Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CAN USE THIS NUMBER--ERROR

Facility

$116.48

Hospital Charge Code	5700998
Hospital Revenue Code	260
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$44.26
Rate for Payer: Aetna Medicare Advantage	$34.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.70
Rate for Payer: Cigna Commercial	$58.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.94
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.47
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$2.81
Rate for Payer: Wellpoint Medicaid Managed Care	$3.09

CAN USE THIS NUMBER--ERROR

Facility

$116.48

Hospital Charge Code	5700996
Hospital Revenue Code	260
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$17.47
Rate for Payer: Qualcare PPO/HMO/WC	$17.47

CAN USE THIS NUMBER--ERROR

Facility

$116.48

Hospital Charge Code	5700996
Hospital Revenue Code	260
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$919.00
Rate for Payer: Aetna Commercial	$44.26
Rate for Payer: Aetna Medicare Advantage	$34.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.70
Rate for Payer: Cigna Commercial	$58.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.94
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.47
Rate for Payer: UnitedHealthcare Commercial	$919.00
Rate for Payer: UnitedHealthcare Community & State	$2.81
Rate for Payer: Wellpoint Medicaid Managed Care	$3.09

CAP 14 MM PSN6-9 EF

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692335
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

CAP 14 MM PSN6-9 EF

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692335
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

CAP ASF PSN 10 MM VE 6-9 CD

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690144
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

CAP ASF PSN 10 MM VE 6-9 CD

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690144
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

CAP ASF PSN 12 MM VEL 3

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690103
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

CAP ASF PSN 12 MM VEL 3

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690103
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

CAP BICART RENAL

Facility

$9.65

Hospital Charge Code	270606422
Hospital Revenue Code	270
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

CAP BICART RENAL

Facility

$9.65

Hospital Charge Code	270606422
Hospital Revenue Code	270
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$3.67
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.90
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$1.93
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

CAP BLUE SEALING 6-12F

Facility

$33.00

Hospital Charge Code	270617618
Hospital Revenue Code	270
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

CAP BLUE SEALING 6-12F

Facility

$33.00

Hospital Charge Code	270617618
Hospital Revenue Code	270
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$12.54
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.90
Rate for Payer: Oxford Commercial	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$6.60
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

CAP BOUFFANT BLUE 24

Facility

$0.21

Hospital Charge Code	270648966
Hospital Revenue Code	270
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.03
Rate for Payer: Qualcare PPO/HMO/WC	$0.03

CAP BOUFFANT BLUE 24

Facility

$0.21

Hospital Charge Code	270648966
Hospital Revenue Code	270
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.11
Rate for Payer: Aetna Commercial	$0.08
Rate for Payer: Aetna Medicare Advantage	$0.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.05
Rate for Payer: Cigna Commercial	$0.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.06
Rate for Payer: Oxford Commercial	$0.04
Rate for Payer: Qualcare PPO/HMO/WC	$0.03
Rate for Payer: UnitedHealthcare Commercial	$0.04
Rate for Payer: UnitedHealthcare Community & State	$0.01
Rate for Payer: Wellpoint Medicaid Managed Care	$0.01

CAP BOUFFANT BLUE 27

Facility

$30.47

Hospital Charge Code	270060200C
Hospital Revenue Code	272
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$15.23
Rate for Payer: Aetna Commercial	$11.58
Rate for Payer: Aetna Medicare Advantage	$9.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.77
Rate for Payer: Cigna Commercial	$15.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.14
Rate for Payer: Oxford Commercial	$6.09
Rate for Payer: Qualcare PPO/HMO/WC	$4.57
Rate for Payer: UnitedHealthcare Commercial	$6.09
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

CAP BOUFFANT BLUE 27

Facility

$30.47

Hospital Charge Code	270060200C
Hospital Revenue Code	272
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$4.57
Rate for Payer: Qualcare PPO/HMO/WC	$4.57

CAP BOUFFANT GREEN 24

Facility

$0.24

Hospital Charge Code	270648965
Hospital Revenue Code	270
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.04
Rate for Payer: Qualcare PPO/HMO/WC	$0.04

CAP BOUFFANT GREEN 24

Facility

$0.24

Hospital Charge Code	270648965
Hospital Revenue Code	270
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.12
Rate for Payer: Aetna Commercial	$0.09
Rate for Payer: Aetna Medicare Advantage	$0.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.06
Rate for Payer: Cigna Commercial	$0.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.07
Rate for Payer: Oxford Commercial	$0.05
Rate for Payer: Qualcare PPO/HMO/WC	$0.04
Rate for Payer: UnitedHealthcare Commercial	$0.05
Rate for Payer: UnitedHealthcare Community & State	$0.01
Rate for Payer: Wellpoint Medicaid Managed Care	$0.01

CAP BOUFFANT HW 24IN BLUE

Facility

$209.60

Hospital Charge Code	270664786
Hospital Revenue Code	270
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$104.80
Rate for Payer: Aetna Commercial	$79.65
Rate for Payer: Aetna Medicare Advantage	$62.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.45
Rate for Payer: Cigna Commercial	$104.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.88
Rate for Payer: Oxford Commercial	$41.92
Rate for Payer: Qualcare PPO/HMO/WC	$31.44
Rate for Payer: UnitedHealthcare Commercial	$41.92
Rate for Payer: UnitedHealthcare Community & State	$5.05
Rate for Payer: Wellpoint Medicaid Managed Care	$5.55

CAP BOUFFANT HW 24IN BLUE

Facility

$209.60

Hospital Charge Code	270664786
Hospital Revenue Code	270
Min. Negotiated Rate	$31.44
Max. Negotiated Rate	$31.44
Rate for Payer: Qualcare PPO/HMO/WC	$31.44

CAP BOUFFANT WHITE 24

Facility

$0.60

Hospital Charge Code	270648967
Hospital Revenue Code	270
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.30
Rate for Payer: Aetna Commercial	$0.23
Rate for Payer: Aetna Medicare Advantage	$0.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.15
Rate for Payer: Cigna Commercial	$0.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.18
Rate for Payer: Oxford Commercial	$0.12
Rate for Payer: Qualcare PPO/HMO/WC	$0.09
Rate for Payer: UnitedHealthcare Commercial	$0.12
Rate for Payer: UnitedHealthcare Community & State	$0.01
Rate for Payer: Wellpoint Medicaid Managed Care	$0.02

CAP BOUFFANT WHITE 24

Facility

$0.60

Hospital Charge Code	270648967
Hospital Revenue Code	270
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.09
Rate for Payer: Qualcare PPO/HMO/WC	$0.09

CAP CPS ASF PSN 14MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270689795
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

CAP CPS ASF PSN 14MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270689795
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

Know your out-of-pocket cost for care.

All Charges