Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DISSECTOR SONICISION 39CM

Facility

$2,074.00

Hospital Charge Code	270696171
Hospital Revenue Code	272
Min. Negotiated Rate	$49.98
Max. Negotiated Rate	$1,037.00
Rate for Payer: Aetna Commercial	$788.12
Rate for Payer: Aetna Medicare Advantage	$622.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$528.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$528.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$528.87
Rate for Payer: Cigna Commercial	$1,037.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$622.20
Rate for Payer: Oxford Commercial	$414.80
Rate for Payer: Qualcare PPO/HMO/WC	$311.10
Rate for Payer: UnitedHealthcare Commercial	$414.80
Rate for Payer: UnitedHealthcare Community & State	$49.98
Rate for Payer: Wellpoint Medicaid Managed Care	$54.96

DISSECTOR SONICISION 39CM

Facility

$2,074.00

Hospital Charge Code	270696171
Hospital Revenue Code	272
Min. Negotiated Rate	$311.10
Max. Negotiated Rate	$311.10
Rate for Payer: Qualcare PPO/HMO/WC	$311.10

DISSECTOR SPACEMAKER BALLOON

Facility

$1,750.00

Hospital Charge Code	270658705
Hospital Revenue Code	272
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$525.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

DISSECTOR SPACEMAKER BALLOON

Facility

$1,750.00

Hospital Charge Code	270658705
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

DISSECTOR TIP DOLP NOSE 3312

Facility

$332.50

Hospital Charge Code	270641140
Hospital Revenue Code	272
Min. Negotiated Rate	$49.88
Max. Negotiated Rate	$49.88
Rate for Payer: Qualcare PPO/HMO/WC	$49.88

DISSECTOR TIP DOLP NOSE 3312

Facility

$332.50

Hospital Charge Code	270641140
Hospital Revenue Code	272
Min. Negotiated Rate	$8.01
Max. Negotiated Rate	$166.25
Rate for Payer: Aetna Commercial	$126.35
Rate for Payer: Aetna Medicare Advantage	$99.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.79
Rate for Payer: Cigna Commercial	$166.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.75
Rate for Payer: Oxford Commercial	$66.50
Rate for Payer: Qualcare PPO/HMO/WC	$49.88
Rate for Payer: UnitedHealthcare Commercial	$66.50
Rate for Payer: UnitedHealthcare Community & State	$8.01
Rate for Payer: Wellpoint Medicaid Managed Care	$8.81

DISSOLVE CLOT HEART VESSEL

Facility

$35,998.44

Service Code	HCPCS 93799
Hospital Charge Code	411092975
Hospital Revenue Code	481
Min. Negotiated Rate	$145.23
Max. Negotiated Rate	$10,799.53
Rate for Payer: Aetna Commercial	$415.81
Rate for Payer: Aetna Medicare Advantage	$495.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$551.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$551.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$152.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$551.81
Rate for Payer: Cigna Commercial	$306.43
Rate for Payer: Cigna Medicare Advantage	$152.87
Rate for Payer: Clover Medicare Advantage	$145.23
Rate for Payer: EmblemHealth Commercial	$458.61
Rate for Payer: Humana Medicare Advantage	$157.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$152.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,799.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$867.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$152.87
Rate for Payer: Wellcare Medicare Advantage	$152.87
Rate for Payer: Wellpoint Medicaid Managed Care	$953.96

DISSOLVE CLOT HEART VESSEL

Facility

$35,998.44

Service Code	HCPCS 93799
Hospital Charge Code	411092975
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

DISTAL 5MM FEMORAL SZ 1

Facility

$3,861.00

Hospital Charge Code	270670057
Hospital Revenue Code	278
Min. Negotiated Rate	$93.05
Max. Negotiated Rate	$1,930.50
Rate for Payer: Aetna Commercial	$1,467.18
Rate for Payer: Aetna Medicare Advantage	$1,158.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$984.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$984.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$772.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$984.55
Rate for Payer: Cigna Commercial	$1,930.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$934.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$849.42
Rate for Payer: Qualcare PPO/HMO/WC	$579.15
Rate for Payer: UnitedHealthcare Community & State	$93.05
Rate for Payer: Wellpoint Medicaid Managed Care	$102.32

DISTAL 5MM FEMORAL SZ 1

Facility

$3,861.00

Hospital Charge Code	270670057
Hospital Revenue Code	278
Min. Negotiated Rate	$579.15
Max. Negotiated Rate	$934.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$772.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$934.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$849.42
Rate for Payer: Qualcare PPO/HMO/WC	$579.15

DISTAL BICEPS REPAIR IMPLANT

Facility

$4,250.00

Hospital Charge Code	270656505
Hospital Revenue Code	278
Min. Negotiated Rate	$102.42
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$935.00
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Community & State	$102.42
Rate for Payer: Wellpoint Medicaid Managed Care	$112.62

DISTAL BICEPS REPAIR IMPLANT

Facility

$4,250.00

Hospital Charge Code	270656505
Hospital Revenue Code	278
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$1,028.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$935.00
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

DISTAL FINGER TUMOR

Facility

$9,636.95

Service Code	HCPCS 26262
Hospital Charge Code	1600000810
Hospital Revenue Code	360
Min. Negotiated Rate	$1,445.54
Max. Negotiated Rate	$1,445.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,445.54

DISTAL FINGER TUMOR

Facility

$9,636.95

Service Code	HCPCS 26262
Hospital Charge Code	1600000810
Hospital Revenue Code	360
Min. Negotiated Rate	$232.25
Max. Negotiated Rate	$6,895.75
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.09
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,445.54
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$232.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$255.38

DISTAL FIXATION RING 22.5mm

Facility

$8,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270679732
Hospital Revenue Code	278
Min. Negotiated Rate	$206.66
Max. Negotiated Rate	$4,287.50
Rate for Payer: Aetna Commercial	$3,258.50
Rate for Payer: Aetna Medicare Advantage	$2,572.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,186.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,186.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,715.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,186.62
Rate for Payer: Cigna Commercial	$4,287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,075.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,886.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,286.25
Rate for Payer: UnitedHealthcare Community & State	$206.66
Rate for Payer: Wellpoint Medicaid Managed Care	$227.24

DISTAL FIXATION RING 22.5mm

Facility

$8,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270679732
Hospital Revenue Code	278
Min. Negotiated Rate	$1,286.25
Max. Negotiated Rate	$2,075.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,075.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,886.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,286.25

DISTAL LAT. FIBULAR LOCKING PL

Facility

$3,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270665201
Hospital Revenue Code	278
Min. Negotiated Rate	$86.76
Max. Negotiated Rate	$1,800.00
Rate for Payer: Aetna Commercial	$1,368.00
Rate for Payer: Aetna Medicare Advantage	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$918.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$918.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$918.00
Rate for Payer: Cigna Commercial	$1,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$792.00
Rate for Payer: Qualcare PPO/HMO/WC	$540.00
Rate for Payer: UnitedHealthcare Community & State	$86.76
Rate for Payer: Wellpoint Medicaid Managed Care	$95.40

DISTAL LAT. FIBULAR LOCKING PL

Facility

$3,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270665201
Hospital Revenue Code	278
Min. Negotiated Rate	$540.00
Max. Negotiated Rate	$871.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$792.00
Rate for Payer: Qualcare PPO/HMO/WC	$540.00

DISTAL LTRAL FIBULR PLT 4H LT

Facility

$2,156.95

Hospital Charge Code	270663179
Hospital Revenue Code	270
Min. Negotiated Rate	$323.54
Max. Negotiated Rate	$323.54
Rate for Payer: Qualcare PPO/HMO/WC	$323.54

DISTAL LTRAL FIBULR PLT 4H LT

Facility

$2,156.95

Hospital Charge Code	270663179
Hospital Revenue Code	270
Min. Negotiated Rate	$51.98
Max. Negotiated Rate	$1,078.47
Rate for Payer: Aetna Commercial	$819.64
Rate for Payer: Aetna Medicare Advantage	$647.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$550.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$550.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$550.02
Rate for Payer: Cigna Commercial	$1,078.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$647.09
Rate for Payer: Oxford Commercial	$431.39
Rate for Payer: Qualcare PPO/HMO/WC	$323.54
Rate for Payer: UnitedHealthcare Commercial	$431.39
Rate for Payer: UnitedHealthcare Community & State	$51.98
Rate for Payer: Wellpoint Medicaid Managed Care	$57.16

DISTAL PLATE

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687654
Hospital Revenue Code	278
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

DISTAL PLATE

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687654
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

DISTAL POSTERER LATERAL PLATE

Facility

$2,557.15

Hospital Charge Code	270656987
Hospital Revenue Code	278
Min. Negotiated Rate	$61.63
Max. Negotiated Rate	$1,278.58
Rate for Payer: Aetna Commercial	$971.72
Rate for Payer: Aetna Medicare Advantage	$767.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$652.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$652.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$511.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$652.07
Rate for Payer: Cigna Commercial	$1,278.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$618.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$562.57
Rate for Payer: Qualcare PPO/HMO/WC	$383.57
Rate for Payer: UnitedHealthcare Community & State	$61.63
Rate for Payer: Wellpoint Medicaid Managed Care	$67.76

DISTAL POSTERER LATERAL PLATE

Facility

$2,557.15

Hospital Charge Code	270656987
Hospital Revenue Code	278
Min. Negotiated Rate	$383.57
Max. Negotiated Rate	$618.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$511.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$618.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$562.57
Rate for Payer: Qualcare PPO/HMO/WC	$383.57

DISTAL RADIAL PLATE 3 HOLE

Facility

$8,224.30

Service Code	HCPCS C1713
Hospital Charge Code	270704349
Hospital Revenue Code	278
Min. Negotiated Rate	$198.21
Max. Negotiated Rate	$4,112.15
Rate for Payer: Aetna Commercial	$3,125.23
Rate for Payer: Aetna Medicare Advantage	$2,467.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,097.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,097.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,644.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,097.20
Rate for Payer: Cigna Commercial	$4,112.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,990.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,809.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,233.64
Rate for Payer: UnitedHealthcare Community & State	$198.21
Rate for Payer: Wellpoint Medicaid Managed Care	$217.94

Know your out-of-pocket cost for care.

All Charges