Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ELECTRODE LOOP 20x12 DLPW11

Facility

$75.00

Hospital Charge Code	270632344
Hospital Revenue Code	272
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

ELECTRODE LOOP 20x12 DLPW11

Facility

$75.00

Hospital Charge Code	270632344
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

ELECTRODE LOOP 24FR

Facility

$662.50

Hospital Charge Code	270657516
Hospital Revenue Code	270
Min. Negotiated Rate	$99.38
Max. Negotiated Rate	$99.38
Rate for Payer: Qualcare PPO/HMO/WC	$99.38

ELECTRODE LOOP 24FR

Facility

$662.50

Hospital Charge Code	270657516
Hospital Revenue Code	270
Min. Negotiated Rate	$15.97
Max. Negotiated Rate	$331.25
Rate for Payer: Aetna Commercial	$251.75
Rate for Payer: Aetna Medicare Advantage	$198.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.94
Rate for Payer: Cigna Commercial	$331.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.75
Rate for Payer: Oxford Commercial	$132.50
Rate for Payer: Qualcare PPO/HMO/WC	$99.38
Rate for Payer: UnitedHealthcare Commercial	$132.50
Rate for Payer: UnitedHealthcare Community & State	$15.97
Rate for Payer: Wellpoint Medicaid Managed Care	$17.56

ELECTRODE LOOP GREEN 10X12mm

Facility

$75.00

Hospital Charge Code	270620072
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

ELECTRODE LOOP GREEN 10X12mm

Facility

$75.00

Hospital Charge Code	270620072
Hospital Revenue Code	272
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

ELECTRODE LOOP HF RESECT 26 FR

Facility

$5,860.05

Hospital Charge Code	270657327
Hospital Revenue Code	272
Min. Negotiated Rate	$879.01
Max. Negotiated Rate	$879.01
Rate for Payer: Qualcare PPO/HMO/WC	$879.01

ELECTRODE LOOP HF RESECT 26 FR

Facility

$5,860.05

Hospital Charge Code	270657327
Hospital Revenue Code	272
Min. Negotiated Rate	$141.23
Max. Negotiated Rate	$2,930.03
Rate for Payer: Aetna Commercial	$2,226.82
Rate for Payer: Aetna Medicare Advantage	$1,758.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,494.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,494.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,494.31
Rate for Payer: Cigna Commercial	$2,930.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,758.02
Rate for Payer: Oxford Commercial	$1,172.01
Rate for Payer: Qualcare PPO/HMO/WC	$879.01
Rate for Payer: UnitedHealthcare Commercial	$1,172.01
Rate for Payer: UnitedHealthcare Community & State	$141.23
Rate for Payer: Wellpoint Medicaid Managed Care	$155.29

ELECTRODE LOOP LLETZ 12x15MM

Facility

$65.50

Hospital Charge Code	270677127
Hospital Revenue Code	272
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$32.75
Rate for Payer: Aetna Commercial	$24.89
Rate for Payer: Aetna Medicare Advantage	$19.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.70
Rate for Payer: Cigna Commercial	$32.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.65
Rate for Payer: Oxford Commercial	$13.10
Rate for Payer: Qualcare PPO/HMO/WC	$9.82
Rate for Payer: UnitedHealthcare Commercial	$13.10
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.74

ELECTRODE LOOP LLETZ 12x15MM

Facility

$65.50

Hospital Charge Code	270677127
Hospital Revenue Code	272
Min. Negotiated Rate	$9.82
Max. Negotiated Rate	$9.82
Rate for Payer: Qualcare PPO/HMO/WC	$9.82

ELECTRODE LOOP SMALL E1559

Facility

$68.42

Hospital Charge Code	270600259
Hospital Revenue Code	272
Min. Negotiated Rate	$10.26
Max. Negotiated Rate	$10.26
Rate for Payer: Qualcare PPO/HMO/WC	$10.26

ELECTRODE LOOP SMALL E1559

Facility

$68.42

Hospital Charge Code	270600259
Hospital Revenue Code	272
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$34.21
Rate for Payer: Aetna Commercial	$26.00
Rate for Payer: Aetna Medicare Advantage	$20.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.45
Rate for Payer: Cigna Commercial	$34.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.53
Rate for Payer: Oxford Commercial	$13.68
Rate for Payer: Qualcare PPO/HMO/WC	$10.26
Rate for Payer: UnitedHealthcare Commercial	$13.68
Rate for Payer: UnitedHealthcare Community & State	$1.65
Rate for Payer: Wellpoint Medicaid Managed Care	$1.81

ELECTRODE LOOP WIDE E1561

Facility

$181.65

Hospital Charge Code	270600258
Hospital Revenue Code	272
Min. Negotiated Rate	$4.38
Max. Negotiated Rate	$90.83
Rate for Payer: Aetna Commercial	$69.03
Rate for Payer: Aetna Medicare Advantage	$54.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.32
Rate for Payer: Cigna Commercial	$90.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.49
Rate for Payer: Oxford Commercial	$36.33
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$36.33
Rate for Payer: UnitedHealthcare Community & State	$4.38
Rate for Payer: Wellpoint Medicaid Managed Care	$4.81

ELECTRODE LOOP WIDE E1561

Facility

$181.65

Hospital Charge Code	270600258
Hospital Revenue Code	272
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

ELECTRODE LP 225361

Facility

$1,075.00

Hospital Charge Code	270638397
Hospital Revenue Code	270
Min. Negotiated Rate	$25.91
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.50
Rate for Payer: Oxford Commercial	$215.00
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Commercial	$215.00
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$28.49

ELECTRODE LP 225361

Facility

$1,075.00

Hospital Charge Code	270638397
Hospital Revenue Code	270
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$161.25
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

Electrode Meditrace 455

Facility

$2.40

Hospital Charge Code	270649777
Hospital Revenue Code	270
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.20
Rate for Payer: Aetna Commercial	$0.91
Rate for Payer: Aetna Medicare Advantage	$0.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.61
Rate for Payer: Cigna Commercial	$1.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.72
Rate for Payer: Oxford Commercial	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.36
Rate for Payer: UnitedHealthcare Commercial	$0.48
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

Electrode Meditrace 455

Facility

$2.40

Hospital Charge Code	270649777
Hospital Revenue Code	270
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.36
Rate for Payer: Qualcare PPO/HMO/WC	$0.36

ELECTRODE MENISECTOMY 9735B

Facility

$604.85

Hospital Charge Code	270600373
Hospital Revenue Code	272
Min. Negotiated Rate	$90.73
Max. Negotiated Rate	$90.73
Rate for Payer: Qualcare PPO/HMO/WC	$90.73

ELECTRODE MENISECTOMY 9735B

Facility

$604.85

Hospital Charge Code	270600373
Hospital Revenue Code	272
Min. Negotiated Rate	$14.58
Max. Negotiated Rate	$302.43
Rate for Payer: Aetna Commercial	$229.84
Rate for Payer: Aetna Medicare Advantage	$181.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.24
Rate for Payer: Cigna Commercial	$302.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.46
Rate for Payer: Oxford Commercial	$120.97
Rate for Payer: Qualcare PPO/HMO/WC	$90.73
Rate for Payer: UnitedHealthcare Commercial	$120.97
Rate for Payer: UnitedHealthcare Community & State	$14.58
Rate for Payer: Wellpoint Medicaid Managed Care	$16.03

ELECTRODE MENISECTOMY BASIC***

Facility

$96.00

Hospital Charge Code	1606219
Hospital Revenue Code	272
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$48.00
Rate for Payer: Aetna Commercial	$36.48
Rate for Payer: Aetna Medicare Advantage	$28.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.48
Rate for Payer: Cigna Commercial	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.80
Rate for Payer: Oxford Commercial	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$14.40
Rate for Payer: UnitedHealthcare Commercial	$19.20
Rate for Payer: UnitedHealthcare Community & State	$2.31
Rate for Payer: Wellpoint Medicaid Managed Care	$2.54

ELECTRODE MENISECTOMY BASIC***

Facility

$96.00

Hospital Charge Code	1606219
Hospital Revenue Code	272
Min. Negotiated Rate	$14.40
Max. Negotiated Rate	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$14.40

ELECTRODE MTK STR 225301

Facility

$1,035.25

Hospital Charge Code	270619099
Hospital Revenue Code	272
Min. Negotiated Rate	$155.29
Max. Negotiated Rate	$155.29
Rate for Payer: Qualcare PPO/HMO/WC	$155.29

ELECTRODE MTK STR 225301

Facility

$1,035.25

Hospital Charge Code	270619099
Hospital Revenue Code	272
Min. Negotiated Rate	$24.95
Max. Negotiated Rate	$517.62
Rate for Payer: Aetna Commercial	$393.39
Rate for Payer: Aetna Medicare Advantage	$310.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.99
Rate for Payer: Cigna Commercial	$517.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.57
Rate for Payer: Oxford Commercial	$207.05
Rate for Payer: Qualcare PPO/HMO/WC	$155.29
Rate for Payer: UnitedHealthcare Commercial	$207.05
Rate for Payer: UnitedHealthcare Community & State	$24.95
Rate for Payer: Wellpoint Medicaid Managed Care	$27.43

ELECTRODE MTK THERM 3.5 225101

Facility

$1,441.65

Hospital Charge Code	270619911
Hospital Revenue Code	272
Min. Negotiated Rate	$216.25
Max. Negotiated Rate	$216.25
Rate for Payer: Qualcare PPO/HMO/WC	$216.25

Know your out-of-pocket cost for care.

All Charges