Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ACLOVATE 0.05%/15GM

Facility

$56.00

Hospital Charge Code	60632390
Hospital Revenue Code	250
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

ACL TENDON-KNEE PER SQ. CM.

Facility

$249.00

Hospital Charge Code	270332705
Hospital Revenue Code	636
Min. Negotiated Rate	$37.35
Max. Negotiated Rate	$60.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.26
Rate for Payer: Qualcare PPO/HMO/WC	$37.35

ACL TENDON-KNEE PER SQ. CM.

Facility

$249.00

Hospital Charge Code	270332705
Hospital Revenue Code	636
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$124.50
Rate for Payer: Aetna Commercial	$94.62
Rate for Payer: Aetna Medicare Advantage	$74.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.49
Rate for Payer: Cigna Commercial	$124.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.26
Rate for Payer: Qualcare PPO/HMO/WC	$37.35
Rate for Payer: UnitedHealthcare Community & State	$6.00
Rate for Payer: Wellpoint Medicaid Managed Care	$6.60

ACL TIGHT ROPE DRILL PIN

Facility

$895.00

Hospital Charge Code	270656488
Hospital Revenue Code	270
Min. Negotiated Rate	$134.25
Max. Negotiated Rate	$134.25
Rate for Payer: Qualcare PPO/HMO/WC	$134.25

ACL TIGHT ROPE DRILL PIN

Facility

$895.00

Hospital Charge Code	270656488
Hospital Revenue Code	270
Min. Negotiated Rate	$21.57
Max. Negotiated Rate	$447.50
Rate for Payer: Aetna Commercial	$340.10
Rate for Payer: Aetna Medicare Advantage	$268.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$228.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$228.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$228.22
Rate for Payer: Cigna Commercial	$447.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.50
Rate for Payer: Oxford Commercial	$179.00
Rate for Payer: Qualcare PPO/HMO/WC	$134.25
Rate for Payer: UnitedHealthcare Commercial	$179.00
Rate for Payer: UnitedHealthcare Community & State	$21.57
Rate for Payer: Wellpoint Medicaid Managed Care	$23.72

ACL TIGHTROPE II DOUBLE LOADED

Facility

$2,394.75

Service Code	HCPCS C1713
Hospital Charge Code	270704449
Hospital Revenue Code	278
Min. Negotiated Rate	$359.21
Max. Negotiated Rate	$579.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$579.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$526.85
Rate for Payer: Qualcare PPO/HMO/WC	$359.21

ACL TIGHTROPE II DOUBLE LOADED

Facility

$2,394.75

Service Code	HCPCS C1713
Hospital Charge Code	270704449
Hospital Revenue Code	278
Min. Negotiated Rate	$57.71
Max. Negotiated Rate	$1,197.38
Rate for Payer: Aetna Commercial	$910.00
Rate for Payer: Aetna Medicare Advantage	$718.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$610.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$610.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$610.66
Rate for Payer: Cigna Commercial	$1,197.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$579.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$526.85
Rate for Payer: Qualcare PPO/HMO/WC	$359.21
Rate for Payer: UnitedHealthcare Community & State	$57.71
Rate for Payer: Wellpoint Medicaid Managed Care	$63.46

ACL TIGHTROPE RT

Facility

$1,750.00

Hospital Charge Code	270663931
Hospital Revenue Code	270
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

ACL TIGHTROPE RT

Facility

$1,750.00

Hospital Charge Code	270663931
Hospital Revenue Code	270
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$525.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

ACL TRAY FEE AR992

Facility

$500.00

Hospital Charge Code	270641554
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

ACL TRAY FEE AR992

Facility

$500.00

Hospital Charge Code	270641554
Hospital Revenue Code	272
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

ACL TR SUTURE CUTTER

Facility

$1,130.00

Hospital Charge Code	270664910
Hospital Revenue Code	272
Min. Negotiated Rate	$169.50
Max. Negotiated Rate	$169.50
Rate for Payer: Qualcare PPO/HMO/WC	$169.50

ACL TR SUTURE CUTTER

Facility

$1,130.00

Hospital Charge Code	270664910
Hospital Revenue Code	272
Min. Negotiated Rate	$27.23
Max. Negotiated Rate	$565.00
Rate for Payer: Aetna Commercial	$429.40
Rate for Payer: Aetna Medicare Advantage	$339.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$288.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$288.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$288.15
Rate for Payer: Cigna Commercial	$565.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.00
Rate for Payer: Oxford Commercial	$226.00
Rate for Payer: Qualcare PPO/HMO/WC	$169.50
Rate for Payer: UnitedHealthcare Commercial	$226.00
Rate for Payer: UnitedHealthcare Community & State	$27.23
Rate for Payer: Wellpoint Medicaid Managed Care	$29.95

ACNE SURGERY

Facility

$990.50

Service Code	HCPCS 10040
Hospital Charge Code	412310040
Hospital Revenue Code	361
Min. Negotiated Rate	$148.57
Max. Negotiated Rate	$148.57
Rate for Payer: Qualcare PPO/HMO/WC	$148.57

ACNE SURGERY

Facility

$990.50

Service Code	HCPCS 10040
Hospital Charge Code	412310040
Hospital Revenue Code	361
Min. Negotiated Rate	$23.87
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.41
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$297.15
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$148.57
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$23.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$26.25

ACORN BUR

Facility

$279.00

Hospital Charge Code	270335567
Hospital Revenue Code	272
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$139.50
Rate for Payer: Aetna Commercial	$106.02
Rate for Payer: Aetna Medicare Advantage	$83.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.14
Rate for Payer: Cigna Commercial	$139.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.70
Rate for Payer: Oxford Commercial	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$41.85
Rate for Payer: UnitedHealthcare Commercial	$55.80
Rate for Payer: UnitedHealthcare Community & State	$6.72
Rate for Payer: Wellpoint Medicaid Managed Care	$7.39

ACORN BUR

Facility

$279.00

Hospital Charge Code	270335567
Hospital Revenue Code	272
Min. Negotiated Rate	$41.85
Max. Negotiated Rate	$41.85
Rate for Payer: Qualcare PPO/HMO/WC	$41.85

ACP 2 LEVEL 40MM

Facility

$5,500.00

Hospital Charge Code	270703572
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

ACP 2 LEVEL 40MM

Facility

$5,500.00

Hospital Charge Code	270703572
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

ACP 3 LVL 51MM

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705057
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

ACP 3 LVL 51MM

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705057
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

ACP DOUBLE SYRINGE

Facility

$225.00

Hospital Charge Code	270339457
Hospital Revenue Code	272
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.50
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$45.00
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

ACP DOUBLE SYRINGE

Facility

$225.00

Hospital Charge Code	270339457
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

ACPELLA ADULT GREEN

Facility

$205.49

Hospital Charge Code	270664898
Hospital Revenue Code	270
Min. Negotiated Rate	$30.82
Max. Negotiated Rate	$30.82
Rate for Payer: Qualcare PPO/HMO/WC	$30.82

ACPELLA ADULT GREEN

Facility

$205.49

Hospital Charge Code	270664898
Hospital Revenue Code	270
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$102.75
Rate for Payer: Aetna Commercial	$78.09
Rate for Payer: Aetna Medicare Advantage	$61.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.40
Rate for Payer: Cigna Commercial	$102.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.65
Rate for Payer: Oxford Commercial	$41.10
Rate for Payer: Qualcare PPO/HMO/WC	$30.82
Rate for Payer: UnitedHealthcare Commercial	$41.10
Rate for Payer: UnitedHealthcare Community & State	$4.95
Rate for Payer: Wellpoint Medicaid Managed Care	$5.45

Know your out-of-pocket cost for care.

All Charges