Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CLAMP 3-D BLUE BAR TO PIN

Facility

$2,830.75

Hospital Charge Code	270668707
Hospital Revenue Code	278
Min. Negotiated Rate	$424.61
Max. Negotiated Rate	$685.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$566.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$685.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$622.76
Rate for Payer: Qualcare PPO/HMO/WC	$424.61

CLAMP 3-D BLUE BAR TO PIN

Facility

$2,830.75

Hospital Charge Code	270668707
Hospital Revenue Code	278
Min. Negotiated Rate	$68.22
Max. Negotiated Rate	$1,415.38
Rate for Payer: Aetna Commercial	$1,075.68
Rate for Payer: Aetna Medicare Advantage	$849.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$721.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$721.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$566.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$721.84
Rate for Payer: Cigna Commercial	$1,415.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$685.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$622.76
Rate for Payer: Qualcare PPO/HMO/WC	$424.61
Rate for Payer: UnitedHealthcare Community & State	$68.22
Rate for Payer: Wellpoint Medicaid Managed Care	$75.01

CLAMP 4.0 ADJUSTABLE

Facility

$3,562.75

Hospital Charge Code	270619757
Hospital Revenue Code	272
Min. Negotiated Rate	$85.86
Max. Negotiated Rate	$1,781.38
Rate for Payer: Aetna Commercial	$1,353.85
Rate for Payer: Aetna Medicare Advantage	$1,068.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$908.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$908.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$908.50
Rate for Payer: Cigna Commercial	$1,781.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,068.83
Rate for Payer: Oxford Commercial	$712.55
Rate for Payer: Qualcare PPO/HMO/WC	$534.41
Rate for Payer: UnitedHealthcare Commercial	$712.55
Rate for Payer: UnitedHealthcare Community & State	$85.86
Rate for Payer: Wellpoint Medicaid Managed Care	$94.41

CLAMP 4.0 ADJUSTABLE

Facility

$3,562.75

Hospital Charge Code	270619757
Hospital Revenue Code	272
Min. Negotiated Rate	$534.41
Max. Negotiated Rate	$534.41
Rate for Payer: Qualcare PPO/HMO/WC	$534.41

CLAMP 4-HOLE 4940-2-020

Facility

$2,885.00

Hospital Charge Code	270647956
Hospital Revenue Code	272
Min. Negotiated Rate	$69.53
Max. Negotiated Rate	$1,442.50
Rate for Payer: Aetna Commercial	$1,096.30
Rate for Payer: Aetna Medicare Advantage	$865.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$735.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$735.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$735.67
Rate for Payer: Cigna Commercial	$1,442.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$865.50
Rate for Payer: Oxford Commercial	$577.00
Rate for Payer: Qualcare PPO/HMO/WC	$432.75
Rate for Payer: UnitedHealthcare Commercial	$577.00
Rate for Payer: UnitedHealthcare Community & State	$69.53
Rate for Payer: Wellpoint Medicaid Managed Care	$76.45

CLAMP 4-HOLE 4940-2-020

Facility

$2,885.00

Hospital Charge Code	270647956
Hospital Revenue Code	272
Min. Negotiated Rate	$432.75
Max. Negotiated Rate	$432.75
Rate for Payer: Qualcare PPO/HMO/WC	$432.75

CLAMP 500S CIRCUMCISION EXTRA

Facility

$939.50

Hospital Charge Code	270663795
Hospital Revenue Code	270
Min. Negotiated Rate	$140.93
Max. Negotiated Rate	$140.93
Rate for Payer: Qualcare PPO/HMO/WC	$140.93

CLAMP 500S CIRCUMCISION EXTRA

Facility

$939.50

Hospital Charge Code	270663795
Hospital Revenue Code	270
Min. Negotiated Rate	$22.64
Max. Negotiated Rate	$469.75
Rate for Payer: Aetna Commercial	$357.01
Rate for Payer: Aetna Medicare Advantage	$281.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.57
Rate for Payer: Cigna Commercial	$469.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.85
Rate for Payer: Oxford Commercial	$187.90
Rate for Payer: Qualcare PPO/HMO/WC	$140.93
Rate for Payer: UnitedHealthcare Commercial	$187.90
Rate for Payer: UnitedHealthcare Community & State	$22.64
Rate for Payer: Wellpoint Medicaid Managed Care	$24.90

CLAMP 5 HOLE

Facility

$3,045.00

Hospital Charge Code	270665210
Hospital Revenue Code	278
Min. Negotiated Rate	$73.38
Max. Negotiated Rate	$1,522.50
Rate for Payer: Aetna Commercial	$1,157.10
Rate for Payer: Aetna Medicare Advantage	$913.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$776.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$776.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$609.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$776.48
Rate for Payer: Cigna Commercial	$1,522.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$736.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$669.90
Rate for Payer: Qualcare PPO/HMO/WC	$456.75
Rate for Payer: UnitedHealthcare Community & State	$73.38
Rate for Payer: Wellpoint Medicaid Managed Care	$80.69

CLAMP 5 HOLE

Facility

$3,045.00

Hospital Charge Code	270665210
Hospital Revenue Code	278
Min. Negotiated Rate	$456.75
Max. Negotiated Rate	$736.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$609.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$736.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$669.90
Rate for Payer: Qualcare PPO/HMO/WC	$456.75

CLAMP 5-HOLE 4922-2-020

Facility

$4,470.00

Hospital Charge Code	270648623
Hospital Revenue Code	272
Min. Negotiated Rate	$670.50
Max. Negotiated Rate	$670.50
Rate for Payer: Qualcare PPO/HMO/WC	$670.50

CLAMP 5-HOLE 4922-2-020

Facility

$4,470.00

Hospital Charge Code	270648623
Hospital Revenue Code	272
Min. Negotiated Rate	$107.73
Max. Negotiated Rate	$2,235.00
Rate for Payer: Aetna Commercial	$1,698.60
Rate for Payer: Aetna Medicare Advantage	$1,341.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,139.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,139.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,139.85
Rate for Payer: Cigna Commercial	$2,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,341.00
Rate for Payer: Oxford Commercial	$894.00
Rate for Payer: Qualcare PPO/HMO/WC	$670.50
Rate for Payer: UnitedHealthcare Commercial	$894.00
Rate for Payer: UnitedHealthcare Community & State	$107.73
Rate for Payer: Wellpoint Medicaid Managed Care	$118.45

CLAMP 5 HOLE HEX SHAFT SQUARE

Facility

$755.00

Hospital Charge Code	270675277
Hospital Revenue Code	278
Min. Negotiated Rate	$18.20
Max. Negotiated Rate	$377.50
Rate for Payer: Aetna Commercial	$286.90
Rate for Payer: Aetna Medicare Advantage	$226.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.53
Rate for Payer: Cigna Commercial	$377.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$166.10
Rate for Payer: Qualcare PPO/HMO/WC	$113.25
Rate for Payer: UnitedHealthcare Community & State	$18.20
Rate for Payer: Wellpoint Medicaid Managed Care	$20.01

CLAMP 5 HOLE HEX SHAFT SQUARE

Facility

$755.00

Hospital Charge Code	270675277
Hospital Revenue Code	278
Min. Negotiated Rate	$113.25
Max. Negotiated Rate	$182.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$151.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$166.10
Rate for Payer: Qualcare PPO/HMO/WC	$113.25

CLAMP ADJUSTABLE LG 39364

Facility

$1,825.00

Hospital Charge Code	270634837
Hospital Revenue Code	272
Min. Negotiated Rate	$43.98
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$693.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$547.50
Rate for Payer: Oxford Commercial	$365.00
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Commercial	$365.00
Rate for Payer: UnitedHealthcare Community & State	$43.98
Rate for Payer: Wellpoint Medicaid Managed Care	$48.36

CLAMP ADJUSTABLE LG 39364

Facility

$1,825.00

Hospital Charge Code	270634837
Hospital Revenue Code	272
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$273.75
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

CLAMP ADJUSTABLE WIRE/PIN

Facility

$3,686.35

Service Code	HCPCS C1713
Hospital Charge Code	270632995
Hospital Revenue Code	272
Min. Negotiated Rate	$88.84
Max. Negotiated Rate	$1,843.17
Rate for Payer: Aetna Commercial	$1,400.81
Rate for Payer: Aetna Medicare Advantage	$1,105.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$940.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$940.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$940.02
Rate for Payer: Cigna Commercial	$1,843.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,105.90
Rate for Payer: Oxford Commercial	$737.27
Rate for Payer: Qualcare PPO/HMO/WC	$552.95
Rate for Payer: UnitedHealthcare Commercial	$737.27
Rate for Payer: UnitedHealthcare Community & State	$88.84
Rate for Payer: Wellpoint Medicaid Managed Care	$97.69

CLAMP ADJUSTABLE WIRE/PIN

Facility

$3,686.35

Service Code	HCPCS C1713
Hospital Charge Code	270632995
Hospital Revenue Code	272
Min. Negotiated Rate	$552.95
Max. Negotiated Rate	$552.95
Rate for Payer: Qualcare PPO/HMO/WC	$552.95

CLAMP ASC CRANIOFIX LG FF101T

Facility

$766.45

Hospital Charge Code	270613401
Hospital Revenue Code	272
Min. Negotiated Rate	$114.97
Max. Negotiated Rate	$114.97
Rate for Payer: Qualcare PPO/HMO/WC	$114.97

CLAMP ASC CRANIOFIX LG FF101T

Facility

$766.45

Hospital Charge Code	270613401
Hospital Revenue Code	272
Min. Negotiated Rate	$18.47
Max. Negotiated Rate	$383.23
Rate for Payer: Aetna Commercial	$291.25
Rate for Payer: Aetna Medicare Advantage	$229.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.44
Rate for Payer: Cigna Commercial	$383.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.94
Rate for Payer: Oxford Commercial	$153.29
Rate for Payer: Qualcare PPO/HMO/WC	$114.97
Rate for Payer: UnitedHealthcare Commercial	$153.29
Rate for Payer: UnitedHealthcare Community & State	$18.47
Rate for Payer: Wellpoint Medicaid Managed Care	$20.31

CLAMP ASC CRANIOFIX SM FF100T

Facility

$614.45

Hospital Charge Code	270615304
Hospital Revenue Code	272
Min. Negotiated Rate	$92.17
Max. Negotiated Rate	$92.17
Rate for Payer: Qualcare PPO/HMO/WC	$92.17

CLAMP ASC CRANIOFIX SM FF100T

Facility

$614.45

Hospital Charge Code	270615304
Hospital Revenue Code	272
Min. Negotiated Rate	$14.81
Max. Negotiated Rate	$307.23
Rate for Payer: Aetna Commercial	$233.49
Rate for Payer: Aetna Medicare Advantage	$184.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.68
Rate for Payer: Cigna Commercial	$307.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.34
Rate for Payer: Oxford Commercial	$122.89
Rate for Payer: Qualcare PPO/HMO/WC	$92.17
Rate for Payer: UnitedHealthcare Commercial	$122.89
Rate for Payer: UnitedHealthcare Community & State	$14.81
Rate for Payer: Wellpoint Medicaid Managed Care	$16.28

CLAMP BAR PIN

Facility

$4,475.00

Hospital Charge Code	270662209
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$984.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

CLAMP BAR PIN

Facility

$4,475.00

Hospital Charge Code	270662209
Hospital Revenue Code	278
Min. Negotiated Rate	$107.85
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$984.50
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$107.85
Rate for Payer: Wellpoint Medicaid Managed Care	$118.59

CLAMP BETA CAP 5K4500

Facility

$39.25

Hospital Charge Code	270607859
Hospital Revenue Code	272
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.62
Rate for Payer: Aetna Commercial	$14.91
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.78
Rate for Payer: Oxford Commercial	$7.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Commercial	$7.85
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

Know your out-of-pocket cost for care.

All Charges