Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FASCIA LATA MENTOR 4X7 937201

Facility

$3,793.65

Hospital Charge Code	270611023
Hospital Revenue Code	278
Min. Negotiated Rate	$569.05
Max. Negotiated Rate	$918.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$834.60
Rate for Payer: Qualcare PPO/HMO/WC	$569.05

FASCIA LATA MENTOR 5X7 937245

Facility

$3,028.00

Hospital Charge Code	270611062
Hospital Revenue Code	278
Min. Negotiated Rate	$72.97
Max. Negotiated Rate	$1,514.00
Rate for Payer: Aetna Commercial	$1,150.64
Rate for Payer: Aetna Medicare Advantage	$908.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$772.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$772.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$772.14
Rate for Payer: Cigna Commercial	$1,514.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$666.16
Rate for Payer: Qualcare PPO/HMO/WC	$454.20
Rate for Payer: UnitedHealthcare Community & State	$72.97
Rate for Payer: Wellpoint Medicaid Managed Care	$80.24

FASCIA LATA MENTOR 5X7 937245

Facility

$3,028.00

Hospital Charge Code	270611062
Hospital Revenue Code	278
Min. Negotiated Rate	$454.20
Max. Negotiated Rate	$732.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$666.16
Rate for Payer: Qualcare PPO/HMO/WC	$454.20

Faslodex 250mg/5ml

Facility

$5,266.45

Hospital Charge Code	6000436
Hospital Revenue Code	636
Min. Negotiated Rate	$126.92
Max. Negotiated Rate	$2,633.22
Rate for Payer: Aetna Commercial	$2,001.25
Rate for Payer: Aetna Medicare Advantage	$1,579.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,342.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,342.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,342.94
Rate for Payer: Cigna Commercial	$2,633.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,274.48
Rate for Payer: Qualcare PPO/HMO/WC	$789.97
Rate for Payer: UnitedHealthcare Community & State	$126.92
Rate for Payer: Wellpoint Medicaid Managed Care	$139.56

Faslodex 250mg/5ml

Facility

$5,266.45

Hospital Charge Code	6000436
Hospital Revenue Code	636
Min. Negotiated Rate	$789.97
Max. Negotiated Rate	$1,274.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,274.48
Rate for Payer: Qualcare PPO/HMO/WC	$789.97

FASTAK II SPEAR W/TROCAR

Facility

$1,850.00

Hospital Charge Code	270656514
Hospital Revenue Code	278
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$447.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$407.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

FASTAK II SPEAR W/TROCAR

Facility

$1,850.00

Hospital Charge Code	270656514
Hospital Revenue Code	278
Min. Negotiated Rate	$44.59
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$703.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$407.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Community & State	$44.59
Rate for Payer: Wellpoint Medicaid Managed Care	$49.02

FASTENER CART EXOSHAPE 11X30mm

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270678722
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

FASTENER CART EXOSHAPE 11X30mm

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270678722
Hospital Revenue Code	278
Min. Negotiated Rate	$95.80
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$95.80
Rate for Payer: Wellpoint Medicaid Managed Care	$105.34

FASTENER FEM EXOSHAPE 10x21MM

Facility

$6,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270678192
Hospital Revenue Code	278
Min. Negotiated Rate	$162.07
Max. Negotiated Rate	$3,362.50
Rate for Payer: Aetna Commercial	$2,555.50
Rate for Payer: Aetna Medicare Advantage	$2,017.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,714.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,714.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,714.88
Rate for Payer: Cigna Commercial	$3,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,627.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,479.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,008.75
Rate for Payer: UnitedHealthcare Community & State	$162.07
Rate for Payer: Wellpoint Medicaid Managed Care	$178.21

FASTENER FEM EXOSHAPE 10x21MM

Facility

$6,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270678192
Hospital Revenue Code	278
Min. Negotiated Rate	$1,008.75
Max. Negotiated Rate	$1,627.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,627.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,479.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,008.75

FASTENER TIB EXOSHAPE 10x30MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270678193
Hospital Revenue Code	278
Min. Negotiated Rate	$95.80
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$95.80
Rate for Payer: Wellpoint Medicaid Managed Care	$105.34

FASTENER TIB EXOSHAPE 10x30MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270678193
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

FAST-FIX 360 CRVD CANNULA

Facility

$740.00

Hospital Charge Code	270661479
Hospital Revenue Code	272
Min. Negotiated Rate	$111.00
Max. Negotiated Rate	$111.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.00

FAST-FIX 360 CRVD CANNULA

Facility

$740.00

Hospital Charge Code	270661479
Hospital Revenue Code	272
Min. Negotiated Rate	$17.83
Max. Negotiated Rate	$370.00
Rate for Payer: Aetna Commercial	$281.20
Rate for Payer: Aetna Medicare Advantage	$222.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.70
Rate for Payer: Cigna Commercial	$370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.00
Rate for Payer: Oxford Commercial	$148.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.00
Rate for Payer: UnitedHealthcare Commercial	$148.00
Rate for Payer: UnitedHealthcare Community & State	$17.83
Rate for Payer: Wellpoint Medicaid Managed Care	$19.61

FAST FIX 360 CURVED NDL DELIVE

Facility

$2,327.80

Hospital Charge Code	270681122
Hospital Revenue Code	272
Min. Negotiated Rate	$56.10
Max. Negotiated Rate	$1,163.90
Rate for Payer: Aetna Commercial	$884.56
Rate for Payer: Aetna Medicare Advantage	$698.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$593.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$593.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$593.59
Rate for Payer: Cigna Commercial	$1,163.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$698.34
Rate for Payer: Oxford Commercial	$465.56
Rate for Payer: Qualcare PPO/HMO/WC	$349.17
Rate for Payer: UnitedHealthcare Commercial	$465.56
Rate for Payer: UnitedHealthcare Community & State	$56.10
Rate for Payer: Wellpoint Medicaid Managed Care	$61.69

FAST FIX 360 CURVED NDL DELIVE

Facility

$2,327.80

Hospital Charge Code	270681122
Hospital Revenue Code	272
Min. Negotiated Rate	$349.17
Max. Negotiated Rate	$349.17
Rate for Payer: Qualcare PPO/HMO/WC	$349.17

FASTFIX 360 CURVE NDL DEL SYS

Facility

$2,327.80

Service Code	HCPCS C1713
Hospital Charge Code	270646586
Hospital Revenue Code	278
Min. Negotiated Rate	$349.17
Max. Negotiated Rate	$563.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$563.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$512.12
Rate for Payer: Qualcare PPO/HMO/WC	$349.17

FASTFIX 360 CURVE NDL DEL SYS

Facility

$2,327.80

Service Code	HCPCS C1713
Hospital Charge Code	270646586
Hospital Revenue Code	278
Min. Negotiated Rate	$56.10
Max. Negotiated Rate	$1,163.90
Rate for Payer: Aetna Commercial	$884.56
Rate for Payer: Aetna Medicare Advantage	$698.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$593.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$593.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$593.59
Rate for Payer: Cigna Commercial	$1,163.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$563.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$512.12
Rate for Payer: Qualcare PPO/HMO/WC	$349.17
Rate for Payer: UnitedHealthcare Community & State	$56.10
Rate for Payer: Wellpoint Medicaid Managed Care	$61.69

FAST FIX 360 REVERSED CURVE ND

Facility

$2,327.80

Hospital Charge Code	270681124
Hospital Revenue Code	272
Min. Negotiated Rate	$349.17
Max. Negotiated Rate	$349.17
Rate for Payer: Qualcare PPO/HMO/WC	$349.17

FAST FIX 360 REVERSED CURVE ND

Facility

$2,327.80

Hospital Charge Code	270681124
Hospital Revenue Code	272
Min. Negotiated Rate	$56.10
Max. Negotiated Rate	$1,163.90
Rate for Payer: Aetna Commercial	$884.56
Rate for Payer: Aetna Medicare Advantage	$698.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$593.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$593.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$593.59
Rate for Payer: Cigna Commercial	$1,163.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$698.34
Rate for Payer: Oxford Commercial	$465.56
Rate for Payer: Qualcare PPO/HMO/WC	$349.17
Rate for Payer: UnitedHealthcare Commercial	$465.56
Rate for Payer: UnitedHealthcare Community & State	$56.10
Rate for Payer: Wellpoint Medicaid Managed Care	$61.69

FAST FIX 360 STRA NEDL DEL SYS

Facility

$2,260.00

Hospital Charge Code	270661478
Hospital Revenue Code	272
Min. Negotiated Rate	$54.47
Max. Negotiated Rate	$1,130.00
Rate for Payer: Aetna Commercial	$858.80
Rate for Payer: Aetna Medicare Advantage	$678.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$576.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$576.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$576.30
Rate for Payer: Cigna Commercial	$1,130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$678.00
Rate for Payer: Oxford Commercial	$452.00
Rate for Payer: Qualcare PPO/HMO/WC	$339.00
Rate for Payer: UnitedHealthcare Commercial	$452.00
Rate for Payer: UnitedHealthcare Community & State	$54.47
Rate for Payer: Wellpoint Medicaid Managed Care	$59.89

FAST FIX 360 STRA NEDL DEL SYS

Facility

$2,260.00

Hospital Charge Code	270661478
Hospital Revenue Code	272
Min. Negotiated Rate	$339.00
Max. Negotiated Rate	$339.00
Rate for Payer: Qualcare PPO/HMO/WC	$339.00

FAST-FIX DELIVERY SYSTEM 360

Facility

$2,260.00

Hospital Charge Code	270661476
Hospital Revenue Code	272
Min. Negotiated Rate	$339.00
Max. Negotiated Rate	$339.00
Rate for Payer: Qualcare PPO/HMO/WC	$339.00

FAST-FIX DELIVERY SYSTEM 360

Facility

$2,260.00

Hospital Charge Code	270661476
Hospital Revenue Code	272
Min. Negotiated Rate	$54.47
Max. Negotiated Rate	$1,130.00
Rate for Payer: Aetna Commercial	$858.80
Rate for Payer: Aetna Medicare Advantage	$678.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$576.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$576.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$576.30
Rate for Payer: Cigna Commercial	$1,130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$678.00
Rate for Payer: Oxford Commercial	$452.00
Rate for Payer: Qualcare PPO/HMO/WC	$339.00
Rate for Payer: UnitedHealthcare Commercial	$452.00
Rate for Payer: UnitedHealthcare Community & State	$54.47
Rate for Payer: Wellpoint Medicaid Managed Care	$59.89

Know your out-of-pocket cost for care.

All Charges