Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ACETABULAR LINER +4 EL-32/54

Facility

$6,995.00

Hospital Charge Code	270669149
Hospital Revenue Code	278
Min. Negotiated Rate	$1,049.25
Max. Negotiated Rate	$1,692.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,399.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,692.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,538.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,049.25

ACETABULAR LINER +4 EL-32/56

Facility

$6,995.00

Hospital Charge Code	270669150
Hospital Revenue Code	278
Min. Negotiated Rate	$168.58
Max. Negotiated Rate	$3,497.50
Rate for Payer: Aetna Commercial	$2,658.10
Rate for Payer: Aetna Medicare Advantage	$2,098.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,783.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,783.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,399.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,783.72
Rate for Payer: Cigna Commercial	$3,497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,692.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,538.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,049.25
Rate for Payer: UnitedHealthcare Community & State	$168.58
Rate for Payer: Wellpoint Medicaid Managed Care	$185.37

ACETABULAR LINER +4 EL-32/56

Facility

$6,995.00

Hospital Charge Code	270669150
Hospital Revenue Code	278
Min. Negotiated Rate	$1,049.25
Max. Negotiated Rate	$1,692.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,399.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,692.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,538.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,049.25

ACETABULAR LINER +4 EL-36/52

Facility

$6,995.00

Hospital Charge Code	270669154
Hospital Revenue Code	278
Min. Negotiated Rate	$1,049.25
Max. Negotiated Rate	$1,692.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,399.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,692.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,538.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,049.25

ACETABULAR LINER +4 EL-36/52

Facility

$6,995.00

Hospital Charge Code	270669154
Hospital Revenue Code	278
Min. Negotiated Rate	$168.58
Max. Negotiated Rate	$3,497.50
Rate for Payer: Aetna Commercial	$2,658.10
Rate for Payer: Aetna Medicare Advantage	$2,098.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,783.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,783.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,399.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,783.72
Rate for Payer: Cigna Commercial	$3,497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,692.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,538.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,049.25
Rate for Payer: UnitedHealthcare Community & State	$168.58
Rate for Payer: Wellpoint Medicaid Managed Care	$185.37

ACETABULAR LINER +4 EL-36/54

Facility

$6,995.00

Hospital Charge Code	270669155
Hospital Revenue Code	278
Min. Negotiated Rate	$1,049.25
Max. Negotiated Rate	$1,692.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,399.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,692.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,538.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,049.25

ACETABULAR LINER +4 EL-36/54

Facility

$6,995.00

Hospital Charge Code	270669155
Hospital Revenue Code	278
Min. Negotiated Rate	$168.58
Max. Negotiated Rate	$3,497.50
Rate for Payer: Aetna Commercial	$2,658.10
Rate for Payer: Aetna Medicare Advantage	$2,098.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,783.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,783.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,399.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,783.72
Rate for Payer: Cigna Commercial	$3,497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,692.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,538.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,049.25
Rate for Payer: UnitedHealthcare Community & State	$168.58
Rate for Payer: Wellpoint Medicaid Managed Care	$185.37

ACETABULAR LINER +4 EL-36/56

Facility

$6,995.00

Hospital Charge Code	270669156
Hospital Revenue Code	278
Min. Negotiated Rate	$1,049.25
Max. Negotiated Rate	$1,692.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,399.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,692.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,538.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,049.25

ACETABULAR LINER +4 EL-36/56

Facility

$6,995.00

Hospital Charge Code	270669156
Hospital Revenue Code	278
Min. Negotiated Rate	$168.58
Max. Negotiated Rate	$3,497.50
Rate for Payer: Aetna Commercial	$2,658.10
Rate for Payer: Aetna Medicare Advantage	$2,098.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,783.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,783.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,399.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,783.72
Rate for Payer: Cigna Commercial	$3,497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,692.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,538.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,049.25
Rate for Payer: UnitedHealthcare Community & State	$168.58
Rate for Payer: Wellpoint Medicaid Managed Care	$185.37

ACETABULAR LINER +4 HI-28/44

Facility

$6,660.00

Hospital Charge Code	270668992
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER +4 HI-28/44

Facility

$6,660.00

Hospital Charge Code	270668992
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER +4 HI-28/46

Facility

$6,660.00

Hospital Charge Code	270668993
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER +4 HI-28/46

Facility

$6,660.00

Hospital Charge Code	270668993
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER +4 HI-28/48

Facility

$6,660.00

Hospital Charge Code	270668994
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER +4 HI-28/48

Facility

$6,660.00

Hospital Charge Code	270668994
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER +4 HI-28/50

Facility

$6,660.00

Hospital Charge Code	270668995
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER +4 HI-28/50

Facility

$6,660.00

Hospital Charge Code	270668995
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER +4 HI-28/52

Facility

$6,660.00

Hospital Charge Code	270668996
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER +4 HI-28/52

Facility

$6,660.00

Hospital Charge Code	270668996
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER +4 HI-28/54

Facility

$6,660.00

Hospital Charge Code	270668997
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER +4 HI-28/54

Facility

$6,660.00

Hospital Charge Code	270668997
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER +4 HI-28/56

Facility

$6,660.00

Hospital Charge Code	270668999
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER +4 HI-28/56

Facility

$6,660.00

Hospital Charge Code	270668999
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

ACETABULAR LINER +4 HI-32/48

Facility

$6,660.00

Hospital Charge Code	270669036
Hospital Revenue Code	278
Min. Negotiated Rate	$999.00
Max. Negotiated Rate	$1,611.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00

ACETABULAR LINER +4 HI-32/48

Facility

$6,660.00

Hospital Charge Code	270669036
Hospital Revenue Code	278
Min. Negotiated Rate	$160.51
Max. Negotiated Rate	$3,330.00
Rate for Payer: Aetna Commercial	$2,530.80
Rate for Payer: Aetna Medicare Advantage	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,698.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,698.30
Rate for Payer: Cigna Commercial	$3,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,465.20
Rate for Payer: Qualcare PPO/HMO/WC	$999.00
Rate for Payer: UnitedHealthcare Community & State	$160.51
Rate for Payer: Wellpoint Medicaid Managed Care	$176.49

Know your out-of-pocket cost for care.

All Charges