Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

WIRE SYN K 0.8 70MM 292.48

Facility

$43.25

Hospital Charge Code	270604430
Hospital Revenue Code	272
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

WIRE SYN K 0.8 70MM 292.48

Facility

$43.25

Hospital Charge Code	270604430
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.62
Rate for Payer: Aetna Commercial	$16.43
Rate for Payer: Aetna Medicare Advantage	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.97
Rate for Payer: Oxford Commercial	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$8.65
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

WIRE SYN K 1.0 150MM 292.50

Facility

$43.25

Hospital Charge Code	270604431
Hospital Revenue Code	272
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

WIRE SYN K 1.0 150MM 292.50

Facility

$43.25

Hospital Charge Code	270604431
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.62
Rate for Payer: Aetna Commercial	$16.43
Rate for Payer: Aetna Medicare Advantage	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.97
Rate for Payer: Oxford Commercial	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$8.65
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

WIRE SYN K 1.0 150MM 492.10

Facility

$46.45

Hospital Charge Code	270603554
Hospital Revenue Code	272
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$23.23
Rate for Payer: Aetna Commercial	$17.65
Rate for Payer: Aetna Medicare Advantage	$13.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.84
Rate for Payer: Cigna Commercial	$23.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.94
Rate for Payer: Oxford Commercial	$9.29
Rate for Payer: Qualcare PPO/HMO/WC	$6.97
Rate for Payer: UnitedHealthcare Commercial	$9.29
Rate for Payer: UnitedHealthcare Community & State	$1.12
Rate for Payer: Wellpoint Medicaid Managed Care	$1.23

WIRE SYN K 1.0 150MM 492.10

Facility

$46.45

Hospital Charge Code	270603554
Hospital Revenue Code	272
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$6.97
Rate for Payer: Qualcare PPO/HMO/WC	$6.97

WIRE SYN K 1.0 285MM 292.11

Facility

$49.65

Hospital Charge Code	270604413
Hospital Revenue Code	272
Min. Negotiated Rate	$7.45
Max. Negotiated Rate	$7.45
Rate for Payer: Qualcare PPO/HMO/WC	$7.45

WIRE SYN K 1.0 285MM 292.11

Facility

$49.65

Hospital Charge Code	270604413
Hospital Revenue Code	272
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$24.82
Rate for Payer: Aetna Commercial	$18.87
Rate for Payer: Aetna Medicare Advantage	$14.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.66
Rate for Payer: Cigna Commercial	$24.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.89
Rate for Payer: Oxford Commercial	$9.93
Rate for Payer: Qualcare PPO/HMO/WC	$7.45
Rate for Payer: UnitedHealthcare Commercial	$9.93
Rate for Payer: UnitedHealthcare Community & State	$1.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

WIRE SYN K 1.25 150MM 292.12

Facility

$40.85

Hospital Charge Code	270604414
Hospital Revenue Code	272
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$20.43
Rate for Payer: Aetna Commercial	$15.52
Rate for Payer: Aetna Medicare Advantage	$12.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.42
Rate for Payer: Cigna Commercial	$20.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.26
Rate for Payer: Oxford Commercial	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$6.13
Rate for Payer: UnitedHealthcare Commercial	$8.17
Rate for Payer: UnitedHealthcare Community & State	$0.98
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

WIRE SYN K 1.25 150MM 292.12

Facility

$40.85

Hospital Charge Code	270604414
Hospital Revenue Code	272
Min. Negotiated Rate	$6.13
Max. Negotiated Rate	$6.13
Rate for Payer: Qualcare PPO/HMO/WC	$6.13

WIRE SYN K 1.25 150MM 292.12

Facility

$436.00

Hospital Charge Code	270601825
Hospital Revenue Code	274
Min. Negotiated Rate	$10.51
Max. Negotiated Rate	$218.00
Rate for Payer: Aetna Commercial	$165.68
Rate for Payer: Aetna Medicare Advantage	$130.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.18
Rate for Payer: Cigna Commercial	$218.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.92
Rate for Payer: Qualcare PPO/HMO/WC	$65.40
Rate for Payer: UnitedHealthcare Community & State	$10.51
Rate for Payer: Wellpoint Medicaid Managed Care	$11.55

WIRE SYN K 1.25 150MM 292.12

Facility

$436.00

Hospital Charge Code	270601825
Hospital Revenue Code	274
Min. Negotiated Rate	$65.40
Max. Negotiated Rate	$105.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.92
Rate for Payer: Qualcare PPO/HMO/WC	$65.40

WIRE SYN K 1.25 285MM 292.13

Facility

$44.75

Hospital Charge Code	270604415
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.38
Rate for Payer: Aetna Commercial	$17.00
Rate for Payer: Aetna Medicare Advantage	$13.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.41
Rate for Payer: Cigna Commercial	$22.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.43
Rate for Payer: Oxford Commercial	$8.95
Rate for Payer: Qualcare PPO/HMO/WC	$6.71
Rate for Payer: UnitedHealthcare Commercial	$8.95
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

WIRE SYN K 1.25 285MM 292.13

Facility

$44.75

Hospital Charge Code	270604415
Hospital Revenue Code	272
Min. Negotiated Rate	$6.71
Max. Negotiated Rate	$6.71
Rate for Payer: Qualcare PPO/HMO/WC	$6.71

WIRE SYN K 1.6 150MM 292.16

Facility

$40.85

Hospital Charge Code	270604416
Hospital Revenue Code	272
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$20.43
Rate for Payer: Aetna Commercial	$15.52
Rate for Payer: Aetna Medicare Advantage	$12.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.42
Rate for Payer: Cigna Commercial	$20.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.26
Rate for Payer: Oxford Commercial	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$6.13
Rate for Payer: UnitedHealthcare Commercial	$8.17
Rate for Payer: UnitedHealthcare Community & State	$0.98
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

WIRE SYN K 1.6 150MM 292.16

Facility

$40.85

Hospital Charge Code	270604416
Hospital Revenue Code	272
Min. Negotiated Rate	$6.13
Max. Negotiated Rate	$6.13
Rate for Payer: Qualcare PPO/HMO/WC	$6.13

WIRE SYN K 1.6 150MM 292.16

Facility

$46.45

Hospital Charge Code	270601826
Hospital Revenue Code	272
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$6.97
Rate for Payer: Qualcare PPO/HMO/WC	$6.97

WIRE SYN K 1.6 150MM 292.16

Facility

$46.45

Hospital Charge Code	270601826
Hospital Revenue Code	272
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$23.23
Rate for Payer: Aetna Commercial	$17.65
Rate for Payer: Aetna Medicare Advantage	$13.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.84
Rate for Payer: Cigna Commercial	$23.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.94
Rate for Payer: Oxford Commercial	$9.29
Rate for Payer: Qualcare PPO/HMO/WC	$6.97
Rate for Payer: UnitedHealthcare Commercial	$9.29
Rate for Payer: UnitedHealthcare Community & State	$1.12
Rate for Payer: Wellpoint Medicaid Managed Care	$1.23

WIRE SYN K 1.6 285MM 492.18

Facility

$49.65

Hospital Charge Code	270604417
Hospital Revenue Code	272
Min. Negotiated Rate	$7.45
Max. Negotiated Rate	$7.45
Rate for Payer: Qualcare PPO/HMO/WC	$7.45

WIRE SYN K 1.6 285MM 492.18

Facility

$56.00

Hospital Charge Code	270603557
Hospital Revenue Code	272
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

WIRE SYN K 1.6 285MM 492.18

Facility

$56.00

Hospital Charge Code	270603557
Hospital Revenue Code	272
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$28.00
Rate for Payer: Aetna Commercial	$21.28
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.28
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.80
Rate for Payer: Oxford Commercial	$11.20
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$11.20
Rate for Payer: UnitedHealthcare Community & State	$1.35
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

WIRE SYN K 1.6 285MM 492.18

Facility

$49.65

Hospital Charge Code	270604417
Hospital Revenue Code	272
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$24.82
Rate for Payer: Aetna Commercial	$18.87
Rate for Payer: Aetna Medicare Advantage	$14.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.66
Rate for Payer: Cigna Commercial	$24.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.89
Rate for Payer: Oxford Commercial	$9.93
Rate for Payer: Qualcare PPO/HMO/WC	$7.45
Rate for Payer: UnitedHealthcare Commercial	$9.93
Rate for Payer: UnitedHealthcare Community & State	$1.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

WIRE SYN K 1.6 70MM 292.71

Facility

$741.65

Hospital Charge Code	270604427
Hospital Revenue Code	272
Min. Negotiated Rate	$111.25
Max. Negotiated Rate	$111.25
Rate for Payer: Qualcare PPO/HMO/WC	$111.25

WIRE SYN K 1.6 70MM 292.71

Facility

$741.65

Hospital Charge Code	270604427
Hospital Revenue Code	272
Min. Negotiated Rate	$17.87
Max. Negotiated Rate	$370.82
Rate for Payer: Aetna Commercial	$281.83
Rate for Payer: Aetna Medicare Advantage	$222.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.12
Rate for Payer: Cigna Commercial	$370.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.50
Rate for Payer: Oxford Commercial	$148.33
Rate for Payer: Qualcare PPO/HMO/WC	$111.25
Rate for Payer: UnitedHealthcare Commercial	$148.33
Rate for Payer: UnitedHealthcare Community & State	$17.87
Rate for Payer: Wellpoint Medicaid Managed Care	$19.65

WIRE SYN K 2.0 150MM 292.20

Facility

$40.85

Hospital Charge Code	270604418
Hospital Revenue Code	272
Min. Negotiated Rate	$6.13
Max. Negotiated Rate	$6.13
Rate for Payer: Qualcare PPO/HMO/WC	$6.13

Know your out-of-pocket cost for care.

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