Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FLEXOR SHUTTLE-SL 4FR 110 CM

Facility

$755.00

Service Code	HCPCS C1894
Hospital Charge Code	270686951N
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	270686951S
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

FLEXOR SHUTTLE-SL 5FR 110 CM

Facility

$755.00

Service Code	HCPCS C1894
Hospital Charge Code	270686953S
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 5FR 110 CM

Facility

$755.00

Service Code	HCPCS C1894
Hospital Charge Code	270686953S
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

FLEXOR SHUTTLE-SL 5FR 110 CM

Facility

$755.00

Service Code	HCPCS C1894
Hospital Charge Code	270686953N
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

FLEXOR SHUTTLE-SL 5FR 110 CM

Facility

$755.00

Service Code	HCPCS C1894
Hospital Charge Code	270686953N
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 5FR 90 CM

Facility

$755.00

Service Code	HCPCS C1894
Hospital Charge Code	270686952N
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 5FR 90 CM

Facility

$755.00

Service Code	HCPCS C1894
Hospital Charge Code	270686952N
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

FLEXOR SHUTTLE-SL 5FR 90 CM

Facility

$755.00

Service Code	HCPCS C1894
Hospital Charge Code	270686952S
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

FLEXOR SHUTTLE-SL 5FR 90 CM

Facility

$755.00

Service Code	HCPCS C1894
Hospital Charge Code	270686952S
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

FLEXPATCH 3X4CM

Facility

$13,500.00

Service Code	HCPCS C1781
Hospital Charge Code	270700031
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,970.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

FLEXPATCH 3X4CM

Facility

$13,500.00

Service Code	HCPCS C1781
Hospital Charge Code	270700031
Hospital Revenue Code	278
Min. Negotiated Rate	$325.35
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$5,130.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,970.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: UnitedHealthcare Community & State	$325.35
Rate for Payer: Wellpoint Medicaid Managed Care	$357.75

FLEXPATCH DYNAMIC MATRIX 4X6CM

Facility

$14,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270700032
Hospital Revenue Code	278
Min. Negotiated Rate	$351.86
Max. Negotiated Rate	$7,300.00
Rate for Payer: Aetna Commercial	$5,548.00
Rate for Payer: Aetna Medicare Advantage	$4,380.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,723.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,723.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,920.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,723.00
Rate for Payer: Cigna Commercial	$7,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,533.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,212.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,190.00
Rate for Payer: UnitedHealthcare Community & State	$351.86
Rate for Payer: Wellpoint Medicaid Managed Care	$386.90

FLEXPATCH DYNAMIC MATRIX 4X6CM

Facility

$14,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270700032
Hospital Revenue Code	278
Min. Negotiated Rate	$2,190.00
Max. Negotiated Rate	$3,533.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,920.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,533.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,212.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,190.00

FLEX SHAFT CONN W JACOB CHUCK

Facility

$1,724.20

Service Code	HCPCS C1713
Hospital Charge Code	270626345
Hospital Revenue Code	278
Min. Negotiated Rate	$41.55
Max. Negotiated Rate	$862.10
Rate for Payer: Aetna Commercial	$655.20
Rate for Payer: Aetna Medicare Advantage	$517.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$344.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.67
Rate for Payer: Cigna Commercial	$862.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.32
Rate for Payer: Qualcare PPO/HMO/WC	$258.63
Rate for Payer: UnitedHealthcare Community & State	$41.55
Rate for Payer: Wellpoint Medicaid Managed Care	$45.69

FLEX SHAFT CONN W JACOB CHUCK

Facility

$1,724.20

Service Code	HCPCS C1713
Hospital Charge Code	270626345
Hospital Revenue Code	278
Min. Negotiated Rate	$258.63
Max. Negotiated Rate	$417.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$344.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$379.32
Rate for Payer: Qualcare PPO/HMO/WC	$258.63

FLEX STRUCTURAL 12CM X 20CM

Facility

$43,590.00

Hospital Charge Code	270657203
Hospital Revenue Code	278
Min. Negotiated Rate	$6,538.50
Max. Negotiated Rate	$10,548.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,718.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,548.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,589.80
Rate for Payer: Qualcare PPO/HMO/WC	$6,538.50

FLEX STRUCTURAL 12CM X 20CM

Facility

$43,590.00

Hospital Charge Code	270657203
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.52
Max. Negotiated Rate	$21,795.00
Rate for Payer: Aetna Commercial	$16,564.20
Rate for Payer: Aetna Medicare Advantage	$13,077.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,115.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,115.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,718.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,115.45
Rate for Payer: Cigna Commercial	$21,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,548.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,589.80
Rate for Payer: Qualcare PPO/HMO/WC	$6,538.50
Rate for Payer: UnitedHealthcare Community & State	$1,050.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1,155.13

FLEX TENDON REP ZONE 2 EACH

Facility

$26,471.80

Service Code	HCPCS 26356
Hospital Charge Code	16000361
Hospital Revenue Code	360
Min. Negotiated Rate	$637.97
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,941.54
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,970.77
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$637.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$701.50

FLEX TENDON REP ZONE 2 EACH

Facility

$26,471.80

Service Code	HCPCS 26356
Hospital Charge Code	16000361
Hospital Revenue Code	360
Min. Negotiated Rate	$3,970.77
Max. Negotiated Rate	$3,970.77
Rate for Payer: Qualcare PPO/HMO/WC	$3,970.77

FLEX TIP NUCLEOTOMY BLADE

Facility

$983.00

Hospital Charge Code	270335307
Hospital Revenue Code	272
Min. Negotiated Rate	$147.45
Max. Negotiated Rate	$147.45
Rate for Payer: Qualcare PPO/HMO/WC	$147.45

FLEX TIP NUCLEOTOMY BLADE

Facility

$983.00

Hospital Charge Code	270335307
Hospital Revenue Code	272
Min. Negotiated Rate	$23.69
Max. Negotiated Rate	$491.50
Rate for Payer: Aetna Commercial	$373.54
Rate for Payer: Aetna Medicare Advantage	$294.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.66
Rate for Payer: Cigna Commercial	$491.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.90
Rate for Payer: Oxford Commercial	$196.60
Rate for Payer: Qualcare PPO/HMO/WC	$147.45
Rate for Payer: UnitedHealthcare Commercial	$196.60
Rate for Payer: UnitedHealthcare Community & State	$23.69
Rate for Payer: Wellpoint Medicaid Managed Care	$26.05

FLEXTIP RF PROBE, 28CM

Facility

$2,975.00

Hospital Charge Code	270702073
Hospital Revenue Code	272
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$446.25
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

FLEXTIP RF PROBE, 28CM

Facility

$2,975.00

Hospital Charge Code	270702073
Hospital Revenue Code	272
Min. Negotiated Rate	$71.70
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$1,130.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$892.50
Rate for Payer: Oxford Commercial	$595.00
Rate for Payer: Qualcare PPO/HMO/WC	$446.25
Rate for Payer: UnitedHealthcare Commercial	$595.00
Rate for Payer: UnitedHealthcare Community & State	$71.70
Rate for Payer: Wellpoint Medicaid Managed Care	$78.84

FLEXTUBE GSP HMEF

Facility

$12.67

Hospital Charge Code	270689023
Hospital Revenue Code	272
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.33
Rate for Payer: Aetna Commercial	$4.81
Rate for Payer: Aetna Medicare Advantage	$3.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.23
Rate for Payer: Cigna Commercial	$6.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.80
Rate for Payer: Oxford Commercial	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$1.90
Rate for Payer: UnitedHealthcare Commercial	$2.53
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

Know your out-of-pocket cost for care.

All Charges