Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FLEXBAND TWIST .30

Facility

$25,478.75

Hospital Charge Code	270702754
Hospital Revenue Code	278
Min. Negotiated Rate	$614.04
Max. Negotiated Rate	$12,739.38
Rate for Payer: Aetna Commercial	$9,681.92
Rate for Payer: Aetna Medicare Advantage	$7,643.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,497.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,497.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,095.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,497.08
Rate for Payer: Cigna Commercial	$12,739.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,165.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,605.32
Rate for Payer: Qualcare PPO/HMO/WC	$3,821.81
Rate for Payer: UnitedHealthcare Community & State	$614.04
Rate for Payer: Wellpoint Medicaid Managed Care	$675.19

FLEXBAND TWIST .30

Facility

$25,478.75

Hospital Charge Code	270702754
Hospital Revenue Code	278
Min. Negotiated Rate	$3,821.81
Max. Negotiated Rate	$6,165.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,095.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,165.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,605.32
Rate for Payer: Qualcare PPO/HMO/WC	$3,821.81

FLEXBAND TWIST DRIVE 3.85

Facility

$3,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270706007
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$804.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$731.50
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

FLEXBAND TWIST DRIVE 3.85

Facility

$3,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270706007
Hospital Revenue Code	278
Min. Negotiated Rate	$80.13
Max. Negotiated Rate	$1,662.50
Rate for Payer: Aetna Commercial	$1,263.50
Rate for Payer: Aetna Medicare Advantage	$997.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$847.88
Rate for Payer: Cigna Commercial	$1,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$731.50
Rate for Payer: Qualcare PPO/HMO/WC	$498.75
Rate for Payer: UnitedHealthcare Community & State	$80.13
Rate for Payer: Wellpoint Medicaid Managed Care	$88.11

FLEXBAND TWIST DRIVE 5.0

Facility

$3,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270706048
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$804.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$731.50
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

FLEXBAND TWIST DRIVE 5.0

Facility

$3,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270706048
Hospital Revenue Code	278
Min. Negotiated Rate	$80.13
Max. Negotiated Rate	$1,662.50
Rate for Payer: Aetna Commercial	$1,263.50
Rate for Payer: Aetna Medicare Advantage	$997.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$847.88
Rate for Payer: Cigna Commercial	$1,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$731.50
Rate for Payer: Qualcare PPO/HMO/WC	$498.75
Rate for Payer: UnitedHealthcare Community & State	$80.13
Rate for Payer: Wellpoint Medicaid Managed Care	$88.11

FLEXCEL CAROT SHUNT

Facility

$270.00

Hospital Charge Code	270683757
Hospital Revenue Code	278
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.40
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Community & State	$6.51
Rate for Payer: Wellpoint Medicaid Managed Care	$7.16

FLEXCEL CAROT SHUNT

Facility

$270.00

Hospital Charge Code	270683757
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$65.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.40
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

FLEX DRILL

Facility

$2,670.00

Hospital Charge Code	270683740
Hospital Revenue Code	272
Min. Negotiated Rate	$400.50
Max. Negotiated Rate	$400.50
Rate for Payer: Qualcare PPO/HMO/WC	$400.50

FLEX DRILL

Facility

$2,670.00

Hospital Charge Code	270683740
Hospital Revenue Code	272
Min. Negotiated Rate	$64.35
Max. Negotiated Rate	$1,335.00
Rate for Payer: Aetna Commercial	$1,014.60
Rate for Payer: Aetna Medicare Advantage	$801.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$680.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$680.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$680.85
Rate for Payer: Cigna Commercial	$1,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$801.00
Rate for Payer: Oxford Commercial	$534.00
Rate for Payer: Qualcare PPO/HMO/WC	$400.50
Rate for Payer: UnitedHealthcare Commercial	$534.00
Rate for Payer: UnitedHealthcare Community & State	$64.35
Rate for Payer: Wellpoint Medicaid Managed Care	$70.75

FLEX DYNAM NATRIX 0.5X16CM

Facility

$21,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704501
Hospital Revenue Code	279
Min. Negotiated Rate	$516.95
Max. Negotiated Rate	$10,725.00
Rate for Payer: Aetna Commercial	$8,151.00
Rate for Payer: Aetna Medicare Advantage	$6,435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,469.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,469.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,469.75
Rate for Payer: Cigna Commercial	$10,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,435.00
Rate for Payer: Oxford Commercial	$4,290.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,217.50
Rate for Payer: UnitedHealthcare Commercial	$4,290.00
Rate for Payer: UnitedHealthcare Community & State	$516.95
Rate for Payer: Wellpoint Medicaid Managed Care	$568.42

FLEX DYNAM NATRIX 0.5X16CM

Facility

$21,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704501
Hospital Revenue Code	279
Min. Negotiated Rate	$3,217.50
Max. Negotiated Rate	$3,217.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,217.50

FLEXERIL/10MG/TAB

Facility

$7.00

Hospital Charge Code	60632996
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.66
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.40
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

FLEXERIL/10MG/TAB

Facility

$7.00

Hospital Charge Code	60632995
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.66
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.40
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

FLEXERIL/10MG/TAB

Facility

$7.00

Hospital Charge Code	60632996
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

FLEXERIL/10MG/TAB

Facility

$7.00

Hospital Charge Code	60632995
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

FLEX HD MESH GRAFTS 6CM X 12CM

Facility

$13,105.00

Hospital Charge Code	270663194
Hospital Revenue Code	278
Min. Negotiated Rate	$315.83
Max. Negotiated Rate	$6,552.50
Rate for Payer: Aetna Commercial	$4,979.90
Rate for Payer: Aetna Medicare Advantage	$3,931.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,341.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,341.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,621.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,341.78
Rate for Payer: Cigna Commercial	$6,552.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,171.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,883.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,965.75
Rate for Payer: UnitedHealthcare Community & State	$315.83
Rate for Payer: Wellpoint Medicaid Managed Care	$347.28

FLEX HD MESH GRAFTS 6CM X 12CM

Facility

$13,105.00

Hospital Charge Code	270663194
Hospital Revenue Code	278
Min. Negotiated Rate	$1,965.75
Max. Negotiated Rate	$3,171.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,621.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,171.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,883.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,965.75

FLEX HD MESH GRAFTS 6CMX16CM

Facility

$17,480.00

Hospital Charge Code	270663195
Hospital Revenue Code	278
Min. Negotiated Rate	$421.27
Max. Negotiated Rate	$8,740.00
Rate for Payer: Aetna Commercial	$6,642.40
Rate for Payer: Aetna Medicare Advantage	$5,244.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,457.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,457.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,496.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,457.40
Rate for Payer: Cigna Commercial	$8,740.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,230.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,845.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,622.00
Rate for Payer: UnitedHealthcare Community & State	$421.27
Rate for Payer: Wellpoint Medicaid Managed Care	$463.22

FLEX HD MESH GRAFTS 6CMX16CM

Facility

$17,480.00

Hospital Charge Code	270663195
Hospital Revenue Code	278
Min. Negotiated Rate	$2,622.00
Max. Negotiated Rate	$4,230.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,496.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,230.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,845.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,622.00

FLEXIBLE COLLODION

Facility

$52.50

Hospital Charge Code	6012561
Hospital Revenue Code	250
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$7.88
Rate for Payer: Qualcare PPO/HMO/WC	$7.88

FLEXIBLE COLLODION

Facility

$52.50

Hospital Charge Code	6012561
Hospital Revenue Code	250
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$26.25
Rate for Payer: Aetna Commercial	$19.95
Rate for Payer: Aetna Medicare Advantage	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.39
Rate for Payer: Cigna Commercial	$26.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.75
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.88
Rate for Payer: UnitedHealthcare Commercial	$10.50
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.39

FLEXIBLE DRILL

Facility

$3,901.95

Hospital Charge Code	270656680
Hospital Revenue Code	272
Min. Negotiated Rate	$585.29
Max. Negotiated Rate	$585.29
Rate for Payer: Qualcare PPO/HMO/WC	$585.29

FLEXIBLE DRILL

Facility

$3,901.95

Hospital Charge Code	270656680
Hospital Revenue Code	272
Min. Negotiated Rate	$94.04
Max. Negotiated Rate	$1,950.97
Rate for Payer: Aetna Commercial	$1,482.74
Rate for Payer: Aetna Medicare Advantage	$1,170.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$995.00
Rate for Payer: Cigna Commercial	$1,950.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,170.59
Rate for Payer: Oxford Commercial	$780.39
Rate for Payer: Qualcare PPO/HMO/WC	$585.29
Rate for Payer: UnitedHealthcare Commercial	$780.39
Rate for Payer: UnitedHealthcare Community & State	$94.04
Rate for Payer: Wellpoint Medicaid Managed Care	$103.40

FLEXIBLE DRILL ASSEMBLE 8 MM

Facility

$1,959.90

Hospital Charge Code	270690396
Hospital Revenue Code	272
Min. Negotiated Rate	$293.99
Max. Negotiated Rate	$293.99
Rate for Payer: Qualcare PPO/HMO/WC	$293.99

Know your out-of-pocket cost for care.

All Charges