Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CORETRAK STERIPACK D 70MM

Facility

$18,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270699897
Hospital Revenue Code	278
Min. Negotiated Rate	$435.37
Max. Negotiated Rate	$9,032.50
Rate for Payer: Aetna Commercial	$6,864.70
Rate for Payer: Aetna Medicare Advantage	$5,419.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,606.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,606.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,613.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,606.57
Rate for Payer: Cigna Commercial	$9,032.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,371.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,974.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,709.75
Rate for Payer: UnitedHealthcare Community & State	$435.37
Rate for Payer: Wellpoint Medicaid Managed Care	$478.72

CORETRAK STERIPACK D 70MM

Facility

$18,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270699897
Hospital Revenue Code	278
Min. Negotiated Rate	$2,709.75
Max. Negotiated Rate	$4,371.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,613.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,371.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,974.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,709.75

CORETRAX HEX DRIVE 3.5 mm

Facility

$555.00

Hospital Charge Code	270680475
Hospital Revenue Code	272
Min. Negotiated Rate	$83.25
Max. Negotiated Rate	$83.25
Rate for Payer: Qualcare PPO/HMO/WC	$83.25

CORETRAX HEX DRIVE 3.5 mm

Facility

$555.00

Hospital Charge Code	270680475
Hospital Revenue Code	272
Min. Negotiated Rate	$13.38
Max. Negotiated Rate	$277.50
Rate for Payer: Aetna Commercial	$210.90
Rate for Payer: Aetna Medicare Advantage	$166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.53
Rate for Payer: Cigna Commercial	$277.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.50
Rate for Payer: Oxford Commercial	$111.00
Rate for Payer: Qualcare PPO/HMO/WC	$83.25
Rate for Payer: UnitedHealthcare Commercial	$111.00
Rate for Payer: UnitedHealthcare Community & State	$13.38
Rate for Payer: Wellpoint Medicaid Managed Care	$14.71

CORE US BIOPSY NEEDLE

Facility

$533.00

Hospital Charge Code	270325614
Hospital Revenue Code	272
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$266.50
Rate for Payer: Aetna Commercial	$202.54
Rate for Payer: Aetna Medicare Advantage	$159.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.91
Rate for Payer: Cigna Commercial	$266.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.90
Rate for Payer: Oxford Commercial	$106.60
Rate for Payer: Qualcare PPO/HMO/WC	$79.95
Rate for Payer: UnitedHealthcare Commercial	$106.60
Rate for Payer: UnitedHealthcare Community & State	$12.85
Rate for Payer: Wellpoint Medicaid Managed Care	$14.12

CORE US BIOPSY NEEDLE

Facility

$533.00

Hospital Charge Code	270325614
Hospital Revenue Code	272
Min. Negotiated Rate	$79.95
Max. Negotiated Rate	$79.95
Rate for Payer: Qualcare PPO/HMO/WC	$79.95

CORGARD/120MG/TAB

Facility

$26.60

Service Code	NDC 378117101
Hospital Charge Code	60632744
Hospital Revenue Code	250
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$13.30
Rate for Payer: Aetna Commercial	$10.11
Rate for Payer: Aetna Medicare Advantage	$7.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.78
Rate for Payer: Cigna Commercial	$13.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.98
Rate for Payer: Oxford Commercial	$5.32
Rate for Payer: Qualcare PPO/HMO/WC	$3.99
Rate for Payer: UnitedHealthcare Commercial	$5.32
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

CORGARD/120MG/TAB

Facility

$26.60

Service Code	NDC 378117101
Hospital Charge Code	60632744
Hospital Revenue Code	250
Min. Negotiated Rate	$3.99
Max. Negotiated Rate	$3.99
Rate for Payer: Qualcare PPO/HMO/WC	$3.99

CORGARD/20MG/TAB

Facility

$7.00

Hospital Charge Code	60632742
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

CORGARD/20MG/TAB

Facility

$7.00

Hospital Charge Code	60632742
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.66
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.40
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

CORGARD/40MG/TAB

Facility

$5.00

Hospital Charge Code	60632743
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

CORGARD/40MG/TAB

Facility

$7.00

Hospital Charge Code	60632746
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

CORGARD/40MG/TAB

Facility

$7.00

Hospital Charge Code	60632746
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.66
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.40
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

CORGARD/40MG/TAB

Facility

$5.00

Hospital Charge Code	60632743
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

CORGARD/80MG/TAB

Facility

$9.72

Service Code	NDC 27505010201
Hospital Charge Code	60632745
Hospital Revenue Code	250
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$1.46
Rate for Payer: Qualcare PPO/HMO/WC	$1.46

CORGARD/80MG/TAB

Facility

$9.72

Service Code	NDC 27505010201
Hospital Charge Code	60632745
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.86
Rate for Payer: Aetna Commercial	$3.69
Rate for Payer: Aetna Medicare Advantage	$2.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.48
Rate for Payer: Cigna Commercial	$4.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$1.94
Rate for Payer: Qualcare PPO/HMO/WC	$1.46
Rate for Payer: UnitedHealthcare Commercial	$1.94
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

CORKSCREW 4.5 X 15 MM

Facility

$1,150.00

Service Code	HCPCS C1713
Hospital Charge Code	270666029
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

CORKSCREW 4.5 X 15 MM

Facility

$1,150.00

Service Code	HCPCS C1713
Hospital Charge Code	270666029
Hospital Revenue Code	278
Min. Negotiated Rate	$27.71
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Community & State	$27.71
Rate for Payer: Wellpoint Medicaid Managed Care	$30.48

CORKSCREW 4.75 MM SUTURE TAPE

Facility

$1,575.00

Hospital Charge Code	270684085
Hospital Revenue Code	272
Min. Negotiated Rate	$37.96
Max. Negotiated Rate	$787.50
Rate for Payer: Aetna Commercial	$598.50
Rate for Payer: Aetna Medicare Advantage	$472.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$401.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$401.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$401.62
Rate for Payer: Cigna Commercial	$787.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$472.50
Rate for Payer: Oxford Commercial	$315.00
Rate for Payer: Qualcare PPO/HMO/WC	$236.25
Rate for Payer: UnitedHealthcare Commercial	$315.00
Rate for Payer: UnitedHealthcare Community & State	$37.96
Rate for Payer: Wellpoint Medicaid Managed Care	$41.74

CORKSCREW 4.75 MM SUTURE TAPE

Facility

$1,575.00

Hospital Charge Code	270684085
Hospital Revenue Code	272
Min. Negotiated Rate	$236.25
Max. Negotiated Rate	$236.25
Rate for Payer: Qualcare PPO/HMO/WC	$236.25

CORKSCREW 4.75 MM W/ SUTURE

Facility

$1,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270684037
Hospital Revenue Code	278
Min. Negotiated Rate	$236.25
Max. Negotiated Rate	$381.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$346.50
Rate for Payer: Qualcare PPO/HMO/WC	$236.25

CORKSCREW 4.75 MM W/ SUTURE

Facility

$1,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270684037
Hospital Revenue Code	278
Min. Negotiated Rate	$37.96
Max. Negotiated Rate	$787.50
Rate for Payer: Aetna Commercial	$598.50
Rate for Payer: Aetna Medicare Advantage	$472.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$401.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$401.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$401.62
Rate for Payer: Cigna Commercial	$787.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$346.50
Rate for Payer: Qualcare PPO/HMO/WC	$236.25
Rate for Payer: UnitedHealthcare Community & State	$37.96
Rate for Payer: Wellpoint Medicaid Managed Care	$41.74

CORKSCREW 5x15.5mm

Facility

$1,500.00

Hospital Charge Code	270665419
Hospital Revenue Code	278
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

CORKSCREW 5x15.5mm

Facility

$1,500.00

Hospital Charge Code	270665419
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

CORKSCREW ANCHOR 3.5X10MM

Facility

$1,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270660658
Hospital Revenue Code	278
Min. Negotiated Rate	$34.34
Max. Negotiated Rate	$712.50
Rate for Payer: Aetna Commercial	$541.50
Rate for Payer: Aetna Medicare Advantage	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.38
Rate for Payer: Cigna Commercial	$712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$313.50
Rate for Payer: Qualcare PPO/HMO/WC	$213.75
Rate for Payer: UnitedHealthcare Community & State	$34.34
Rate for Payer: Wellpoint Medicaid Managed Care	$37.76

Know your out-of-pocket cost for care.

All Charges