Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FIBER PLUS 5CC

Facility

$6,250.00

Service Code	HCPCS C1765
Hospital Charge Code	270706119
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
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

FIBER PLUS 5CC

Facility

$6,250.00

Service Code	HCPCS C1765
Hospital Charge Code	27706118
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
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

FIBERS 5CC

Facility

$5,375.00

Hospital Charge Code	270703014
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

FIBERS 5CC

Facility

$5,375.00

Hospital Charge Code	270703014
Hospital Revenue Code	278
Min. Negotiated Rate	$129.54
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$2,042.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,182.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25
Rate for Payer: UnitedHealthcare Community & State	$129.54
Rate for Payer: Wellpoint Medicaid Managed Care	$142.44

FIBER SITCH IMPLANT CURVED

Facility

$2,475.00

Service Code	HCPCS C1781
Hospital Charge Code	270688601
Hospital Revenue Code	278
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

FIBER SITCH IMPLANT CURVED

Facility

$2,475.00

Service Code	HCPCS C1781
Hospital Charge Code	270688601
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

FIBER SMALL BIONEST

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270692119
Hospital Revenue Code	278
Min. Negotiated Rate	$45.19
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$49.69

FIBER SMALL BIONEST

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270692119
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

FIBERS NMPS LONG LARGE

Facility

$27,425.00

Hospital Charge Code	270703251
Hospital Revenue Code	278
Min. Negotiated Rate	$660.94
Max. Negotiated Rate	$13,712.50
Rate for Payer: Aetna Commercial	$10,421.50
Rate for Payer: Aetna Medicare Advantage	$8,227.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,993.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,993.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,993.38
Rate for Payer: Cigna Commercial	$13,712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,636.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,033.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,113.75
Rate for Payer: UnitedHealthcare Community & State	$660.94
Rate for Payer: Wellpoint Medicaid Managed Care	$726.76

FIBERS NMPS LONG LARGE

Facility

$27,425.00

Hospital Charge Code	270703251
Hospital Revenue Code	278
Min. Negotiated Rate	$4,113.75
Max. Negotiated Rate	$6,636.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,636.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,033.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,113.75

FIBER STACK PATCHES

Facility

$10,500.00

Hospital Charge Code	270670494
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

FIBER STACK PATCHES

Facility

$10,500.00

Hospital Charge Code	270670494
Hospital Revenue Code	278
Min. Negotiated Rate	$253.05
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$253.05
Rate for Payer: Wellpoint Medicaid Managed Care	$278.25

FIBERSTICH IMPL 24D

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270697671
Hospital Revenue Code	278
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

FIBERSTICH IMPL 24D

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270697671
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

FIBER STICK

Facility

$250.00

Hospital Charge Code	270652152
Hospital Revenue Code	270
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

FIBER STICK

Facility

$250.00

Hospital Charge Code	270652152
Hospital Revenue Code	270
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

FIBERSTICK 1.3MM SUTURE TAPE

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	270703173
Hospital Revenue Code	278
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$94.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$85.80
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FIBERSTICK 1.3MM SUTURE TAPE

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	270703173
Hospital Revenue Code	278
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$85.80
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Community & State	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

FIBERSTITCH 1.5

Facility

$2,832.50

Hospital Charge Code	270702600
Hospital Revenue Code	278
Min. Negotiated Rate	$68.26
Max. Negotiated Rate	$1,416.25
Rate for Payer: Aetna Commercial	$1,076.35
Rate for Payer: Aetna Medicare Advantage	$849.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$722.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$722.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$566.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$722.29
Rate for Payer: Cigna Commercial	$1,416.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$685.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$623.15
Rate for Payer: Qualcare PPO/HMO/WC	$424.88
Rate for Payer: UnitedHealthcare Community & State	$68.26
Rate for Payer: Wellpoint Medicaid Managed Care	$75.06

FIBERSTITCH 1.5

Facility

$2,832.50

Hospital Charge Code	270702600
Hospital Revenue Code	278
Min. Negotiated Rate	$424.88
Max. Negotiated Rate	$685.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$566.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$685.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$623.15
Rate for Payer: Qualcare PPO/HMO/WC	$424.88

FIBERSTITCH IMPLANT 1.5 CURVED

Facility

$2,832.50

Service Code	HCPCS C1889
Hospital Charge Code	270703169
Hospital Revenue Code	278
Min. Negotiated Rate	$68.26
Max. Negotiated Rate	$1,416.25
Rate for Payer: Aetna Commercial	$1,076.35
Rate for Payer: Aetna Medicare Advantage	$849.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$722.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$722.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$566.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$722.29
Rate for Payer: Cigna Commercial	$1,416.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$685.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$623.15
Rate for Payer: Qualcare PPO/HMO/WC	$424.88
Rate for Payer: UnitedHealthcare Community & State	$68.26
Rate for Payer: Wellpoint Medicaid Managed Care	$75.06

FIBERSTITCH IMPLANT 1.5 CURVED

Facility

$2,832.50

Service Code	HCPCS C1889
Hospital Charge Code	270703169
Hospital Revenue Code	278
Min. Negotiated Rate	$424.88
Max. Negotiated Rate	$685.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$566.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$685.47
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$623.15
Rate for Payer: Qualcare PPO/HMO/WC	$424.88

FIBER SUPER 270 RE HF0200RSSMS

Facility

$4,464.00

Hospital Charge Code	270634053
Hospital Revenue Code	272
Min. Negotiated Rate	$107.58
Max. Negotiated Rate	$2,232.00
Rate for Payer: Aetna Commercial	$1,696.32
Rate for Payer: Aetna Medicare Advantage	$1,339.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,138.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,138.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,138.32
Rate for Payer: Cigna Commercial	$2,232.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,339.20
Rate for Payer: Oxford Commercial	$892.80
Rate for Payer: Qualcare PPO/HMO/WC	$669.60
Rate for Payer: UnitedHealthcare Commercial	$892.80
Rate for Payer: UnitedHealthcare Community & State	$107.58
Rate for Payer: Wellpoint Medicaid Managed Care	$118.30

FIBER SUPER 270 RE HF0200RSSMS

Facility

$4,464.00

Hospital Charge Code	270634053
Hospital Revenue Code	272
Min. Negotiated Rate	$669.60
Max. Negotiated Rate	$669.60
Rate for Payer: Qualcare PPO/HMO/WC	$669.60

FIBERTACK SUT ANCHOR KNOTLESS

Facility

$2,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270695226
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$719.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$654.50
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

Know your out-of-pocket cost for care.

All Charges