Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ENDO GIA MLTFR 60 2.5

Facility

$587.00

Hospital Charge Code	1603471
Hospital Revenue Code	272
Min. Negotiated Rate	$88.05
Max. Negotiated Rate	$88.05
Rate for Payer: Qualcare PPO/HMO/WC	$88.05

ENDO GIA MLTFR 60 3.5 *****

Facility

$1,680.00

Hospital Charge Code	1603455
Hospital Revenue Code	272
Min. Negotiated Rate	$252.00
Max. Negotiated Rate	$252.00
Rate for Payer: Qualcare PPO/HMO/WC	$252.00

ENDO GIA MLTFR 60 3.5 *****

Facility

$1,680.00

Hospital Charge Code	1603455
Hospital Revenue Code	272
Min. Negotiated Rate	$40.49
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Commercial	$638.40
Rate for Payer: Aetna Medicare Advantage	$504.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$428.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$428.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$428.40
Rate for Payer: Cigna Commercial	$840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$504.00
Rate for Payer: Oxford Commercial	$336.00
Rate for Payer: Qualcare PPO/HMO/WC	$252.00
Rate for Payer: UnitedHealthcare Commercial	$336.00
Rate for Payer: UnitedHealthcare Community & State	$40.49
Rate for Payer: Wellpoint Medicaid Managed Care	$44.52

ENDO GIA RELOAD 45MM MED THICK

Facility

$481.84

Hospital Charge Code	270652106
Hospital Revenue Code	272
Min. Negotiated Rate	$11.61
Max. Negotiated Rate	$240.92
Rate for Payer: Aetna Commercial	$183.10
Rate for Payer: Aetna Medicare Advantage	$144.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.87
Rate for Payer: Cigna Commercial	$240.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.55
Rate for Payer: Oxford Commercial	$96.37
Rate for Payer: Qualcare PPO/HMO/WC	$72.28
Rate for Payer: UnitedHealthcare Commercial	$96.37
Rate for Payer: UnitedHealthcare Community & State	$11.61
Rate for Payer: Wellpoint Medicaid Managed Care	$12.77

ENDO GIA RELOAD 45MM MED THICK

Facility

$481.84

Hospital Charge Code	270652106
Hospital Revenue Code	272
Min. Negotiated Rate	$72.28
Max. Negotiated Rate	$72.28
Rate for Payer: Qualcare PPO/HMO/WC	$72.28

ENDO GIA UNIV ULTRA STD

Facility

$539.98

Hospital Charge Code	270655981
Hospital Revenue Code	271
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$81.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.00

ENDO GIA UNIV ULTRA STD

Facility

$539.98

Hospital Charge Code	270655981
Hospital Revenue Code	271
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$269.99
Rate for Payer: Aetna Commercial	$205.19
Rate for Payer: Aetna Medicare Advantage	$161.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.69
Rate for Payer: Cigna Commercial	$269.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.99
Rate for Payer: Oxford Commercial	$108.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.00
Rate for Payer: UnitedHealthcare Commercial	$108.00
Rate for Payer: UnitedHealthcare Community & State	$13.01
Rate for Payer: Wellpoint Medicaid Managed Care	$14.31

ENDO GLUCOSE CAPILLARY FINGERS

Facility

$20.85

Service Code	HCPCS 82948
Hospital Charge Code	2300901
Hospital Revenue Code	301
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$13.71
Rate for Payer: Aetna Medicare Advantage	$16.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.19
Rate for Payer: Cigna Commercial	$10.43
Rate for Payer: Cigna Medicare Advantage	$5.04
Rate for Payer: Clover Medicare Advantage	$4.79
Rate for Payer: EmblemHealth Commercial	$15.12
Rate for Payer: Humana Medicare Advantage	$5.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.13
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.04
Rate for Payer: Wellcare Medicare Advantage	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.55

ENDO GLUCOSE CAPILLARY FINGERS

Facility

$20.85

Service Code	HCPCS 82948
Hospital Charge Code	2300901
Hospital Revenue Code	301
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$3.13
Rate for Payer: Qualcare PPO/HMO/WC	$3.13

ENDOGRAFT BIFUR BA28-90/I16-30

Facility

$56,475.00

Hospital Charge Code	270647242C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,361.05
Max. Negotiated Rate	$28,237.50
Rate for Payer: Aetna Commercial	$21,460.50
Rate for Payer: Aetna Medicare Advantage	$16,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,401.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,401.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,401.12
Rate for Payer: Cigna Commercial	$28,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,666.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12,424.50
Rate for Payer: Qualcare PPO/HMO/WC	$8,471.25
Rate for Payer: UnitedHealthcare Community & State	$1,361.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1,496.59

ENDOGRAFT BIFUR BA28-90/I16-30

Facility

$56,475.00

Hospital Charge Code	270647242C
Hospital Revenue Code	278
Min. Negotiated Rate	$8,471.25
Max. Negotiated Rate	$13,666.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,666.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12,424.50
Rate for Payer: Qualcare PPO/HMO/WC	$8,471.25

ENDOGRAFT BIFURCATED MAIN BODY

Facility

$57,900.00

Hospital Charge Code	270665548
Hospital Revenue Code	278
Min. Negotiated Rate	$8,685.00
Max. Negotiated Rate	$14,011.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,011.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12,738.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,685.00

ENDOGRAFT BIFURCATED MAIN BODY

Facility

$57,900.00

Hospital Charge Code	270665548
Hospital Revenue Code	278
Min. Negotiated Rate	$1,395.39
Max. Negotiated Rate	$28,950.00
Rate for Payer: Aetna Commercial	$22,002.00
Rate for Payer: Aetna Medicare Advantage	$17,370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,764.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,764.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,580.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,764.50
Rate for Payer: Cigna Commercial	$28,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,011.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12,738.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,685.00
Rate for Payer: UnitedHealthcare Community & State	$1,395.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1,534.35

ENDO GRASP

Facility

$908.00

Hospital Charge Code	270335076
Hospital Revenue Code	272
Min. Negotiated Rate	$136.20
Max. Negotiated Rate	$136.20
Rate for Payer: Qualcare PPO/HMO/WC	$136.20

ENDO GRASP

Facility

$908.00

Hospital Charge Code	270335076
Hospital Revenue Code	272
Min. Negotiated Rate	$21.88
Max. Negotiated Rate	$454.00
Rate for Payer: Aetna Commercial	$345.04
Rate for Payer: Aetna Medicare Advantage	$272.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.54
Rate for Payer: Cigna Commercial	$454.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.40
Rate for Payer: Oxford Commercial	$181.60
Rate for Payer: Qualcare PPO/HMO/WC	$136.20
Rate for Payer: UnitedHealthcare Commercial	$181.60
Rate for Payer: UnitedHealthcare Community & State	$21.88
Rate for Payer: Wellpoint Medicaid Managed Care	$24.06

ENDO HERNIA LOAD UNIT

Facility

$223.00

Hospital Charge Code	270335081
Hospital Revenue Code	272
Min. Negotiated Rate	$33.45
Max. Negotiated Rate	$33.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.45

ENDO HERNIA LOAD UNIT

Facility

$223.00

Hospital Charge Code	270335081
Hospital Revenue Code	272
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$111.50
Rate for Payer: Aetna Commercial	$84.74
Rate for Payer: Aetna Medicare Advantage	$66.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.87
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.90
Rate for Payer: Oxford Commercial	$44.60
Rate for Payer: Qualcare PPO/HMO/WC	$33.45
Rate for Payer: UnitedHealthcare Commercial	$44.60
Rate for Payer: UnitedHealthcare Community & State	$5.37
Rate for Payer: Wellpoint Medicaid Managed Care	$5.91

ENDO HERNIA MLTFR #174007 ****

Facility

$245.00

Hospital Charge Code	1605955
Hospital Revenue Code	272
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$36.75
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

ENDO HERNIA MLTFR #174007 ****

Facility

$245.00

Hospital Charge Code	1605955
Hospital Revenue Code	272
Min. Negotiated Rate	$5.90
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.50
Rate for Payer: Oxford Commercial	$49.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Commercial	$49.00
Rate for Payer: UnitedHealthcare Community & State	$5.90
Rate for Payer: Wellpoint Medicaid Managed Care	$6.49

ENDO HERNIA STAPLER

Facility

$770.00

Hospital Charge Code	270335080
Hospital Revenue Code	272
Min. Negotiated Rate	$18.56
Max. Negotiated Rate	$385.00
Rate for Payer: Aetna Commercial	$292.60
Rate for Payer: Aetna Medicare Advantage	$231.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.35
Rate for Payer: Cigna Commercial	$385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.00
Rate for Payer: Oxford Commercial	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$115.50
Rate for Payer: UnitedHealthcare Commercial	$154.00
Rate for Payer: UnitedHealthcare Community & State	$18.56
Rate for Payer: Wellpoint Medicaid Managed Care	$20.41

ENDO HERNIA STAPLER

Facility

$770.00

Hospital Charge Code	270335080
Hospital Revenue Code	272
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$115.50

ENDOHOLDER ENDOSUTURE SYSTEM

Facility

$1,184.70

Hospital Charge Code	270669354
Hospital Revenue Code	272
Min. Negotiated Rate	$177.71
Max. Negotiated Rate	$177.71
Rate for Payer: Qualcare PPO/HMO/WC	$177.71

ENDOHOLDER ENDOSUTURE SYSTEM

Facility

$1,184.70

Hospital Charge Code	270669354
Hospital Revenue Code	272
Min. Negotiated Rate	$28.55
Max. Negotiated Rate	$592.35
Rate for Payer: Aetna Commercial	$450.19
Rate for Payer: Aetna Medicare Advantage	$355.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$302.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$302.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$302.10
Rate for Payer: Cigna Commercial	$592.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.41
Rate for Payer: Oxford Commercial	$236.94
Rate for Payer: Qualcare PPO/HMO/WC	$177.71
Rate for Payer: UnitedHealthcare Commercial	$236.94
Rate for Payer: UnitedHealthcare Community & State	$28.55
Rate for Payer: Wellpoint Medicaid Managed Care	$31.39

ENDOKNOT ETHIBOND

Facility

$124.00

Hospital Charge Code	270335232
Hospital Revenue Code	272
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$62.00
Rate for Payer: Aetna Commercial	$47.12
Rate for Payer: Aetna Medicare Advantage	$37.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.62
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.20
Rate for Payer: Oxford Commercial	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$24.80
Rate for Payer: UnitedHealthcare Community & State	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

ENDOKNOT ETHIBOND

Facility

$124.00

Hospital Charge Code	270335232
Hospital Revenue Code	272
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

Know your out-of-pocket cost for care.

All Charges