Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

EXPANDER TISSUE CPX 450CC

Facility

$9,875.00

Hospital Charge Code	270701488
Hospital Revenue Code	278
Min. Negotiated Rate	$1,481.25
Max. Negotiated Rate	$2,389.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,389.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,172.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,481.25

EXPANDER TISSUE CPX 450CC

Facility

$9,875.00

Hospital Charge Code	270701488
Hospital Revenue Code	278
Min. Negotiated Rate	$237.99
Max. Negotiated Rate	$4,937.50
Rate for Payer: Aetna Commercial	$3,752.50
Rate for Payer: Aetna Medicare Advantage	$2,962.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,518.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,518.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,518.12
Rate for Payer: Cigna Commercial	$4,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,389.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,172.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,481.25
Rate for Payer: UnitedHealthcare Community & State	$237.99
Rate for Payer: Wellpoint Medicaid Managed Care	$261.69

EXPANDER TISSUE MED HT 270 CC

Facility

$8,225.00

Hospital Charge Code	270677729
Hospital Revenue Code	278
Min. Negotiated Rate	$1,233.75
Max. Negotiated Rate	$1,990.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,990.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,809.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,233.75

EXPANDER TISSUE MED HT 270 CC

Facility

$8,225.00

Hospital Charge Code	270677729
Hospital Revenue Code	278
Min. Negotiated Rate	$198.22
Max. Negotiated Rate	$4,112.50
Rate for Payer: Aetna Commercial	$3,125.50
Rate for Payer: Aetna Medicare Advantage	$2,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,097.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,097.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,097.38
Rate for Payer: Cigna Commercial	$4,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,990.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,809.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,233.75
Rate for Payer: UnitedHealthcare Community & State	$198.22
Rate for Payer: Wellpoint Medicaid Managed Care	$217.96

EXPANDER TISSUE MED HT 450CC

Facility

$8,475.00

Service Code	HCPCS C1789
Hospital Charge Code	270677731
Hospital Revenue Code	278
Min. Negotiated Rate	$1,271.25
Max. Negotiated Rate	$2,050.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,050.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,864.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.25

EXPANDER TISSUE MED HT 450CC

Facility

$8,475.00

Service Code	HCPCS C1789
Hospital Charge Code	270677731
Hospital Revenue Code	278
Min. Negotiated Rate	$204.25
Max. Negotiated Rate	$4,237.50
Rate for Payer: Aetna Commercial	$3,220.50
Rate for Payer: Aetna Medicare Advantage	$2,542.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,161.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,161.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,161.12
Rate for Payer: Cigna Commercial	$4,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,050.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,864.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.25
Rate for Payer: UnitedHealthcare Community & State	$204.25
Rate for Payer: Wellpoint Medicaid Managed Care	$224.59

EXPANDER TISSUE MED HT 550CC

Facility

$8,475.00

Service Code	HCPCS C1789
Hospital Charge Code	270677732
Hospital Revenue Code	278
Min. Negotiated Rate	$204.25
Max. Negotiated Rate	$4,237.50
Rate for Payer: Aetna Commercial	$3,220.50
Rate for Payer: Aetna Medicare Advantage	$2,542.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,161.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,161.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,161.12
Rate for Payer: Cigna Commercial	$4,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,050.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,864.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.25
Rate for Payer: UnitedHealthcare Community & State	$204.25
Rate for Payer: Wellpoint Medicaid Managed Care	$224.59

EXPANDER TISSUE MED HT 550CC

Facility

$8,475.00

Service Code	HCPCS C1789
Hospital Charge Code	270677732
Hospital Revenue Code	278
Min. Negotiated Rate	$1,271.25
Max. Negotiated Rate	$2,050.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,050.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,864.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.25

EXPANDER TISSUE MED HT 950 CC

Facility

$8,225.00

Hospital Charge Code	270677730
Hospital Revenue Code	278
Min. Negotiated Rate	$198.22
Max. Negotiated Rate	$4,112.50
Rate for Payer: Aetna Commercial	$3,125.50
Rate for Payer: Aetna Medicare Advantage	$2,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,097.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,097.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,097.38
Rate for Payer: Cigna Commercial	$4,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,990.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,809.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,233.75
Rate for Payer: UnitedHealthcare Community & State	$198.22
Rate for Payer: Wellpoint Medicaid Managed Care	$217.96

EXPANDER TISSUE MED HT 950 CC

Facility

$8,225.00

Hospital Charge Code	270677730
Hospital Revenue Code	278
Min. Negotiated Rate	$1,233.75
Max. Negotiated Rate	$1,990.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,990.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,809.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,233.75

EXPANDER VALVULOTOME

Facility

$16,475.00

Hospital Charge Code	270657779
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$3,986.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,624.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

EXPANDER VALVULOTOME

Facility

$16,475.00

Hospital Charge Code	270657779
Hospital Revenue Code	278
Min. Negotiated Rate	$397.05
Max. Negotiated Rate	$8,237.50
Rate for Payer: Aetna Commercial	$6,260.50
Rate for Payer: Aetna Medicare Advantage	$4,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,201.12
Rate for Payer: Cigna Commercial	$8,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,624.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25
Rate for Payer: UnitedHealthcare Community & State	$397.05
Rate for Payer: Wellpoint Medicaid Managed Care	$436.59

EXPANDER VALVULOTOME LEM

Facility

$2,684.85

Hospital Charge Code	270601100
Hospital Revenue Code	278
Min. Negotiated Rate	$402.73
Max. Negotiated Rate	$649.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$536.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$649.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$590.67
Rate for Payer: Qualcare PPO/HMO/WC	$402.73

EXPANDER VALVULOTOME LEM

Facility

$2,684.85

Hospital Charge Code	270601100
Hospital Revenue Code	278
Min. Negotiated Rate	$64.70
Max. Negotiated Rate	$1,342.42
Rate for Payer: Aetna Commercial	$1,020.24
Rate for Payer: Aetna Medicare Advantage	$805.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$684.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$684.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$536.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$684.64
Rate for Payer: Cigna Commercial	$1,342.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$649.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$590.67
Rate for Payer: Qualcare PPO/HMO/WC	$402.73
Rate for Payer: UnitedHealthcare Community & State	$64.70
Rate for Payer: Wellpoint Medicaid Managed Care	$71.15

EXPANDSIENTRASMMIDHT340-420

Facility

$9,845.00

Service Code	HCPCS L8600
Hospital Charge Code	270700136
Hospital Revenue Code	278
Min. Negotiated Rate	$1,476.75
Max. Negotiated Rate	$2,382.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,969.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,382.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,165.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,476.75

EXPANDSIENTRASMMIDHT340-420

Facility

$9,845.00

Service Code	HCPCS L8600
Hospital Charge Code	270700136
Hospital Revenue Code	278
Min. Negotiated Rate	$237.26
Max. Negotiated Rate	$4,922.50
Rate for Payer: Aetna Commercial	$3,741.10
Rate for Payer: Aetna Medicare Advantage	$2,953.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,510.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,510.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,969.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,510.47
Rate for Payer: Cigna Commercial	$4,922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,382.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,165.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,476.75
Rate for Payer: UnitedHealthcare Community & State	$237.26
Rate for Payer: Wellpoint Medicaid Managed Care	$260.89

EXPEDIUM SCREW 4 X 40 MM

Facility

$9,825.00

Hospital Charge Code	270665830
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.75
Max. Negotiated Rate	$2,377.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,161.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.75

EXPEDIUM SCREW 4 X 40 MM

Facility

$9,825.00

Hospital Charge Code	270665830
Hospital Revenue Code	278
Min. Negotiated Rate	$236.78
Max. Negotiated Rate	$4,912.50
Rate for Payer: Aetna Commercial	$3,733.50
Rate for Payer: Aetna Medicare Advantage	$2,947.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,505.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,505.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,505.38
Rate for Payer: Cigna Commercial	$4,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,161.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.75
Rate for Payer: UnitedHealthcare Community & State	$236.78
Rate for Payer: Wellpoint Medicaid Managed Care	$260.36

EXPEDIUM SCREW SET 5.5

Facility

$791.00

Service Code	HCPCS C1713
Hospital Charge Code	270691062
Hospital Revenue Code	278
Min. Negotiated Rate	$19.06
Max. Negotiated Rate	$395.50
Rate for Payer: Aetna Commercial	$300.58
Rate for Payer: Aetna Medicare Advantage	$237.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.71
Rate for Payer: Cigna Commercial	$395.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$174.02
Rate for Payer: Qualcare PPO/HMO/WC	$118.65
Rate for Payer: UnitedHealthcare Community & State	$19.06
Rate for Payer: Wellpoint Medicaid Managed Care	$20.96

EXPEDIUM SCREW SET 5.5

Facility

$791.00

Service Code	HCPCS C1713
Hospital Charge Code	270691062
Hospital Revenue Code	278
Min. Negotiated Rate	$118.65
Max. Negotiated Rate	$191.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$174.02
Rate for Payer: Qualcare PPO/HMO/WC	$118.65

EXPLANT BLADE LONG

Facility

$4,418.70

Hospital Charge Code	270657009
Hospital Revenue Code	272
Min. Negotiated Rate	$106.49
Max. Negotiated Rate	$2,209.35
Rate for Payer: Aetna Commercial	$1,679.11
Rate for Payer: Aetna Medicare Advantage	$1,325.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,126.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,126.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,126.77
Rate for Payer: Cigna Commercial	$2,209.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,325.61
Rate for Payer: Oxford Commercial	$883.74
Rate for Payer: Qualcare PPO/HMO/WC	$662.80
Rate for Payer: UnitedHealthcare Commercial	$883.74
Rate for Payer: UnitedHealthcare Community & State	$106.49
Rate for Payer: Wellpoint Medicaid Managed Care	$117.10

EXPLANT BLADE LONG

Facility

$4,418.70

Hospital Charge Code	270657009
Hospital Revenue Code	272
Min. Negotiated Rate	$662.80
Max. Negotiated Rate	$662.80
Rate for Payer: Qualcare PPO/HMO/WC	$662.80

EXPLANT BLADE SHORT

Facility

$4,418.70

Hospital Charge Code	270657011
Hospital Revenue Code	272
Min. Negotiated Rate	$106.49
Max. Negotiated Rate	$2,209.35
Rate for Payer: Aetna Commercial	$1,679.11
Rate for Payer: Aetna Medicare Advantage	$1,325.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,126.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,126.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,126.77
Rate for Payer: Cigna Commercial	$2,209.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,325.61
Rate for Payer: Oxford Commercial	$883.74
Rate for Payer: Qualcare PPO/HMO/WC	$662.80
Rate for Payer: UnitedHealthcare Commercial	$883.74
Rate for Payer: UnitedHealthcare Community & State	$106.49
Rate for Payer: Wellpoint Medicaid Managed Care	$117.10

EXPLANT BLADE SHORT

Facility

$4,418.70

Hospital Charge Code	270657011
Hospital Revenue Code	272
Min. Negotiated Rate	$662.80
Max. Negotiated Rate	$662.80
Rate for Payer: Qualcare PPO/HMO/WC	$662.80

EXPLANT LDH PROVISION HEAD SIZ

Facility

$1,440.00

Service Code	HCPCS C1776
Hospital Charge Code	270698036
Hospital Revenue Code	278
Min. Negotiated Rate	$34.70
Max. Negotiated Rate	$720.00
Rate for Payer: Aetna Commercial	$547.20
Rate for Payer: Aetna Medicare Advantage	$432.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$367.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$367.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$288.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$367.20
Rate for Payer: Cigna Commercial	$720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$348.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$316.80
Rate for Payer: Qualcare PPO/HMO/WC	$216.00
Rate for Payer: UnitedHealthcare Community & State	$34.70
Rate for Payer: Wellpoint Medicaid Managed Care	$38.16

Know your out-of-pocket cost for care.

All Charges