Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS

Facility

$22,964.16

Service Code	APR-DRG 8422
Min. Negotiated Rate	$22,513.88
Max. Negotiated Rate	$22,964.16
Rate for Payer: UnitedHealthcare Community & State	$22,513.88
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,964.16
Rate for Payer: Wellpoint Medicaid Managed Care	$22,513.88

BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS

Facility

$119,522.95

Service Code	APR-DRG 8424
Min. Negotiated Rate	$117,179.36
Max. Negotiated Rate	$119,522.95
Rate for Payer: UnitedHealthcare Community & State	$117,179.36
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$119,522.95
Rate for Payer: Wellpoint Medicaid Managed Care	$117,179.36

BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS

Facility

$42,656.13

Service Code	APR-DRG 8423
Min. Negotiated Rate	$41,819.74
Max. Negotiated Rate	$42,656.13
Rate for Payer: UnitedHealthcare Community & State	$41,819.74
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$42,656.13
Rate for Payer: Wellpoint Medicaid Managed Care	$41,819.74

BUR OVAL 4.0/8MM 6010706****

Facility

$44.40

Hospital Charge Code	2706016070
Hospital Revenue Code	279
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$22.20
Rate for Payer: Aetna Commercial	$16.87
Rate for Payer: Aetna Medicare Advantage	$13.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.32
Rate for Payer: Cigna Commercial	$22.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.32
Rate for Payer: Oxford Commercial	$8.88
Rate for Payer: Qualcare PPO/HMO/WC	$6.66
Rate for Payer: UnitedHealthcare Commercial	$8.88
Rate for Payer: UnitedHealthcare Community & State	$1.07
Rate for Payer: Wellpoint Medicaid Managed Care	$1.18

BUR OVAL 4.0/8MM 6010706****

Facility

$44.40

Hospital Charge Code	2706016070
Hospital Revenue Code	279
Min. Negotiated Rate	$6.66
Max. Negotiated Rate	$6.66
Rate for Payer: Qualcare PPO/HMO/WC	$6.66

BUR PEAR STD 8 FLUTE 5.0MM

Facility

$1,553.50

Hospital Charge Code	270658045
Hospital Revenue Code	278
Min. Negotiated Rate	$37.44
Max. Negotiated Rate	$776.75
Rate for Payer: Aetna Commercial	$590.33
Rate for Payer: Aetna Medicare Advantage	$466.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$396.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$396.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$396.14
Rate for Payer: Cigna Commercial	$776.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$341.77
Rate for Payer: Qualcare PPO/HMO/WC	$233.03
Rate for Payer: UnitedHealthcare Community & State	$37.44
Rate for Payer: Wellpoint Medicaid Managed Care	$41.17

BUR PEAR STD 8 FLUTE 5.0MM

Facility

$1,553.50

Hospital Charge Code	270658045
Hospital Revenue Code	278
Min. Negotiated Rate	$233.03
Max. Negotiated Rate	$375.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$341.77
Rate for Payer: Qualcare PPO/HMO/WC	$233.03

BUR PRECISION TWO FLUTE 4.0MM

Facility

$1,125.00

Hospital Charge Code	270673205
Hospital Revenue Code	272
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Commercial	$225.00
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

BUR PRECISION TWO FLUTE 4.0MM

Facility

$1,125.00

Hospital Charge Code	270673205
Hospital Revenue Code	272
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BUR PRECISION TWO FLUTE 5.0MM

Facility

$1,125.00

Hospital Charge Code	270673206
Hospital Revenue Code	272
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BUR PRECISION TWO FLUTE 5.0MM

Facility

$1,125.00

Hospital Charge Code	270673206
Hospital Revenue Code	272
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Commercial	$225.00
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

BUR PRECISION TWO FLUTE 6MM

Facility

$1,125.00

Hospital Charge Code	270675219
Hospital Revenue Code	272
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BUR PRECISION TWO FLUTE 6MM

Facility

$1,125.00

Hospital Charge Code	270675219
Hospital Revenue Code	272
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Commercial	$225.00
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

BUR PRECISION TWO FLUTE 7.5MM

Facility

$1,125.00

Hospital Charge Code	270675303
Hospital Revenue Code	272
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BUR PRECISION TWO FLUTE 7.5MM

Facility

$1,125.00

Hospital Charge Code	270675303
Hospital Revenue Code	272
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Commercial	$225.00
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

BURR

Facility

$1,082.50

Hospital Charge Code	270705521
Hospital Revenue Code	279
Min. Negotiated Rate	$162.38
Max. Negotiated Rate	$162.38
Rate for Payer: Qualcare PPO/HMO/WC	$162.38

BURR

Facility

$1,082.50

Hospital Charge Code	270705521
Hospital Revenue Code	279
Min. Negotiated Rate	$26.09
Max. Negotiated Rate	$541.25
Rate for Payer: Aetna Commercial	$411.35
Rate for Payer: Aetna Medicare Advantage	$324.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$276.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$276.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$276.04
Rate for Payer: Cigna Commercial	$541.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.75
Rate for Payer: Oxford Commercial	$216.50
Rate for Payer: Qualcare PPO/HMO/WC	$162.38
Rate for Payer: UnitedHealthcare Commercial	$216.50
Rate for Payer: UnitedHealthcare Community & State	$26.09
Rate for Payer: Wellpoint Medicaid Managed Care	$28.69

BURR 2.0MM HEAD

Facility

$607.55

Hospital Charge Code	270688301
Hospital Revenue Code	272
Min. Negotiated Rate	$14.64
Max. Negotiated Rate	$303.77
Rate for Payer: Aetna Commercial	$230.87
Rate for Payer: Aetna Medicare Advantage	$182.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.93
Rate for Payer: Cigna Commercial	$303.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.26
Rate for Payer: Oxford Commercial	$121.51
Rate for Payer: Qualcare PPO/HMO/WC	$91.13
Rate for Payer: UnitedHealthcare Commercial	$121.51
Rate for Payer: UnitedHealthcare Community & State	$14.64
Rate for Payer: Wellpoint Medicaid Managed Care	$16.10

BURR 2.0MM HEAD

Facility

$607.55

Hospital Charge Code	270688301
Hospital Revenue Code	272
Min. Negotiated Rate	$91.13
Max. Negotiated Rate	$91.13
Rate for Payer: Qualcare PPO/HMO/WC	$91.13

BURR 2.2 MM HEAD

Facility

$1,250.00

Hospital Charge Code	270688289
Hospital Revenue Code	272
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$250.00
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

BURR 2.2 MM HEAD

Facility

$1,250.00

Hospital Charge Code	270688289
Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

BURR 2.2X20MM

Facility

$1,365.00

Hospital Charge Code	270705570
Hospital Revenue Code	279
Min. Negotiated Rate	$204.75
Max. Negotiated Rate	$204.75
Rate for Payer: Qualcare PPO/HMO/WC	$204.75

BURR 2.2X20MM

Facility

$1,365.00

Hospital Charge Code	270705570
Hospital Revenue Code	279
Min. Negotiated Rate	$32.90
Max. Negotiated Rate	$682.50
Rate for Payer: Aetna Commercial	$518.70
Rate for Payer: Aetna Medicare Advantage	$409.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$348.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$348.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$348.07
Rate for Payer: Cigna Commercial	$682.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$409.50
Rate for Payer: Oxford Commercial	$273.00
Rate for Payer: Qualcare PPO/HMO/WC	$204.75
Rate for Payer: UnitedHealthcare Commercial	$273.00
Rate for Payer: UnitedHealthcare Community & State	$32.90
Rate for Payer: Wellpoint Medicaid Managed Care	$36.17

BURR 2.9X13MM

Facility

$1,365.00

Hospital Charge Code	270705388
Hospital Revenue Code	279
Min. Negotiated Rate	$204.75
Max. Negotiated Rate	$204.75
Rate for Payer: Qualcare PPO/HMO/WC	$204.75

BURR 2.9X13MM

Facility

$1,365.00

Hospital Charge Code	270705388
Hospital Revenue Code	279
Min. Negotiated Rate	$32.90
Max. Negotiated Rate	$682.50
Rate for Payer: Aetna Commercial	$518.70
Rate for Payer: Aetna Medicare Advantage	$409.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$348.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$348.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$348.07
Rate for Payer: Cigna Commercial	$682.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$409.50
Rate for Payer: Oxford Commercial	$273.00
Rate for Payer: Qualcare PPO/HMO/WC	$204.75
Rate for Payer: UnitedHealthcare Commercial	$273.00
Rate for Payer: UnitedHealthcare Community & State	$32.90
Rate for Payer: Wellpoint Medicaid Managed Care	$36.17

Know your out-of-pocket cost for care.

All Charges