Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

17 KETOSTEROIDS,URINE

Facility

$390.00

Service Code	HCPCS 83586
Hospital Charge Code	38472383
Hospital Revenue Code	301
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$34.82
Rate for Payer: Aetna Medicare Advantage	$41.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.20
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.80
Rate for Payer: Clover Medicare Advantage	$12.16
Rate for Payer: EmblemHealth Commercial	$38.40
Rate for Payer: Humana Medicare Advantage	$13.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.80
Rate for Payer: Wellcare Medicare Advantage	$12.80
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

1.7MM DRILL BIT

Facility

$875.00

Hospital Charge Code	270681047
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

1.7MM DRILL BIT

Facility

$875.00

Hospital Charge Code	270681047
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

1.7 MM SOLID DRILL BIT

Facility

$565.00

Hospital Charge Code	270656156
Hospital Revenue Code	270
Min. Negotiated Rate	$13.62
Max. Negotiated Rate	$282.50
Rate for Payer: Aetna Commercial	$214.70
Rate for Payer: Aetna Medicare Advantage	$169.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.07
Rate for Payer: Cigna Commercial	$282.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.50
Rate for Payer: Oxford Commercial	$113.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.75
Rate for Payer: UnitedHealthcare Commercial	$113.00
Rate for Payer: UnitedHealthcare Community & State	$13.62
Rate for Payer: Wellpoint Medicaid Managed Care	$14.97

1.7 MM SOLID DRILL BIT

Facility

$565.00

Hospital Charge Code	270656156
Hospital Revenue Code	270
Min. Negotiated Rate	$84.75
Max. Negotiated Rate	$84.75
Rate for Payer: Qualcare PPO/HMO/WC	$84.75

1.7MM SQUARE DRIVER

Facility

$385.00

Hospital Charge Code	270688189
Hospital Revenue Code	272
Min. Negotiated Rate	$57.75
Max. Negotiated Rate	$57.75
Rate for Payer: Qualcare PPO/HMO/WC	$57.75

1.7MM SQUARE DRIVER

Facility

$385.00

Hospital Charge Code	270688189
Hospital Revenue Code	272
Min. Negotiated Rate	$9.28
Max. Negotiated Rate	$192.50
Rate for Payer: Aetna Commercial	$146.30
Rate for Payer: Aetna Medicare Advantage	$115.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.17
Rate for Payer: Cigna Commercial	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.50
Rate for Payer: Oxford Commercial	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.75
Rate for Payer: UnitedHealthcare Commercial	$77.00
Rate for Payer: UnitedHealthcare Community & State	$9.28
Rate for Payer: Wellpoint Medicaid Managed Care	$10.20

17-OH-PREGNENOLONE,SERUM

Facility

$390.00

Service Code	HCPCS 84143
Hospital Charge Code	39900122
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

17-OH-PREGNENOLONE,SERUM

Facility

$390.00

Service Code	HCPCS 84143
Hospital Charge Code	39900122
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$62.04
Rate for Payer: Aetna Medicare Advantage	$73.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.34
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$22.81
Rate for Payer: Clover Medicare Advantage	$21.67
Rate for Payer: EmblemHealth Commercial	$68.43
Rate for Payer: Humana Medicare Advantage	$23.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$18.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.81
Rate for Payer: Wellcare Medicare Advantage	$22.81
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

1.7X05 LOCK SCREW

Facility

$705.00

Hospital Charge Code	270656391
Hospital Revenue Code	278
Min. Negotiated Rate	$16.99
Max. Negotiated Rate	$352.50
Rate for Payer: Aetna Commercial	$267.90
Rate for Payer: Aetna Medicare Advantage	$211.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.78
Rate for Payer: Cigna Commercial	$352.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.10
Rate for Payer: Qualcare PPO/HMO/WC	$105.75
Rate for Payer: UnitedHealthcare Community & State	$16.99
Rate for Payer: Wellpoint Medicaid Managed Care	$18.68

1.7X05 LOCK SCREW

Facility

$705.00

Hospital Charge Code	270656391
Hospital Revenue Code	278
Min. Negotiated Rate	$105.75
Max. Negotiated Rate	$170.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$155.10
Rate for Payer: Qualcare PPO/HMO/WC	$105.75

1.7X12 BONE SCREW

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270656392
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

1.7X12 BONE SCREW

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270656392
Hospital Revenue Code	278
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

1.7X6 BONE SCREW

Facility

$550.00

Hospital Charge Code	270656393
Hospital Revenue Code	278
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

1.7X6 BONE SCREW

Facility

$550.00

Hospital Charge Code	270656393
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

1801 AXONICS LEAD IMPLANT KIT

Facility

$1,800.00

Hospital Charge Code	270702022
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

1801 AXONICS LEAD IMPLANT KIT

Facility

$1,800.00

Hospital Charge Code	270702022
Hospital Revenue Code	278
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Community & State	$43.38
Rate for Payer: Wellpoint Medicaid Managed Care	$47.70

180/40 HA PINS

Facility

$720.00

Hospital Charge Code	270656613
Hospital Revenue Code	278
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Community & State	$17.35
Rate for Payer: Wellpoint Medicaid Managed Care	$19.08

180/40 HA PINS

Facility

$720.00

Hospital Charge Code	270656613
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.40
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

180X5.0 PINS

Facility

$930.00

Hospital Charge Code	270656400
Hospital Revenue Code	278
Min. Negotiated Rate	$22.41
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$353.40
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.60
Rate for Payer: Qualcare PPO/HMO/WC	$139.50
Rate for Payer: UnitedHealthcare Community & State	$22.41
Rate for Payer: Wellpoint Medicaid Managed Care	$24.64

180X5.0 PINS

Facility

$930.00

Hospital Charge Code	270656400
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$225.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.60
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

18 G 5 INCH TOUHEY NEEDLE

Facility

$447.00

Hospital Charge Code	270325446
Hospital Revenue Code	272
Min. Negotiated Rate	$67.05
Max. Negotiated Rate	$67.05
Rate for Payer: Qualcare PPO/HMO/WC	$67.05

18 G 5 INCH TOUHEY NEEDLE

Facility

$447.00

Hospital Charge Code	270325446
Hospital Revenue Code	272
Min. Negotiated Rate	$10.77
Max. Negotiated Rate	$223.50
Rate for Payer: Aetna Commercial	$169.86
Rate for Payer: Aetna Medicare Advantage	$134.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.98
Rate for Payer: Cigna Commercial	$223.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.10
Rate for Payer: Oxford Commercial	$89.40
Rate for Payer: Qualcare PPO/HMO/WC	$67.05
Rate for Payer: UnitedHealthcare Commercial	$89.40
Rate for Payer: UnitedHealthcare Community & State	$10.77
Rate for Payer: Wellpoint Medicaid Managed Care	$11.85

18 GAUGE 7.0CM NEEDLE

Facility

$267.50

Hospital Charge Code	270662663
Hospital Revenue Code	272
Min. Negotiated Rate	$40.12
Max. Negotiated Rate	$40.12
Rate for Payer: Qualcare PPO/HMO/WC	$40.12

18 GAUGE 7.0CM NEEDLE

Facility

$267.50

Hospital Charge Code	270662663
Hospital Revenue Code	272
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$133.75
Rate for Payer: Aetna Commercial	$101.65
Rate for Payer: Aetna Medicare Advantage	$80.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.21
Rate for Payer: Cigna Commercial	$133.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.25
Rate for Payer: Oxford Commercial	$53.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.12
Rate for Payer: UnitedHealthcare Commercial	$53.50
Rate for Payer: UnitedHealthcare Community & State	$6.45
Rate for Payer: Wellpoint Medicaid Managed Care	$7.09

Know your out-of-pocket cost for care.

All Charges