Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility

$22,876.07

Service Code	APR-DRG 5133
Min. Negotiated Rate	$22,427.52
Max. Negotiated Rate	$22,876.07
Rate for Payer: UnitedHealthcare Community & State	$22,427.52
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,876.07
Rate for Payer: Wellpoint Medicaid Managed Care	$22,427.52

UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility

$39,487.32

Service Code	APR-DRG 5134
Min. Negotiated Rate	$38,713.06
Max. Negotiated Rate	$39,487.32
Rate for Payer: UnitedHealthcare Community & State	$38,713.06
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$39,487.32
Rate for Payer: Wellpoint Medicaid Managed Care	$38,713.06

UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA

Facility

$12,096.84

Service Code	APR-DRG 5131
Min. Negotiated Rate	$11,859.65
Max. Negotiated Rate	$12,096.84
Rate for Payer: UnitedHealthcare Community & State	$11,859.65
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,096.84
Rate for Payer: Wellpoint Medicaid Managed Care	$11,859.65

UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC

Facility

$61,437.85

Service Code	MSDRG 742
Min. Negotiated Rate	$18,707.04
Max. Negotiated Rate	$61,437.85
Rate for Payer: Aetna Commercial	$42,472.13
Rate for Payer: Aetna Medicare Advantage	$61,437.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41,404.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41,404.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,691.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41,404.58
Rate for Payer: Cigna Commercial	$34,336.45
Rate for Payer: Cigna Medicare Advantage	$19,691.62
Rate for Payer: Clover Medicare Advantage	$18,707.04
Rate for Payer: EmblemHealth Commercial	$59,074.86
Rate for Payer: Humana Medicare Advantage	$20,282.37
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19,691.62
Rate for Payer: Oxford Commercial	$24,678.06
Rate for Payer: UnitedHealthcare Commercial	$43,273.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,691.62
Rate for Payer: Wellcare Medicare Advantage	$19,691.62

UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC

Facility

$42,235.56

Service Code	MSDRG 743
Min. Negotiated Rate	$12,860.19
Max. Negotiated Rate	$42,235.56
Rate for Payer: Aetna Commercial	$29,277.99
Rate for Payer: Aetna Medicare Advantage	$42,235.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,982.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,982.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,537.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26,982.76
Rate for Payer: Cigna Commercial	$23,218.46
Rate for Payer: Cigna Medicare Advantage	$13,537.04
Rate for Payer: Clover Medicare Advantage	$12,860.19
Rate for Payer: EmblemHealth Commercial	$40,611.12
Rate for Payer: Humana Medicare Advantage	$13,943.15
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,537.04
Rate for Payer: Oxford Commercial	$16,687.42
Rate for Payer: UnitedHealthcare Commercial	$29,261.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,537.04
Rate for Payer: Wellcare Medicare Advantage	$13,537.04

UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility

$18,258.22

Service Code	APR-DRG 5122
Min. Negotiated Rate	$17,900.22
Max. Negotiated Rate	$18,258.22
Rate for Payer: UnitedHealthcare Community & State	$17,900.22
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,258.22
Rate for Payer: Wellpoint Medicaid Managed Care	$17,900.22

UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility

$53,434.11

Service Code	APR-DRG 5124
Min. Negotiated Rate	$52,386.38
Max. Negotiated Rate	$53,434.11
Rate for Payer: UnitedHealthcare Community & State	$52,386.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$53,434.11
Rate for Payer: Wellpoint Medicaid Managed Care	$52,386.38

UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility

$15,766.09

Service Code	APR-DRG 5121
Min. Negotiated Rate	$15,456.95
Max. Negotiated Rate	$15,766.09
Rate for Payer: UnitedHealthcare Community & State	$15,456.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,766.09
Rate for Payer: Wellpoint Medicaid Managed Care	$15,456.95

UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY

Facility

$28,353.17

Service Code	APR-DRG 5123
Min. Negotiated Rate	$27,797.23
Max. Negotiated Rate	$28,353.17
Rate for Payer: UnitedHealthcare Community & State	$27,797.23
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$28,353.17
Rate for Payer: Wellpoint Medicaid Managed Care	$27,797.23

UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC

Facility

$60,623.35

Service Code	MSDRG 740
Min. Negotiated Rate	$18,459.03
Max. Negotiated Rate	$60,623.35
Rate for Payer: Aetna Commercial	$41,912.49
Rate for Payer: Aetna Medicare Advantage	$60,623.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41,637.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41,637.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,430.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41,637.19
Rate for Payer: Cigna Commercial	$33,864.85
Rate for Payer: Cigna Medicare Advantage	$19,430.56
Rate for Payer: Clover Medicare Advantage	$18,459.03
Rate for Payer: EmblemHealth Commercial	$58,291.68
Rate for Payer: Humana Medicare Advantage	$20,013.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19,430.56
Rate for Payer: Oxford Commercial	$24,339.12
Rate for Payer: UnitedHealthcare Commercial	$42,679.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,430.56
Rate for Payer: Wellcare Medicare Advantage	$19,430.56

UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC

Facility

$117,936.09

Service Code	MSDRG 739
Min. Negotiated Rate	$35,910.03
Max. Negotiated Rate	$117,936.09
Rate for Payer: Aetna Commercial	$81,292.86
Rate for Payer: Aetna Medicare Advantage	$117,936.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84,204.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84,204.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37,800.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84,204.82
Rate for Payer: Cigna Commercial	$65,991.18
Rate for Payer: Cigna Medicare Advantage	$37,800.03
Rate for Payer: Clover Medicare Advantage	$35,910.03
Rate for Payer: EmblemHealth Commercial	$113,400.09
Rate for Payer: Humana Medicare Advantage	$38,934.03
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$37,800.03
Rate for Payer: Oxford Commercial	$47,428.74
Rate for Payer: UnitedHealthcare Commercial	$83,167.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$37,800.03
Rate for Payer: Wellcare Medicare Advantage	$37,800.03

UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC

Facility

$48,227.93

Service Code	MSDRG 741
Min. Negotiated Rate	$14,684.79
Max. Negotiated Rate	$48,227.93
Rate for Payer: Aetna Commercial	$33,395.42
Rate for Payer: Aetna Medicare Advantage	$48,227.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,239.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,239.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,457.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30,239.30
Rate for Payer: Cigna Commercial	$26,688.04
Rate for Payer: Cigna Medicare Advantage	$15,457.67
Rate for Payer: Clover Medicare Advantage	$14,684.79
Rate for Payer: EmblemHealth Commercial	$46,373.01
Rate for Payer: Humana Medicare Advantage	$15,921.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,457.67
Rate for Payer: Oxford Commercial	$19,181.04
Rate for Payer: UnitedHealthcare Commercial	$33,634.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,457.67
Rate for Payer: Wellcare Medicare Advantage	$15,457.67

UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility

$20,622.71

Service Code	APR-DRG 5112
Min. Negotiated Rate	$20,218.34
Max. Negotiated Rate	$20,622.71
Rate for Payer: UnitedHealthcare Community & State	$20,218.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,622.71
Rate for Payer: Wellpoint Medicaid Managed Care	$20,218.34

UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility

$17,038.96

Service Code	APR-DRG 5111
Min. Negotiated Rate	$16,704.86
Max. Negotiated Rate	$17,038.96
Rate for Payer: UnitedHealthcare Community & State	$16,704.86
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,038.96
Rate for Payer: Wellpoint Medicaid Managed Care	$16,704.86

UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility

$29,384.76

Service Code	APR-DRG 5113
Min. Negotiated Rate	$28,808.59
Max. Negotiated Rate	$29,384.76
Rate for Payer: UnitedHealthcare Community & State	$28,808.59
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,384.76
Rate for Payer: Wellpoint Medicaid Managed Care	$28,808.59

UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY

Facility

$57,730.27

Service Code	APR-DRG 5114
Min. Negotiated Rate	$56,598.30
Max. Negotiated Rate	$57,730.27
Rate for Payer: UnitedHealthcare Community & State	$56,598.30
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$57,730.27
Rate for Payer: Wellpoint Medicaid Managed Care	$56,598.30

UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC

Facility

$68,736.06

Service Code	MSDRG 737
Min. Negotiated Rate	$20,929.25
Max. Negotiated Rate	$68,736.06
Rate for Payer: Aetna Commercial	$47,486.83
Rate for Payer: Aetna Medicare Advantage	$68,736.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,824.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,824.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,030.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45,824.17
Rate for Payer: Cigna Commercial	$38,562.07
Rate for Payer: Cigna Medicare Advantage	$22,030.79
Rate for Payer: Clover Medicare Advantage	$20,929.25
Rate for Payer: EmblemHealth Commercial	$66,092.37
Rate for Payer: Humana Medicare Advantage	$22,691.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22,030.79
Rate for Payer: Oxford Commercial	$27,715.07
Rate for Payer: UnitedHealthcare Commercial	$48,599.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,030.79
Rate for Payer: Wellcare Medicare Advantage	$22,030.79

UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC

Facility

$117,667.80

Service Code	MSDRG 736
Min. Negotiated Rate	$35,828.34
Max. Negotiated Rate	$117,667.80
Rate for Payer: Aetna Commercial	$81,108.52
Rate for Payer: Aetna Medicare Advantage	$117,667.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90,485.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90,485.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37,714.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90,485.29
Rate for Payer: Cigna Commercial	$66,893.19
Rate for Payer: Cigna Medicare Advantage	$37,714.04
Rate for Payer: Clover Medicare Advantage	$35,828.34
Rate for Payer: EmblemHealth Commercial	$113,142.12
Rate for Payer: Humana Medicare Advantage	$38,845.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$37,714.04
Rate for Payer: Oxford Commercial	$48,077.03
Rate for Payer: UnitedHealthcare Commercial	$84,304.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$37,714.04
Rate for Payer: Wellcare Medicare Advantage	$37,714.04

UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC

Facility

$49,598.45

Service Code	MSDRG 738
Min. Negotiated Rate	$15,102.09
Max. Negotiated Rate	$49,598.45
Rate for Payer: Aetna Commercial	$34,337.12
Rate for Payer: Aetna Medicare Advantage	$49,598.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,634.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,634.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,896.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,634.96
Rate for Payer: Cigna Commercial	$27,481.51
Rate for Payer: Cigna Medicare Advantage	$15,896.94
Rate for Payer: Clover Medicare Advantage	$15,102.09
Rate for Payer: EmblemHealth Commercial	$47,690.82
Rate for Payer: Humana Medicare Advantage	$16,373.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,896.94
Rate for Payer: Oxford Commercial	$19,751.33
Rate for Payer: UnitedHealthcare Commercial	$34,634.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,896.94
Rate for Payer: Wellcare Medicare Advantage	$15,896.94

UTLTY CART W/3 TUB SHELVES BLU

Facility

$712.50

Hospital Charge Code	270662654
Hospital Revenue Code	270
Min. Negotiated Rate	$106.88
Max. Negotiated Rate	$106.88
Rate for Payer: Qualcare PPO/HMO/WC	$106.88

UTLTY CART W/3 TUB SHELVES BLU

Facility

$712.50

Hospital Charge Code	270662654
Hospital Revenue Code	270
Min. Negotiated Rate	$17.17
Max. Negotiated Rate	$356.25
Rate for Payer: Aetna Commercial	$270.75
Rate for Payer: Aetna Medicare Advantage	$213.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.69
Rate for Payer: Cigna Commercial	$356.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.75
Rate for Payer: Oxford Commercial	$142.50
Rate for Payer: Qualcare PPO/HMO/WC	$106.88
Rate for Payer: UnitedHealthcare Commercial	$142.50
Rate for Payer: UnitedHealthcare Community & State	$17.17
Rate for Payer: Wellpoint Medicaid Managed Care	$18.88

V 8600 - PRIMARY PUMP SET***

Facility

$23.00

Hospital Charge Code	7000680
Hospital Revenue Code	279
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

V 8600 - PRIMARY PUMP SET***

Facility

$23.00

Hospital Charge Code	7000680
Hospital Revenue Code	279
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$8.74
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.90
Rate for Payer: Oxford Commercial	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$4.60
Rate for Payer: UnitedHealthcare Community & State	$0.55
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

V92 CELLULAR BONE MATRIX

Facility

$3,750.00

Service Code	HCPCS C1762
Hospital Charge Code	270687475
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

V92 CELLULAR BONE MATRIX

Facility

$3,750.00

Service Code	HCPCS C1762
Hospital Charge Code	270687475
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

Know your out-of-pocket cost for care.

All Charges