Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ACETABULAR LINER +4 HI-32/50

Facility

$6,660.00

Hospital Charge Code	270669037
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-32/50

Facility

$6,660.00

Hospital Charge Code	270669037
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-32/52

Facility

$6,660.00

Hospital Charge Code	270669038
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-32/52

Facility

$6,660.00

Hospital Charge Code	270669038
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-32/54

Facility

$6,660.00

Hospital Charge Code	270669039
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-32/54

Facility

$6,660.00

Hospital Charge Code	270669039
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-32/56

Facility

$6,660.00

Hospital Charge Code	270669040
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-32/56

Facility

$6,660.00

Hospital Charge Code	270669040
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-36/52

Facility

$6,660.00

Hospital Charge Code	270669044
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-36/52

Facility

$6,660.00

Hospital Charge Code	270669044
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-36/54

Facility

$6,660.00

Hospital Charge Code	270669045
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-36/54

Facility

$6,660.00

Hospital Charge Code	270669045
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-36/56

Facility

$6,660.00

Hospital Charge Code	270669046
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-36/56

Facility

$6,660.00

Hospital Charge Code	270669046
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 +4OFF-28/44

Facility

$6,660.00

Hospital Charge Code	270668939
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 +4OFF-28/44

Facility

$6,660.00

Hospital Charge Code	270668939
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 +4OFF-28/46

Facility

$6,660.00

Hospital Charge Code	270668940
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 +4OFF-28/46

Facility

$6,660.00

Hospital Charge Code	270668940
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 +4OFF-28/48

Facility

$6,660.00

Hospital Charge Code	270668941
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 +4OFF-28/48

Facility

$6,660.00

Hospital Charge Code	270668941
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 +4OFF-28/50

Facility

$6,660.00

Hospital Charge Code	270668942
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 +4OFF-28/50

Facility

$6,660.00

Hospital Charge Code	270668942
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 +4OFF-28/52

Facility

$6,660.00

Hospital Charge Code	270668943
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 +4OFF-28/52

Facility

$6,660.00

Hospital Charge Code	270668943
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 +4OFF-28/54

Facility

$6,660.00

Hospital Charge Code	270668944
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