Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ADAPTER BMT DRLL 4.3 471843

Facility

$930.00

Hospital Charge Code	270617541
Hospital Revenue Code	272
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$139.50
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

ADAPTER CELL MERLIN TRANSMIT

Facility

$2,250.00

Hospital Charge Code	270676937V
Hospital Revenue Code	271
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

ADAPTER CELL MERLIN TRANSMIT

Facility

$2,250.00

Hospital Charge Code	270676937V
Hospital Revenue Code	271
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$675.00
Rate for Payer: Oxford Commercial	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$450.00
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

ADAPTER CLEANING BIOPSY 16006

Facility

$125.00

Hospital Charge Code	270665136
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

ADAPTER CLEANING BIOPSY 16006

Facility

$125.00

Hospital Charge Code	270665136
Hospital Revenue Code	272
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

ADAPTER DC-1 FILTER 022367

Facility

$29.65

Hospital Charge Code	270608727
Hospital Revenue Code	272
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$4.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.45

ADAPTER DC-1 FILTER 022367

Facility

$29.65

Hospital Charge Code	270608727
Hospital Revenue Code	272
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$14.82
Rate for Payer: Aetna Commercial	$11.27
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.56
Rate for Payer: Cigna Commercial	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.89
Rate for Payer: Oxford Commercial	$5.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.45
Rate for Payer: UnitedHealthcare Commercial	$5.93
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

ADAPTER DOUBLE MALE*****

Facility

$5.00

Hospital Charge Code	8004343
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

ADAPTER DOUBLE MALE*****

Facility

$5.00

Hospital Charge Code	8004343
Hospital Revenue Code	272
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

ADAPTER DUAL IRRIG 250070419

Facility

$59.31

Hospital Charge Code	270621072
Hospital Revenue Code	272
Min. Negotiated Rate	$8.90
Max. Negotiated Rate	$8.90
Rate for Payer: Qualcare PPO/HMO/WC	$8.90

ADAPTER DUAL IRRIG 250070419

Facility

$59.31

Hospital Charge Code	270621072
Hospital Revenue Code	272
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$29.66
Rate for Payer: Aetna Commercial	$22.54
Rate for Payer: Aetna Medicare Advantage	$17.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.12
Rate for Payer: Cigna Commercial	$29.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.79
Rate for Payer: Oxford Commercial	$11.86
Rate for Payer: Qualcare PPO/HMO/WC	$8.90
Rate for Payer: UnitedHealthcare Commercial	$11.86
Rate for Payer: UnitedHealthcare Community & State	$1.43
Rate for Payer: Wellpoint Medicaid Managed Care	$1.57

ADAPTER DUAL PRT FD 000333****

Facility

$26.00

Hospital Charge Code	8004293
Hospital Revenue Code	272
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$13.00
Rate for Payer: Aetna Commercial	$9.88
Rate for Payer: Aetna Medicare Advantage	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.63
Rate for Payer: Cigna Commercial	$13.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$5.20
Rate for Payer: Qualcare PPO/HMO/WC	$3.90
Rate for Payer: UnitedHealthcare Commercial	$5.20
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.69

ADAPTER DUAL PRT FD 000333****

Facility

$26.00

Hospital Charge Code	8004293
Hospital Revenue Code	272
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.90

ADAPTER G2 SLIM 65W HP ACCESSO

Facility

$345.00

Hospital Charge Code	270684748
Hospital Revenue Code	272
Min. Negotiated Rate	$8.31
Max. Negotiated Rate	$172.50
Rate for Payer: Aetna Commercial	$131.10
Rate for Payer: Aetna Medicare Advantage	$103.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.97
Rate for Payer: Cigna Commercial	$172.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.50
Rate for Payer: Oxford Commercial	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.75
Rate for Payer: UnitedHealthcare Commercial	$69.00
Rate for Payer: UnitedHealthcare Community & State	$8.31
Rate for Payer: Wellpoint Medicaid Managed Care	$9.14

ADAPTER G2 SLIM 65W HP ACCESSO

Facility

$345.00

Hospital Charge Code	270684748
Hospital Revenue Code	272
Min. Negotiated Rate	$51.75
Max. Negotiated Rate	$51.75
Rate for Payer: Qualcare PPO/HMO/WC	$51.75

ADAPTER HEMOSTASIS VALU

Facility

$121.65

Hospital Charge Code	270601030
Hospital Revenue Code	272
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$60.83
Rate for Payer: Aetna Commercial	$46.23
Rate for Payer: Aetna Medicare Advantage	$36.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.02
Rate for Payer: Cigna Commercial	$60.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.49
Rate for Payer: Oxford Commercial	$24.33
Rate for Payer: Qualcare PPO/HMO/WC	$18.25
Rate for Payer: UnitedHealthcare Commercial	$24.33
Rate for Payer: UnitedHealthcare Community & State	$2.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.22

ADAPTER HEMOSTASIS VALU

Facility

$121.65

Hospital Charge Code	270601030
Hospital Revenue Code	272
Min. Negotiated Rate	$18.25
Max. Negotiated Rate	$18.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.25

ADAPTER HEMOSTASIS VALVE 8FR

Facility

$100.00

Hospital Charge Code	270645891
Hospital Revenue Code	272
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$38.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.00
Rate for Payer: Oxford Commercial	$20.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$20.00
Rate for Payer: UnitedHealthcare Community & State	$2.41
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

ADAPTER HEMOSTASIS VALVE 8FR

Facility

$100.00

Hospital Charge Code	270645891
Hospital Revenue Code	272
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

ADAPTER HEMO VALVE 9F POLY

Facility

$57.20

Hospital Charge Code	270698324S
Hospital Revenue Code	272
Min. Negotiated Rate	$8.58
Max. Negotiated Rate	$8.58
Rate for Payer: Qualcare PPO/HMO/WC	$8.58

ADAPTER HEMO VALVE 9F POLY

Facility

$57.20

Hospital Charge Code	270698324S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$28.60
Rate for Payer: Aetna Commercial	$21.74
Rate for Payer: Aetna Medicare Advantage	$17.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.59
Rate for Payer: Cigna Commercial	$28.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.16
Rate for Payer: Oxford Commercial	$11.44
Rate for Payer: Qualcare PPO/HMO/WC	$8.58
Rate for Payer: UnitedHealthcare Commercial	$11.44
Rate for Payer: UnitedHealthcare Community & State	$1.38
Rate for Payer: Wellpoint Medicaid Managed Care	$1.52

ADAPTER HIP NECK LENGTH 6MM

Facility

$1,425.00

Service Code	HCPCS C1776
Hospital Charge Code	270686604
Hospital Revenue Code	278
Min. Negotiated Rate	$34.34
Max. Negotiated Rate	$712.50
Rate for Payer: Aetna Commercial	$541.50
Rate for Payer: Aetna Medicare Advantage	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.38
Rate for Payer: Cigna Commercial	$712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$313.50
Rate for Payer: Qualcare PPO/HMO/WC	$213.75
Rate for Payer: UnitedHealthcare Community & State	$34.34
Rate for Payer: Wellpoint Medicaid Managed Care	$37.76

ADAPTER HIP NECK LENGTH 6MM

Facility

$1,425.00

Service Code	HCPCS C1776
Hospital Charge Code	270686604
Hospital Revenue Code	278
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$344.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$313.50
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

ADAPTER II FLOWPORT FG

Facility

$4,538.45

Hospital Charge Code	270691411
Hospital Revenue Code	272
Min. Negotiated Rate	$109.38
Max. Negotiated Rate	$2,269.22
Rate for Payer: Aetna Commercial	$1,724.61
Rate for Payer: Aetna Medicare Advantage	$1,361.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,157.30
Rate for Payer: Cigna Commercial	$2,269.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,361.54
Rate for Payer: Oxford Commercial	$907.69
Rate for Payer: Qualcare PPO/HMO/WC	$680.77
Rate for Payer: UnitedHealthcare Commercial	$907.69
Rate for Payer: UnitedHealthcare Community & State	$109.38
Rate for Payer: Wellpoint Medicaid Managed Care	$120.27

ADAPTER II FLOWPORT FG

Facility

$4,538.45

Hospital Charge Code	270691411
Hospital Revenue Code	272
Min. Negotiated Rate	$680.77
Max. Negotiated Rate	$680.77
Rate for Payer: Qualcare PPO/HMO/WC	$680.77

Know your out-of-pocket cost for care.

All Charges