Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CLAMP RAYPRT MUS BX SU130-1113

Facility

$150.45

Hospital Charge Code	270601097
Hospital Revenue Code	272
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$75.22
Rate for Payer: Aetna Commercial	$57.17
Rate for Payer: Aetna Medicare Advantage	$45.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.36
Rate for Payer: Cigna Commercial	$75.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.13
Rate for Payer: Oxford Commercial	$30.09
Rate for Payer: Qualcare PPO/HMO/WC	$22.57
Rate for Payer: UnitedHealthcare Commercial	$30.09
Rate for Payer: UnitedHealthcare Community & State	$3.63
Rate for Payer: Wellpoint Medicaid Managed Care	$3.99

CLAMP RAYPRT MUS BX SU130-1113

Facility

$150.45

Hospital Charge Code	270601097
Hospital Revenue Code	272
Min. Negotiated Rate	$22.57
Max. Negotiated Rate	$22.57
Rate for Payer: Qualcare PPO/HMO/WC	$22.57

CLAMP RENAL RED OC-100-R

Facility

$11.25

Hospital Charge Code	270606794
Hospital Revenue Code	270
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

CLAMP RENAL RED OC-100-R

Facility

$11.25

Hospital Charge Code	270606794
Hospital Revenue Code	270
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

CLAMP RENAL YELLOW OC-100-Y

Facility

$11.25

Hospital Charge Code	270606419
Hospital Revenue Code	270
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

CLAMP RENAL YELLOW OC-100-Y

Facility

$11.25

Hospital Charge Code	270606419
Hospital Revenue Code	270
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

CLAMP RF SPIN DOWN 12MM

Facility

$1,930.00

Hospital Charge Code	270662172
Hospital Revenue Code	272
Min. Negotiated Rate	$46.51
Max. Negotiated Rate	$965.00
Rate for Payer: Aetna Commercial	$733.40
Rate for Payer: Aetna Medicare Advantage	$579.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.15
Rate for Payer: Cigna Commercial	$965.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$579.00
Rate for Payer: Oxford Commercial	$386.00
Rate for Payer: Qualcare PPO/HMO/WC	$289.50
Rate for Payer: UnitedHealthcare Commercial	$386.00
Rate for Payer: UnitedHealthcare Community & State	$46.51
Rate for Payer: Wellpoint Medicaid Managed Care	$51.15

CLAMP RF SPIN DOWN 12MM

Facility

$1,930.00

Hospital Charge Code	270662172
Hospital Revenue Code	272
Min. Negotiated Rate	$289.50
Max. Negotiated Rate	$289.50
Rate for Payer: Qualcare PPO/HMO/WC	$289.50

CLAMP RF SPIN DOWN 16MM

Facility

$2,020.00

Hospital Charge Code	270662173
Hospital Revenue Code	272
Min. Negotiated Rate	$303.00
Max. Negotiated Rate	$303.00
Rate for Payer: Qualcare PPO/HMO/WC	$303.00

CLAMP RF SPIN DOWN 16MM

Facility

$2,020.00

Hospital Charge Code	270662173
Hospital Revenue Code	272
Min. Negotiated Rate	$48.68
Max. Negotiated Rate	$1,010.00
Rate for Payer: Aetna Commercial	$767.60
Rate for Payer: Aetna Medicare Advantage	$606.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$515.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$515.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$515.10
Rate for Payer: Cigna Commercial	$1,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$606.00
Rate for Payer: Oxford Commercial	$404.00
Rate for Payer: Qualcare PPO/HMO/WC	$303.00
Rate for Payer: UnitedHealthcare Commercial	$404.00
Rate for Payer: UnitedHealthcare Community & State	$48.68
Rate for Payer: Wellpoint Medicaid Managed Care	$53.53

CLAMP RF SPINDOWN 20MM

Facility

$2,270.00

Service Code	HCPCS C1713
Hospital Charge Code	270662174
Hospital Revenue Code	278
Min. Negotiated Rate	$54.71
Max. Negotiated Rate	$1,135.00
Rate for Payer: Aetna Commercial	$862.60
Rate for Payer: Aetna Medicare Advantage	$681.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$578.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$578.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$454.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$578.85
Rate for Payer: Cigna Commercial	$1,135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$549.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$499.40
Rate for Payer: Qualcare PPO/HMO/WC	$340.50
Rate for Payer: UnitedHealthcare Community & State	$54.71
Rate for Payer: Wellpoint Medicaid Managed Care	$60.16

CLAMP RF SPINDOWN 20MM

Facility

$2,270.00

Service Code	HCPCS C1713
Hospital Charge Code	270662174
Hospital Revenue Code	278
Min. Negotiated Rate	$340.50
Max. Negotiated Rate	$549.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$454.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$549.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$499.40
Rate for Payer: Qualcare PPO/HMO/WC	$340.50

CLAMP RING 4936-2-010

Facility

$2,685.00

Hospital Charge Code	270643404
Hospital Revenue Code	272
Min. Negotiated Rate	$402.75
Max. Negotiated Rate	$402.75
Rate for Payer: Qualcare PPO/HMO/WC	$402.75

CLAMP RING 4936-2-010

Facility

$2,685.00

Hospital Charge Code	270643404
Hospital Revenue Code	272
Min. Negotiated Rate	$64.71
Max. Negotiated Rate	$1,342.50
Rate for Payer: Aetna Commercial	$1,020.30
Rate for Payer: Aetna Medicare Advantage	$805.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$684.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$684.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$684.67
Rate for Payer: Cigna Commercial	$1,342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$805.50
Rate for Payer: Oxford Commercial	$537.00
Rate for Payer: Qualcare PPO/HMO/WC	$402.75
Rate for Payer: UnitedHealthcare Commercial	$537.00
Rate for Payer: UnitedHealthcare Community & State	$64.71
Rate for Payer: Wellpoint Medicaid Managed Care	$71.15

CLAMP ROD ATTACH LG MULTI PIN

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270699323
Hospital Revenue Code	278
Min. Negotiated Rate	$45.19
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$49.69

CLAMP ROD ATTACH LG MULTI PIN

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270699323
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

CLAMP SLIM RAPID ROD TO ROD

Facility

$2,790.00

Hospital Charge Code	270643269
Hospital Revenue Code	272
Min. Negotiated Rate	$67.24
Max. Negotiated Rate	$1,395.00
Rate for Payer: Aetna Commercial	$1,060.20
Rate for Payer: Aetna Medicare Advantage	$837.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$711.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$711.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$711.45
Rate for Payer: Cigna Commercial	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$837.00
Rate for Payer: Oxford Commercial	$558.00
Rate for Payer: Qualcare PPO/HMO/WC	$418.50
Rate for Payer: UnitedHealthcare Commercial	$558.00
Rate for Payer: UnitedHealthcare Community & State	$67.24
Rate for Payer: Wellpoint Medicaid Managed Care	$73.94

CLAMP SLIM RAPID ROD TO ROD

Facility

$2,790.00

Hospital Charge Code	270643269
Hospital Revenue Code	272
Min. Negotiated Rate	$418.50
Max. Negotiated Rate	$418.50
Rate for Payer: Qualcare PPO/HMO/WC	$418.50

CLAMP SM EXT FIX 4x2.5mm

Facility

$1,435.40

Hospital Charge Code	270601817
Hospital Revenue Code	272
Min. Negotiated Rate	$34.59
Max. Negotiated Rate	$717.70
Rate for Payer: Aetna Commercial	$545.45
Rate for Payer: Aetna Medicare Advantage	$430.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$366.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$366.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$366.03
Rate for Payer: Cigna Commercial	$717.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$430.62
Rate for Payer: Oxford Commercial	$287.08
Rate for Payer: Qualcare PPO/HMO/WC	$215.31
Rate for Payer: UnitedHealthcare Commercial	$287.08
Rate for Payer: UnitedHealthcare Community & State	$34.59
Rate for Payer: Wellpoint Medicaid Managed Care	$38.04

CLAMP SM EXT FIX 4x2.5mm

Facility

$1,435.40

Hospital Charge Code	270601817
Hospital Revenue Code	272
Min. Negotiated Rate	$215.31
Max. Negotiated Rate	$215.31
Rate for Payer: Qualcare PPO/HMO/WC	$215.31

CLAMP SOFT JAW SPRING

Facility

$121.00

Hospital Charge Code	270335198
Hospital Revenue Code	272
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$60.50
Rate for Payer: Aetna Commercial	$45.98
Rate for Payer: Aetna Medicare Advantage	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.86
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Oxford Commercial	$24.20
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$24.20
Rate for Payer: UnitedHealthcare Community & State	$2.92
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

CLAMP SOFT JAW SPRING

Facility

$121.00

Hospital Charge Code	270335198
Hospital Revenue Code	272
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

CLAMP STAND ANLLE CCLAMP 01350

Facility

$7,435.10

Hospital Charge Code	270634727
Hospital Revenue Code	272
Min. Negotiated Rate	$179.19
Max. Negotiated Rate	$3,717.55
Rate for Payer: Aetna Commercial	$2,825.34
Rate for Payer: Aetna Medicare Advantage	$2,230.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,895.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,895.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,895.95
Rate for Payer: Cigna Commercial	$3,717.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,230.53
Rate for Payer: Oxford Commercial	$1,487.02
Rate for Payer: Qualcare PPO/HMO/WC	$1,115.27
Rate for Payer: UnitedHealthcare Commercial	$1,487.02
Rate for Payer: UnitedHealthcare Community & State	$179.19
Rate for Payer: Wellpoint Medicaid Managed Care	$197.03

CLAMP STAND ANLLE CCLAMP 01350

Facility

$7,435.10

Hospital Charge Code	270634727
Hospital Revenue Code	272
Min. Negotiated Rate	$1,115.27
Max. Negotiated Rate	$1,115.27
Rate for Payer: Qualcare PPO/HMO/WC	$1,115.27

CLAMP SYN EXT FIX 4/2.5 395.54

Facility

$1,689.65

Hospital Charge Code	270601815
Hospital Revenue Code	278
Min. Negotiated Rate	$40.72
Max. Negotiated Rate	$844.83
Rate for Payer: Aetna Commercial	$642.07
Rate for Payer: Aetna Medicare Advantage	$506.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$430.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$430.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$337.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$430.86
Rate for Payer: Cigna Commercial	$844.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$408.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$371.72
Rate for Payer: Qualcare PPO/HMO/WC	$253.45
Rate for Payer: UnitedHealthcare Community & State	$40.72
Rate for Payer: Wellpoint Medicaid Managed Care	$44.78

Know your out-of-pocket cost for care.

All Charges