Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DHEA-SULFATE

Facility

$306.45

Service Code	HCPCS 82627
Hospital Charge Code	3006194
Hospital Revenue Code	301
Min. Negotiated Rate	$8.12
Max. Negotiated Rate	$153.22
Rate for Payer: Aetna Commercial	$60.47
Rate for Payer: Aetna Medicare Advantage	$72.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.24
Rate for Payer: Cigna Commercial	$153.22
Rate for Payer: Cigna Medicare Advantage	$22.23
Rate for Payer: Clover Medicare Advantage	$21.12
Rate for Payer: EmblemHealth Commercial	$66.69
Rate for Payer: Humana Medicare Advantage	$22.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.94
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.97
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$17.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.23
Rate for Payer: Wellcare Medicare Advantage	$22.23
Rate for Payer: Wellpoint Medicaid Managed Care	$8.12

DHEA-SULFATE

Facility

$306.45

Service Code	HCPCS 82627
Hospital Charge Code	3006194
Hospital Revenue Code	301
Min. Negotiated Rate	$45.97
Max. Negotiated Rate	$45.97
Rate for Payer: Qualcare PPO/HMO/WC	$45.97

D-HELP DEFOGGER

Facility

$279.31

Hospital Charge Code	270664269
Hospital Revenue Code	272
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$139.66
Rate for Payer: Aetna Commercial	$106.14
Rate for Payer: Aetna Medicare Advantage	$83.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.22
Rate for Payer: Cigna Commercial	$139.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.79
Rate for Payer: Oxford Commercial	$55.86
Rate for Payer: Qualcare PPO/HMO/WC	$41.90
Rate for Payer: UnitedHealthcare Commercial	$55.86
Rate for Payer: UnitedHealthcare Community & State	$6.73
Rate for Payer: Wellpoint Medicaid Managed Care	$7.40

D-HELP DEFOGGER

Facility

$279.31

Hospital Charge Code	270664269
Hospital Revenue Code	272
Min. Negotiated Rate	$41.90
Max. Negotiated Rate	$41.90
Rate for Payer: Qualcare PPO/HMO/WC	$41.90

DHS COMPRESSION SCREW

Facility

$192.55

Service Code	HCPCS C1713
Hospital Charge Code	270682626
Hospital Revenue Code	278
Min. Negotiated Rate	$4.64
Max. Negotiated Rate	$96.28
Rate for Payer: Aetna Commercial	$73.17
Rate for Payer: Aetna Medicare Advantage	$57.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.10
Rate for Payer: Cigna Commercial	$96.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.36
Rate for Payer: Qualcare PPO/HMO/WC	$28.88
Rate for Payer: UnitedHealthcare Community & State	$4.64
Rate for Payer: Wellpoint Medicaid Managed Care	$5.10

DHS COMPRESSION SCREW

Facility

$192.55

Service Code	HCPCS C1713
Hospital Charge Code	270682626
Hospital Revenue Code	278
Min. Negotiated Rate	$28.88
Max. Negotiated Rate	$46.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.36
Rate for Payer: Qualcare PPO/HMO/WC	$28.88

DHS/DCS COUPLING SCREW LONG

Facility

$479.40

Service Code	HCPCS C1713
Hospital Charge Code	270687790
Hospital Revenue Code	278
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$239.70
Rate for Payer: Aetna Commercial	$182.17
Rate for Payer: Aetna Medicare Advantage	$143.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.25
Rate for Payer: Cigna Commercial	$239.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$105.47
Rate for Payer: Qualcare PPO/HMO/WC	$71.91
Rate for Payer: UnitedHealthcare Community & State	$11.55
Rate for Payer: Wellpoint Medicaid Managed Care	$12.70

DHS/DCS COUPLING SCREW LONG

Facility

$479.40

Service Code	HCPCS C1713
Hospital Charge Code	270687790
Hospital Revenue Code	278
Min. Negotiated Rate	$71.91
Max. Negotiated Rate	$116.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$105.47
Rate for Payer: Qualcare PPO/HMO/WC	$71.91

DHS/DCS WRENCH

Facility

$695.60

Hospital Charge Code	270687789
Hospital Revenue Code	272
Min. Negotiated Rate	$16.76
Max. Negotiated Rate	$347.80
Rate for Payer: Aetna Commercial	$264.33
Rate for Payer: Aetna Medicare Advantage	$208.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.38
Rate for Payer: Cigna Commercial	$347.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.68
Rate for Payer: Oxford Commercial	$139.12
Rate for Payer: Qualcare PPO/HMO/WC	$104.34
Rate for Payer: UnitedHealthcare Commercial	$139.12
Rate for Payer: UnitedHealthcare Community & State	$16.76
Rate for Payer: Wellpoint Medicaid Managed Care	$18.43

DHS/DCS WRENCH

Facility

$695.60

Hospital Charge Code	270687789
Hospital Revenue Code	272
Min. Negotiated Rate	$104.34
Max. Negotiated Rate	$104.34
Rate for Payer: Qualcare PPO/HMO/WC	$104.34

DHS LAG SCREW-90MM

Facility

$1,495.85

Service Code	HCPCS C1713
Hospital Charge Code	270682627
Hospital Revenue Code	278
Min. Negotiated Rate	$36.05
Max. Negotiated Rate	$747.92
Rate for Payer: Aetna Commercial	$568.42
Rate for Payer: Aetna Medicare Advantage	$448.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$381.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$381.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$381.44
Rate for Payer: Cigna Commercial	$747.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$362.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$329.09
Rate for Payer: Qualcare PPO/HMO/WC	$224.38
Rate for Payer: UnitedHealthcare Community & State	$36.05
Rate for Payer: Wellpoint Medicaid Managed Care	$39.64

DHS LAG SCREW-90MM

Facility

$1,495.85

Service Code	HCPCS C1713
Hospital Charge Code	270682627
Hospital Revenue Code	278
Min. Negotiated Rate	$224.38
Max. Negotiated Rate	$362.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$362.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$329.09
Rate for Payer: Qualcare PPO/HMO/WC	$224.38

DHS PLATE

Facility

$785.00

Hospital Charge Code	270335052
Hospital Revenue Code	278
Min. Negotiated Rate	$18.92
Max. Negotiated Rate	$392.50
Rate for Payer: Aetna Commercial	$298.30
Rate for Payer: Aetna Medicare Advantage	$235.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.18
Rate for Payer: Cigna Commercial	$392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$172.70
Rate for Payer: Qualcare PPO/HMO/WC	$117.75
Rate for Payer: UnitedHealthcare Community & State	$18.92
Rate for Payer: Wellpoint Medicaid Managed Care	$20.80

DHS PLATE

Facility

$785.00

Hospital Charge Code	270335052
Hospital Revenue Code	278
Min. Negotiated Rate	$117.75
Max. Negotiated Rate	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$172.70
Rate for Payer: Qualcare PPO/HMO/WC	$117.75

DHS PLATE135/2HOLE/46MM

Facility

$2,555.70

Service Code	HCPCS C1713
Hospital Charge Code	270682725
Hospital Revenue Code	278
Min. Negotiated Rate	$383.36
Max. Negotiated Rate	$618.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$511.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$618.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$562.25
Rate for Payer: Qualcare PPO/HMO/WC	$383.36

DHS PLATE135/2HOLE/46MM

Facility

$2,555.70

Service Code	HCPCS C1713
Hospital Charge Code	270682725
Hospital Revenue Code	278
Min. Negotiated Rate	$61.59
Max. Negotiated Rate	$1,277.85
Rate for Payer: Aetna Commercial	$971.17
Rate for Payer: Aetna Medicare Advantage	$766.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$651.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$651.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$511.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$651.70
Rate for Payer: Cigna Commercial	$1,277.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$618.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$562.25
Rate for Payer: Qualcare PPO/HMO/WC	$383.36
Rate for Payer: UnitedHealthcare Community & State	$61.59
Rate for Payer: Wellpoint Medicaid Managed Care	$67.73

DHSREAMING HEAD STANDARD

Facility

$2,934.45

Hospital Charge Code	270683136
Hospital Revenue Code	272
Min. Negotiated Rate	$440.17
Max. Negotiated Rate	$440.17
Rate for Payer: Qualcare PPO/HMO/WC	$440.17

DHSREAMING HEAD STANDARD

Facility

$2,934.45

Hospital Charge Code	270683136
Hospital Revenue Code	272
Min. Negotiated Rate	$70.72
Max. Negotiated Rate	$1,467.22
Rate for Payer: Aetna Commercial	$1,115.09
Rate for Payer: Aetna Medicare Advantage	$880.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$748.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$748.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$748.28
Rate for Payer: Cigna Commercial	$1,467.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$880.34
Rate for Payer: Oxford Commercial	$586.89
Rate for Payer: Qualcare PPO/HMO/WC	$440.17
Rate for Payer: UnitedHealthcare Commercial	$586.89
Rate for Payer: UnitedHealthcare Community & State	$70.72
Rate for Payer: Wellpoint Medicaid Managed Care	$77.76

DHT/0.125MG/TAB

Facility

$6.00

Hospital Charge Code	60632816
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

DHT/0.125MG/TAB

Facility

$6.00

Hospital Charge Code	60632816
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

DHT/0.2MG/TAB

Facility

$6.00

Hospital Charge Code	60632814
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

DHT/0.2MG/TAB

Facility

$6.00

Hospital Charge Code	60632813
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

DHT/0.2MG/TAB

Facility

$6.00

Hospital Charge Code	60632813
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

DHT/0.2MG/TAB

Facility

$6.00

Hospital Charge Code	60632814
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

DHT/0.4MG/TAB

Facility

$6.00

Hospital Charge Code	60632815
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

Know your out-of-pocket cost for care.

All Charges