Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ENDO CANNULA FLOWPORT II

Facility

$1,445.00

Hospital Charge Code	270668508
Hospital Revenue Code	272
Min. Negotiated Rate	$34.82
Max. Negotiated Rate	$722.50
Rate for Payer: Aetna Commercial	$549.10
Rate for Payer: Aetna Medicare Advantage	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$368.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$368.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$368.48
Rate for Payer: Cigna Commercial	$722.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.50
Rate for Payer: Oxford Commercial	$289.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.75
Rate for Payer: UnitedHealthcare Commercial	$289.00
Rate for Payer: UnitedHealthcare Community & State	$34.82
Rate for Payer: Wellpoint Medicaid Managed Care	$38.29

ENDO CANNULA TRANSPORT

Facility

$450.00

Hospital Charge Code	270668506
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

ENDO CANNULA TRANSPORT

Facility

$450.00

Hospital Charge Code	270668506
Hospital Revenue Code	272
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.00
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$90.00
Rate for Payer: UnitedHealthcare Community & State	$10.85
Rate for Payer: Wellpoint Medicaid Managed Care	$11.93

ENDO CATCH *******

Facility

$494.00

Hospital Charge Code	1603521
Hospital Revenue Code	272
Min. Negotiated Rate	$74.10
Max. Negotiated Rate	$74.10
Rate for Payer: Qualcare PPO/HMO/WC	$74.10

ENDO CATCH *******

Facility

$494.00

Hospital Charge Code	1603521
Hospital Revenue Code	272
Min. Negotiated Rate	$11.91
Max. Negotiated Rate	$247.00
Rate for Payer: Aetna Commercial	$187.72
Rate for Payer: Aetna Medicare Advantage	$148.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.97
Rate for Payer: Cigna Commercial	$247.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.20
Rate for Payer: Oxford Commercial	$98.80
Rate for Payer: Qualcare PPO/HMO/WC	$74.10
Rate for Payer: UnitedHealthcare Commercial	$98.80
Rate for Payer: UnitedHealthcare Community & State	$11.91
Rate for Payer: Wellpoint Medicaid Managed Care	$13.09

ENDO CATCH GOLD POUCH 10MM

Facility

$2,028.10

Hospital Charge Code	270600099
Hospital Revenue Code	272
Min. Negotiated Rate	$48.88
Max. Negotiated Rate	$1,014.05
Rate for Payer: Aetna Commercial	$770.68
Rate for Payer: Aetna Medicare Advantage	$608.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$517.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$517.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$517.17
Rate for Payer: Cigna Commercial	$1,014.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$608.43
Rate for Payer: Oxford Commercial	$405.62
Rate for Payer: Qualcare PPO/HMO/WC	$304.21
Rate for Payer: UnitedHealthcare Commercial	$405.62
Rate for Payer: UnitedHealthcare Community & State	$48.88
Rate for Payer: Wellpoint Medicaid Managed Care	$53.74

ENDO CATCH GOLD POUCH 10MM

Facility

$2,028.10

Hospital Charge Code	270600099
Hospital Revenue Code	272
Min. Negotiated Rate	$304.21
Max. Negotiated Rate	$304.21
Rate for Payer: Qualcare PPO/HMO/WC	$304.21

ENDO CATCH II ********

Facility

$464.00

Hospital Charge Code	1606599
Hospital Revenue Code	278
Min. Negotiated Rate	$69.60
Max. Negotiated Rate	$112.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$102.08
Rate for Payer: Qualcare PPO/HMO/WC	$69.60

ENDO CATCH II ********

Facility

$464.00

Hospital Charge Code	1606599
Hospital Revenue Code	278
Min. Negotiated Rate	$11.18
Max. Negotiated Rate	$232.00
Rate for Payer: Aetna Commercial	$176.32
Rate for Payer: Aetna Medicare Advantage	$139.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.32
Rate for Payer: Cigna Commercial	$232.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$102.08
Rate for Payer: Qualcare PPO/HMO/WC	$69.60
Rate for Payer: UnitedHealthcare Community & State	$11.18
Rate for Payer: Wellpoint Medicaid Managed Care	$12.30

ENDO CATCH SPECIMEN POUCH 10mm

Facility

$316.20

Hospital Charge Code	270657207
Hospital Revenue Code	272
Min. Negotiated Rate	$47.43
Max. Negotiated Rate	$47.43
Rate for Payer: Qualcare PPO/HMO/WC	$47.43

ENDO CATCH SPECIMEN POUCH 10mm

Facility

$316.20

Hospital Charge Code	270657207
Hospital Revenue Code	272
Min. Negotiated Rate	$7.62
Max. Negotiated Rate	$158.10
Rate for Payer: Aetna Commercial	$120.16
Rate for Payer: Aetna Medicare Advantage	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.63
Rate for Payer: Cigna Commercial	$158.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.86
Rate for Payer: Oxford Commercial	$63.24
Rate for Payer: Qualcare PPO/HMO/WC	$47.43
Rate for Payer: UnitedHealthcare Commercial	$63.24
Rate for Payer: UnitedHealthcare Community & State	$7.62
Rate for Payer: Wellpoint Medicaid Managed Care	$8.38

ENDO CATH II 15MM POUCH SPECIM

Facility

$1,800.97

Hospital Charge Code	270622365
Hospital Revenue Code	272
Min. Negotiated Rate	$270.15
Max. Negotiated Rate	$270.15
Rate for Payer: Qualcare PPO/HMO/WC	$270.15

ENDO CATH II 15MM POUCH SPECIM

Facility

$1,800.97

Hospital Charge Code	270622365
Hospital Revenue Code	272
Min. Negotiated Rate	$43.40
Max. Negotiated Rate	$900.49
Rate for Payer: Aetna Commercial	$684.37
Rate for Payer: Aetna Medicare Advantage	$540.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.25
Rate for Payer: Cigna Commercial	$900.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$540.29
Rate for Payer: Oxford Commercial	$360.19
Rate for Payer: Qualcare PPO/HMO/WC	$270.15
Rate for Payer: UnitedHealthcare Commercial	$360.19
Rate for Payer: UnitedHealthcare Community & State	$43.40
Rate for Payer: Wellpoint Medicaid Managed Care	$47.73

ENDOCERV CURETTAGE W/SCOPE

Facility

$1,573.30

Service Code	HCPCS 57456
Hospital Charge Code	412357456
Hospital Revenue Code	361
Min. Negotiated Rate	$37.92
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$984.72
Rate for Payer: Aetna Medicare Advantage	$1,172.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,306.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,306.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$362.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,306.82
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: Cigna Medicare Advantage	$362.03
Rate for Payer: Clover Medicare Advantage	$343.93
Rate for Payer: EmblemHealth Commercial	$1,086.09
Rate for Payer: Humana Medicare Advantage	$372.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$362.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.99
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$236.00
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$37.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$362.03
Rate for Payer: Wellcare Medicare Advantage	$362.03
Rate for Payer: Wellpoint Medicaid Managed Care	$41.69

ENDOCERV CURETTAGE W/SCOPE

Facility

$1,573.30

Service Code	HCPCS 57456
Hospital Charge Code	412357456
Hospital Revenue Code	361
Min. Negotiated Rate	$236.00
Max. Negotiated Rate	$236.00
Rate for Payer: Qualcare PPO/HMO/WC	$236.00

ENDO CHANNEL TUBING

Facility

$32.50

Hospital Charge Code	270658747
Hospital Revenue Code	270
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$4.88
Rate for Payer: Qualcare PPO/HMO/WC	$4.88

ENDO CHANNEL TUBING

Facility

$32.50

Hospital Charge Code	270658747
Hospital Revenue Code	270
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$16.25
Rate for Payer: Aetna Commercial	$12.35
Rate for Payer: Aetna Medicare Advantage	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.29
Rate for Payer: Cigna Commercial	$16.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.88
Rate for Payer: UnitedHealthcare Commercial	$6.50
Rate for Payer: UnitedHealthcare Community & State	$0.78
Rate for Payer: Wellpoint Medicaid Managed Care	$0.86

ENDO CLINCH *******

Facility

$519.00

Hospital Charge Code	1603547
Hospital Revenue Code	272
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$77.85
Rate for Payer: Qualcare PPO/HMO/WC	$77.85

ENDO CLINCH *******

Facility

$519.00

Hospital Charge Code	1603547
Hospital Revenue Code	272
Min. Negotiated Rate	$12.51
Max. Negotiated Rate	$259.50
Rate for Payer: Aetna Commercial	$197.22
Rate for Payer: Aetna Medicare Advantage	$155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.34
Rate for Payer: Cigna Commercial	$259.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.70
Rate for Payer: Oxford Commercial	$103.80
Rate for Payer: Qualcare PPO/HMO/WC	$77.85
Rate for Payer: UnitedHealthcare Commercial	$103.80
Rate for Payer: UnitedHealthcare Community & State	$12.51
Rate for Payer: Wellpoint Medicaid Managed Care	$13.75

ENDO CLINCH 174305

Facility

$1,740.00

Hospital Charge Code	270600101
Hospital Revenue Code	272
Min. Negotiated Rate	$41.93
Max. Negotiated Rate	$870.00
Rate for Payer: Aetna Commercial	$661.20
Rate for Payer: Aetna Medicare Advantage	$522.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$443.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$443.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$443.70
Rate for Payer: Cigna Commercial	$870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$522.00
Rate for Payer: Oxford Commercial	$348.00
Rate for Payer: Qualcare PPO/HMO/WC	$261.00
Rate for Payer: UnitedHealthcare Commercial	$348.00
Rate for Payer: UnitedHealthcare Community & State	$41.93
Rate for Payer: Wellpoint Medicaid Managed Care	$46.11

ENDO CLINCH 174305

Facility

$1,740.00

Hospital Charge Code	270600101
Hospital Revenue Code	272
Min. Negotiated Rate	$261.00
Max. Negotiated Rate	$261.00
Rate for Payer: Qualcare PPO/HMO/WC	$261.00

ENDOCLIP APPLIER 10MM

Facility

$211.00

Hospital Charge Code	270338726
Hospital Revenue Code	272
Min. Negotiated Rate	$5.09
Max. Negotiated Rate	$105.50
Rate for Payer: Aetna Commercial	$80.18
Rate for Payer: Aetna Medicare Advantage	$63.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.80
Rate for Payer: Cigna Commercial	$105.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.30
Rate for Payer: Oxford Commercial	$42.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.65
Rate for Payer: UnitedHealthcare Commercial	$42.20
Rate for Payer: UnitedHealthcare Community & State	$5.09
Rate for Payer: Wellpoint Medicaid Managed Care	$5.59

ENDOCLIP APPLIER 10MM

Facility

$211.00

Hospital Charge Code	270338726
Hospital Revenue Code	272
Min. Negotiated Rate	$31.65
Max. Negotiated Rate	$31.65
Rate for Payer: Qualcare PPO/HMO/WC	$31.65

ENDOCLIP APPLIER 5MM

Facility

$279.00

Hospital Charge Code	270338725
Hospital Revenue Code	272
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$139.50
Rate for Payer: Aetna Commercial	$106.02
Rate for Payer: Aetna Medicare Advantage	$83.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.14
Rate for Payer: Cigna Commercial	$139.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.70
Rate for Payer: Oxford Commercial	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$41.85
Rate for Payer: UnitedHealthcare Commercial	$55.80
Rate for Payer: UnitedHealthcare Community & State	$6.72
Rate for Payer: Wellpoint Medicaid Managed Care	$7.39

ENDOCLIP APPLIER 5MM

Facility

$279.00

Hospital Charge Code	270338725
Hospital Revenue Code	272
Min. Negotiated Rate	$41.85
Max. Negotiated Rate	$41.85
Rate for Payer: Qualcare PPO/HMO/WC	$41.85

Know your out-of-pocket cost for care.

All Charges