Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ENDO CLIP II #176657 *****

Facility

$781.00

Hospital Charge Code	1606102
Hospital Revenue Code	272
Min. Negotiated Rate	$117.15
Max. Negotiated Rate	$117.15
Rate for Payer: Qualcare PPO/HMO/WC	$117.15

ENDO CLIP II #176657 *****

Facility

$781.00

Hospital Charge Code	1606102
Hospital Revenue Code	272
Min. Negotiated Rate	$18.82
Max. Negotiated Rate	$390.50
Rate for Payer: Aetna Commercial	$296.78
Rate for Payer: Aetna Medicare Advantage	$234.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.16
Rate for Payer: Cigna Commercial	$390.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.30
Rate for Payer: Oxford Commercial	$156.20
Rate for Payer: Qualcare PPO/HMO/WC	$117.15
Rate for Payer: UnitedHealthcare Commercial	$156.20
Rate for Payer: UnitedHealthcare Community & State	$18.82
Rate for Payer: Wellpoint Medicaid Managed Care	$20.70

ENDO CLIP LARGE *******

Facility

$696.00

Hospital Charge Code	1603505
Hospital Revenue Code	272
Min. Negotiated Rate	$104.40
Max. Negotiated Rate	$104.40
Rate for Payer: Qualcare PPO/HMO/WC	$104.40

ENDO CLIP LARGE *******

Facility

$696.00

Hospital Charge Code	1603505
Hospital Revenue Code	272
Min. Negotiated Rate	$16.77
Max. Negotiated Rate	$348.00
Rate for Payer: Aetna Commercial	$264.48
Rate for Payer: Aetna Medicare Advantage	$208.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.48
Rate for Payer: Cigna Commercial	$348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.80
Rate for Payer: Oxford Commercial	$139.20
Rate for Payer: Qualcare PPO/HMO/WC	$104.40
Rate for Payer: UnitedHealthcare Commercial	$139.20
Rate for Payer: UnitedHealthcare Community & State	$16.77
Rate for Payer: Wellpoint Medicaid Managed Care	$18.44

ENDOCLIP LG 10MM PISTOL GRIP

Facility

$1,496.82

Hospital Charge Code	270600102
Hospital Revenue Code	272
Min. Negotiated Rate	$36.07
Max. Negotiated Rate	$748.41
Rate for Payer: Aetna Commercial	$568.79
Rate for Payer: Aetna Medicare Advantage	$449.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$381.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$381.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$381.69
Rate for Payer: Cigna Commercial	$748.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$449.05
Rate for Payer: Oxford Commercial	$299.36
Rate for Payer: Qualcare PPO/HMO/WC	$224.52
Rate for Payer: UnitedHealthcare Commercial	$299.36
Rate for Payer: UnitedHealthcare Community & State	$36.07
Rate for Payer: Wellpoint Medicaid Managed Care	$39.67

ENDOCLIP LG 10MM PISTOL GRIP

Facility

$1,496.82

Hospital Charge Code	270600102
Hospital Revenue Code	272
Min. Negotiated Rate	$224.52
Max. Negotiated Rate	$224.52
Rate for Payer: Qualcare PPO/HMO/WC	$224.52

ENDO CLIP MED-LG DISP APPLIER

Facility

$103.00

Hospital Charge Code	270334625
Hospital Revenue Code	272
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$51.50
Rate for Payer: Aetna Commercial	$39.14
Rate for Payer: Aetna Medicare Advantage	$30.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.27
Rate for Payer: Cigna Commercial	$51.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.90
Rate for Payer: Oxford Commercial	$20.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.45
Rate for Payer: UnitedHealthcare Commercial	$20.60
Rate for Payer: UnitedHealthcare Community & State	$2.48
Rate for Payer: Wellpoint Medicaid Managed Care	$2.73

ENDO CLIP MED-LG DISP APPLIER

Facility

$103.00

Hospital Charge Code	270334625
Hospital Revenue Code	272
Min. Negotiated Rate	$15.45
Max. Negotiated Rate	$15.45
Rate for Payer: Qualcare PPO/HMO/WC	$15.45

ENDO CLIP ML 176615

Facility

$1,192.00

Hospital Charge Code	270600103
Hospital Revenue Code	272
Min. Negotiated Rate	$28.73
Max. Negotiated Rate	$596.00
Rate for Payer: Aetna Commercial	$452.96
Rate for Payer: Aetna Medicare Advantage	$357.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$303.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$303.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$303.96
Rate for Payer: Cigna Commercial	$596.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$357.60
Rate for Payer: Oxford Commercial	$238.40
Rate for Payer: Qualcare PPO/HMO/WC	$178.80
Rate for Payer: UnitedHealthcare Commercial	$238.40
Rate for Payer: UnitedHealthcare Community & State	$28.73
Rate for Payer: Wellpoint Medicaid Managed Care	$31.59

ENDO CLIP ML 176615

Facility

$1,192.00

Hospital Charge Code	270600103
Hospital Revenue Code	272
Min. Negotiated Rate	$178.80
Max. Negotiated Rate	$178.80
Rate for Payer: Qualcare PPO/HMO/WC	$178.80

ENDO CLOSE 173022

Facility

$271.25

Hospital Charge Code	270600056
Hospital Revenue Code	272
Min. Negotiated Rate	$6.54
Max. Negotiated Rate	$135.62
Rate for Payer: Aetna Commercial	$103.08
Rate for Payer: Aetna Medicare Advantage	$81.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.17
Rate for Payer: Cigna Commercial	$135.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.38
Rate for Payer: Oxford Commercial	$54.25
Rate for Payer: Qualcare PPO/HMO/WC	$40.69
Rate for Payer: UnitedHealthcare Commercial	$54.25
Rate for Payer: UnitedHealthcare Community & State	$6.54
Rate for Payer: Wellpoint Medicaid Managed Care	$7.19

ENDO CLOSE 173022

Facility

$271.25

Hospital Charge Code	270600056
Hospital Revenue Code	272
Min. Negotiated Rate	$40.69
Max. Negotiated Rate	$40.69
Rate for Payer: Qualcare PPO/HMO/WC	$40.69

ENDOCRINE DISORDERS WITH CC

Facility

$35,263.80

Service Code	MSDRG 644
Min. Negotiated Rate	$10,737.38
Max. Negotiated Rate	$35,263.80
Rate for Payer: Aetna Commercial	$24,487.57
Rate for Payer: Aetna Medicare Advantage	$35,263.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,656.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,656.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,656.66
Rate for Payer: Cigna Commercial	$19,181.85
Rate for Payer: Cigna Medicare Advantage	$11,302.50
Rate for Payer: Clover Medicare Advantage	$10,737.38
Rate for Payer: EmblemHealth Commercial	$33,907.50
Rate for Payer: Humana Medicare Advantage	$11,641.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11,302.50
Rate for Payer: Oxford Commercial	$13,786.25
Rate for Payer: UnitedHealthcare Commercial	$24,174.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,302.50
Rate for Payer: Wellcare Medicare Advantage	$11,302.50

ENDOCRINE DISORDERS WITH MCC

Facility

$55,338.78

Service Code	MSDRG 643
Min. Negotiated Rate	$16,849.95
Max. Negotiated Rate	$55,338.78
Rate for Payer: Aetna Commercial	$38,281.40
Rate for Payer: Aetna Medicare Advantage	$55,338.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38,380.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38,380.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,736.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38,380.65
Rate for Payer: Cigna Commercial	$30,805.12
Rate for Payer: Cigna Medicare Advantage	$17,736.79
Rate for Payer: Clover Medicare Advantage	$16,849.95
Rate for Payer: EmblemHealth Commercial	$53,210.37
Rate for Payer: Humana Medicare Advantage	$18,268.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17,736.79
Rate for Payer: Oxford Commercial	$22,140.04
Rate for Payer: UnitedHealthcare Commercial	$38,823.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,736.79
Rate for Payer: Wellcare Medicare Advantage	$17,736.79

ENDOCRINE DISORDERS WITHOUT CC/MCC

Facility

$26,966.75

Service Code	MSDRG 645
Min. Negotiated Rate	$8,211.03
Max. Negotiated Rate	$26,966.75
Rate for Payer: Aetna Commercial	$18,786.57
Rate for Payer: Aetna Medicare Advantage	$26,966.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,678.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,678.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,643.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,678.36
Rate for Payer: Cigna Commercial	$14,377.97
Rate for Payer: Cigna Medicare Advantage	$8,643.19
Rate for Payer: Clover Medicare Advantage	$8,211.03
Rate for Payer: EmblemHealth Commercial	$25,929.57
Rate for Payer: Humana Medicare Advantage	$8,902.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,643.19
Rate for Payer: Oxford Commercial	$10,333.64
Rate for Payer: UnitedHealthcare Commercial	$18,120.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,643.19
Rate for Payer: Wellcare Medicare Advantage	$8,643.19

ENDO DISC KIT

Facility

$12,500.00

Hospital Charge Code	270702956
Hospital Revenue Code	272
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$1,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

ENDO DISC KIT

Facility

$12,500.00

Hospital Charge Code	270702956
Hospital Revenue Code	272
Min. Negotiated Rate	$301.25
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,750.00
Rate for Payer: Oxford Commercial	$2,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Commercial	$2,500.00
Rate for Payer: UnitedHealthcare Community & State	$301.25
Rate for Payer: Wellpoint Medicaid Managed Care	$331.25

ENDO DISSECTOR ******

Facility

$519.00

Hospital Charge Code	1603372
Hospital Revenue Code	272
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$77.85
Rate for Payer: Qualcare PPO/HMO/WC	$77.85

ENDO DISSECTOR ******

Facility

$519.00

Hospital Charge Code	1603372
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 EMR KIT

Facility

$495.00

Hospital Charge Code	270325500
Hospital Revenue Code	272
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$74.25
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

ENDO EMR KIT

Facility

$495.00

Hospital Charge Code	270325500
Hospital Revenue Code	272
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.50
Rate for Payer: Oxford Commercial	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Commercial	$99.00
Rate for Payer: UnitedHealthcare Community & State	$11.93
Rate for Payer: Wellpoint Medicaid Managed Care	$13.12

ENDO GAUGE ******

Facility

$33.00

Hospital Charge Code	1603422
Hospital Revenue Code	272
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

ENDO GAUGE ******

Facility

$33.00

Hospital Charge Code	1603422
Hospital Revenue Code	272
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$12.54
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.90
Rate for Payer: Oxford Commercial	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$6.60
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

ENDO GAUGE 6.0 ******

Facility

$83.00

Hospital Charge Code	1603497
Hospital Revenue Code	272
Min. Negotiated Rate	$12.45
Max. Negotiated Rate	$12.45
Rate for Payer: Qualcare PPO/HMO/WC	$12.45

ENDO GAUGE 6.0 ******

Facility

$83.00

Hospital Charge Code	1603497
Hospital Revenue Code	272
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$41.50
Rate for Payer: Aetna Commercial	$31.54
Rate for Payer: Aetna Medicare Advantage	$24.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.16
Rate for Payer: Cigna Commercial	$41.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.90
Rate for Payer: Oxford Commercial	$16.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.45
Rate for Payer: UnitedHealthcare Commercial	$16.60
Rate for Payer: UnitedHealthcare Community & State	$2.00
Rate for Payer: Wellpoint Medicaid Managed Care	$2.20

Know your out-of-pocket cost for care.

All Charges