Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FIBER LASER HOLMIUM 550

Facility

$1,340.00

Hospital Charge Code	270673456
Hospital Revenue Code	272
Min. Negotiated Rate	$32.29
Max. Negotiated Rate	$670.00
Rate for Payer: Aetna Commercial	$509.20
Rate for Payer: Aetna Medicare Advantage	$402.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$341.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$341.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$341.70
Rate for Payer: Cigna Commercial	$670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$402.00
Rate for Payer: Oxford Commercial	$268.00
Rate for Payer: Qualcare PPO/HMO/WC	$201.00
Rate for Payer: UnitedHealthcare Commercial	$268.00
Rate for Payer: UnitedHealthcare Community & State	$32.29
Rate for Payer: Wellpoint Medicaid Managed Care	$35.51

FIBER LASER SLIMLINE 1000

Facility

$6,301.75

Hospital Charge Code	270668931
Hospital Revenue Code	272
Min. Negotiated Rate	$945.26
Max. Negotiated Rate	$945.26
Rate for Payer: Qualcare PPO/HMO/WC	$945.26

FIBER LASER SLIMLINE 1000

Facility

$6,301.75

Hospital Charge Code	270668931
Hospital Revenue Code	272
Min. Negotiated Rate	$151.87
Max. Negotiated Rate	$3,150.88
Rate for Payer: Aetna Commercial	$2,394.66
Rate for Payer: Aetna Medicare Advantage	$1,890.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,606.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,606.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,606.95
Rate for Payer: Cigna Commercial	$3,150.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,890.53
Rate for Payer: Oxford Commercial	$1,260.35
Rate for Payer: Qualcare PPO/HMO/WC	$945.26
Rate for Payer: UnitedHealthcare Commercial	$1,260.35
Rate for Payer: UnitedHealthcare Community & State	$151.87
Rate for Payer: Wellpoint Medicaid Managed Care	$167.00

FIBER LOOP #2

Facility

$250.00

Hospital Charge Code	270672233
Hospital Revenue Code	272
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.00
Rate for Payer: Oxford Commercial	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$50.00
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

FIBER LOOP #2

Facility

$250.00

Hospital Charge Code	270661067
Hospital Revenue Code	272
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

FIBER LOOP #2

Facility

$250.00

Hospital Charge Code	270661067
Hospital Revenue Code	272
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.00
Rate for Payer: Oxford Commercial	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$50.00
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

FIBER LOOP #2

Facility

$250.00

Hospital Charge Code	270672233
Hospital Revenue Code	272
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

FIBERLOOP SUTURETAPE TIGER STR

Facility

$350.00

Hospital Charge Code	270683448
Hospital Revenue Code	272
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.00
Rate for Payer: Oxford Commercial	$70.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Commercial	$70.00
Rate for Payer: UnitedHealthcare Community & State	$8.44
Rate for Payer: Wellpoint Medicaid Managed Care	$9.28

FIBERLOOP SUTURETAPE TIGER STR

Facility

$350.00

Hospital Charge Code	270683448
Hospital Revenue Code	272
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

FIBER MEDIUM BIONEST

Facility

$3,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692121
Hospital Revenue Code	278
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

FIBER MEDIUM BIONEST

Facility

$3,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692121
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

FIBER MICRON FLEXIVA 1000MM

Facility

$4,924.90

Hospital Charge Code	270655920
Hospital Revenue Code	272
Min. Negotiated Rate	$118.69
Max. Negotiated Rate	$2,462.45
Rate for Payer: Aetna Commercial	$1,871.46
Rate for Payer: Aetna Medicare Advantage	$1,477.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,255.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,255.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,255.85
Rate for Payer: Cigna Commercial	$2,462.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,477.47
Rate for Payer: Oxford Commercial	$984.98
Rate for Payer: Qualcare PPO/HMO/WC	$738.74
Rate for Payer: UnitedHealthcare Commercial	$984.98
Rate for Payer: UnitedHealthcare Community & State	$118.69
Rate for Payer: Wellpoint Medicaid Managed Care	$130.51

FIBER MICRON FLEXIVA 1000MM

Facility

$4,924.90

Hospital Charge Code	270655920
Hospital Revenue Code	272
Min. Negotiated Rate	$738.74
Max. Negotiated Rate	$738.74
Rate for Payer: Qualcare PPO/HMO/WC	$738.74

FIBER MICRON FLEXIVA 200MM

Facility

$6,056.40

Hospital Charge Code	270655917
Hospital Revenue Code	272
Min. Negotiated Rate	$145.96
Max. Negotiated Rate	$3,028.20
Rate for Payer: Aetna Commercial	$2,301.43
Rate for Payer: Aetna Medicare Advantage	$1,816.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,544.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,544.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,544.38
Rate for Payer: Cigna Commercial	$3,028.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,816.92
Rate for Payer: Oxford Commercial	$1,211.28
Rate for Payer: Qualcare PPO/HMO/WC	$908.46
Rate for Payer: UnitedHealthcare Commercial	$1,211.28
Rate for Payer: UnitedHealthcare Community & State	$145.96
Rate for Payer: Wellpoint Medicaid Managed Care	$160.49

FIBER MICRON FLEXIVA 200MM

Facility

$2,229.75

Hospital Charge Code	270656984
Hospital Revenue Code	278
Min. Negotiated Rate	$334.46
Max. Negotiated Rate	$539.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$445.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$539.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$490.55
Rate for Payer: Qualcare PPO/HMO/WC	$334.46

FIBER MICRON FLEXIVA 200MM

Facility

$2,229.75

Hospital Charge Code	270656984
Hospital Revenue Code	278
Min. Negotiated Rate	$53.74
Max. Negotiated Rate	$1,114.88
Rate for Payer: Aetna Commercial	$847.30
Rate for Payer: Aetna Medicare Advantage	$668.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$568.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$568.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$445.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$568.59
Rate for Payer: Cigna Commercial	$1,114.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$539.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$490.55
Rate for Payer: Qualcare PPO/HMO/WC	$334.46
Rate for Payer: UnitedHealthcare Community & State	$53.74
Rate for Payer: Wellpoint Medicaid Managed Care	$59.09

FIBER MICRON FLEXIVA 200MM

Facility

$6,056.40

Hospital Charge Code	270655917
Hospital Revenue Code	272
Min. Negotiated Rate	$908.46
Max. Negotiated Rate	$908.46
Rate for Payer: Qualcare PPO/HMO/WC	$908.46

FIBER MICRON FLEXIVA 550MM

Facility

$2,350.00

Hospital Charge Code	270655921
Hospital Revenue Code	272
Min. Negotiated Rate	$56.63
Max. Negotiated Rate	$1,175.00
Rate for Payer: Aetna Commercial	$893.00
Rate for Payer: Aetna Medicare Advantage	$705.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$599.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$599.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$599.25
Rate for Payer: Cigna Commercial	$1,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$705.00
Rate for Payer: Oxford Commercial	$470.00
Rate for Payer: Qualcare PPO/HMO/WC	$352.50
Rate for Payer: UnitedHealthcare Commercial	$470.00
Rate for Payer: UnitedHealthcare Community & State	$56.63
Rate for Payer: Wellpoint Medicaid Managed Care	$62.27

FIBER MICRON FLEXIVA 550MM

Facility

$2,350.00

Hospital Charge Code	270655921
Hospital Revenue Code	272
Min. Negotiated Rate	$352.50
Max. Negotiated Rate	$352.50
Rate for Payer: Qualcare PPO/HMO/WC	$352.50

FIBER MOXY LASER

Facility

$4,975.00

Hospital Charge Code	270644949
Hospital Revenue Code	270
Min. Negotiated Rate	$119.90
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,890.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,492.50
Rate for Payer: Oxford Commercial	$995.00
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Commercial	$995.00
Rate for Payer: UnitedHealthcare Community & State	$119.90
Rate for Payer: Wellpoint Medicaid Managed Care	$131.84

FIBER MOXY LASER

Facility

$4,975.00

Hospital Charge Code	270644949
Hospital Revenue Code	270
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$746.25
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

FIBEROPTIC LIGHT CABLE 4.6MM

Facility

$2,750.00

Hospital Charge Code	270698067
Hospital Revenue Code	272
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.00
Rate for Payer: Oxford Commercial	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Commercial	$550.00
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

FIBEROPTIC LIGHT CABLE 4.6MM

Facility

$2,750.00

Hospital Charge Code	270698067
Hospital Revenue Code	272
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

FIBER PLUS 5CC

Facility

$6,250.00

Service Code	HCPCS C1765
Hospital Charge Code	27706118
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

FIBER PLUS 5CC

Facility

$6,250.00

Service Code	HCPCS C1765
Hospital Charge Code	270706119
Hospital Revenue Code	278
Min. Negotiated Rate	$150.62
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$150.62
Rate for Payer: Wellpoint Medicaid Managed Care	$165.62

Know your out-of-pocket cost for care.

All Charges