Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FIBERWIRE #2 2.4x12MM

Facility

$2,180.00

Hospital Charge Code	270672002
Hospital Revenue Code	272
Min. Negotiated Rate	$327.00
Max. Negotiated Rate	$327.00
Rate for Payer: Qualcare PPO/HMO/WC	$327.00

FIBER WIRE 2/5 METRIC

Facility

$110.00

Hospital Charge Code	270668477
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 2/5 METRIC

Facility

$110.00

Hospital Charge Code	270668477
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 DOUBLE W/NEEDLE

Facility

$240.00

Hospital Charge Code	270676222
Hospital Revenue Code	272
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.00
Rate for Payer: Oxford Commercial	$48.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$48.00
Rate for Payer: UnitedHealthcare Community & State	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

FIBERWIRE #2 DOUBLE W/NEEDLE

Facility

$240.00

Hospital Charge Code	270676222
Hospital Revenue Code	272
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

FIBERWIRE #2 TPR 36MM 1.2 CIRC

Facility

$110.00

Hospital Charge Code	270684048
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 TPR 36MM 1.2 CIRC

Facility

$110.00

Hospital Charge Code	270684048
Hospital Revenue Code	272
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

FIBERWIRE CRVD NDL 26 MM 1/2 C

Facility

$95.00

Hospital Charge Code	270689196
Hospital Revenue Code	272
Min. Negotiated Rate	$14.25
Max. Negotiated Rate	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$14.25

FIBERWIRE CRVD NDL 26 MM 1/2 C

Facility

$95.00

Hospital Charge Code	270689196
Hospital Revenue Code	272
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$47.50
Rate for Payer: Aetna Commercial	$36.10
Rate for Payer: Aetna Medicare Advantage	$28.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.23
Rate for Payer: Cigna Commercial	$47.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.50
Rate for Payer: Oxford Commercial	$19.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.25
Rate for Payer: UnitedHealthcare Commercial	$19.00
Rate for Payer: UnitedHealthcare Community & State	$2.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2.52

FIBERWIRE FIBERSTICK 2-0

Facility

$210.00

Hospital Charge Code	270691001
Hospital Revenue Code	272
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

FIBERWIRE FIBERSTICK 2-0

Facility

$210.00

Hospital Charge Code	270691001
Hospital Revenue Code	272
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$79.80
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.00
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$42.00
Rate for Payer: UnitedHealthcare Community & State	$5.06
Rate for Payer: Wellpoint Medicaid Managed Care	$5.57

FIBERWIRE GRASPER

Facility

$7,475.00

Hospital Charge Code	270656516
Hospital Revenue Code	271
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,121.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

FIBERWIRE GRASPER

Facility

$7,475.00

Hospital Charge Code	270656516
Hospital Revenue Code	271
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,242.50
Rate for Payer: Oxford Commercial	$1,495.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Commercial	$1,495.00
Rate for Payer: UnitedHealthcare Community & State	$180.15
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

FIBERWIRE MENISCAL 2-0 SMALL

Facility

$360.00

Service Code	HCPCS A4649
Hospital Charge Code	270697672
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

FIBERWIRE MENISCAL 2-0 SMALL

Facility

$360.00

Service Code	HCPCS A4649
Hospital Charge Code	270697672
Hospital Revenue Code	272
Min. Negotiated Rate	$8.68
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$136.80
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.00
Rate for Payer: Oxford Commercial	$72.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$72.00
Rate for Payer: UnitedHealthcare Community & State	$8.68
Rate for Payer: Wellpoint Medicaid Managed Care	$9.54

FIB LAS 550 MIC HOL DHBFSF550D

Facility

$1,310.00

Hospital Charge Code	270640373
Hospital Revenue Code	272
Min. Negotiated Rate	$31.57
Max. Negotiated Rate	$655.00
Rate for Payer: Aetna Commercial	$497.80
Rate for Payer: Aetna Medicare Advantage	$393.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$334.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$334.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$334.05
Rate for Payer: Cigna Commercial	$655.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.00
Rate for Payer: Oxford Commercial	$262.00
Rate for Payer: Qualcare PPO/HMO/WC	$196.50
Rate for Payer: UnitedHealthcare Commercial	$262.00
Rate for Payer: UnitedHealthcare Community & State	$31.57
Rate for Payer: Wellpoint Medicaid Managed Care	$34.72

FIB LAS 550 MIC HOL DHBFSF550D

Facility

$1,310.00

Hospital Charge Code	270640373
Hospital Revenue Code	272
Min. Negotiated Rate	$196.50
Max. Negotiated Rate	$196.50
Rate for Payer: Qualcare PPO/HMO/WC	$196.50

FIBRINET (MMRB0004)

Facility

$8,975.00

Hospital Charge Code	270693823
Hospital Revenue Code	272
Min. Negotiated Rate	$216.30
Max. Negotiated Rate	$4,487.50
Rate for Payer: Aetna Commercial	$3,410.50
Rate for Payer: Aetna Medicare Advantage	$2,692.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,288.62
Rate for Payer: Cigna Commercial	$4,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,692.50
Rate for Payer: Oxford Commercial	$1,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25
Rate for Payer: UnitedHealthcare Commercial	$1,795.00
Rate for Payer: UnitedHealthcare Community & State	$216.30
Rate for Payer: Wellpoint Medicaid Managed Care	$237.84

FIBRINET (MMRB0004)

Facility

$8,975.00

Hospital Charge Code	270693823
Hospital Revenue Code	272
Min. Negotiated Rate	$1,346.25
Max. Negotiated Rate	$1,346.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25

FIBRINET PLATELETRICHPLASMAKIT

Facility

$17,500.00

Hospital Charge Code	270686056
Hospital Revenue Code	270
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$2,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

FIBRINET PLATELETRICHPLASMAKIT

Facility

$17,500.00

Hospital Charge Code	270686056
Hospital Revenue Code	270
Min. Negotiated Rate	$421.75
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$6,650.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,250.00
Rate for Payer: Oxford Commercial	$3,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Commercial	$3,500.00
Rate for Payer: UnitedHealthcare Community & State	$421.75
Rate for Payer: Wellpoint Medicaid Managed Care	$463.75

FIBRINET PRP

Facility

$8,975.00

Hospital Charge Code	270693149
Hospital Revenue Code	272
Min. Negotiated Rate	$1,346.25
Max. Negotiated Rate	$1,346.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25

FIBRINET PRP

Facility

$8,975.00

Hospital Charge Code	270693149
Hospital Revenue Code	272
Min. Negotiated Rate	$216.30
Max. Negotiated Rate	$4,487.50
Rate for Payer: Aetna Commercial	$3,410.50
Rate for Payer: Aetna Medicare Advantage	$2,692.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,288.62
Rate for Payer: Cigna Commercial	$4,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,692.50
Rate for Payer: Oxford Commercial	$1,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25
Rate for Payer: UnitedHealthcare Commercial	$1,795.00
Rate for Payer: UnitedHealthcare Community & State	$216.30
Rate for Payer: Wellpoint Medicaid Managed Care	$237.84

FIBRINOGEN

Facility

$58.40

Service Code	HCPCS 85384
Hospital Charge Code	39900171
Hospital Revenue Code	305
Min. Negotiated Rate	$8.76
Max. Negotiated Rate	$8.76
Rate for Payer: Qualcare PPO/HMO/WC	$8.76

FIBRINOGEN

Facility

$118.00

Service Code	HCPCS 85384
Hospital Charge Code	38478014
Hospital Revenue Code	305
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$26.44
Rate for Payer: Aetna Medicare Advantage	$31.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.09
Rate for Payer: Cigna Commercial	$59.00
Rate for Payer: Cigna Medicare Advantage	$9.72
Rate for Payer: Clover Medicare Advantage	$9.23
Rate for Payer: EmblemHealth Commercial	$29.16
Rate for Payer: Humana Medicare Advantage	$10.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.72
Rate for Payer: Wellcare Medicare Advantage	$9.72
Rate for Payer: Wellpoint Medicaid Managed Care	$3.13

Know your out-of-pocket cost for care.

All Charges