Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BLN STRL 39031-30601

Facility

$1,909.00

Hospital Charge Code	270644095C
Hospital Revenue Code	278
Min. Negotiated Rate	$46.01
Max. Negotiated Rate	$954.50
Rate for Payer: Aetna Commercial	$725.42
Rate for Payer: Aetna Medicare Advantage	$572.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$486.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$486.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$381.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$486.80
Rate for Payer: Cigna Commercial	$954.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$461.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$419.98
Rate for Payer: Qualcare PPO/HMO/WC	$286.35
Rate for Payer: UnitedHealthcare Community & State	$46.01
Rate for Payer: Wellpoint Medicaid Managed Care	$50.59

BLN STRL 39031-30601

Facility

$1,909.00

Hospital Charge Code	270644095C
Hospital Revenue Code	278
Min. Negotiated Rate	$286.35
Max. Negotiated Rate	$461.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$381.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$461.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$419.98
Rate for Payer: Qualcare PPO/HMO/WC	$286.35

BLN STRLNG 39031-65201

Facility

$2,381.25

Hospital Charge Code	270644096C
Hospital Revenue Code	278
Min. Negotiated Rate	$357.19
Max. Negotiated Rate	$576.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$576.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$523.88
Rate for Payer: Qualcare PPO/HMO/WC	$357.19

BLN STRLNG 39031-65201

Facility

$2,381.25

Hospital Charge Code	270644096C
Hospital Revenue Code	278
Min. Negotiated Rate	$57.39
Max. Negotiated Rate	$1,190.62
Rate for Payer: Aetna Commercial	$904.88
Rate for Payer: Aetna Medicare Advantage	$714.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$607.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$607.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$607.22
Rate for Payer: Cigna Commercial	$1,190.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$576.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$523.88
Rate for Payer: Qualcare PPO/HMO/WC	$357.19
Rate for Payer: UnitedHealthcare Community & State	$57.39
Rate for Payer: Wellpoint Medicaid Managed Care	$63.10

BLN VYGR RX 2.25x12 1011393-12

Facility

$1,175.00

Hospital Charge Code	270643089C
Hospital Revenue Code	278
Min. Negotiated Rate	$28.32
Max. Negotiated Rate	$587.50
Rate for Payer: Aetna Commercial	$446.50
Rate for Payer: Aetna Medicare Advantage	$352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.62
Rate for Payer: Cigna Commercial	$587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$258.50
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Community & State	$28.32
Rate for Payer: Wellpoint Medicaid Managed Care	$31.14

BLN VYGR RX 2.25x12 1011393-12

Facility

$1,175.00

Hospital Charge Code	270643089C
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$258.50
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

BLOCADREN/10MG/TAB

Facility

$3.00

Hospital Charge Code	60634354
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

BLOCADREN/10MG/TAB

Facility

$3.00

Hospital Charge Code	60634354
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

BLOCADREN/5MG/TAB

Facility

$3.00

Hospital Charge Code	60634353
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

BLOCADREN/5MG/TAB

Facility

$3.00

Hospital Charge Code	60634353
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

BLOCK BD BITE LG 000428

Facility

$46.68

Hospital Charge Code	270617369
Hospital Revenue Code	270
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$23.34
Rate for Payer: Aetna Commercial	$17.74
Rate for Payer: Aetna Medicare Advantage	$14.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.90
Rate for Payer: Cigna Commercial	$23.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.00
Rate for Payer: Oxford Commercial	$9.34
Rate for Payer: Qualcare PPO/HMO/WC	$7.00
Rate for Payer: UnitedHealthcare Commercial	$9.34
Rate for Payer: UnitedHealthcare Community & State	$1.12
Rate for Payer: Wellpoint Medicaid Managed Care	$1.24

BLOCK BD BITE LG 000428

Facility

$46.68

Hospital Charge Code	270617369
Hospital Revenue Code	270
Min. Negotiated Rate	$7.00
Max. Negotiated Rate	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.00

BLOCKER

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270691011
Hospital Revenue Code	278
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

BLOCKER

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270691011
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

BLOCKERS

Facility

$500.00

Hospital Charge Code	270701776
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

BLOCKERS

Facility

$500.00

Hospital Charge Code	270701776
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

BLOCK FEM AUGMENT 6x60 145341

Facility

$4,226.00

Hospital Charge Code	270635588
Hospital Revenue Code	278
Min. Negotiated Rate	$633.90
Max. Negotiated Rate	$1,022.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$845.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,022.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$929.72
Rate for Payer: Qualcare PPO/HMO/WC	$633.90

BLOCK FEM AUGMENT 6x60 145341

Facility

$4,226.00

Hospital Charge Code	270635588
Hospital Revenue Code	278
Min. Negotiated Rate	$101.85
Max. Negotiated Rate	$2,113.00
Rate for Payer: Aetna Commercial	$1,605.88
Rate for Payer: Aetna Medicare Advantage	$1,267.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,077.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,077.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$845.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,077.63
Rate for Payer: Cigna Commercial	$2,113.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,022.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$929.72
Rate for Payer: Qualcare PPO/HMO/WC	$633.90
Rate for Payer: UnitedHealthcare Community & State	$101.85
Rate for Payer: Wellpoint Medicaid Managed Care	$111.99

BLOCK INJ PLANTAR DIGIT

Facility

$1,227.12

Service Code	HCPCS 64455
Hospital Charge Code	16001034
Hospital Revenue Code	360
Min. Negotiated Rate	$184.07
Max. Negotiated Rate	$184.07
Rate for Payer: Qualcare PPO/HMO/WC	$184.07

BLOCK INJ PLANTAR DIGIT

Facility

$1,227.12

Service Code	HCPCS 64455
Hospital Charge Code	16001034
Hospital Revenue Code	360
Min. Negotiated Rate	$29.57
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
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	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.14
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$184.07
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$29.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$835.79
Rate for Payer: Wellpoint Medicaid Managed Care	$819.40

BLOCK PROPHECY 2R ALIGN GD

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697279
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

BLOCK PROPHECY 2R ALIGN GD

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697279
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

BLOCKS

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	201701776
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

BLOCKS

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	201701776
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

BLOCK TIB FULL AUG TIB 67MM

Facility

$5,550.00

Service Code	HCPCS C1776
Hospital Charge Code	270694499
Hospital Revenue Code	278
Min. Negotiated Rate	$133.75
Max. Negotiated Rate	$2,775.00
Rate for Payer: Aetna Commercial	$2,109.00
Rate for Payer: Aetna Medicare Advantage	$1,665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,415.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,415.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,415.25
Rate for Payer: Cigna Commercial	$2,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,343.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,221.00
Rate for Payer: Qualcare PPO/HMO/WC	$832.50
Rate for Payer: UnitedHealthcare Community & State	$133.75
Rate for Payer: Wellpoint Medicaid Managed Care	$147.07

Know your out-of-pocket cost for care.

All Charges