Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CONICAL SUBTALAR IMPLANT 9MM

Facility

$6,475.00

Hospital Charge Code	270656735
Hospital Revenue Code	278
Min. Negotiated Rate	$156.05
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$2,460.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,424.50
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Community & State	$156.05
Rate for Payer: Wellpoint Medicaid Managed Care	$171.59

CONICAL SUBTALAR IMPLANT 9MM

Facility

$6,475.00

Hospital Charge Code	270656735
Hospital Revenue Code	278
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$1,566.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,424.50
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

CONICAL SUBTALAR IMPLANT 9MM

Facility

$8,350.00

Service Code	HCPCS C1776
Hospital Charge Code	270678241
Hospital Revenue Code	278
Min. Negotiated Rate	$1,252.50
Max. Negotiated Rate	$2,020.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,020.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,837.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,252.50

CONICAL SUBTALAR IMPLANT 9MM

Facility

$8,350.00

Service Code	HCPCS C1776
Hospital Charge Code	270678241
Hospital Revenue Code	278
Min. Negotiated Rate	$201.24
Max. Negotiated Rate	$4,175.00
Rate for Payer: Aetna Commercial	$3,173.00
Rate for Payer: Aetna Medicare Advantage	$2,505.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,129.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,129.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,129.25
Rate for Payer: Cigna Commercial	$4,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,020.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,837.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,252.50
Rate for Payer: UnitedHealthcare Community & State	$201.24
Rate for Payer: Wellpoint Medicaid Managed Care	$221.28

CONIVAPTAN 5MG/ML INJ

Facility

$3,918.46

Hospital Charge Code	606350917
Hospital Revenue Code	250
Min. Negotiated Rate	$94.43
Max. Negotiated Rate	$1,959.23
Rate for Payer: Aetna Commercial	$1,489.01
Rate for Payer: Aetna Medicare Advantage	$1,175.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$999.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$999.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$999.21
Rate for Payer: Cigna Commercial	$1,959.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,175.54
Rate for Payer: Oxford Commercial	$783.69
Rate for Payer: Qualcare PPO/HMO/WC	$587.77
Rate for Payer: UnitedHealthcare Commercial	$783.69
Rate for Payer: UnitedHealthcare Community & State	$94.43
Rate for Payer: Wellpoint Medicaid Managed Care	$103.84

CONIVAPTAN 5MG/ML INJ

Facility

$3,918.46

Hospital Charge Code	606350917
Hospital Revenue Code	250
Min. Negotiated Rate	$587.77
Max. Negotiated Rate	$587.77
Rate for Payer: Qualcare PPO/HMO/WC	$587.77

CONIZATION OF CERVIX

Facility

$29,961.70

Service Code	HCPCS 57520
Hospital Charge Code	1600000654
Hospital Revenue Code	360
Min. Negotiated Rate	$722.08
Max. Negotiated Rate	$13,882.15
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,882.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,882.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,882.15
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,988.51
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,494.26
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$722.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$793.99

CONIZATION OF CERVIX

Facility

$29,961.70

Service Code	HCPCS 57520
Hospital Charge Code	1600000654
Hospital Revenue Code	360
Min. Negotiated Rate	$4,494.26
Max. Negotiated Rate	$4,494.26
Rate for Payer: Qualcare PPO/HMO/WC	$4,494.26

CONIZATION OF CERVIX-LEEP

Facility

$24,422.22

Service Code	HCPCS 57522
Hospital Charge Code	160000188
Hospital Revenue Code	360
Min. Negotiated Rate	$588.58
Max. Negotiated Rate	$13,882.15
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,882.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,882.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,882.15
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,326.67
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,663.33
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$588.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$647.19

CONIZATION OF CERVIX-LEEP

Facility

$24,422.22

Service Code	HCPCS 57522
Hospital Charge Code	160000188
Hospital Revenue Code	360
Min. Negotiated Rate	$3,663.33
Max. Negotiated Rate	$3,663.33
Rate for Payer: Qualcare PPO/HMO/WC	$3,663.33

CONIZATION OF CERVIX-LEEP

Facility

$24,422.22

Service Code	HCPCS 57522
Hospital Charge Code	160000217
Hospital Revenue Code	360
Min. Negotiated Rate	$588.58
Max. Negotiated Rate	$13,882.15
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,882.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,882.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,882.15
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,326.67
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,663.33
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$588.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$647.19

CONIZATION OF CERVIX-LEEP

Facility

$24,422.22

Service Code	HCPCS 57522
Hospital Charge Code	160000217
Hospital Revenue Code	360
Min. Negotiated Rate	$3,663.33
Max. Negotiated Rate	$3,663.33
Rate for Payer: Qualcare PPO/HMO/WC	$3,663.33

CONJUGATED ESTROG INJ 25MG/5ML

Facility

$1,615.10

Service Code	HCPCS J1410
Hospital Charge Code	60628222
Hospital Revenue Code	636
Min. Negotiated Rate	$38.92
Max. Negotiated Rate	$1,413.99
Rate for Payer: Aetna Commercial	$1,065.48
Rate for Payer: Aetna Medicare Advantage	$1,269.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,413.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,413.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$391.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$415.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,413.99
Rate for Payer: Cigna Medicare Advantage	$391.72
Rate for Payer: Clover Medicare Advantage	$372.13
Rate for Payer: EmblemHealth Commercial	$1,175.16
Rate for Payer: Humana Medicare Advantage	$403.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$391.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.85
Rate for Payer: Qualcare PPO/HMO/WC	$242.26
Rate for Payer: UnitedHealthcare Community & State	$38.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$391.72
Rate for Payer: Wellcare Medicare Advantage	$391.72
Rate for Payer: Wellpoint Medicaid Managed Care	$42.80

CONJUGATED ESTROG INJ 25MG/5ML

Facility

$1,615.10

Service Code	HCPCS J1410
Hospital Charge Code	60628222
Hospital Revenue Code	636
Min. Negotiated Rate	$242.26
Max. Negotiated Rate	$390.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.85
Rate for Payer: Qualcare PPO/HMO/WC	$242.26

CONJUGATED ESTROG TAB 0.3MG

Facility

$8.24

Service Code	NDC 46110081
Hospital Charge Code	60628219
Hospital Revenue Code	250
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$1.24
Rate for Payer: Qualcare PPO/HMO/WC	$1.24

CONJUGATED ESTROG TAB 0.3MG

Facility

$8.24

Service Code	NDC 46110081
Hospital Charge Code	60628219
Hospital Revenue Code	250
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$4.12
Rate for Payer: Aetna Commercial	$3.13
Rate for Payer: Aetna Medicare Advantage	$2.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.10
Rate for Payer: Cigna Commercial	$4.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.47
Rate for Payer: Oxford Commercial	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.24
Rate for Payer: UnitedHealthcare Commercial	$1.65
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

CONJUGATED ESTROG TAB 0.625MG

Facility

$7.10

Service Code	NDC 46110281
Hospital Charge Code	60628220
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.55
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.81
Rate for Payer: Cigna Commercial	$3.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.13
Rate for Payer: Oxford Commercial	$1.42
Rate for Payer: Qualcare PPO/HMO/WC	$1.06
Rate for Payer: UnitedHealthcare Commercial	$1.42
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

CONJUGATED ESTROG TAB 0.625MG

Facility

$7.10

Service Code	NDC 46110281
Hospital Charge Code	60628220
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$1.06
Rate for Payer: Qualcare PPO/HMO/WC	$1.06

CONJUGATED ESTROG TAB 1.25MG

Facility

$8.58

Service Code	NDC 52959022200
Hospital Charge Code	60628221
Hospital Revenue Code	250
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$1.29

CONJUGATED ESTROG TAB 1.25MG

Facility

$8.58

Service Code	NDC 52959022200
Hospital Charge Code	60628221
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.29
Rate for Payer: Aetna Commercial	$3.26
Rate for Payer: Aetna Medicare Advantage	$2.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.19
Rate for Payer: Cigna Commercial	$4.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.57
Rate for Payer: Oxford Commercial	$1.72
Rate for Payer: Qualcare PPO/HMO/WC	$1.29
Rate for Payer: UnitedHealthcare Commercial	$1.72
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

CONJUGATED ESTROG VAG CRM

Facility

$2,742.65

Service Code	NDC 46087221
Hospital Charge Code	60628214
Hospital Revenue Code	250
Min. Negotiated Rate	$66.10
Max. Negotiated Rate	$1,371.33
Rate for Payer: Aetna Commercial	$1,042.21
Rate for Payer: Aetna Medicare Advantage	$822.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$699.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$699.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$699.38
Rate for Payer: Cigna Commercial	$1,371.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$822.79
Rate for Payer: Oxford Commercial	$548.53
Rate for Payer: Qualcare PPO/HMO/WC	$411.40
Rate for Payer: UnitedHealthcare Commercial	$548.53
Rate for Payer: UnitedHealthcare Community & State	$66.10
Rate for Payer: Wellpoint Medicaid Managed Care	$72.68

CONJUGATED ESTROG VAG CRM

Facility

$2,742.65

Service Code	NDC 46087221
Hospital Charge Code	60628214
Hospital Revenue Code	250
Min. Negotiated Rate	$411.40
Max. Negotiated Rate	$411.40
Rate for Payer: Qualcare PPO/HMO/WC	$411.40

CONNECTING NUT M8 SHORT

Facility

$120.00

Hospital Charge Code	270674287
Hospital Revenue Code	272
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

CONNECTING NUT M8 SHORT

Facility

$120.00

Hospital Charge Code	270674287
Hospital Revenue Code	272
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$45.60
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.00
Rate for Payer: Oxford Commercial	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$24.00
Rate for Payer: UnitedHealthcare Community & State	$2.89
Rate for Payer: Wellpoint Medicaid Managed Care	$3.18

CONNECTING SCREW

Facility

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	270686084
Hospital Revenue Code	278
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$125.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.40
Rate for Payer: Qualcare PPO/HMO/WC	$78.00

Know your out-of-pocket cost for care.

All Charges