Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CLAMP MIXTER 8 1/4

Facility

$219.80

Hospital Charge Code	270689133
Hospital Revenue Code	272
Min. Negotiated Rate	$32.97
Max. Negotiated Rate	$32.97
Rate for Payer: Qualcare PPO/HMO/WC	$32.97

CLAMP MONOTUBE RED 51503175

Facility

$4,300.00

Hospital Charge Code	270643409
Hospital Revenue Code	272
Min. Negotiated Rate	$103.63
Max. Negotiated Rate	$2,150.00
Rate for Payer: Aetna Commercial	$1,634.00
Rate for Payer: Aetna Medicare Advantage	$1,290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,096.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,096.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,096.50
Rate for Payer: Cigna Commercial	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,290.00
Rate for Payer: Oxford Commercial	$860.00
Rate for Payer: Qualcare PPO/HMO/WC	$645.00
Rate for Payer: UnitedHealthcare Commercial	$860.00
Rate for Payer: UnitedHealthcare Community & State	$103.63
Rate for Payer: Wellpoint Medicaid Managed Care	$113.95

CLAMP MONOTUBE RED 51503175

Facility

$4,300.00

Hospital Charge Code	270643409
Hospital Revenue Code	272
Min. Negotiated Rate	$645.00
Max. Negotiated Rate	$645.00
Rate for Payer: Qualcare PPO/HMO/WC	$645.00

CLAMP MRI 5-HOLE 4921-2-020

Facility

$3,885.00

Hospital Charge Code	270643439
Hospital Revenue Code	272
Min. Negotiated Rate	$93.63
Max. Negotiated Rate	$1,942.50
Rate for Payer: Aetna Commercial	$1,476.30
Rate for Payer: Aetna Medicare Advantage	$1,165.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$990.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$990.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$990.67
Rate for Payer: Cigna Commercial	$1,942.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,165.50
Rate for Payer: Oxford Commercial	$777.00
Rate for Payer: Qualcare PPO/HMO/WC	$582.75
Rate for Payer: UnitedHealthcare Commercial	$777.00
Rate for Payer: UnitedHealthcare Community & State	$93.63
Rate for Payer: Wellpoint Medicaid Managed Care	$102.95

CLAMP MRI 5-HOLE 4921-2-020

Facility

$3,885.00

Hospital Charge Code	270643439
Hospital Revenue Code	272
Min. Negotiated Rate	$582.75
Max. Negotiated Rate	$582.75
Rate for Payer: Qualcare PPO/HMO/WC	$582.75

CLAMP MULTI-PIN LARGE

Facility

$2,000.00

Service Code	HCPCS A4649
Hospital Charge Code	270699855
Hospital Revenue Code	272
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CLAMP MULTI-PIN LARGE

Facility

$2,000.00

Service Code	HCPCS A4649
Hospital Charge Code	270699855
Hospital Revenue Code	272
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Commercial	$400.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

CLAMP OPEN

Facility

$1,109.30

Service Code	HCPCS C1713
Hospital Charge Code	270639890
Hospital Revenue Code	278
Min. Negotiated Rate	$166.40
Max. Negotiated Rate	$268.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$221.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$244.05
Rate for Payer: Qualcare PPO/HMO/WC	$166.40

CLAMP OPEN

Facility

$1,109.30

Service Code	HCPCS C1713
Hospital Charge Code	270639890
Hospital Revenue Code	278
Min. Negotiated Rate	$26.73
Max. Negotiated Rate	$554.65
Rate for Payer: Aetna Commercial	$421.53
Rate for Payer: Aetna Medicare Advantage	$332.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$282.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$282.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$221.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$282.87
Rate for Payer: Cigna Commercial	$554.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$244.05
Rate for Payer: Qualcare PPO/HMO/WC	$166.40
Rate for Payer: UnitedHealthcare Community & State	$26.73
Rate for Payer: Wellpoint Medicaid Managed Care	$29.40

CLAMP OPEN ADJUSTBL MED

Facility

$1,965.00

Hospital Charge Code	270676712
Hospital Revenue Code	272
Min. Negotiated Rate	$47.36
Max. Negotiated Rate	$982.50
Rate for Payer: Aetna Commercial	$746.70
Rate for Payer: Aetna Medicare Advantage	$589.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$501.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$501.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$501.07
Rate for Payer: Cigna Commercial	$982.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$589.50
Rate for Payer: Oxford Commercial	$393.00
Rate for Payer: Qualcare PPO/HMO/WC	$294.75
Rate for Payer: UnitedHealthcare Commercial	$393.00
Rate for Payer: UnitedHealthcare Community & State	$47.36
Rate for Payer: Wellpoint Medicaid Managed Care	$52.07

CLAMP OPEN ADJUSTBL MED

Facility

$1,965.00

Hospital Charge Code	270676712
Hospital Revenue Code	272
Min. Negotiated Rate	$294.75
Max. Negotiated Rate	$294.75
Rate for Payer: Qualcare PPO/HMO/WC	$294.75

CLAMP OSTOMY POUCH

Facility

$5.82

Hospital Charge Code	270649910
Hospital Revenue Code	270
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.91
Rate for Payer: Aetna Commercial	$2.21
Rate for Payer: Aetna Medicare Advantage	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.48
Rate for Payer: Cigna Commercial	$2.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.75
Rate for Payer: Oxford Commercial	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$0.87
Rate for Payer: UnitedHealthcare Commercial	$1.16
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

CLAMP OSTOMY POUCH

Facility

$5.82

Hospital Charge Code	270649910
Hospital Revenue Code	270
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$0.87
Rate for Payer: Qualcare PPO/HMO/WC	$0.87

CLAMP OUTLET PORT 5C4170

Facility

$44.85

Hospital Charge Code	270607858
Hospital Revenue Code	272
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$6.73
Rate for Payer: Qualcare PPO/HMO/WC	$6.73

CLAMP OUTLET PORT 5C4170

Facility

$44.85

Hospital Charge Code	270607858
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.43
Rate for Payer: Aetna Commercial	$17.04
Rate for Payer: Aetna Medicare Advantage	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.44
Rate for Payer: Cigna Commercial	$22.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.46
Rate for Payer: Oxford Commercial	$8.97
Rate for Payer: Qualcare PPO/HMO/WC	$6.73
Rate for Payer: UnitedHealthcare Commercial	$8.97
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

CLAMP PENILE CUNNINGHAM 004054

Facility

$120.95

Hospital Charge Code	270633278
Hospital Revenue Code	272
Min. Negotiated Rate	$2.91
Max. Negotiated Rate	$60.48
Rate for Payer: Aetna Commercial	$45.96
Rate for Payer: Aetna Medicare Advantage	$36.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.84
Rate for Payer: Cigna Commercial	$60.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.28
Rate for Payer: Oxford Commercial	$24.19
Rate for Payer: Qualcare PPO/HMO/WC	$18.14
Rate for Payer: UnitedHealthcare Commercial	$24.19
Rate for Payer: UnitedHealthcare Community & State	$2.91
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

CLAMP PENILE CUNNINGHAM 004054

Facility

$120.95

Hospital Charge Code	270633278
Hospital Revenue Code	272
Min. Negotiated Rate	$18.14
Max. Negotiated Rate	$18.14
Rate for Payer: Qualcare PPO/HMO/WC	$18.14

CLAMP PIN 5 HOLE W/ 11MM POST

Facility

$3,833.30

Hospital Charge Code	270674578
Hospital Revenue Code	278
Min. Negotiated Rate	$575.00
Max. Negotiated Rate	$927.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$766.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$927.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$843.33
Rate for Payer: Qualcare PPO/HMO/WC	$575.00

CLAMP PIN 5 HOLE W/ 11MM POST

Facility

$3,833.30

Hospital Charge Code	270674578
Hospital Revenue Code	278
Min. Negotiated Rate	$92.38
Max. Negotiated Rate	$1,916.65
Rate for Payer: Aetna Commercial	$1,456.65
Rate for Payer: Aetna Medicare Advantage	$1,149.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$977.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$977.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$766.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$977.49
Rate for Payer: Cigna Commercial	$1,916.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$927.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$843.33
Rate for Payer: Qualcare PPO/HMO/WC	$575.00
Rate for Payer: UnitedHealthcare Community & State	$92.38
Rate for Payer: Wellpoint Medicaid Managed Care	$101.58

CLAMP PIN LENGTHENER MICRO HI

Facility

$7,889.20

Hospital Charge Code	270688787
Hospital Revenue Code	272
Min. Negotiated Rate	$1,183.38
Max. Negotiated Rate	$1,183.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,183.38

CLAMP PIN LENGTHENER MICRO HI

Facility

$7,889.20

Hospital Charge Code	270688787
Hospital Revenue Code	272
Min. Negotiated Rate	$190.13
Max. Negotiated Rate	$3,944.60
Rate for Payer: Aetna Commercial	$2,997.90
Rate for Payer: Aetna Medicare Advantage	$2,366.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,011.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,011.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,011.75
Rate for Payer: Cigna Commercial	$3,944.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,366.76
Rate for Payer: Oxford Commercial	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,183.38
Rate for Payer: UnitedHealthcare Commercial	$1,577.84
Rate for Payer: UnitedHealthcare Community & State	$190.13
Rate for Payer: Wellpoint Medicaid Managed Care	$209.06

CLAMP PIN TO BAR SMALL

Facility

$2,560.00

Hospital Charge Code	270669002
Hospital Revenue Code	272
Min. Negotiated Rate	$384.00
Max. Negotiated Rate	$384.00
Rate for Payer: Qualcare PPO/HMO/WC	$384.00

CLAMP PIN TO BAR SMALL

Facility

$2,560.00

Hospital Charge Code	270669002
Hospital Revenue Code	272
Min. Negotiated Rate	$61.70
Max. Negotiated Rate	$1,280.00
Rate for Payer: Aetna Commercial	$972.80
Rate for Payer: Aetna Medicare Advantage	$768.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$652.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$652.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$652.80
Rate for Payer: Cigna Commercial	$1,280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$768.00
Rate for Payer: Oxford Commercial	$512.00
Rate for Payer: Qualcare PPO/HMO/WC	$384.00
Rate for Payer: UnitedHealthcare Commercial	$512.00
Rate for Payer: UnitedHealthcare Community & State	$61.70
Rate for Payer: Wellpoint Medicaid Managed Care	$67.84

CLAMP PRESSURE PATIENT ARM

Facility

$21.25

Hospital Charge Code	270645384
Hospital Revenue Code	270
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$10.62
Rate for Payer: Aetna Commercial	$8.07
Rate for Payer: Aetna Medicare Advantage	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.42
Rate for Payer: Cigna Commercial	$10.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.38
Rate for Payer: Oxford Commercial	$4.25
Rate for Payer: Qualcare PPO/HMO/WC	$3.19
Rate for Payer: UnitedHealthcare Commercial	$4.25
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

CLAMP PRESSURE PATIENT ARM

Facility

$21.25

Hospital Charge Code	270645384
Hospital Revenue Code	270
Min. Negotiated Rate	$3.19
Max. Negotiated Rate	$3.19
Rate for Payer: Qualcare PPO/HMO/WC	$3.19

Know your out-of-pocket cost for care.

All Charges