Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DISSECTING TOOL

Facility

$764.75

Hospital Charge Code	270657887
Hospital Revenue Code	272
Min. Negotiated Rate	$114.71
Max. Negotiated Rate	$114.71
Rate for Payer: Qualcare PPO/HMO/WC	$114.71

DISSECTING TOOL PURPLE

Facility

$755.25

Hospital Charge Code	270657257
Hospital Revenue Code	272
Min. Negotiated Rate	$18.20
Max. Negotiated Rate	$377.62
Rate for Payer: Aetna Commercial	$287.00
Rate for Payer: Aetna Medicare Advantage	$226.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.59
Rate for Payer: Cigna Commercial	$377.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.57
Rate for Payer: Oxford Commercial	$151.05
Rate for Payer: Qualcare PPO/HMO/WC	$113.29
Rate for Payer: UnitedHealthcare Commercial	$151.05
Rate for Payer: UnitedHealthcare Community & State	$18.20
Rate for Payer: Wellpoint Medicaid Managed Care	$20.01

DISSECTING TOOL PURPLE

Facility

$755.25

Hospital Charge Code	270657257
Hospital Revenue Code	272
Min. Negotiated Rate	$113.29
Max. Negotiated Rate	$113.29
Rate for Payer: Qualcare PPO/HMO/WC	$113.29

DISSECTOR 3.5MM x 7CM

Facility

$330.00

Hospital Charge Code	270702077
Hospital Revenue Code	272
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$165.00
Rate for Payer: Aetna Commercial	$125.40
Rate for Payer: Aetna Medicare Advantage	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.15
Rate for Payer: Cigna Commercial	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.00
Rate for Payer: Oxford Commercial	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.50
Rate for Payer: UnitedHealthcare Commercial	$66.00
Rate for Payer: UnitedHealthcare Community & State	$7.95
Rate for Payer: Wellpoint Medicaid Managed Care	$8.74

DISSECTOR 3.5MM x 7CM

Facility

$330.00

Hospital Charge Code	270702077
Hospital Revenue Code	272
Min. Negotiated Rate	$49.50
Max. Negotiated Rate	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$49.50

DISSECTOR BALLN 240CC VBD-240T

Facility

$1,572.85

Hospital Charge Code	270622271
Hospital Revenue Code	272
Min. Negotiated Rate	$235.93
Max. Negotiated Rate	$235.93
Rate for Payer: Qualcare PPO/HMO/WC	$235.93

DISSECTOR BALLN 240CC VBD-240T

Facility

$1,572.85

Hospital Charge Code	270622271
Hospital Revenue Code	272
Min. Negotiated Rate	$37.91
Max. Negotiated Rate	$786.42
Rate for Payer: Aetna Commercial	$597.68
Rate for Payer: Aetna Medicare Advantage	$471.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$401.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$401.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$401.08
Rate for Payer: Cigna Commercial	$786.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.86
Rate for Payer: Oxford Commercial	$314.57
Rate for Payer: Qualcare PPO/HMO/WC	$235.93
Rate for Payer: UnitedHealthcare Commercial	$314.57
Rate for Payer: UnitedHealthcare Community & State	$37.91
Rate for Payer: Wellpoint Medicaid Managed Care	$41.68

DISSECTOR BALLOON OVAL

Facility

$2,744.58

Hospital Charge Code	270655645
Hospital Revenue Code	272
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$1,372.29
Rate for Payer: Aetna Commercial	$1,042.94
Rate for Payer: Aetna Medicare Advantage	$823.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$699.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$699.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$699.87
Rate for Payer: Cigna Commercial	$1,372.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$823.37
Rate for Payer: Oxford Commercial	$548.92
Rate for Payer: Qualcare PPO/HMO/WC	$411.69
Rate for Payer: UnitedHealthcare Commercial	$548.92
Rate for Payer: UnitedHealthcare Community & State	$66.14
Rate for Payer: Wellpoint Medicaid Managed Care	$72.73

DISSECTOR BALLOON OVAL

Facility

$2,744.58

Hospital Charge Code	270655645
Hospital Revenue Code	272
Min. Negotiated Rate	$411.69
Max. Negotiated Rate	$411.69
Rate for Payer: Qualcare PPO/HMO/WC	$411.69

DISSECTOR BALLOON ROUND

Facility

$1,790.60

Service Code	HCPCS C1727
Hospital Charge Code	270665626
Hospital Revenue Code	278
Min. Negotiated Rate	$268.59
Max. Negotiated Rate	$433.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$358.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$393.93
Rate for Payer: Qualcare PPO/HMO/WC	$268.59

DISSECTOR BALLOON ROUND

Facility

$1,790.60

Service Code	HCPCS C1727
Hospital Charge Code	270665626
Hospital Revenue Code	278
Min. Negotiated Rate	$43.15
Max. Negotiated Rate	$895.30
Rate for Payer: Aetna Commercial	$680.43
Rate for Payer: Aetna Medicare Advantage	$537.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$456.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$456.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$358.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$456.60
Rate for Payer: Cigna Commercial	$895.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$393.93
Rate for Payer: Qualcare PPO/HMO/WC	$268.59
Rate for Payer: UnitedHealthcare Community & State	$43.15
Rate for Payer: Wellpoint Medicaid Managed Care	$47.45

DISSECTOR BALLOON SBT ROUND SM

Facility

$6,836.00

Hospital Charge Code	270683704
Hospital Revenue Code	272
Min. Negotiated Rate	$164.75
Max. Negotiated Rate	$3,418.00
Rate for Payer: Aetna Commercial	$2,597.68
Rate for Payer: Aetna Medicare Advantage	$2,050.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.18
Rate for Payer: Cigna Commercial	$3,418.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,050.80
Rate for Payer: Oxford Commercial	$1,367.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,025.40
Rate for Payer: UnitedHealthcare Commercial	$1,367.20
Rate for Payer: UnitedHealthcare Community & State	$164.75
Rate for Payer: Wellpoint Medicaid Managed Care	$181.15

DISSECTOR BALLOON SBT ROUND SM

Facility

$6,836.00

Hospital Charge Code	270683704
Hospital Revenue Code	272
Min. Negotiated Rate	$1,025.40
Max. Negotiated Rate	$1,025.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,025.40

DISSECTOR BLUNT TIP 5MM

Facility

$2,249.25

Hospital Charge Code	270637402
Hospital Revenue Code	272
Min. Negotiated Rate	$337.39
Max. Negotiated Rate	$337.39
Rate for Payer: Qualcare PPO/HMO/WC	$337.39

DISSECTOR BLUNT TIP 5MM

Facility

$2,249.25

Hospital Charge Code	270637402
Hospital Revenue Code	272
Min. Negotiated Rate	$54.21
Max. Negotiated Rate	$1,124.62
Rate for Payer: Aetna Commercial	$854.72
Rate for Payer: Aetna Medicare Advantage	$674.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.56
Rate for Payer: Cigna Commercial	$1,124.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$674.77
Rate for Payer: Oxford Commercial	$449.85
Rate for Payer: Qualcare PPO/HMO/WC	$337.39
Rate for Payer: UnitedHealthcare Commercial	$449.85
Rate for Payer: UnitedHealthcare Community & State	$54.21
Rate for Payer: Wellpoint Medicaid Managed Care	$59.61

DISSECTOR CRVD ULTRASONIC 39MM

Facility

$2,440.00

Service Code	HCPCS A4649
Hospital Charge Code	270696236
Hospital Revenue Code	272
Min. Negotiated Rate	$58.80
Max. Negotiated Rate	$1,220.00
Rate for Payer: Aetna Commercial	$927.20
Rate for Payer: Aetna Medicare Advantage	$732.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$622.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$622.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$622.20
Rate for Payer: Cigna Commercial	$1,220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.00
Rate for Payer: Oxford Commercial	$488.00
Rate for Payer: Qualcare PPO/HMO/WC	$366.00
Rate for Payer: UnitedHealthcare Commercial	$488.00
Rate for Payer: UnitedHealthcare Community & State	$58.80
Rate for Payer: Wellpoint Medicaid Managed Care	$64.66

DISSECTOR CRVD ULTRASONIC 39MM

Facility

$2,440.00

Service Code	HCPCS A4649
Hospital Charge Code	270696236
Hospital Revenue Code	272
Min. Negotiated Rate	$366.00
Max. Negotiated Rate	$366.00
Rate for Payer: Qualcare PPO/HMO/WC	$366.00

DISSECTOR ENDO DISPOSAB RGBRS1

Facility

$925.00

Hospital Charge Code	270641143
Hospital Revenue Code	272
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$138.75
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

DISSECTOR ENDO DISPOSAB RGBRS1

Facility

$925.00

Hospital Charge Code	270641143
Hospital Revenue Code	272
Min. Negotiated Rate	$22.29
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$351.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.50
Rate for Payer: Oxford Commercial	$185.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.75
Rate for Payer: UnitedHealthcare Commercial	$185.00
Rate for Payer: UnitedHealthcare Community & State	$22.29
Rate for Payer: Wellpoint Medicaid Managed Care	$24.51

DISSECTOR ENDO ULTRASONIC 39CM

Facility

$2,040.00

Hospital Charge Code	270683165
Hospital Revenue Code	270
Min. Negotiated Rate	$49.16
Max. Negotiated Rate	$1,020.00
Rate for Payer: Aetna Commercial	$775.20
Rate for Payer: Aetna Medicare Advantage	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$520.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$520.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$520.20
Rate for Payer: Cigna Commercial	$1,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$612.00
Rate for Payer: Oxford Commercial	$408.00
Rate for Payer: Qualcare PPO/HMO/WC	$306.00
Rate for Payer: UnitedHealthcare Commercial	$408.00
Rate for Payer: UnitedHealthcare Community & State	$49.16
Rate for Payer: Wellpoint Medicaid Managed Care	$54.06

DISSECTOR ENDO ULTRASONIC 39CM

Facility

$2,040.00

Hospital Charge Code	270683165
Hospital Revenue Code	270
Min. Negotiated Rate	$306.00
Max. Negotiated Rate	$306.00
Rate for Payer: Qualcare PPO/HMO/WC	$306.00

DISSECTOR GSI BALLOON 174016

Facility

$900.85

Hospital Charge Code	270618803
Hospital Revenue Code	272
Min. Negotiated Rate	$135.13
Max. Negotiated Rate	$135.13
Rate for Payer: Qualcare PPO/HMO/WC	$135.13

DISSECTOR GSI BALLOON 174016

Facility

$900.85

Hospital Charge Code	270618803
Hospital Revenue Code	272
Min. Negotiated Rate	$21.71
Max. Negotiated Rate	$450.43
Rate for Payer: Aetna Commercial	$342.32
Rate for Payer: Aetna Medicare Advantage	$270.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.72
Rate for Payer: Cigna Commercial	$450.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.25
Rate for Payer: Oxford Commercial	$180.17
Rate for Payer: Qualcare PPO/HMO/WC	$135.13
Rate for Payer: UnitedHealthcare Commercial	$180.17
Rate for Payer: UnitedHealthcare Community & State	$21.71
Rate for Payer: Wellpoint Medicaid Managed Care	$23.87

DISSECTOR GSI VAS BALLOON

Facility

$2,966.45

Hospital Charge Code	270605751
Hospital Revenue Code	278
Min. Negotiated Rate	$71.49
Max. Negotiated Rate	$1,483.22
Rate for Payer: Aetna Commercial	$1,127.25
Rate for Payer: Aetna Medicare Advantage	$889.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$756.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$756.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$593.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$756.44
Rate for Payer: Cigna Commercial	$1,483.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$717.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$652.62
Rate for Payer: Qualcare PPO/HMO/WC	$444.97
Rate for Payer: UnitedHealthcare Community & State	$71.49
Rate for Payer: Wellpoint Medicaid Managed Care	$78.61

DISSECTOR GSI VAS BALLOON

Facility

$2,966.45

Hospital Charge Code	270605751
Hospital Revenue Code	278
Min. Negotiated Rate	$444.97
Max. Negotiated Rate	$717.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$593.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$717.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$652.62
Rate for Payer: Qualcare PPO/HMO/WC	$444.97

Know your out-of-pocket cost for care.

All Charges