Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

ADAPTER TAP MAGM 52-60 139268

Facility

$1,607.10

Hospital Charge Code	270634574
Hospital Revenue Code	272
Min. Negotiated Rate	$241.06
Max. Negotiated Rate	$241.06
Rate for Payer: Qualcare PPO/HMO/WC	$241.06

ADAPTER TAP MAGM 52-60 139268

Facility

$1,607.10

Hospital Charge Code	270634574
Hospital Revenue Code	272
Min. Negotiated Rate	$38.73
Max. Negotiated Rate	$803.55
Rate for Payer: Aetna Commercial	$610.70
Rate for Payer: Aetna Medicare Advantage	$482.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$409.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$409.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$409.81
Rate for Payer: Cigna Commercial	$803.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.13
Rate for Payer: Oxford Commercial	$321.42
Rate for Payer: Qualcare PPO/HMO/WC	$241.06
Rate for Payer: UnitedHealthcare Commercial	$321.42
Rate for Payer: UnitedHealthcare Community & State	$38.73
Rate for Payer: Wellpoint Medicaid Managed Care	$42.59

ADAPTER T-BAR

Facility

$4.00

Hospital Charge Code	270600608
Hospital Revenue Code	272
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

ADAPTER T-BAR

Facility

$4.00

Hospital Charge Code	270600608
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ADAPTER T-BAR 15MM X 22 MM

Facility

$196.90

Hospital Charge Code	270651379
Hospital Revenue Code	270
Min. Negotiated Rate	$4.75
Max. Negotiated Rate	$98.45
Rate for Payer: Aetna Commercial	$74.82
Rate for Payer: Aetna Medicare Advantage	$59.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.21
Rate for Payer: Cigna Commercial	$98.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.07
Rate for Payer: Oxford Commercial	$39.38
Rate for Payer: Qualcare PPO/HMO/WC	$29.54
Rate for Payer: UnitedHealthcare Commercial	$39.38
Rate for Payer: UnitedHealthcare Community & State	$4.75
Rate for Payer: Wellpoint Medicaid Managed Care	$5.22

ADAPTER T-BAR 15MM X 22 MM

Facility

$196.90

Hospital Charge Code	270651379
Hospital Revenue Code	270
Min. Negotiated Rate	$29.54
Max. Negotiated Rate	$29.54
Rate for Payer: Qualcare PPO/HMO/WC	$29.54

ADAPTER THREE WAY MULTIPURPOSE

Facility

$82.50

Hospital Charge Code	270632023
Hospital Revenue Code	270
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$41.25
Rate for Payer: Aetna Commercial	$31.35
Rate for Payer: Aetna Medicare Advantage	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.04
Rate for Payer: Cigna Commercial	$41.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.75
Rate for Payer: Oxford Commercial	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$12.38
Rate for Payer: UnitedHealthcare Commercial	$16.50
Rate for Payer: UnitedHealthcare Community & State	$1.99
Rate for Payer: Wellpoint Medicaid Managed Care	$2.19

ADAPTER THREE WAY MULTIPURPOSE

Facility

$82.50

Hospital Charge Code	270632023
Hospital Revenue Code	270
Min. Negotiated Rate	$12.38
Max. Negotiated Rate	$12.38
Rate for Payer: Qualcare PPO/HMO/WC	$12.38

ADAPTER TITANIUM ******

Facility

$300.00

Hospital Charge Code	8003048
Hospital Revenue Code	279
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

ADAPTER TITANIUM ******

Facility

$300.00

Hospital Charge Code	8003048
Hospital Revenue Code	279
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

ADAPTER TITANIUM 2 PART

Facility

$625.00

Hospital Charge Code	270674105
Hospital Revenue Code	272
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

ADAPTER TITANIUM 2 PART

Facility

$625.00

Hospital Charge Code	270674105
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

ADAPTER TRI-125 91400235

Facility

$625.00

Hospital Charge Code	270636400
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

ADAPTER TRI-125 91400235

Facility

$625.00

Hospital Charge Code	270636400
Hospital Revenue Code	272
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

ADAPTER TUOHY BORST SIDE PRT**

Facility

$37.00

Hospital Charge Code	1604461
Hospital Revenue Code	272
Min. Negotiated Rate	$5.55
Max. Negotiated Rate	$5.55
Rate for Payer: Qualcare PPO/HMO/WC	$5.55

ADAPTER TUOHY BORST SIDE PRT**

Facility

$37.00

Hospital Charge Code	1604461
Hospital Revenue Code	272
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$18.50
Rate for Payer: Aetna Commercial	$14.06
Rate for Payer: Aetna Medicare Advantage	$11.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.44
Rate for Payer: Cigna Commercial	$18.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.10
Rate for Payer: Oxford Commercial	$7.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.55
Rate for Payer: UnitedHealthcare Commercial	$7.40
Rate for Payer: UnitedHealthcare Community & State	$0.89
Rate for Payer: Wellpoint Medicaid Managed Care	$0.98

ADAPTER TUOHY BORST TYPE

Facility

$108.00

Hospital Charge Code	270601033
Hospital Revenue Code	272
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$16.20

ADAPTER TUOHY BORST TYPE

Facility

$108.00

Hospital Charge Code	270601033
Hospital Revenue Code	272
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna Commercial	$41.04
Rate for Payer: Aetna Medicare Advantage	$32.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.54
Rate for Payer: Cigna Commercial	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.40
Rate for Payer: Oxford Commercial	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$16.20
Rate for Payer: UnitedHealthcare Commercial	$21.60
Rate for Payer: UnitedHealthcare Community & State	$2.60
Rate for Payer: Wellpoint Medicaid Managed Care	$2.86

ADAPTER TWIST DRILL4.5 471847

Facility

$624.00

Hospital Charge Code	270645058
Hospital Revenue Code	272
Min. Negotiated Rate	$93.60
Max. Negotiated Rate	$93.60
Rate for Payer: Qualcare PPO/HMO/WC	$93.60

ADAPTER TWIST DRILL4.5 471847

Facility

$624.00

Hospital Charge Code	270645058
Hospital Revenue Code	272
Min. Negotiated Rate	$15.04
Max. Negotiated Rate	$312.00
Rate for Payer: Aetna Commercial	$237.12
Rate for Payer: Aetna Medicare Advantage	$187.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.12
Rate for Payer: Cigna Commercial	$312.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.20
Rate for Payer: Oxford Commercial	$124.80
Rate for Payer: Qualcare PPO/HMO/WC	$93.60
Rate for Payer: UnitedHealthcare Commercial	$124.80
Rate for Payer: UnitedHealthcare Community & State	$15.04
Rate for Payer: Wellpoint Medicaid Managed Care	$16.54

ADAPTER TYPE1 TPER SZ6 6501064

Facility

$1,110.00

Service Code	HCPCS C1776
Hospital Charge Code	270644873
Hospital Revenue Code	278
Min. Negotiated Rate	$166.50
Max. Negotiated Rate	$268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$244.20
Rate for Payer: Qualcare PPO/HMO/WC	$166.50

ADAPTER TYPE1 TPER SZ6 6501064

Facility

$1,110.00

Service Code	HCPCS C1776
Hospital Charge Code	270644873
Hospital Revenue Code	278
Min. Negotiated Rate	$26.75
Max. Negotiated Rate	$555.00
Rate for Payer: Aetna Commercial	$421.80
Rate for Payer: Aetna Medicare Advantage	$333.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.05
Rate for Payer: Cigna Commercial	$555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$244.20
Rate for Payer: Qualcare PPO/HMO/WC	$166.50
Rate for Payer: UnitedHealthcare Community & State	$26.75
Rate for Payer: Wellpoint Medicaid Managed Care	$29.41

ADAPTER UNIVERSAL METER DOSE

Facility

$24.50

Hospital Charge Code	270688935
Hospital Revenue Code	272
Min. Negotiated Rate	$3.67
Max. Negotiated Rate	$3.67
Rate for Payer: Qualcare PPO/HMO/WC	$3.67

ADAPTER UNIVERSAL METER DOSE

Facility

$24.50

Hospital Charge Code	270688935
Hospital Revenue Code	272
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$12.25
Rate for Payer: Aetna Commercial	$9.31
Rate for Payer: Aetna Medicare Advantage	$7.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.25
Rate for Payer: Cigna Commercial	$12.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.35
Rate for Payer: Oxford Commercial	$4.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.67
Rate for Payer: UnitedHealthcare Commercial	$4.90
Rate for Payer: UnitedHealthcare Community & State	$0.59
Rate for Payer: Wellpoint Medicaid Managed Care	$0.65

Know your out-of-pocket cost for care.

All Charges