Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FORCEP JAGWIRE 9 450CM 5659

Facility

$1,280.85

Hospital Charge Code	270603947
Hospital Revenue Code	270
Min. Negotiated Rate	$192.13
Max. Negotiated Rate	$192.13
Rate for Payer: Qualcare PPO/HMO/WC	$192.13

FORCEP JUMBO

Facility

$96.38

Hospital Charge Code	270655594
Hospital Revenue Code	272
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$14.46
Rate for Payer: Qualcare PPO/HMO/WC	$14.46

FORCEP JUMBO

Facility

$96.38

Hospital Charge Code	270655594
Hospital Revenue Code	272
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$48.19
Rate for Payer: Aetna Commercial	$36.62
Rate for Payer: Aetna Medicare Advantage	$28.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.58
Rate for Payer: Cigna Commercial	$48.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.91
Rate for Payer: Oxford Commercial	$19.28
Rate for Payer: Qualcare PPO/HMO/WC	$14.46
Rate for Payer: UnitedHealthcare Commercial	$19.28
Rate for Payer: UnitedHealthcare Community & State	$2.32
Rate for Payer: Wellpoint Medicaid Managed Care	$2.55

FORCEP MCV BILI BALLN 24F 8MM

Facility

$2,148.85

Hospital Charge Code	270607735
Hospital Revenue Code	272
Min. Negotiated Rate	$322.33
Max. Negotiated Rate	$322.33
Rate for Payer: Qualcare PPO/HMO/WC	$322.33

FORCEP MCV BILI BALLN 24F 8MM

Facility

$2,148.85

Hospital Charge Code	270607735
Hospital Revenue Code	272
Min. Negotiated Rate	$51.79
Max. Negotiated Rate	$1,074.42
Rate for Payer: Aetna Commercial	$816.56
Rate for Payer: Aetna Medicare Advantage	$644.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$547.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$547.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$547.96
Rate for Payer: Cigna Commercial	$1,074.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$644.65
Rate for Payer: Oxford Commercial	$429.77
Rate for Payer: Qualcare PPO/HMO/WC	$322.33
Rate for Payer: UnitedHealthcare Commercial	$429.77
Rate for Payer: UnitedHealthcare Community & State	$51.79
Rate for Payer: Wellpoint Medicaid Managed Care	$56.94

FORCEP PEDIATRIC SMALL

Facility

$134.00

Hospital Charge Code	270658672
Hospital Revenue Code	272
Min. Negotiated Rate	$20.10
Max. Negotiated Rate	$20.10
Rate for Payer: Qualcare PPO/HMO/WC	$20.10

FORCEP PEDIATRIC SMALL

Facility

$134.00

Hospital Charge Code	270658672
Hospital Revenue Code	272
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$67.00
Rate for Payer: Aetna Commercial	$50.92
Rate for Payer: Aetna Medicare Advantage	$40.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.17
Rate for Payer: Cigna Commercial	$67.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.20
Rate for Payer: Oxford Commercial	$26.80
Rate for Payer: Qualcare PPO/HMO/WC	$20.10
Rate for Payer: UnitedHealthcare Commercial	$26.80
Rate for Payer: UnitedHealthcare Community & State	$3.23
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

FORCEP PLATE HOLDNG SWIVEL SZ0

Facility

$2,742.00

Hospital Charge Code	270677036
Hospital Revenue Code	278
Min. Negotiated Rate	$66.08
Max. Negotiated Rate	$1,371.00
Rate for Payer: Aetna Commercial	$1,041.96
Rate for Payer: Aetna Medicare Advantage	$822.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$699.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$699.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$548.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$699.21
Rate for Payer: Cigna Commercial	$1,371.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$603.24
Rate for Payer: Qualcare PPO/HMO/WC	$411.30
Rate for Payer: UnitedHealthcare Community & State	$66.08
Rate for Payer: Wellpoint Medicaid Managed Care	$72.66

FORCEP PLATE HOLDNG SWIVEL SZ0

Facility

$2,742.00

Hospital Charge Code	270677036
Hospital Revenue Code	278
Min. Negotiated Rate	$411.30
Max. Negotiated Rate	$663.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$548.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$603.24
Rate for Payer: Qualcare PPO/HMO/WC	$411.30

FORCEP RAD EDGE 1.8 100 1556

Facility

$154.58

Hospital Charge Code	270609316
Hospital Revenue Code	270
Min. Negotiated Rate	$23.19
Max. Negotiated Rate	$23.19
Rate for Payer: Qualcare PPO/HMO/WC	$23.19

FORCEP RAD EDGE 1.8 100 1556

Facility

$154.58

Hospital Charge Code	270609316
Hospital Revenue Code	270
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$77.29
Rate for Payer: Aetna Commercial	$58.74
Rate for Payer: Aetna Medicare Advantage	$46.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.42
Rate for Payer: Cigna Commercial	$77.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.37
Rate for Payer: Oxford Commercial	$30.92
Rate for Payer: Qualcare PPO/HMO/WC	$23.19
Rate for Payer: UnitedHealthcare Commercial	$30.92
Rate for Payer: UnitedHealthcare Community & State	$3.73
Rate for Payer: Wellpoint Medicaid Managed Care	$4.10

FORCEP RADIAL EDGE

Facility

$240.00

Hospital Charge Code	270654571
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

FORCEP RADIAL EDGE

Facility

$240.00

Hospital Charge Code	270654571
Hospital Revenue Code	272
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

FORCEP RADIAL JAW

Facility

$37.50

Hospital Charge Code	270656988
Hospital Revenue Code	272
Min. Negotiated Rate	$5.62
Max. Negotiated Rate	$5.62
Rate for Payer: Qualcare PPO/HMO/WC	$5.62

FORCEP RADIAL JAW

Facility

$37.50

Hospital Charge Code	270656988
Hospital Revenue Code	272
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$18.75
Rate for Payer: Aetna Commercial	$14.25
Rate for Payer: Aetna Medicare Advantage	$11.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.56
Rate for Payer: Cigna Commercial	$18.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.25
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.62
Rate for Payer: UnitedHealthcare Commercial	$7.50
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.99

Forcep Radial Jaw w/needle

Facility

$72.00

Hospital Charge Code	270686400
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$36.00
Rate for Payer: Aetna Commercial	$27.36
Rate for Payer: Aetna Medicare Advantage	$21.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.36
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.60
Rate for Payer: Oxford Commercial	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$14.40
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

Forcep Radial Jaw w/needle

Facility

$72.00

Hospital Charge Code	270686400
Hospital Revenue Code	272
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

FORCEP RAD JAW 111 240CM

Facility

$286.00

Hospital Charge Code	270603900
Hospital Revenue Code	279
Min. Negotiated Rate	$42.90
Max. Negotiated Rate	$42.90
Rate for Payer: Qualcare PPO/HMO/WC	$42.90

FORCEP RAD JAW 111 240CM

Facility

$286.00

Hospital Charge Code	270603900
Hospital Revenue Code	279
Min. Negotiated Rate	$6.89
Max. Negotiated Rate	$143.00
Rate for Payer: Aetna Commercial	$108.68
Rate for Payer: Aetna Medicare Advantage	$85.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.93
Rate for Payer: Cigna Commercial	$143.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.80
Rate for Payer: Oxford Commercial	$57.20
Rate for Payer: Qualcare PPO/HMO/WC	$42.90
Rate for Payer: UnitedHealthcare Commercial	$57.20
Rate for Payer: UnitedHealthcare Community & State	$6.89
Rate for Payer: Wellpoint Medicaid Managed Care	$7.58

FORCEP RAD JAW 3 240CM 1536-20

Facility

$228.85

Hospital Charge Code	270607142
Hospital Revenue Code	270
Min. Negotiated Rate	$34.33
Max. Negotiated Rate	$34.33
Rate for Payer: Qualcare PPO/HMO/WC	$34.33

FORCEP RAD JAW 3 240CM 1536-20

Facility

$228.85

Hospital Charge Code	270607142
Hospital Revenue Code	270
Min. Negotiated Rate	$5.52
Max. Negotiated Rate	$114.42
Rate for Payer: Aetna Commercial	$86.96
Rate for Payer: Aetna Medicare Advantage	$68.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.36
Rate for Payer: Cigna Commercial	$114.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.66
Rate for Payer: Oxford Commercial	$45.77
Rate for Payer: Qualcare PPO/HMO/WC	$34.33
Rate for Payer: UnitedHealthcare Commercial	$45.77
Rate for Payer: UnitedHealthcare Community & State	$5.52
Rate for Payer: Wellpoint Medicaid Managed Care	$6.06

FORCEP RAD JAW 3LC 240 1598-20

Facility

$192.05

Hospital Charge Code	270609387
Hospital Revenue Code	270
Min. Negotiated Rate	$28.81
Max. Negotiated Rate	$28.81
Rate for Payer: Qualcare PPO/HMO/WC	$28.81

FORCEP RAD JAW 3LC 240 1598-20

Facility

$192.05

Hospital Charge Code	270609387
Hospital Revenue Code	270
Min. Negotiated Rate	$4.63
Max. Negotiated Rate	$96.03
Rate for Payer: Aetna Commercial	$72.98
Rate for Payer: Aetna Medicare Advantage	$57.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.97
Rate for Payer: Cigna Commercial	$96.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.62
Rate for Payer: Oxford Commercial	$38.41
Rate for Payer: Qualcare PPO/HMO/WC	$28.81
Rate for Payer: UnitedHealthcare Commercial	$38.41
Rate for Payer: UnitedHealthcare Community & State	$4.63
Rate for Payer: Wellpoint Medicaid Managed Care	$5.09

FORCEP RAD JAW HOT BIOP

Facility

$180.00

Hospital Charge Code	270603901
Hospital Revenue Code	279
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

FORCEP RAD JAW HOT BIOP

Facility

$180.00

Hospital Charge Code	270603901
Hospital Revenue Code	279
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$90.00
Rate for Payer: Aetna Commercial	$68.40
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.00
Rate for Payer: Oxford Commercial	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$36.00
Rate for Payer: UnitedHealthcare Community & State	$4.34
Rate for Payer: Wellpoint Medicaid Managed Care	$4.77

Know your out-of-pocket cost for care.

All Charges