Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

EXTRACTOR CONICAL LARGE

Facility

$1,750.00

Hospital Charge Code	270688297
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

EXTRACTOR CONICAL LARGE

Facility

$1,750.00

Hospital Charge Code	270688297
Hospital Revenue Code	272
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$525.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

EXTRACTOR MCV TRPL LMN 5047-05

Facility

$936.85

Hospital Charge Code	270616279
Hospital Revenue Code	272
Min. Negotiated Rate	$140.53
Max. Negotiated Rate	$140.53
Rate for Payer: Qualcare PPO/HMO/WC	$140.53

EXTRACTOR MCV TRPL LMN 5047-05

Facility

$936.85

Hospital Charge Code	270616279
Hospital Revenue Code	272
Min. Negotiated Rate	$22.58
Max. Negotiated Rate	$468.43
Rate for Payer: Aetna Commercial	$356.00
Rate for Payer: Aetna Medicare Advantage	$281.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.90
Rate for Payer: Cigna Commercial	$468.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.06
Rate for Payer: Oxford Commercial	$187.37
Rate for Payer: Qualcare PPO/HMO/WC	$140.53
Rate for Payer: UnitedHealthcare Commercial	$187.37
Rate for Payer: UnitedHealthcare Community & State	$22.58
Rate for Payer: Wellpoint Medicaid Managed Care	$24.83

EXTRACTOR NAIL CONICAL 12MM

Facility

$1,750.00

Hospital Charge Code	270694835
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

EXTRACTOR NAIL CONICAL 12MM

Facility

$1,750.00

Hospital Charge Code	270694835
Hospital Revenue Code	272
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$525.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

EXTRACTOR NAIL CONICAL 12MM

Facility

$1,750.00

Hospital Charge Code	270694535
Hospital Revenue Code	272
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$525.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

EXTRACTOR NAIL CONICAL 12MM

Facility

$1,750.00

Hospital Charge Code	270694535
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

EXTRACTOR NAIL SOLID LARGE

Facility

$1,500.00

Hospital Charge Code	270688298
Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

EXTRACTOR NAIL SOLID LARGE

Facility

$1,500.00

Hospital Charge Code	270688298
Hospital Revenue Code	272
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$450.00
Rate for Payer: Oxford Commercial	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Commercial	$300.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

EXTRACTOR NCIRCLE STONE

Facility

$1,011.40

Hospital Charge Code	270653910
Hospital Revenue Code	272
Min. Negotiated Rate	$151.71
Max. Negotiated Rate	$151.71
Rate for Payer: Qualcare PPO/HMO/WC	$151.71

EXTRACTOR NCIRCLE STONE

Facility

$1,011.40

Hospital Charge Code	270653910
Hospital Revenue Code	272
Min. Negotiated Rate	$24.37
Max. Negotiated Rate	$505.70
Rate for Payer: Aetna Commercial	$384.33
Rate for Payer: Aetna Medicare Advantage	$303.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$257.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$257.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$257.91
Rate for Payer: Cigna Commercial	$505.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.42
Rate for Payer: Oxford Commercial	$202.28
Rate for Payer: Qualcare PPO/HMO/WC	$151.71
Rate for Payer: UnitedHealthcare Commercial	$202.28
Rate for Payer: UnitedHealthcare Community & State	$24.37
Rate for Payer: Wellpoint Medicaid Managed Care	$26.80

EXTRACTOR NCIRCLE STONE 2.4FR

Facility

$1,127.65

Hospital Charge Code	270658550
Hospital Revenue Code	278
Min. Negotiated Rate	$27.18
Max. Negotiated Rate	$563.83
Rate for Payer: Aetna Commercial	$428.51
Rate for Payer: Aetna Medicare Advantage	$338.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$287.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$287.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$287.55
Rate for Payer: Cigna Commercial	$563.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$248.08
Rate for Payer: Qualcare PPO/HMO/WC	$169.15
Rate for Payer: UnitedHealthcare Community & State	$27.18
Rate for Payer: Wellpoint Medicaid Managed Care	$29.88

EXTRACTOR NCIRCLE STONE 2.4FR

Facility

$1,127.65

Hospital Charge Code	270658550
Hospital Revenue Code	278
Min. Negotiated Rate	$169.15
Max. Negotiated Rate	$272.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$248.08
Rate for Payer: Qualcare PPO/HMO/WC	$169.15

EXTRACTOR PREMIUM DISPOSABLE

Facility

$9.64

Hospital Charge Code	270658686
Hospital Revenue Code	270
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

EXTRACTOR PREMIUM DISPOSABLE

Facility

$9.64

Hospital Charge Code	270658686
Hospital Revenue Code	270
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.82
Rate for Payer: Aetna Commercial	$3.66
Rate for Payer: Aetna Medicare Advantage	$2.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.89
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$1.93
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

EXTRACTOR RX 12-15 BALLON 4691

Facility

$987.10

Hospital Charge Code	270632641
Hospital Revenue Code	272
Min. Negotiated Rate	$148.06
Max. Negotiated Rate	$148.06
Rate for Payer: Qualcare PPO/HMO/WC	$148.06

EXTRACTOR RX 12-15 BALLON 4691

Facility

$987.10

Hospital Charge Code	270632641
Hospital Revenue Code	272
Min. Negotiated Rate	$23.79
Max. Negotiated Rate	$493.55
Rate for Payer: Aetna Commercial	$375.10
Rate for Payer: Aetna Medicare Advantage	$296.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.71
Rate for Payer: Cigna Commercial	$493.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.13
Rate for Payer: Oxford Commercial	$197.42
Rate for Payer: Qualcare PPO/HMO/WC	$148.06
Rate for Payer: UnitedHealthcare Commercial	$197.42
Rate for Payer: UnitedHealthcare Community & State	$23.79
Rate for Payer: Wellpoint Medicaid Managed Care	$26.16

EXTRACTOR RX 15-18mm 4692

Facility

$775.00

Hospital Charge Code	270639283
Hospital Revenue Code	272
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$116.25
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

EXTRACTOR RX 15-18mm 4692

Facility

$775.00

Hospital Charge Code	270639283
Hospital Revenue Code	272
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.50
Rate for Payer: Oxford Commercial	$155.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Commercial	$155.00
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

EXTRACTOR RX 9-12mm BALLN 4693

Facility

$775.00

Hospital Charge Code	270644048
Hospital Revenue Code	272
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$116.25
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

EXTRACTOR RX 9-12mm BALLN 4693

Facility

$775.00

Hospital Charge Code	270644048
Hospital Revenue Code	272
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.50
Rate for Payer: Oxford Commercial	$155.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Commercial	$155.00
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

EXTRACTOR RX 9-12mm BALON 4690

Facility

$987.10

Hospital Charge Code	270633201
Hospital Revenue Code	272
Min. Negotiated Rate	$148.06
Max. Negotiated Rate	$148.06
Rate for Payer: Qualcare PPO/HMO/WC	$148.06

EXTRACTOR RX 9-12mm BALON 4690

Facility

$987.10

Hospital Charge Code	270633201
Hospital Revenue Code	272
Min. Negotiated Rate	$23.79
Max. Negotiated Rate	$493.55
Rate for Payer: Aetna Commercial	$375.10
Rate for Payer: Aetna Medicare Advantage	$296.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.71
Rate for Payer: Cigna Commercial	$493.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.13
Rate for Payer: Oxford Commercial	$197.42
Rate for Payer: Qualcare PPO/HMO/WC	$148.06
Rate for Payer: UnitedHealthcare Commercial	$197.42
Rate for Payer: UnitedHealthcare Community & State	$23.79
Rate for Payer: Wellpoint Medicaid Managed Care	$26.16

EXTRACTOR S9 BROKEN 2MM DISP

Facility

$1,700.00

Hospital Charge Code	270696266
Hospital Revenue Code	272
Min. Negotiated Rate	$40.97
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$646.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$510.00
Rate for Payer: Oxford Commercial	$340.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Commercial	$340.00
Rate for Payer: UnitedHealthcare Community & State	$40.97
Rate for Payer: Wellpoint Medicaid Managed Care	$45.05

Know your out-of-pocket cost for care.

All Charges