Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DEVICE INFLATION LEVEEN

Facility

$209.95

Hospital Charge Code	270645619
Hospital Revenue Code	272
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$104.97
Rate for Payer: Aetna Commercial	$79.78
Rate for Payer: Aetna Medicare Advantage	$62.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.54
Rate for Payer: Cigna Commercial	$104.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.98
Rate for Payer: Oxford Commercial	$41.99
Rate for Payer: Qualcare PPO/HMO/WC	$31.49
Rate for Payer: UnitedHealthcare Commercial	$41.99
Rate for Payer: UnitedHealthcare Community & State	$5.06
Rate for Payer: Wellpoint Medicaid Managed Care	$5.56

DEVICE INFLATION PRESTO

Facility

$170.00

Hospital Charge Code	270695684
Hospital Revenue Code	272
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

DEVICE INFLATION PRESTO

Facility

$170.00

Hospital Charge Code	270695684
Hospital Revenue Code	272
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$85.00
Rate for Payer: Aetna Commercial	$64.60
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.00
Rate for Payer: Oxford Commercial	$34.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$34.00
Rate for Payer: UnitedHealthcare Community & State	$4.10
Rate for Payer: Wellpoint Medicaid Managed Care	$4.50

DEVICEINTERBDYFUSIONFORTLINK

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270694166
Hospital Revenue Code	278
Min. Negotiated Rate	$397.05
Max. Negotiated Rate	$8,237.50
Rate for Payer: Aetna Commercial	$6,260.50
Rate for Payer: Aetna Medicare Advantage	$4,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,201.12
Rate for Payer: Cigna Commercial	$8,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,624.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25
Rate for Payer: UnitedHealthcare Community & State	$397.05
Rate for Payer: Wellpoint Medicaid Managed Care	$436.59

DEVICEINTERBDYFUSIONFORTLINK

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270694166
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$3,986.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,624.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

DEVICE KPN KYPHOPAK FX F05A

Facility

$552.75

Hospital Charge Code	270629407
Hospital Revenue Code	272
Min. Negotiated Rate	$13.32
Max. Negotiated Rate	$276.38
Rate for Payer: Aetna Commercial	$210.04
Rate for Payer: Aetna Medicare Advantage	$165.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.95
Rate for Payer: Cigna Commercial	$276.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.82
Rate for Payer: Oxford Commercial	$110.55
Rate for Payer: Qualcare PPO/HMO/WC	$82.91
Rate for Payer: UnitedHealthcare Commercial	$110.55
Rate for Payer: UnitedHealthcare Community & State	$13.32
Rate for Payer: Wellpoint Medicaid Managed Care	$14.65

DEVICE KPN KYPHOPAK FX F05A

Facility

$552.75

Hospital Charge Code	270629407
Hospital Revenue Code	272
Min. Negotiated Rate	$82.91
Max. Negotiated Rate	$82.91
Rate for Payer: Qualcare PPO/HMO/WC	$82.91

DEVICE KPN KYPHOPAK FX F05A

Facility

$750.00

Hospital Charge Code	270629407V
Hospital Revenue Code	270
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

DEVICE KPN KYPHOPAK FX F05A

Facility

$750.00

Hospital Charge Code	270629407V
Hospital Revenue Code	270
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

DEVICE LOCKING BX CAP SYST

Facility

$46.13

Hospital Charge Code	270650916
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$23.07
Rate for Payer: Aetna Commercial	$17.53
Rate for Payer: Aetna Medicare Advantage	$13.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.76
Rate for Payer: Cigna Commercial	$23.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.84
Rate for Payer: Oxford Commercial	$9.23
Rate for Payer: Qualcare PPO/HMO/WC	$6.92
Rate for Payer: UnitedHealthcare Commercial	$9.23
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$1.22

DEVICE LOCKING BX CAP SYST

Facility

$46.13

Hospital Charge Code	270650916
Hospital Revenue Code	272
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$6.92
Rate for Payer: Qualcare PPO/HMO/WC	$6.92

DEVICE LOOP LIGATING MAJ-254

Facility

$161.65

Hospital Charge Code	270618994
Hospital Revenue Code	272
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$80.83
Rate for Payer: Aetna Commercial	$61.43
Rate for Payer: Aetna Medicare Advantage	$48.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.22
Rate for Payer: Cigna Commercial	$80.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.49
Rate for Payer: Oxford Commercial	$32.33
Rate for Payer: Qualcare PPO/HMO/WC	$24.25
Rate for Payer: UnitedHealthcare Commercial	$32.33
Rate for Payer: UnitedHealthcare Community & State	$3.90
Rate for Payer: Wellpoint Medicaid Managed Care	$4.28

DEVICE LOOP LIGATING MAJ-254

Facility

$161.65

Hospital Charge Code	270618994
Hospital Revenue Code	272
Min. Negotiated Rate	$24.25
Max. Negotiated Rate	$24.25
Rate for Payer: Qualcare PPO/HMO/WC	$24.25

DEVICE MCV CAPIO SUTR 831-135

Facility

$3,844.00

Hospital Charge Code	270621602
Hospital Revenue Code	278
Min. Negotiated Rate	$92.64
Max. Negotiated Rate	$1,922.00
Rate for Payer: Aetna Commercial	$1,460.72
Rate for Payer: Aetna Medicare Advantage	$1,153.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$980.22
Rate for Payer: Cigna Commercial	$1,922.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$845.68
Rate for Payer: Qualcare PPO/HMO/WC	$576.60
Rate for Payer: UnitedHealthcare Community & State	$92.64
Rate for Payer: Wellpoint Medicaid Managed Care	$101.87

DEVICE MCV CAPIO SUTR 831-135

Facility

$3,844.00

Hospital Charge Code	270621602
Hospital Revenue Code	278
Min. Negotiated Rate	$576.60
Max. Negotiated Rate	$930.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$845.68
Rate for Payer: Qualcare PPO/HMO/WC	$576.60

DEVICE MCV LOCK BILIARY 4527

Facility

$59.25

Hospital Charge Code	270627942
Hospital Revenue Code	272
Min. Negotiated Rate	$8.89
Max. Negotiated Rate	$8.89
Rate for Payer: Qualcare PPO/HMO/WC	$8.89

DEVICE MCV LOCK BILIARY 4527

Facility

$59.25

Hospital Charge Code	270627942
Hospital Revenue Code	272
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$29.62
Rate for Payer: Aetna Commercial	$22.52
Rate for Payer: Aetna Medicare Advantage	$17.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.11
Rate for Payer: Cigna Commercial	$29.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.77
Rate for Payer: Oxford Commercial	$11.85
Rate for Payer: Qualcare PPO/HMO/WC	$8.89
Rate for Payer: UnitedHealthcare Commercial	$11.85
Rate for Payer: UnitedHealthcare Community & State	$1.43
Rate for Payer: Wellpoint Medicaid Managed Care	$1.57

DEVICE MM COMPCT INFLAT IN4125

Facility

$185.65

Hospital Charge Code	270623750
Hospital Revenue Code	272
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$92.83
Rate for Payer: Aetna Commercial	$70.55
Rate for Payer: Aetna Medicare Advantage	$55.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.34
Rate for Payer: Cigna Commercial	$92.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.70
Rate for Payer: Oxford Commercial	$37.13
Rate for Payer: Qualcare PPO/HMO/WC	$27.85
Rate for Payer: UnitedHealthcare Commercial	$37.13
Rate for Payer: UnitedHealthcare Community & State	$4.47
Rate for Payer: Wellpoint Medicaid Managed Care	$4.92

DEVICE MM COMPCT INFLAT IN4125

Facility

$185.65

Hospital Charge Code	270623750
Hospital Revenue Code	272
Min. Negotiated Rate	$27.85
Max. Negotiated Rate	$27.85
Rate for Payer: Qualcare PPO/HMO/WC	$27.85

DEVICE MYOSURE POLYP REMOVAL

Facility

$7,190.10

Hospital Charge Code	270662592
Hospital Revenue Code	272
Min. Negotiated Rate	$173.28
Max. Negotiated Rate	$3,595.05
Rate for Payer: Aetna Commercial	$2,732.24
Rate for Payer: Aetna Medicare Advantage	$2,157.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,833.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,833.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,833.48
Rate for Payer: Cigna Commercial	$3,595.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,157.03
Rate for Payer: Oxford Commercial	$1,438.02
Rate for Payer: Qualcare PPO/HMO/WC	$1,078.52
Rate for Payer: UnitedHealthcare Commercial	$1,438.02
Rate for Payer: UnitedHealthcare Community & State	$173.28
Rate for Payer: Wellpoint Medicaid Managed Care	$190.54

DEVICE MYOSURE POLYP REMOVAL

Facility

$7,190.10

Hospital Charge Code	270662592
Hospital Revenue Code	272
Min. Negotiated Rate	$1,078.52
Max. Negotiated Rate	$1,078.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,078.52

DEVICE NEEDLE LOCK ******

Facility

$2.00

Hospital Charge Code	8003253
Hospital Revenue Code	264
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.76
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.60
Rate for Payer: Oxford Commercial	$0.40
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$0.40
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

DEVICE NEEDLE LOCK ******

Facility

$2.00

Hospital Charge Code	8003253
Hospital Revenue Code	264
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

DEVICE NEEDLE LOCK***

Facility

$1.00

Hospital Charge Code	270301279
Hospital Revenue Code	272
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.38
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.30
Rate for Payer: Oxford Commercial	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.20
Rate for Payer: UnitedHealthcare Community & State	$0.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.03

DEVICE NEEDLE LOCK***

Facility

$1.00

Hospital Charge Code	270301279
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

Know your out-of-pocket cost for care.

All Charges