Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FLEXIBLE DRILL ASSEMBLE 8 MM

Facility

$1,959.90

Hospital Charge Code	270690396
Hospital Revenue Code	272
Min. Negotiated Rate	$47.23
Max. Negotiated Rate	$979.95
Rate for Payer: Aetna Commercial	$744.76
Rate for Payer: Aetna Medicare Advantage	$587.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.77
Rate for Payer: Cigna Commercial	$979.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$587.97
Rate for Payer: Oxford Commercial	$391.98
Rate for Payer: Qualcare PPO/HMO/WC	$293.99
Rate for Payer: UnitedHealthcare Commercial	$391.98
Rate for Payer: UnitedHealthcare Community & State	$47.23
Rate for Payer: Wellpoint Medicaid Managed Care	$51.94

FLEXIBLE ENDOSCOPIC EVAL

Facility

$361.05

Service Code	HCPCS 92612GN
Hospital Charge Code	74204034
Hospital Revenue Code	440
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$137.20
Rate for Payer: Aetna Medicare Advantage	$108.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.07
Rate for Payer: Cigna Commercial	$180.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.31
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.16
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$8.70
Rate for Payer: Wellpoint Medicaid Managed Care	$9.57

FLEXIBLE ENDOSCOPIC EVAL

Facility

$361.05

Service Code	HCPCS 92612GN
Hospital Charge Code	74204034
Hospital Revenue Code	440
Min. Negotiated Rate	$54.16
Max. Negotiated Rate	$54.16
Rate for Payer: Qualcare PPO/HMO/WC	$54.16

FLEXIBLE IRIS RETRACTOR

Facility

$569.25

Hospital Charge Code	270666843
Hospital Revenue Code	272
Min. Negotiated Rate	$85.39
Max. Negotiated Rate	$85.39
Rate for Payer: Qualcare PPO/HMO/WC	$85.39

FLEXIBLE IRIS RETRACTOR

Facility

$569.25

Hospital Charge Code	270666843
Hospital Revenue Code	272
Min. Negotiated Rate	$13.72
Max. Negotiated Rate	$284.62
Rate for Payer: Aetna Commercial	$216.31
Rate for Payer: Aetna Medicare Advantage	$170.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.16
Rate for Payer: Cigna Commercial	$284.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.78
Rate for Payer: Oxford Commercial	$113.85
Rate for Payer: Qualcare PPO/HMO/WC	$85.39
Rate for Payer: UnitedHealthcare Commercial	$113.85
Rate for Payer: UnitedHealthcare Community & State	$13.72
Rate for Payer: Wellpoint Medicaid Managed Care	$15.09

FLEXIBLE REAMER 11 MM

Facility

$1,750.00

Hospital Charge Code	270688543
Hospital Revenue Code	272
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$525.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

FLEXIBLE REAMER 11 MM

Facility

$1,750.00

Hospital Charge Code	270688543
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

FLEXIGRAFT

Facility

$15,277.50

Service Code	HCPCS C1781
Hospital Charge Code	270664582
Hospital Revenue Code	278
Min. Negotiated Rate	$2,291.62
Max. Negotiated Rate	$3,697.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,055.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,697.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,361.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,291.62

FLEXIGRAFT

Facility

$15,277.50

Service Code	HCPCS C1781
Hospital Charge Code	270664582
Hospital Revenue Code	278
Min. Negotiated Rate	$368.19
Max. Negotiated Rate	$7,638.75
Rate for Payer: Aetna Commercial	$5,805.45
Rate for Payer: Aetna Medicare Advantage	$4,583.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,895.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,895.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,055.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,895.76
Rate for Payer: Cigna Commercial	$7,638.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,697.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,361.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,291.62
Rate for Payer: UnitedHealthcare Community & State	$368.19
Rate for Payer: Wellpoint Medicaid Managed Care	$404.85

FLEXIGRAFT CONNECT PRE ZORC

Facility

$6,111.50

Service Code	HCPCS C1713
Hospital Charge Code	270693942
Hospital Revenue Code	278
Min. Negotiated Rate	$147.29
Max. Negotiated Rate	$3,055.75
Rate for Payer: Aetna Commercial	$2,322.37
Rate for Payer: Aetna Medicare Advantage	$1,833.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,558.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,558.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,222.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,558.43
Rate for Payer: Cigna Commercial	$3,055.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,478.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,344.53
Rate for Payer: Qualcare PPO/HMO/WC	$916.73
Rate for Payer: UnitedHealthcare Community & State	$147.29
Rate for Payer: Wellpoint Medicaid Managed Care	$161.95

FLEXIGRAFT CONNECT PRE ZORC

Facility

$6,111.50

Service Code	HCPCS C1713
Hospital Charge Code	270693942
Hospital Revenue Code	278
Min. Negotiated Rate	$916.73
Max. Negotiated Rate	$1,478.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,222.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,478.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,344.53
Rate for Payer: Qualcare PPO/HMO/WC	$916.73

FLEXIGRAFT MENISCUS MEDIAL RT

Facility

$23,523.75

Service Code	HCPCS C1762
Hospital Charge Code	270697618
Hospital Revenue Code	278
Min. Negotiated Rate	$566.92
Max. Negotiated Rate	$11,761.88
Rate for Payer: Aetna Commercial	$8,939.02
Rate for Payer: Aetna Medicare Advantage	$7,057.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,998.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,998.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,704.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,998.56
Rate for Payer: Cigna Commercial	$11,761.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,692.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,175.23
Rate for Payer: Qualcare PPO/HMO/WC	$3,528.56
Rate for Payer: UnitedHealthcare Community & State	$566.92
Rate for Payer: Wellpoint Medicaid Managed Care	$623.38

FLEXIGRAFT MENISCUS MEDIAL RT

Facility

$23,523.75

Service Code	HCPCS C1762
Hospital Charge Code	270697618
Hospital Revenue Code	278
Min. Negotiated Rate	$3,528.56
Max. Negotiated Rate	$5,692.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,704.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,692.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,175.23
Rate for Payer: Qualcare PPO/HMO/WC	$3,528.56

Flexima Biliary Catheter 8Fr

Facility

$405.00

Service Code	HCPCS C1729
Hospital Charge Code	270688760
Hospital Revenue Code	272
Min. Negotiated Rate	$9.76
Max. Negotiated Rate	$202.50
Rate for Payer: Aetna Commercial	$153.90
Rate for Payer: Aetna Medicare Advantage	$121.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.28
Rate for Payer: Cigna Commercial	$202.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.50
Rate for Payer: Oxford Commercial	$81.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.75
Rate for Payer: UnitedHealthcare Commercial	$81.00
Rate for Payer: UnitedHealthcare Community & State	$9.76
Rate for Payer: Wellpoint Medicaid Managed Care	$10.73

Flexima Biliary Catheter 8Fr

Facility

$405.00

Service Code	HCPCS C1729
Hospital Charge Code	270688760
Hospital Revenue Code	272
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$60.75
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

FLEXI-SEAL COLLECTION BAG

Facility

$30.60

Hospital Charge Code	270646932
Hospital Revenue Code	272
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$15.30
Rate for Payer: Aetna Commercial	$11.63
Rate for Payer: Aetna Medicare Advantage	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.80
Rate for Payer: Cigna Commercial	$15.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.18
Rate for Payer: Oxford Commercial	$6.12
Rate for Payer: Qualcare PPO/HMO/WC	$4.59
Rate for Payer: UnitedHealthcare Commercial	$6.12
Rate for Payer: UnitedHealthcare Community & State	$0.74
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

FLEXI-SEAL COLLECTION BAG

Facility

$30.60

Hospital Charge Code	270646932
Hospital Revenue Code	272
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$4.59
Rate for Payer: Qualcare PPO/HMO/WC	$4.59

FLEXI-SEAL FECAL MGMT SYSTEM

Facility

$796.53

Hospital Charge Code	270646928
Hospital Revenue Code	272
Min. Negotiated Rate	$119.48
Max. Negotiated Rate	$119.48
Rate for Payer: Qualcare PPO/HMO/WC	$119.48

FLEXI-SEAL FECAL MGMT SYSTEM

Facility

$796.53

Hospital Charge Code	270646928
Hospital Revenue Code	272
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$398.26
Rate for Payer: Aetna Commercial	$302.68
Rate for Payer: Aetna Medicare Advantage	$238.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.12
Rate for Payer: Cigna Commercial	$398.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.96
Rate for Payer: Oxford Commercial	$159.31
Rate for Payer: Qualcare PPO/HMO/WC	$119.48
Rate for Payer: UnitedHealthcare Commercial	$159.31
Rate for Payer: UnitedHealthcare Community & State	$19.20
Rate for Payer: Wellpoint Medicaid Managed Care	$21.11

FLEXISEAL FMS CL 1638411107

Facility

$668.33

Hospital Charge Code	270663373
Hospital Revenue Code	272
Min. Negotiated Rate	$16.11
Max. Negotiated Rate	$334.17
Rate for Payer: Aetna Commercial	$253.97
Rate for Payer: Aetna Medicare Advantage	$200.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.42
Rate for Payer: Cigna Commercial	$334.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.50
Rate for Payer: Oxford Commercial	$133.67
Rate for Payer: Qualcare PPO/HMO/WC	$100.25
Rate for Payer: UnitedHealthcare Commercial	$133.67
Rate for Payer: UnitedHealthcare Community & State	$16.11
Rate for Payer: Wellpoint Medicaid Managed Care	$17.71

FLEXISEAL FMS CL 1638411107

Facility

$668.33

Hospital Charge Code	270663373
Hospital Revenue Code	272
Min. Negotiated Rate	$100.25
Max. Negotiated Rate	$100.25
Rate for Payer: Qualcare PPO/HMO/WC	$100.25

FLEXOR CONTRA LAT BALKIN 7FR

Facility

$323.25

Hospital Charge Code	270624720
Hospital Revenue Code	278
Min. Negotiated Rate	$48.49
Max. Negotiated Rate	$78.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$71.11
Rate for Payer: Qualcare PPO/HMO/WC	$48.49

FLEXOR CONTRA LAT BALKIN 7FR

Facility

$323.25

Hospital Charge Code	270624720
Hospital Revenue Code	278
Min. Negotiated Rate	$7.79
Max. Negotiated Rate	$161.62
Rate for Payer: Aetna Commercial	$122.83
Rate for Payer: Aetna Medicare Advantage	$96.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.43
Rate for Payer: Cigna Commercial	$161.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$71.11
Rate for Payer: Qualcare PPO/HMO/WC	$48.49
Rate for Payer: UnitedHealthcare Community & State	$7.79
Rate for Payer: Wellpoint Medicaid Managed Care	$8.57

FLEXOR SHUTTLE-SL 4FR 110 CM

Facility

$755.00

Service Code	HCPCS C1894
Hospital Charge Code	270686951S
Hospital Revenue Code	278
Min. Negotiated Rate	$18.20
Max. Negotiated Rate	$377.50
Rate for Payer: Aetna Commercial	$286.90
Rate for Payer: Aetna Medicare Advantage	$226.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.53
Rate for Payer: Cigna Commercial	$377.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$166.10
Rate for Payer: Qualcare PPO/HMO/WC	$113.25
Rate for Payer: UnitedHealthcare Community & State	$18.20
Rate for Payer: Wellpoint Medicaid Managed Care	$20.01

FLEXOR SHUTTLE-SL 4FR 110 CM

Facility

$755.00

Service Code	HCPCS C1894
Hospital Charge Code	270686951N
Hospital Revenue Code	278
Min. Negotiated Rate	$113.25
Max. Negotiated Rate	$182.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$151.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$166.10
Rate for Payer: Qualcare PPO/HMO/WC	$113.25

Know your out-of-pocket cost for care.

All Charges