Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FIBER TAPE 2MM

Facility

$630.00

Hospital Charge Code	270662177
Hospital Revenue Code	272
Min. Negotiated Rate	$94.50
Max. Negotiated Rate	$94.50
Rate for Payer: Qualcare PPO/HMO/WC	$94.50

FIBER TAPE 2MM

Facility

$630.00

Hospital Charge Code	270662177
Hospital Revenue Code	272
Min. Negotiated Rate	$15.18
Max. Negotiated Rate	$315.00
Rate for Payer: Aetna Commercial	$239.40
Rate for Payer: Aetna Medicare Advantage	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.65
Rate for Payer: Cigna Commercial	$315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.00
Rate for Payer: Oxford Commercial	$126.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.50
Rate for Payer: UnitedHealthcare Commercial	$126.00
Rate for Payer: UnitedHealthcare Community & State	$15.18
Rate for Payer: Wellpoint Medicaid Managed Care	$16.70

FIBER TAPE 2MM 7 BLUE

Facility

$250.00

Hospital Charge Code	270664798
Hospital Revenue Code	270
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

FIBER TAPE 2MM 7 BLUE

Facility

$250.00

Hospital Charge Code	270664798
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

FIBER TAPE 54,2mm BLUE

Facility

$475.00

Hospital Charge Code	270655833
Hospital Revenue Code	271
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

FIBER TAPE 54,2mm BLUE

Facility

$475.00

Hospital Charge Code	270655833
Hospital Revenue Code	271
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.50
Rate for Payer: Oxford Commercial	$95.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Commercial	$95.00
Rate for Payer: UnitedHealthcare Community & State	$11.45
Rate for Payer: Wellpoint Medicaid Managed Care	$12.59

FIBER TAPE BLUE ST NEEDLE 2mm

Facility

$250.00

Hospital Charge Code	270678377
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 TAPE BLUE ST NEEDLE 2mm

Facility

$250.00

Hospital Charge Code	270678377
Hospital Revenue Code	272
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

FIBERTAPE CERLAGE SUTURE

Facility

$2,250.00

Hospital Charge Code	270686292
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

FIBERTAPE CERLAGE SUTURE

Facility

$2,250.00

Hospital Charge Code	270686292
Hospital Revenue Code	272
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$675.00
Rate for Payer: Oxford Commercial	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$450.00
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

FIBERTAPE CUTTER

Facility

$5,250.00

Hospital Charge Code	270675962
Hospital Revenue Code	272
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$787.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

FIBERTAPE CUTTER

Facility

$5,250.00

Hospital Charge Code	270675962
Hospital Revenue Code	272
Min. Negotiated Rate	$126.53
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,575.00
Rate for Payer: Oxford Commercial	$1,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Commercial	$1,050.00
Rate for Payer: UnitedHealthcare Community & State	$126.53
Rate for Payer: Wellpoint Medicaid Managed Care	$139.12

FIBERTAPE STERNAL CLOSURE W TA

Facility

$901.25

Service Code	HCPCS C1765
Hospital Charge Code	270706199
Hospital Revenue Code	278
Min. Negotiated Rate	$135.19
Max. Negotiated Rate	$218.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.28
Rate for Payer: Qualcare PPO/HMO/WC	$135.19

FIBERTAPE STERNAL CLOSURE W TA

Facility

$901.25

Service Code	HCPCS C1765
Hospital Charge Code	270706199
Hospital Revenue Code	278
Min. Negotiated Rate	$21.72
Max. Negotiated Rate	$450.62
Rate for Payer: Aetna Commercial	$342.48
Rate for Payer: Aetna Medicare Advantage	$270.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.82
Rate for Payer: Cigna Commercial	$450.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.28
Rate for Payer: Qualcare PPO/HMO/WC	$135.19
Rate for Payer: UnitedHealthcare Community & State	$21.72
Rate for Payer: Wellpoint Medicaid Managed Care	$23.88

FIBERTAPE STRAIGHT PASSER

Facility

$1,158.75

Hospital Charge Code	270705444
Hospital Revenue Code	272
Min. Negotiated Rate	$173.81
Max. Negotiated Rate	$173.81
Rate for Payer: Qualcare PPO/HMO/WC	$173.81

FIBERTAPE STRAIGHT PASSER

Facility

$1,158.75

Hospital Charge Code	270705444
Hospital Revenue Code	272
Min. Negotiated Rate	$27.93
Max. Negotiated Rate	$579.38
Rate for Payer: Aetna Commercial	$440.32
Rate for Payer: Aetna Medicare Advantage	$347.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$295.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$295.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$295.48
Rate for Payer: Cigna Commercial	$579.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.62
Rate for Payer: Oxford Commercial	$231.75
Rate for Payer: Qualcare PPO/HMO/WC	$173.81
Rate for Payer: UnitedHealthcare Commercial	$231.75
Rate for Payer: UnitedHealthcare Community & State	$27.93
Rate for Payer: Wellpoint Medicaid Managed Care	$30.71

FIBERTAPE TENDON COMPRESSION

Facility

$3,000.00

Hospital Charge Code	270686294
Hospital Revenue Code	272
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

FIBERTAPE TENDON COMPRESSION

Facility

$3,000.00

Hospital Charge Code	270686294
Hospital Revenue Code	272
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$900.00
Rate for Payer: Oxford Commercial	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Commercial	$600.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

FIBERWIRE

Facility

$110.00

Hospital Charge Code	270656515
Hospital Revenue Code	271
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.00
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$22.00
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

FIBERWIRE

Facility

$110.00

Hospital Charge Code	270656515
Hospital Revenue Code	271
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

FIBER WIRE 0 38

Facility

$110.00

Hospital Charge Code	270681225
Hospital Revenue Code	272
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

FIBER WIRE 0 38

Facility

$110.00

Hospital Charge Code	270681225
Hospital Revenue Code	272
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.00
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$22.00
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

FIBERWIRE 2-0

Facility

$110.00

Hospital Charge Code	270659179
Hospital Revenue Code	272
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.00
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$22.00
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

FIBERWIRE 2-0

Facility

$110.00

Hospital Charge Code	270659179
Hospital Revenue Code	272
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

FIBERWIRE #2 2.4x12MM

Facility

$2,180.00

Hospital Charge Code	270672002
Hospital Revenue Code	272
Min. Negotiated Rate	$52.54
Max. Negotiated Rate	$1,090.00
Rate for Payer: Aetna Commercial	$828.40
Rate for Payer: Aetna Medicare Advantage	$654.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$555.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$555.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$555.90
Rate for Payer: Cigna Commercial	$1,090.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.00
Rate for Payer: Oxford Commercial	$436.00
Rate for Payer: Qualcare PPO/HMO/WC	$327.00
Rate for Payer: UnitedHealthcare Commercial	$436.00
Rate for Payer: UnitedHealthcare Community & State	$52.54
Rate for Payer: Wellpoint Medicaid Managed Care	$57.77

Know your out-of-pocket cost for care.

All Charges