306
Min. Negotiated Rate	$31.04
Max. Negotiated Rate	$31.04
Rate for Payer: Qualcare PPO/HMO/WC	$31.04

BINAXNOW COVID19 ANTIGEN POC

Facility

$206.90

Service Code	HCPCS 87811
Hospital Charge Code	401187811
Hospital Revenue Code	306
Min. Negotiated Rate	$5.48
Max. Negotiated Rate	$149.37
Rate for Payer: Aetna Commercial	$112.55
Rate for Payer: Aetna Medicare Advantage	$134.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.37
Rate for Payer: Cigna Commercial	$103.45
Rate for Payer: Cigna Medicare Advantage	$41.38
Rate for Payer: Clover Medicare Advantage	$39.31
Rate for Payer: EmblemHealth Commercial	$124.14
Rate for Payer: Humana Medicare Advantage	$42.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$41.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.04
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$33.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$41.38
Rate for Payer: Wellcare Medicare Advantage	$41.38
Rate for Payer: Wellpoint Medicaid Managed Care	$5.48

BIN BREA LIN 2XL 45-49 S-XL/L

Facility

$110.00

Hospital Charge Code	270637535
Hospital Revenue Code	272
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

BIN BREA LIN 2XL 45-49 S-XL/L

Facility

$110.00

Hospital Charge Code	270637535
Hospital Revenue Code	272
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.00
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$22.00
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

BIN BR LIN LG 36-40 L/L-BBIND

Facility

$232.20

Hospital Charge Code	270637533
Hospital Revenue Code	272
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$116.10
Rate for Payer: Aetna Commercial	$88.24
Rate for Payer: Aetna Medicare Advantage	$69.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.21
Rate for Payer: Cigna Commercial	$116.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.66
Rate for Payer: Oxford Commercial	$46.44
Rate for Payer: Qualcare PPO/HMO/WC	$34.83
Rate for Payer: UnitedHealthcare Commercial	$46.44
Rate for Payer: UnitedHealthcare Community & State	$5.60
Rate for Payer: Wellpoint Medicaid Managed Care	$6.15

BIN BR LIN LG 36-40 L/L-BBIND

Facility

$232.20

Hospital Charge Code	270637533
Hospital Revenue Code	272
Min. Negotiated Rate	$34.83
Max. Negotiated Rate	$34.83
Rate for Payer: Qualcare PPO/HMO/WC	$34.83

BIN BR LIN MED 34-36 M/L-BBIND

Facility

$110.00

Hospital Charge Code	270637532
Hospital Revenue Code	272
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.00
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$22.00
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

BIN BR LIN MED 34-36 M/L-BBIND

Facility

$110.00

Hospital Charge Code	270637532
Hospital Revenue Code	272
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

BIN BR LIN XLG 42-46XL/L-BBIND

Facility

$233.25

Hospital Charge Code	270637534
Hospital Revenue Code	272
Min. Negotiated Rate	$5.62
Max. Negotiated Rate	$116.62
Rate for Payer: Aetna Commercial	$88.64
Rate for Payer: Aetna Medicare Advantage	$69.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.48
Rate for Payer: Cigna Commercial	$116.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.97
Rate for Payer: Oxford Commercial	$46.65
Rate for Payer: Qualcare PPO/HMO/WC	$34.99
Rate for Payer: UnitedHealthcare Commercial	$46.65
Rate for Payer: UnitedHealthcare Community & State	$5.62
Rate for Payer: Wellpoint Medicaid Managed Care	$6.18

BIN BR LIN XLG 42-46XL/L-BBIND

Facility

$233.25

Hospital Charge Code	270637534
Hospital Revenue Code	272
Min. Negotiated Rate	$34.99
Max. Negotiated Rate	$34.99
Rate for Payer: Qualcare PPO/HMO/WC	$34.99

BIN BR LI SM 32-34in S/L-BBIND

Facility

$110.00

Hospital Charge Code	270637531
Hospital Revenue Code	272
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.00
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$22.00
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

BIN BR LI SM 32-34in S/L-BBIND

Facility

$110.00

Hospital Charge Code	270637531
Hospital Revenue Code	272
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

BINDER ABDOMINAL

Facility

$31.70

Hospital Charge Code	270303090
Hospital Revenue Code	270
Min. Negotiated Rate	$4.75
Max. Negotiated Rate	$4.75
Rate for Payer: Qualcare PPO/HMO/WC	$4.75

BINDER ABDOMINAL

Facility

$31.70

Hospital Charge Code	270303090
Hospital Revenue Code	270
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$15.85
Rate for Payer: Aetna Commercial	$12.05
Rate for Payer: Aetna Medicare Advantage	$9.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.08
Rate for Payer: Cigna Commercial	$15.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.51
Rate for Payer: Oxford Commercial	$6.34
Rate for Payer: Qualcare PPO/HMO/WC	$4.75
Rate for Payer: UnitedHealthcare Commercial	$6.34
Rate for Payer: UnitedHealthcare Community & State	$0.76
Rate for Payer: Wellpoint Medicaid Managed Care	$0.84

BINDER ABDOMINAL******

Facility

$19.00

Hospital Charge Code	8000051
Hospital Revenue Code	279
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.50
Rate for Payer: Aetna Commercial	$7.22
Rate for Payer: Aetna Medicare Advantage	$5.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.84
Rate for Payer: Cigna Commercial	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.70
Rate for Payer: Oxford Commercial	$3.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.85
Rate for Payer: UnitedHealthcare Commercial	$3.80
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

BINDER ABDOMINAL******

Facility

$19.00

Hospital Charge Code	8000051
Hospital Revenue Code	279
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$2.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.85

BINDER ABDOMINAL 3 PANEL 26-49

Facility

$38.95

Hospital Charge Code	270650460
Hospital Revenue Code	272
Min. Negotiated Rate	$5.84
Max. Negotiated Rate	$5.84
Rate for Payer: Qualcare PPO/HMO/WC	$5.84

BINDER ABDOMINAL 3 PANEL 26-49

Facility

$38.95

Hospital Charge Code	270650460
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$19.48
Rate for Payer: Aetna Commercial	$14.80
Rate for Payer: Aetna Medicare Advantage	$11.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.93
Rate for Payer: Cigna Commercial	$19.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.69
Rate for Payer: Oxford Commercial	$7.79
Rate for Payer: Qualcare PPO/HMO/WC	$5.84
Rate for Payer: UnitedHealthcare Commercial	$7.79
Rate for Payer: UnitedHealthcare Community & State	$0.94
Rate for Payer: Wellpoint Medicaid Managed Care	$1.03

BINDER ABDOMINAL 3 PANEL 46-62

Facility

$39.45

Hospital Charge Code	270650463
Hospital Revenue Code	272
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.73
Rate for Payer: Aetna Commercial	$14.99
Rate for Payer: Aetna Medicare Advantage	$11.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.06
Rate for Payer: Cigna Commercial	$19.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.84
Rate for Payer: Oxford Commercial	$7.89
Rate for Payer: Qualcare PPO/HMO/WC	$5.92
Rate for Payer: UnitedHealthcare Commercial	$7.89
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.05

BINDER ABDOMINAL 3 PANEL 46-62

Facility

$39.45

Hospital Charge Code	270650463
Hospital Revenue Code	272
Min. Negotiated Rate	$5.92
Max. Negotiated Rate	$5.92
Rate for Payer: Qualcare PPO/HMO/WC	$5.92

BINDER ABDOMINAL 46-62

Facility

$24.00

Hospital Charge Code	270650243
Hospital Revenue Code	272
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$9.12
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.20
Rate for Payer: Oxford Commercial	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$4.80
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

Know your out-of-pocket cost for care.

All Charges