Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

COUPLING HMD 5/3-4 4940-1-020

Facility

$1,595.25

Hospital Charge Code	270619340
Hospital Revenue Code	272
Min. Negotiated Rate	$38.45
Max. Negotiated Rate	$797.62
Rate for Payer: Aetna Commercial	$606.20
Rate for Payer: Aetna Medicare Advantage	$478.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$406.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$406.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$406.79
Rate for Payer: Cigna Commercial	$797.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$478.57
Rate for Payer: Oxford Commercial	$319.05
Rate for Payer: Qualcare PPO/HMO/WC	$239.29
Rate for Payer: UnitedHealthcare Commercial	$319.05
Rate for Payer: UnitedHealthcare Community & State	$38.45
Rate for Payer: Wellpoint Medicaid Managed Care	$42.27

COUPLING HMD 5/5 4940-1-010

Facility

$1,603.25

Hospital Charge Code	270619341
Hospital Revenue Code	272
Min. Negotiated Rate	$240.49
Max. Negotiated Rate	$240.49
Rate for Payer: Qualcare PPO/HMO/WC	$240.49

COUPLING HMD 5/5 4940-1-010

Facility

$1,603.25

Hospital Charge Code	270619341
Hospital Revenue Code	272
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$801.62
Rate for Payer: Aetna Commercial	$609.24
Rate for Payer: Aetna Medicare Advantage	$480.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$408.83
Rate for Payer: Cigna Commercial	$801.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$480.98
Rate for Payer: Oxford Commercial	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$240.49
Rate for Payer: UnitedHealthcare Commercial	$320.65
Rate for Payer: UnitedHealthcare Community & State	$38.64
Rate for Payer: Wellpoint Medicaid Managed Care	$42.49

COUPLING HMD 8/4-5 4920-1-020

Facility

$2,247.25

Hospital Charge Code	270621581
Hospital Revenue Code	270
Min. Negotiated Rate	$54.16
Max. Negotiated Rate	$1,123.62
Rate for Payer: Aetna Commercial	$853.96
Rate for Payer: Aetna Medicare Advantage	$674.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.05
Rate for Payer: Cigna Commercial	$1,123.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$674.17
Rate for Payer: Oxford Commercial	$449.45
Rate for Payer: Qualcare PPO/HMO/WC	$337.09
Rate for Payer: UnitedHealthcare Commercial	$449.45
Rate for Payer: UnitedHealthcare Community & State	$54.16
Rate for Payer: Wellpoint Medicaid Managed Care	$59.55

COUPLING HMD 8/4-5 4920-1-020

Facility

$2,247.25

Hospital Charge Code	270621581
Hospital Revenue Code	270
Min. Negotiated Rate	$337.09
Max. Negotiated Rate	$337.09
Rate for Payer: Qualcare PPO/HMO/WC	$337.09

COUPLING HMD 8/8 4920-1-010

Facility

$2,247.25

Hospital Charge Code	270621582
Hospital Revenue Code	270
Min. Negotiated Rate	$337.09
Max. Negotiated Rate	$337.09
Rate for Payer: Qualcare PPO/HMO/WC	$337.09

COUPLING HMD 8/8 4920-1-010

Facility

$2,247.25

Hospital Charge Code	270621582
Hospital Revenue Code	270
Min. Negotiated Rate	$54.16
Max. Negotiated Rate	$1,123.62
Rate for Payer: Aetna Commercial	$853.96
Rate for Payer: Aetna Medicare Advantage	$674.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.05
Rate for Payer: Cigna Commercial	$1,123.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$674.17
Rate for Payer: Oxford Commercial	$449.45
Rate for Payer: Qualcare PPO/HMO/WC	$337.09
Rate for Payer: UnitedHealthcare Commercial	$449.45
Rate for Payer: UnitedHealthcare Community & State	$54.16
Rate for Payer: Wellpoint Medicaid Managed Care	$59.55

COUPLING LG ARTICULATING******

Facility

$434.00

Hospital Charge Code	1601897
Hospital Revenue Code	274
Min. Negotiated Rate	$65.10
Max. Negotiated Rate	$105.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.48
Rate for Payer: Qualcare PPO/HMO/WC	$65.10

COUPLING LG ARTICULATING******

Facility

$434.00

Hospital Charge Code	1601897
Hospital Revenue Code	274
Min. Negotiated Rate	$10.46
Max. Negotiated Rate	$217.00
Rate for Payer: Aetna Commercial	$164.92
Rate for Payer: Aetna Medicare Advantage	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.67
Rate for Payer: Cigna Commercial	$217.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$95.48
Rate for Payer: Qualcare PPO/HMO/WC	$65.10
Rate for Payer: UnitedHealthcare Community & State	$10.46
Rate for Payer: Wellpoint Medicaid Managed Care	$11.50

COUPLING ROD HOFFMAN 5H 11MM

Facility

$5,676.20

Service Code	HCPCS C1713
Hospital Charge Code	270700694
Hospital Revenue Code	278
Min. Negotiated Rate	$136.80
Max. Negotiated Rate	$2,838.10
Rate for Payer: Aetna Commercial	$2,156.96
Rate for Payer: Aetna Medicare Advantage	$1,702.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,447.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,447.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,135.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,447.43
Rate for Payer: Cigna Commercial	$2,838.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,373.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,248.76
Rate for Payer: Qualcare PPO/HMO/WC	$851.43
Rate for Payer: UnitedHealthcare Community & State	$136.80
Rate for Payer: Wellpoint Medicaid Managed Care	$150.42

COUPLING ROD HOFFMAN 5H 11MM

Facility

$5,676.20

Service Code	HCPCS C1713
Hospital Charge Code	270700694
Hospital Revenue Code	278
Min. Negotiated Rate	$851.43
Max. Negotiated Rate	$1,373.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,135.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,373.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,248.76
Rate for Payer: Qualcare PPO/HMO/WC	$851.43

CO VAC SUCTION SHAVER 3.0MM

Facility

$445.70

Hospital Charge Code	270654235
Hospital Revenue Code	272
Min. Negotiated Rate	$10.74
Max. Negotiated Rate	$222.85
Rate for Payer: Aetna Commercial	$169.37
Rate for Payer: Aetna Medicare Advantage	$133.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.65
Rate for Payer: Cigna Commercial	$222.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.71
Rate for Payer: Oxford Commercial	$89.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.86
Rate for Payer: UnitedHealthcare Commercial	$89.14
Rate for Payer: UnitedHealthcare Community & State	$10.74
Rate for Payer: Wellpoint Medicaid Managed Care	$11.81

CO VAC SUCTION SHAVER 3.0MM

Facility

$445.70

Hospital Charge Code	270654235
Hospital Revenue Code	272
Min. Negotiated Rate	$66.86
Max. Negotiated Rate	$66.86
Rate for Payer: Qualcare PPO/HMO/WC	$66.86

COVERALL FLUID RESISTANT UNIV

Facility

$163.20

Hospital Charge Code	270651926
Hospital Revenue Code	270
Min. Negotiated Rate	$24.48
Max. Negotiated Rate	$24.48
Rate for Payer: Qualcare PPO/HMO/WC	$24.48

COVERALL FLUID RESISTANT UNIV

Facility

$163.20

Hospital Charge Code	270651926
Hospital Revenue Code	270
Min. Negotiated Rate	$3.93
Max. Negotiated Rate	$81.60
Rate for Payer: Aetna Commercial	$62.02
Rate for Payer: Aetna Medicare Advantage	$48.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.62
Rate for Payer: Cigna Commercial	$81.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.96
Rate for Payer: Oxford Commercial	$32.64
Rate for Payer: Qualcare PPO/HMO/WC	$24.48
Rate for Payer: UnitedHealthcare Commercial	$32.64
Rate for Payer: UnitedHealthcare Community & State	$3.93
Rate for Payer: Wellpoint Medicaid Managed Care	$4.32

COVER BACK TABLE 90X40

Facility

$12.01

Hospital Charge Code	270649385
Hospital Revenue Code	270
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

COVER BACK TABLE 90X40

Facility

$12.01

Hospital Charge Code	270649385
Hospital Revenue Code	270
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

COVER BACK TABLE STER

Facility

$5.94

Hospital Charge Code	270061495
Hospital Revenue Code	272
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$0.89
Rate for Payer: Qualcare PPO/HMO/WC	$0.89

COVER BACK TABLE STER

Facility

$5.94

Hospital Charge Code	270061495
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.97
Rate for Payer: Aetna Commercial	$2.26
Rate for Payer: Aetna Medicare Advantage	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.51
Rate for Payer: Cigna Commercial	$2.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.78
Rate for Payer: Oxford Commercial	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$0.89
Rate for Payer: UnitedHealthcare Commercial	$1.19
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

COVER BURR HOLE LP 17MM

Facility

$2,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270695507
Hospital Revenue Code	278
Min. Negotiated Rate	$50.97
Max. Negotiated Rate	$1,057.50
Rate for Payer: Aetna Commercial	$803.70
Rate for Payer: Aetna Medicare Advantage	$634.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$539.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$539.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$423.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$539.33
Rate for Payer: Cigna Commercial	$1,057.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$511.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$465.30
Rate for Payer: Qualcare PPO/HMO/WC	$317.25
Rate for Payer: UnitedHealthcare Community & State	$50.97
Rate for Payer: Wellpoint Medicaid Managed Care	$56.05

COVER BURR HOLE LP 17MM

Facility

$2,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270695507
Hospital Revenue Code	278
Min. Negotiated Rate	$317.25
Max. Negotiated Rate	$511.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$423.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$511.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$465.30
Rate for Payer: Qualcare PPO/HMO/WC	$317.25

COVER BURRHOLEMATRIXNEURO15MM

Facility

$2,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270698657
Hospital Revenue Code	278
Min. Negotiated Rate	$55.43
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$874.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$506.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00
Rate for Payer: UnitedHealthcare Community & State	$55.43
Rate for Payer: Wellpoint Medicaid Managed Care	$60.95

COVER BURRHOLEMATRIXNEURO15MM

Facility

$2,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270698657
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$506.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

COVER BURRHOLEMATRIXNEURO24MM

Facility

$5,185.00

Service Code	HCPCS C1713
Hospital Charge Code	270700168
Hospital Revenue Code	278
Min. Negotiated Rate	$777.75
Max. Negotiated Rate	$1,254.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,037.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,254.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,140.70
Rate for Payer: Qualcare PPO/HMO/WC	$777.75

COVER BURRHOLEMATRIXNEURO24MM

Facility

$5,185.00

Service Code	HCPCS C1713
Hospital Charge Code	270700168
Hospital Revenue Code	278
Min. Negotiated Rate	$124.96
Max. Negotiated Rate	$2,592.50
Rate for Payer: Aetna Commercial	$1,970.30
Rate for Payer: Aetna Medicare Advantage	$1,555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,322.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,322.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,037.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,322.17
Rate for Payer: Cigna Commercial	$2,592.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,254.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,140.70
Rate for Payer: Qualcare PPO/HMO/WC	$777.75
Rate for Payer: UnitedHealthcare Community & State	$124.96
Rate for Payer: Wellpoint Medicaid Managed Care	$137.40

Know your out-of-pocket cost for care.

All Charges