Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

COAPTITE INJECTABLE IMPLANT

Facility

$1,675.00

Service Code	HCPCS L8606
Hospital Charge Code	270662270
Hospital Revenue Code	278
Min. Negotiated Rate	$40.37
Max. Negotiated Rate	$837.50
Rate for Payer: Aetna Commercial	$636.50
Rate for Payer: Aetna Medicare Advantage	$502.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$427.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$427.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$427.12
Rate for Payer: Cigna Commercial	$837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$368.50
Rate for Payer: Qualcare PPO/HMO/WC	$251.25
Rate for Payer: UnitedHealthcare Community & State	$40.37
Rate for Payer: Wellpoint Medicaid Managed Care	$44.39

COARTEM TAB 20-120MG

Facility

$34.04

Service Code	NDC 78056845
Hospital Charge Code	606390530
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$17.02
Rate for Payer: Aetna Commercial	$12.94
Rate for Payer: Aetna Medicare Advantage	$10.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.68
Rate for Payer: Cigna Commercial	$17.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.21
Rate for Payer: Oxford Commercial	$6.81
Rate for Payer: Qualcare PPO/HMO/WC	$5.11
Rate for Payer: UnitedHealthcare Commercial	$6.81
Rate for Payer: UnitedHealthcare Community & State	$0.82
Rate for Payer: Wellpoint Medicaid Managed Care	$0.90

COARTEM TAB 20-120MG

Facility

$34.04

Service Code	NDC 78056845
Hospital Charge Code	606390530
Hospital Revenue Code	250
Min. Negotiated Rate	$5.11
Max. Negotiated Rate	$5.11
Rate for Payer: Qualcare PPO/HMO/WC	$5.11

COAT BOND 9MMx30MM 11-210064

Facility

$8,785.00

Hospital Charge Code	270661177
Hospital Revenue Code	278
Min. Negotiated Rate	$1,317.75
Max. Negotiated Rate	$2,125.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,757.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,125.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,932.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,317.75

COAT BOND 9MMx30MM 11-210064

Facility

$8,785.00

Hospital Charge Code	270661177
Hospital Revenue Code	278
Min. Negotiated Rate	$211.72
Max. Negotiated Rate	$4,392.50
Rate for Payer: Aetna Commercial	$3,338.30
Rate for Payer: Aetna Medicare Advantage	$2,635.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,240.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,240.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,757.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,240.18
Rate for Payer: Cigna Commercial	$4,392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,125.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,932.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,317.75
Rate for Payer: UnitedHealthcare Community & State	$211.72
Rate for Payer: Wellpoint Medicaid Managed Care	$232.80

COAT LAB UNISEX WHITE KNEE

Facility

$52.50

Hospital Charge Code	270658868
Hospital Revenue Code	270
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$7.88
Rate for Payer: Qualcare PPO/HMO/WC	$7.88

COAT LAB UNISEX WHITE KNEE

Facility

$52.50

Hospital Charge Code	270658868
Hospital Revenue Code	270
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$26.25
Rate for Payer: Aetna Commercial	$19.95
Rate for Payer: Aetna Medicare Advantage	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.39
Rate for Payer: Cigna Commercial	$26.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.75
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.88
Rate for Payer: UnitedHealthcare Commercial	$10.50
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.39

COAT LAB UNISEX WHITE KNEE

Facility

$52.50

Hospital Charge Code	270658870
Hospital Revenue Code	270
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$26.25
Rate for Payer: Aetna Commercial	$19.95
Rate for Payer: Aetna Medicare Advantage	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.39
Rate for Payer: Cigna Commercial	$26.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.75
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.88
Rate for Payer: UnitedHealthcare Commercial	$10.50
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.39

COAT LAB UNISEX WHITE KNEE

Facility

$52.50

Hospital Charge Code	270658871
Hospital Revenue Code	270
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$26.25
Rate for Payer: Aetna Commercial	$19.95
Rate for Payer: Aetna Medicare Advantage	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.39
Rate for Payer: Cigna Commercial	$26.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.75
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.88
Rate for Payer: UnitedHealthcare Commercial	$10.50
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.39

COAT LAB UNISEX WHITE KNEE

Facility

$52.50

Hospital Charge Code	270658871
Hospital Revenue Code	270
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$7.88
Rate for Payer: Qualcare PPO/HMO/WC	$7.88

COAT LAB UNISEX WHITE KNEE

Facility

$52.50

Hospital Charge Code	270658870
Hospital Revenue Code	270
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$7.88
Rate for Payer: Qualcare PPO/HMO/WC	$7.88

COAT LAB UNISEX WHITE KNEE

Facility

$52.50

Hospital Charge Code	270658939
Hospital Revenue Code	270
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$7.88
Rate for Payer: Qualcare PPO/HMO/WC	$7.88

COAT LAB UNISEX WHITE KNEE

Facility

$52.50

Hospital Charge Code	270658869
Hospital Revenue Code	270
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$7.88
Rate for Payer: Qualcare PPO/HMO/WC	$7.88

COAT LAB UNISEX WHITE KNEE

Facility

$52.50

Hospital Charge Code	270658939
Hospital Revenue Code	270
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$26.25
Rate for Payer: Aetna Commercial	$19.95
Rate for Payer: Aetna Medicare Advantage	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.39
Rate for Payer: Cigna Commercial	$26.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.75
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.88
Rate for Payer: UnitedHealthcare Commercial	$10.50
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.39

COAT LAB UNISEX WHITE KNEE

Facility

$52.50

Hospital Charge Code	270658869
Hospital Revenue Code	270
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$26.25
Rate for Payer: Aetna Commercial	$19.95
Rate for Payer: Aetna Medicare Advantage	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.39
Rate for Payer: Cigna Commercial	$26.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.75
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.88
Rate for Payer: UnitedHealthcare Commercial	$10.50
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.39

COAXIAL INTRO NEEDLE 17G X 6.8

Facility

$70.00

Hospital Charge Code	270CH0110
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$35.00
Rate for Payer: Aetna Commercial	$26.60
Rate for Payer: Aetna Medicare Advantage	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.85
Rate for Payer: Cigna Commercial	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.00
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.50
Rate for Payer: UnitedHealthcare Commercial	$14.00
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

COAXIAL INTRO NEEDLE 17G X 6.8

Facility

$70.00

Hospital Charge Code	270CH0110
Hospital Revenue Code	272
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.50

COAXIAL INTRO NEEDLE 17Gx6.8cm

Facility

$70.00

Hospital Charge Code	2709003585
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$35.00
Rate for Payer: Aetna Commercial	$26.60
Rate for Payer: Aetna Medicare Advantage	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.85
Rate for Payer: Cigna Commercial	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.00
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.50
Rate for Payer: UnitedHealthcare Commercial	$14.00
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

COAXIAL INTRO NEEDLE 17Gx6.8cm

Facility

$70.00

Hospital Charge Code	2709003585
Hospital Revenue Code	272
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.50

COBALT

Facility

$152.25

Service Code	HCPCS 83018
Hospital Charge Code	3000363
Hospital Revenue Code	301
Min. Negotiated Rate	$22.84
Max. Negotiated Rate	$22.84
Rate for Payer: Qualcare PPO/HMO/WC	$22.84

COBALT

Facility

$152.25

Service Code	HCPCS 83018
Hospital Charge Code	3000363
Hospital Revenue Code	301
Min. Negotiated Rate	$4.03
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$59.73
Rate for Payer: Aetna Medicare Advantage	$71.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.27
Rate for Payer: Cigna Commercial	$76.12
Rate for Payer: Cigna Medicare Advantage	$21.96
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.84
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$17.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Medicare Advantage	$21.96
Rate for Payer: Wellpoint Medicaid Managed Care	$4.03

COBALT, SERUM/PLASMA

Facility

$150.95

Service Code	HCPCS 83018
Hospital Charge Code	39900090
Hospital Revenue Code	301
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$59.73
Rate for Payer: Aetna Medicare Advantage	$71.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.27
Rate for Payer: Cigna Commercial	$75.47
Rate for Payer: Cigna Medicare Advantage	$21.96
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.64
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$17.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Medicare Advantage	$21.96
Rate for Payer: Wellpoint Medicaid Managed Care	$4.00

COBALT, SERUM/PLASMA

Facility

$150.95

Service Code	HCPCS 83018
Hospital Charge Code	39900090
Hospital Revenue Code	301
Min. Negotiated Rate	$22.64
Max. Negotiated Rate	$22.64
Rate for Payer: Qualcare PPO/HMO/WC	$22.64

COBAN 4 ROLL STER 1584S

Facility

$10.50

Hospital Charge Code	270600350
Hospital Revenue Code	272
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$1.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.57

COBAN 4 ROLL STER 1584S

Facility

$10.50

Hospital Charge Code	270600350
Hospital Revenue Code	272
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.25
Rate for Payer: Aetna Commercial	$3.99
Rate for Payer: Aetna Medicare Advantage	$3.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.68
Rate for Payer: Cigna Commercial	$5.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.15
Rate for Payer: Oxford Commercial	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$1.57
Rate for Payer: UnitedHealthcare Commercial	$2.10
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

Know your out-of-pocket cost for care.

All Charges