Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

COMPREHENSIVE METABOLIC PANL**

Facility

$26.00

Service Code	HCPCS 80054
Hospital Charge Code	3001050
Hospital Revenue Code	301
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.90

COMPREHENSIVE METABOLIC PANL**

Facility

$24.00

Service Code	HCPCS 80054
Hospital Charge Code	30001050
Hospital Revenue Code	300
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$9.12
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

COMPREHENSIVE METABOLIC PANL**

Facility

$26.00

Service Code	HCPCS 80054
Hospital Charge Code	3001050
Hospital Revenue Code	301
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$9.88
Rate for Payer: Aetna Medicare Advantage	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.63
Rate for Payer: Cigna Commercial	$13.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.90
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.69

COMPREHENSIVE METABOLIC PROFIL

Facility

$1,406.54

Service Code	HCPCS 80053
Hospital Charge Code	3001049
Hospital Revenue Code	301
Min. Negotiated Rate	$8.45
Max. Negotiated Rate	$703.27
Rate for Payer: Aetna Commercial	$28.72
Rate for Payer: Aetna Medicare Advantage	$34.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.12
Rate for Payer: Cigna Commercial	$703.27
Rate for Payer: Cigna Medicare Advantage	$10.56
Rate for Payer: Clover Medicare Advantage	$10.03
Rate for Payer: EmblemHealth Commercial	$31.68
Rate for Payer: Humana Medicare Advantage	$10.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.96
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.98
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.56
Rate for Payer: Wellcare Medicare Advantage	$10.56
Rate for Payer: Wellpoint Medicaid Managed Care	$37.27

COMPREHENSIVE METABOLIC PROFIL

Facility

$1,406.54

Service Code	HCPCS 80053
Hospital Charge Code	3001049
Hospital Revenue Code	301
Min. Negotiated Rate	$210.98
Max. Negotiated Rate	$210.98
Rate for Payer: Qualcare PPO/HMO/WC	$210.98

COMPRESSED AIR STAND-BY****

Facility

$27.00

Hospital Charge Code	9500273
Hospital Revenue Code	279
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$10.26
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.10
Rate for Payer: Oxford Commercial	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$5.40
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.72

COMPRESSED AIR STAND-BY****

Facility

$27.00

Hospital Charge Code	9500273
Hospital Revenue Code	279
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

COMPRESSION BONE SCREW

Facility

$162.00

Hospital Charge Code	270335082
Hospital Revenue Code	278
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$81.00
Rate for Payer: Aetna Commercial	$61.56
Rate for Payer: Aetna Medicare Advantage	$48.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.31
Rate for Payer: Cigna Commercial	$81.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.64
Rate for Payer: Qualcare PPO/HMO/WC	$24.30
Rate for Payer: UnitedHealthcare Community & State	$3.90
Rate for Payer: Wellpoint Medicaid Managed Care	$4.29

COMPRESSION BONE SCREW

Facility

$162.00

Hospital Charge Code	270335082
Hospital Revenue Code	278
Min. Negotiated Rate	$24.30
Max. Negotiated Rate	$39.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.64
Rate for Payer: Qualcare PPO/HMO/WC	$24.30

COMPRESSION NUT FOR SCREW

Facility

$878.40

Hospital Charge Code	270691500
Hospital Revenue Code	272
Min. Negotiated Rate	$131.76
Max. Negotiated Rate	$131.76
Rate for Payer: Qualcare PPO/HMO/WC	$131.76

COMPRESSION NUT FOR SCREW

Facility

$878.40

Hospital Charge Code	270691500
Hospital Revenue Code	272
Min. Negotiated Rate	$21.17
Max. Negotiated Rate	$439.20
Rate for Payer: Aetna Commercial	$333.79
Rate for Payer: Aetna Medicare Advantage	$263.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.99
Rate for Payer: Cigna Commercial	$439.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$263.52
Rate for Payer: Oxford Commercial	$175.68
Rate for Payer: Qualcare PPO/HMO/WC	$131.76
Rate for Payer: UnitedHealthcare Commercial	$175.68
Rate for Payer: UnitedHealthcare Community & State	$21.17
Rate for Payer: Wellpoint Medicaid Managed Care	$23.28

COMPRESSION ROD

Facility

$2,810.50

Hospital Charge Code	270666231
Hospital Revenue Code	272
Min. Negotiated Rate	$421.57
Max. Negotiated Rate	$421.57
Rate for Payer: Qualcare PPO/HMO/WC	$421.57

COMPRESSION ROD

Facility

$2,810.50

Hospital Charge Code	270666231
Hospital Revenue Code	272
Min. Negotiated Rate	$67.73
Max. Negotiated Rate	$1,405.25
Rate for Payer: Aetna Commercial	$1,067.99
Rate for Payer: Aetna Medicare Advantage	$843.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$716.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$716.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$716.68
Rate for Payer: Cigna Commercial	$1,405.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$843.15
Rate for Payer: Oxford Commercial	$562.10
Rate for Payer: Qualcare PPO/HMO/WC	$421.57
Rate for Payer: UnitedHealthcare Commercial	$562.10
Rate for Payer: UnitedHealthcare Community & State	$67.73
Rate for Payer: Wellpoint Medicaid Managed Care	$74.48

COMPRESSION TUBE PLATE

Facility

$988.00

Hospital Charge Code	270335021
Hospital Revenue Code	278
Min. Negotiated Rate	$23.81
Max. Negotiated Rate	$494.00
Rate for Payer: Aetna Commercial	$375.44
Rate for Payer: Aetna Medicare Advantage	$296.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$197.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.94
Rate for Payer: Cigna Commercial	$494.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$217.36
Rate for Payer: Qualcare PPO/HMO/WC	$148.20
Rate for Payer: UnitedHealthcare Community & State	$23.81
Rate for Payer: Wellpoint Medicaid Managed Care	$26.18

COMPRESSION TUBE PLATE

Facility

$988.00

Hospital Charge Code	270335021
Hospital Revenue Code	278
Min. Negotiated Rate	$148.20
Max. Negotiated Rate	$239.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$197.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$217.36
Rate for Payer: Qualcare PPO/HMO/WC	$148.20

COMPRESSOR OPEN

Facility

$2,366.95

Hospital Charge Code	270646750
Hospital Revenue Code	272
Min. Negotiated Rate	$355.04
Max. Negotiated Rate	$355.04
Rate for Payer: Qualcare PPO/HMO/WC	$355.04

COMPRESSOR OPEN

Facility

$2,366.95

Hospital Charge Code	270646750
Hospital Revenue Code	272
Min. Negotiated Rate	$57.04
Max. Negotiated Rate	$1,183.47
Rate for Payer: Aetna Commercial	$899.44
Rate for Payer: Aetna Medicare Advantage	$710.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$603.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$603.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$603.57
Rate for Payer: Cigna Commercial	$1,183.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$710.09
Rate for Payer: Oxford Commercial	$473.39
Rate for Payer: Qualcare PPO/HMO/WC	$355.04
Rate for Payer: UnitedHealthcare Commercial	$473.39
Rate for Payer: UnitedHealthcare Community & State	$57.04
Rate for Payer: Wellpoint Medicaid Managed Care	$62.72

COMPRESSOR OP FSM EX FIX 39551

Facility

$2,705.00

Hospital Charge Code	270608360
Hospital Revenue Code	278
Min. Negotiated Rate	$405.75
Max. Negotiated Rate	$654.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$541.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$595.10
Rate for Payer: Qualcare PPO/HMO/WC	$405.75

COMPRESSOR OP FSM EX FIX 39551

Facility

$2,705.00

Hospital Charge Code	270608360
Hospital Revenue Code	278
Min. Negotiated Rate	$65.19
Max. Negotiated Rate	$1,352.50
Rate for Payer: Aetna Commercial	$1,027.90
Rate for Payer: Aetna Medicare Advantage	$811.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$689.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$689.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$689.77
Rate for Payer: Cigna Commercial	$1,352.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$595.10
Rate for Payer: Qualcare PPO/HMO/WC	$405.75
Rate for Payer: UnitedHealthcare Community & State	$65.19
Rate for Payer: Wellpoint Medicaid Managed Care	$71.68

COMPR FT SCREW 4.0 STD 38 MM L

Facility

$1,802.50

Hospital Charge Code	270699696
Hospital Revenue Code	278
Min. Negotiated Rate	$270.38
Max. Negotiated Rate	$436.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$436.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.55
Rate for Payer: Qualcare PPO/HMO/WC	$270.38

COMPR FT SCREW 4.0 STD 38 MM L

Facility

$1,802.50

Hospital Charge Code	270699696
Hospital Revenue Code	278
Min. Negotiated Rate	$43.44
Max. Negotiated Rate	$901.25
Rate for Payer: Aetna Commercial	$684.95
Rate for Payer: Aetna Medicare Advantage	$540.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.64
Rate for Payer: Cigna Commercial	$901.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$436.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.55
Rate for Payer: Qualcare PPO/HMO/WC	$270.38
Rate for Payer: UnitedHealthcare Community & State	$43.44
Rate for Payer: Wellpoint Medicaid Managed Care	$47.77

COMPR FT SCRW 7.0XL 65MM

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693861
Hospital Revenue Code	278
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$840.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$764.50
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

COMPR FT SCRW 7.0XL 65MM

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693861
Hospital Revenue Code	278
Min. Negotiated Rate	$83.75
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,320.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$764.50
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Community & State	$83.75
Rate for Payer: Wellpoint Medicaid Managed Care	$92.09

COMPR FT SCRW 7.0 XL 75MM

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693862
Hospital Revenue Code	278
Min. Negotiated Rate	$83.75
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,320.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$764.50
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Community & State	$83.75
Rate for Payer: Wellpoint Medicaid Managed Care	$92.09

COMPR FT SCRW 7.0 XL 75MM

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693862
Hospital Revenue Code	278
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$840.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$764.50
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

Know your out-of-pocket cost for care.

All Charges