Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BSS 500ML & ALCON NDC OPHTH***

Facility

$75.00

Hospital Charge Code	1600790
Hospital Revenue Code	279
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

BSS 500ML OPHTH *******

Facility

$60.00

Hospital Charge Code	1600782
Hospital Revenue Code	279
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.00
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

BSS 500ML OPHTH *******

Facility

$60.00

Hospital Charge Code	1600782
Hospital Revenue Code	279
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

BSS BRAUNSTEIN E

Facility

$107.00

Hospital Charge Code	60635600
Hospital Revenue Code	250
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

BSS BRAUNSTEIN E

Facility

$107.00

Hospital Charge Code	60635600
Hospital Revenue Code	250
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$53.50
Rate for Payer: Aetna Commercial	$40.66
Rate for Payer: Aetna Medicare Advantage	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.29
Rate for Payer: Cigna Commercial	$53.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.10
Rate for Payer: Oxford Commercial	$21.40
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Commercial	$21.40
Rate for Payer: UnitedHealthcare Community & State	$2.58
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

BSS BRAUNSTEIN S

Facility

$107.00

Hospital Charge Code	60635601
Hospital Revenue Code	250
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$53.50
Rate for Payer: Aetna Commercial	$40.66
Rate for Payer: Aetna Medicare Advantage	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.29
Rate for Payer: Cigna Commercial	$53.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.10
Rate for Payer: Oxford Commercial	$21.40
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Commercial	$21.40
Rate for Payer: UnitedHealthcare Community & State	$2.58
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

BSS BRAUNSTEIN S

Facility

$107.00

Hospital Charge Code	60635601
Hospital Revenue Code	250
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

BSS BRAUNSTEIN S 500ML

Facility

$180.00

Hospital Charge Code	270654888
Hospital Revenue Code	270
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

BSS BRAUNSTEIN S 500ML

Facility

$180.00

Hospital Charge Code	270654888
Hospital Revenue Code	270
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$90.00
Rate for Payer: Aetna Commercial	$68.40
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.00
Rate for Payer: Oxford Commercial	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$36.00
Rate for Payer: UnitedHealthcare Community & State	$4.34
Rate for Payer: Wellpoint Medicaid Managed Care	$4.77

BSS IRRIG 500ML

Facility

$108.92

Hospital Charge Code	60635869
Hospital Revenue Code	272
Min. Negotiated Rate	$2.62
Max. Negotiated Rate	$54.46
Rate for Payer: Aetna Commercial	$41.39
Rate for Payer: Aetna Medicare Advantage	$32.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.77
Rate for Payer: Cigna Commercial	$54.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.68
Rate for Payer: Oxford Commercial	$21.78
Rate for Payer: Qualcare PPO/HMO/WC	$16.34
Rate for Payer: UnitedHealthcare Commercial	$21.78
Rate for Payer: UnitedHealthcare Community & State	$2.62
Rate for Payer: Wellpoint Medicaid Managed Care	$2.89

BSS IRRIG 500ML

Facility

$108.92

Hospital Charge Code	60635869
Hospital Revenue Code	272
Min. Negotiated Rate	$16.34
Max. Negotiated Rate	$16.34
Rate for Payer: Qualcare PPO/HMO/WC	$16.34

BSS OPTH SOL

Facility

$55.34

Service Code	NDC 65079515
Hospital Charge Code	6063943066
Hospital Revenue Code	250
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$27.67
Rate for Payer: Aetna Commercial	$21.03
Rate for Payer: Aetna Medicare Advantage	$16.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.11
Rate for Payer: Cigna Commercial	$27.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.60
Rate for Payer: Oxford Commercial	$11.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.30
Rate for Payer: UnitedHealthcare Commercial	$11.07
Rate for Payer: UnitedHealthcare Community & State	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$1.47

BSS OPTH SOL

Facility

$55.34

Service Code	NDC 65079515
Hospital Charge Code	6063943066
Hospital Revenue Code	250
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$8.30
Rate for Payer: Qualcare PPO/HMO/WC	$8.30

BSS PANARIELLO

Facility

$107.00

Hospital Charge Code	60635599
Hospital Revenue Code	250
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

BSS PANARIELLO

Facility

$107.00

Hospital Charge Code	60635599
Hospital Revenue Code	250
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$53.50
Rate for Payer: Aetna Commercial	$40.66
Rate for Payer: Aetna Medicare Advantage	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.29
Rate for Payer: Cigna Commercial	$53.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.10
Rate for Payer: Oxford Commercial	$21.40
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Commercial	$21.40
Rate for Payer: UnitedHealthcare Community & State	$2.58
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

BSS RICCIARDELLI

Facility

$107.00

Hospital Charge Code	60635602
Hospital Revenue Code	250
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

BSS RICCIARDELLI

Facility

$107.00

Hospital Charge Code	60635602
Hospital Revenue Code	250
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$53.50
Rate for Payer: Aetna Commercial	$40.66
Rate for Payer: Aetna Medicare Advantage	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.29
Rate for Payer: Cigna Commercial	$53.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.10
Rate for Payer: Oxford Commercial	$21.40
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Commercial	$21.40
Rate for Payer: UnitedHealthcare Community & State	$2.58
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

BSS VORA

Facility

$107.00

Hospital Charge Code	60635603
Hospital Revenue Code	250
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

BSS VORA

Facility

$107.00

Hospital Charge Code	60635603
Hospital Revenue Code	250
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$53.50
Rate for Payer: Aetna Commercial	$40.66
Rate for Payer: Aetna Medicare Advantage	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.29
Rate for Payer: Cigna Commercial	$53.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.10
Rate for Payer: Oxford Commercial	$21.40
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Commercial	$21.40
Rate for Payer: UnitedHealthcare Community & State	$2.58
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

BSS YEE

Facility

$107.00

Hospital Charge Code	60635604
Hospital Revenue Code	250
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

BSS YEE

Facility

$107.00

Hospital Charge Code	60635604
Hospital Revenue Code	250
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$53.50
Rate for Payer: Aetna Commercial	$40.66
Rate for Payer: Aetna Medicare Advantage	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.29
Rate for Payer: Cigna Commercial	$53.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.10
Rate for Payer: Oxford Commercial	$21.40
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Commercial	$21.40
Rate for Payer: UnitedHealthcare Community & State	$2.58
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

BT30 CANN HLOBE DRIVER W/ZH

Facility

$4,550.00

Hospital Charge Code	270704599
Hospital Revenue Code	279
Min. Negotiated Rate	$109.66
Max. Negotiated Rate	$2,275.00
Rate for Payer: Aetna Commercial	$1,729.00
Rate for Payer: Aetna Medicare Advantage	$1,365.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,160.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,160.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,160.25
Rate for Payer: Cigna Commercial	$2,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,365.00
Rate for Payer: Oxford Commercial	$910.00
Rate for Payer: Qualcare PPO/HMO/WC	$682.50
Rate for Payer: UnitedHealthcare Commercial	$910.00
Rate for Payer: UnitedHealthcare Community & State	$109.66
Rate for Payer: Wellpoint Medicaid Managed Care	$120.58

BT30 CANN HLOBE DRIVER W/ZH

Facility

$4,550.00

Hospital Charge Code	270704599
Hospital Revenue Code	279
Min. Negotiated Rate	$682.50
Max. Negotiated Rate	$682.50
Rate for Payer: Qualcare PPO/HMO/WC	$682.50

BTB TIGHT ROPE RT

Facility

$2,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270656498
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.50
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

BTB TIGHT ROPE RT

Facility

$2,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270656498
Hospital Revenue Code	278
Min. Negotiated Rate	$51.21
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.50
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Community & State	$51.21
Rate for Payer: Wellpoint Medicaid Managed Care	$56.31

Know your out-of-pocket cost for care.

All Charges