Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ADAPTER SLEEVE FEMR HD -3.5MM

Facility

$3,000.00

Hospital Charge Code	270672500
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

ADAPTER SLEEVE FEMR HD -3.5MM

Facility

$3,000.00

Hospital Charge Code	270672500
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

ADAPTER SLEEVE FEMR HD +7MM

Facility

$3,000.00

Hospital Charge Code	270672504
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

ADAPTER SLEEVE FEMR HD +7MM

Facility

$3,000.00

Hospital Charge Code	270672504
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

ADAPTER SPIKE N2050

Facility

$11.25

Hospital Charge Code	270040010
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

ADAPTER SPIKE N2050

Facility

$11.25

Hospital Charge Code	270040010
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

ADAPTER STEM OFFSET 6MM

Facility

$1,284.00

Service Code	HCPCS C1776
Hospital Charge Code	270676880
Hospital Revenue Code	278
Min. Negotiated Rate	$192.60
Max. Negotiated Rate	$310.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$282.48
Rate for Payer: Qualcare PPO/HMO/WC	$192.60

ADAPTER STEM OFFSET 6MM

Facility

$1,284.00

Service Code	HCPCS C1776
Hospital Charge Code	270676880
Hospital Revenue Code	278
Min. Negotiated Rate	$30.94
Max. Negotiated Rate	$642.00
Rate for Payer: Aetna Commercial	$487.92
Rate for Payer: Aetna Medicare Advantage	$385.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$327.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$327.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$327.42
Rate for Payer: Cigna Commercial	$642.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$282.48
Rate for Payer: Qualcare PPO/HMO/WC	$192.60
Rate for Payer: UnitedHealthcare Community & State	$30.94
Rate for Payer: Wellpoint Medicaid Managed Care	$34.03

ADAPTER SWIVEL***

Facility

$84.00

Hospital Charge Code	9501222
Hospital Revenue Code	279
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

ADAPTER SWIVEL***

Facility

$84.00

Hospital Charge Code	9501222
Hospital Revenue Code	279
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$31.92
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.20
Rate for Payer: Oxford Commercial	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$16.80
Rate for Payer: UnitedHealthcare Community & State	$2.02
Rate for Payer: Wellpoint Medicaid Managed Care	$2.23

ADAPTER SWIVEL ANGLE PEEP

Facility

$8.71

Hospital Charge Code	270660203
Hospital Revenue Code	270
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.36
Rate for Payer: Aetna Commercial	$3.31
Rate for Payer: Aetna Medicare Advantage	$2.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.22
Rate for Payer: Cigna Commercial	$4.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.61
Rate for Payer: Oxford Commercial	$1.74
Rate for Payer: Qualcare PPO/HMO/WC	$1.31
Rate for Payer: UnitedHealthcare Commercial	$1.74
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

ADAPTER SWIVEL ANGLE PEEP

Facility

$8.71

Hospital Charge Code	270660203
Hospital Revenue Code	270
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$1.31

ADAPTER SWIVEL BRONCH 625191

Facility

$65.65

Hospital Charge Code	270600857
Hospital Revenue Code	272
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$32.83
Rate for Payer: Aetna Commercial	$24.95
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.70
Rate for Payer: Oxford Commercial	$13.13
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$13.13
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.74

ADAPTER SWIVEL BRONCH 625191

Facility

$65.65

Hospital Charge Code	270600857
Hospital Revenue Code	272
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

ADAPTER SWIVEL FIBEROPTIC

Facility

$87.20

Hospital Charge Code	270655451
Hospital Revenue Code	270
Min. Negotiated Rate	$13.08
Max. Negotiated Rate	$13.08
Rate for Payer: Qualcare PPO/HMO/WC	$13.08

ADAPTER SWIVEL FIBEROPTIC

Facility

$87.20

Hospital Charge Code	270655451
Hospital Revenue Code	270
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$43.60
Rate for Payer: Aetna Commercial	$33.14
Rate for Payer: Aetna Medicare Advantage	$26.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.24
Rate for Payer: Cigna Commercial	$43.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.16
Rate for Payer: Oxford Commercial	$17.44
Rate for Payer: Qualcare PPO/HMO/WC	$13.08
Rate for Payer: UnitedHealthcare Commercial	$17.44
Rate for Payer: UnitedHealthcare Community & State	$2.10
Rate for Payer: Wellpoint Medicaid Managed Care	$2.31

ADAPTER T 15MM X 15MM VALVED

Facility

$232.95

Hospital Charge Code	270651381
Hospital Revenue Code	270
Min. Negotiated Rate	$5.61
Max. Negotiated Rate	$116.47
Rate for Payer: Aetna Commercial	$88.52
Rate for Payer: Aetna Medicare Advantage	$69.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.40
Rate for Payer: Cigna Commercial	$116.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.89
Rate for Payer: Oxford Commercial	$46.59
Rate for Payer: Qualcare PPO/HMO/WC	$34.94
Rate for Payer: UnitedHealthcare Commercial	$46.59
Rate for Payer: UnitedHealthcare Community & State	$5.61
Rate for Payer: Wellpoint Medicaid Managed Care	$6.17

ADAPTER T 15MM X 15MM VALVED

Facility

$232.95

Hospital Charge Code	270651381
Hospital Revenue Code	270
Min. Negotiated Rate	$34.94
Max. Negotiated Rate	$34.94
Rate for Payer: Qualcare PPO/HMO/WC	$34.94

ADAPTER T 22MM X 22MM VALVED

Facility

$227.90

Hospital Charge Code	270651380
Hospital Revenue Code	270
Min. Negotiated Rate	$34.19
Max. Negotiated Rate	$34.19
Rate for Payer: Qualcare PPO/HMO/WC	$34.19

ADAPTER T 22MM X 22MM VALVED

Facility

$227.90

Hospital Charge Code	270651380
Hospital Revenue Code	270
Min. Negotiated Rate	$5.49
Max. Negotiated Rate	$113.95
Rate for Payer: Aetna Commercial	$86.60
Rate for Payer: Aetna Medicare Advantage	$68.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.11
Rate for Payer: Cigna Commercial	$113.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.37
Rate for Payer: Oxford Commercial	$45.58
Rate for Payer: Qualcare PPO/HMO/WC	$34.19
Rate for Payer: UnitedHealthcare Commercial	$45.58
Rate for Payer: UnitedHealthcare Community & State	$5.49
Rate for Payer: Wellpoint Medicaid Managed Care	$6.04

ADAPTER TAPE BIO-MOORE 139240

Facility

$718.45

Hospital Charge Code	270608618
Hospital Revenue Code	272
Min. Negotiated Rate	$107.77
Max. Negotiated Rate	$107.77
Rate for Payer: Qualcare PPO/HMO/WC	$107.77

ADAPTER TAPE BIO-MOORE 139240

Facility

$718.45

Hospital Charge Code	270608618
Hospital Revenue Code	272
Min. Negotiated Rate	$17.31
Max. Negotiated Rate	$359.23
Rate for Payer: Aetna Commercial	$273.01
Rate for Payer: Aetna Medicare Advantage	$215.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.20
Rate for Payer: Cigna Commercial	$359.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.53
Rate for Payer: Oxford Commercial	$143.69
Rate for Payer: Qualcare PPO/HMO/WC	$107.77
Rate for Payer: UnitedHealthcare Commercial	$143.69
Rate for Payer: UnitedHealthcare Community & State	$17.31
Rate for Payer: Wellpoint Medicaid Managed Care	$19.04

ADAPTER TAPER ECCENTRICAL 2MM

Facility

$2,335.00

Service Code	HCPCS C1776
Hospital Charge Code	270666202
Hospital Revenue Code	278
Min. Negotiated Rate	$56.27
Max. Negotiated Rate	$1,167.50
Rate for Payer: Aetna Commercial	$887.30
Rate for Payer: Aetna Medicare Advantage	$700.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$595.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$595.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$467.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$595.42
Rate for Payer: Cigna Commercial	$1,167.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$565.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$513.70
Rate for Payer: Qualcare PPO/HMO/WC	$350.25
Rate for Payer: UnitedHealthcare Community & State	$56.27
Rate for Payer: Wellpoint Medicaid Managed Care	$61.88

ADAPTER TAPER ECCENTRICAL 2MM

Facility

$2,335.00

Service Code	HCPCS C1776
Hospital Charge Code	270666202
Hospital Revenue Code	278
Min. Negotiated Rate	$350.25
Max. Negotiated Rate	$565.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$467.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$565.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$513.70
Rate for Payer: Qualcare PPO/HMO/WC	$350.25

ADAPTER TAPER NEUTRAL

Facility

$1,500.00

Hospital Charge Code	270676241
Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

Know your out-of-pocket cost for care.

All Charges