Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ENDOPROSTHESIS AORTIC 23X30

Facility

$12,585.00

Hospital Charge Code	270640081
Hospital Revenue Code	278
Min. Negotiated Rate	$1,887.75
Max. Negotiated Rate	$3,045.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,517.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,045.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,768.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.75

ENDOPROSTHESIS AORTIC 26X30

Facility

$12,585.00

Hospital Charge Code	270639872
Hospital Revenue Code	278
Min. Negotiated Rate	$303.30
Max. Negotiated Rate	$6,292.50
Rate for Payer: Aetna Commercial	$4,782.30
Rate for Payer: Aetna Medicare Advantage	$3,775.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,209.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,209.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,517.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,209.18
Rate for Payer: Cigna Commercial	$6,292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,045.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,768.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.75
Rate for Payer: UnitedHealthcare Community & State	$303.30
Rate for Payer: Wellpoint Medicaid Managed Care	$333.50

ENDOPROSTHESIS AORTIC 26X30

Facility

$12,585.00

Hospital Charge Code	270639872
Hospital Revenue Code	278
Min. Negotiated Rate	$1,887.75
Max. Negotiated Rate	$3,045.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,517.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,045.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,768.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,887.75

ENDOPROSTHESIS LEG 20MMX9.5CM

Facility

$21,500.00

Hospital Charge Code	270670934
Hospital Revenue Code	278
Min. Negotiated Rate	$3,225.00
Max. Negotiated Rate	$5,203.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,730.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00

ENDOPROSTHESIS LEG 20MMX9.5CM

Facility

$21,500.00

Hospital Charge Code	270670934
Hospital Revenue Code	278
Min. Negotiated Rate	$518.15
Max. Negotiated Rate	$10,750.00
Rate for Payer: Aetna Commercial	$8,170.00
Rate for Payer: Aetna Medicare Advantage	$6,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,482.50
Rate for Payer: Cigna Commercial	$10,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,730.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00
Rate for Payer: UnitedHealthcare Community & State	$518.15
Rate for Payer: Wellpoint Medicaid Managed Care	$569.75

ENDO PYELOT STENT SET-SMITH***

Facility

$232.00

Hospital Charge Code	1604362
Hospital Revenue Code	272
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$116.00
Rate for Payer: Aetna Commercial	$88.16
Rate for Payer: Aetna Medicare Advantage	$69.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.16
Rate for Payer: Cigna Commercial	$116.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.60
Rate for Payer: Oxford Commercial	$46.40
Rate for Payer: Qualcare PPO/HMO/WC	$34.80
Rate for Payer: UnitedHealthcare Commercial	$46.40
Rate for Payer: UnitedHealthcare Community & State	$5.59
Rate for Payer: Wellpoint Medicaid Managed Care	$6.15

ENDO PYELOT STENT SET-SMITH***

Facility

$232.00

Hospital Charge Code	1604362
Hospital Revenue Code	272
Min. Negotiated Rate	$34.80
Max. Negotiated Rate	$34.80
Rate for Payer: Qualcare PPO/HMO/WC	$34.80

ENDO REACH NANAOPASS

Facility

$1,445.00

Hospital Charge Code	270668509
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 REACH NANAOPASS

Facility

$1,445.00

Hospital Charge Code	270668509
Hospital Revenue Code	272
Min. Negotiated Rate	$216.75
Max. Negotiated Rate	$216.75
Rate for Payer: Qualcare PPO/HMO/WC	$216.75

ENDO RECOVERY EA ADD 30 MIN

Facility

$400.00

Hospital Charge Code	2300915
Hospital Revenue Code	710
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

ENDO RECOVERY EA ADD 30 MIN

Facility

$400.00

Hospital Charge Code	2300915
Hospital Revenue Code	710
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.00
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$80.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

ENDO RECOVERY UP TO 1 HOUR

Facility

$800.00

Hospital Charge Code	2300914
Hospital Revenue Code	710
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.00
Rate for Payer: Oxford Commercial	$160.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$160.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$21.20

ENDO RECOVERY UP TO 1 HOUR

Facility

$800.00

Hospital Charge Code	2300914
Hospital Revenue Code	710
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

ENDO RETRACT II 10MM 176647

Facility

$1,214.45

Hospital Charge Code	270600114
Hospital Revenue Code	272
Min. Negotiated Rate	$29.27
Max. Negotiated Rate	$607.23
Rate for Payer: Aetna Commercial	$461.49
Rate for Payer: Aetna Medicare Advantage	$364.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.68
Rate for Payer: Cigna Commercial	$607.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.33
Rate for Payer: Oxford Commercial	$242.89
Rate for Payer: Qualcare PPO/HMO/WC	$182.17
Rate for Payer: UnitedHealthcare Commercial	$242.89
Rate for Payer: UnitedHealthcare Community & State	$29.27
Rate for Payer: Wellpoint Medicaid Managed Care	$32.18

ENDO RETRACT II 10MM 176647

Facility

$1,214.45

Hospital Charge Code	270600114
Hospital Revenue Code	272
Min. Negotiated Rate	$182.17
Max. Negotiated Rate	$182.17
Rate for Payer: Qualcare PPO/HMO/WC	$182.17

ENDO RETRACT II #176647 ******

Facility

$716.00

Hospital Charge Code	1606110
Hospital Revenue Code	272
Min. Negotiated Rate	$107.40
Max. Negotiated Rate	$107.40
Rate for Payer: Qualcare PPO/HMO/WC	$107.40

ENDO RETRACT II #176647 ******

Facility

$716.00

Hospital Charge Code	1606110
Hospital Revenue Code	272
Min. Negotiated Rate	$17.26
Max. Negotiated Rate	$358.00
Rate for Payer: Aetna Commercial	$272.08
Rate for Payer: Aetna Medicare Advantage	$214.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.58
Rate for Payer: Cigna Commercial	$358.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.80
Rate for Payer: Oxford Commercial	$143.20
Rate for Payer: Qualcare PPO/HMO/WC	$107.40
Rate for Payer: UnitedHealthcare Commercial	$143.20
Rate for Payer: UnitedHealthcare Community & State	$17.26
Rate for Payer: Wellpoint Medicaid Managed Care	$18.97

ENDORPHIN

Facility

$333.00

Service Code	HCPCS 84999
Hospital Charge Code	38472426
Hospital Revenue Code	301
Min. Negotiated Rate	$49.95
Max. Negotiated Rate	$49.95
Rate for Payer: Qualcare PPO/HMO/WC	$49.95

ENDORPHIN

Facility

$333.00

Service Code	HCPCS 84999
Hospital Charge Code	38472426
Hospital Revenue Code	301
Min. Negotiated Rate	$8.03
Max. Negotiated Rate	$166.50
Rate for Payer: Aetna Commercial	$126.54
Rate for Payer: Aetna Medicare Advantage	$99.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.92
Rate for Payer: Cigna Commercial	$166.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.95
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.03
Rate for Payer: Wellpoint Medicaid Managed Care	$8.82

ENDO SCIZ *******

Facility

$554.00

Hospital Charge Code	1603554
Hospital Revenue Code	272
Min. Negotiated Rate	$83.10
Max. Negotiated Rate	$83.10
Rate for Payer: Qualcare PPO/HMO/WC	$83.10

ENDO SCIZ *******

Facility

$554.00

Hospital Charge Code	1603554
Hospital Revenue Code	272
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$277.00
Rate for Payer: Aetna Commercial	$210.52
Rate for Payer: Aetna Medicare Advantage	$166.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.27
Rate for Payer: Cigna Commercial	$277.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.20
Rate for Payer: Oxford Commercial	$110.80
Rate for Payer: Qualcare PPO/HMO/WC	$83.10
Rate for Payer: UnitedHealthcare Commercial	$110.80
Rate for Payer: UnitedHealthcare Community & State	$13.35
Rate for Payer: Wellpoint Medicaid Managed Care	$14.68

ENDOSCOP APPLICATOR 5MMX41CM

Facility

$282.66

Service Code	HCPCS A4649
Hospital Charge Code	270662368
Hospital Revenue Code	272
Min. Negotiated Rate	$6.81
Max. Negotiated Rate	$141.33
Rate for Payer: Aetna Commercial	$107.41
Rate for Payer: Aetna Medicare Advantage	$84.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.08
Rate for Payer: Cigna Commercial	$141.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.80
Rate for Payer: Oxford Commercial	$56.53
Rate for Payer: Qualcare PPO/HMO/WC	$42.40
Rate for Payer: UnitedHealthcare Commercial	$56.53
Rate for Payer: UnitedHealthcare Community & State	$6.81
Rate for Payer: Wellpoint Medicaid Managed Care	$7.49

ENDOSCOP APPLICATOR 5MMX41CM

Facility

$282.66

Service Code	HCPCS A4649
Hospital Charge Code	270662368
Hospital Revenue Code	272
Min. Negotiated Rate	$42.40
Max. Negotiated Rate	$42.40
Rate for Payer: Qualcare PPO/HMO/WC	$42.40

ENDOSCOPIC GASTROC RELEASE KIT

Facility

$4,672.80

Hospital Charge Code	270667237
Hospital Revenue Code	272
Min. Negotiated Rate	$112.61
Max. Negotiated Rate	$2,336.40
Rate for Payer: Aetna Commercial	$1,775.66
Rate for Payer: Aetna Medicare Advantage	$1,401.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,191.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,191.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,191.56
Rate for Payer: Cigna Commercial	$2,336.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,401.84
Rate for Payer: Oxford Commercial	$934.56
Rate for Payer: Qualcare PPO/HMO/WC	$700.92
Rate for Payer: UnitedHealthcare Commercial	$934.56
Rate for Payer: UnitedHealthcare Community & State	$112.61
Rate for Payer: Wellpoint Medicaid Managed Care	$123.83

ENDOSCOPIC GASTROC RELEASE KIT

Facility

$4,672.80

Hospital Charge Code	270667237
Hospital Revenue Code	272
Min. Negotiated Rate	$700.92
Max. Negotiated Rate	$700.92
Rate for Payer: Qualcare PPO/HMO/WC	$700.92

Know your out-of-pocket cost for care.

All Charges