Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FORCEP REMOVAL CRANOFIX 2

Facility

$1,613.65

Hospital Charge Code	270684902
Hospital Revenue Code	272
Min. Negotiated Rate	$242.05
Max. Negotiated Rate	$242.05
Rate for Payer: Qualcare PPO/HMO/WC	$242.05

FORCEP RESCUE NET RETIRVAL DEV

Facility

$425.00

Hospital Charge Code	270688849
Hospital Revenue Code	272
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.50
Rate for Payer: Oxford Commercial	$85.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$85.00
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

FORCEP RESCUE NET RETIRVAL DEV

Facility

$425.00

Hospital Charge Code	270688849
Hospital Revenue Code	272
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

FORCEP RESUE COMBO RAT ALLIGAT

Facility

$425.00

Hospital Charge Code	270680398
Hospital Revenue Code	272
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.50
Rate for Payer: Oxford Commercial	$85.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$85.00
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

FORCEP RESUE COMBO RAT ALLIGAT

Facility

$425.00

Hospital Charge Code	270680398
Hospital Revenue Code	272
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

FORCEP RETRIEVAL ALLIGATOR

Facility

$61.75

Hospital Charge Code	270700754
Hospital Revenue Code	272
Min. Negotiated Rate	$9.26
Max. Negotiated Rate	$9.26
Rate for Payer: Qualcare PPO/HMO/WC	$9.26

FORCEP RETRIEVAL ALLIGATOR

Facility

$61.75

Hospital Charge Code	270700754
Hospital Revenue Code	272
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$30.88
Rate for Payer: Aetna Commercial	$23.46
Rate for Payer: Aetna Medicare Advantage	$18.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.75
Rate for Payer: Cigna Commercial	$30.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.52
Rate for Payer: Oxford Commercial	$12.35
Rate for Payer: Qualcare PPO/HMO/WC	$9.26
Rate for Payer: UnitedHealthcare Commercial	$12.35
Rate for Payer: UnitedHealthcare Community & State	$1.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1.64

FORCEPS 1x2 TEETH, 6 1/4 IN OC

Facility

$79.55

Hospital Charge Code	270608501
Hospital Revenue Code	270
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$11.93
Rate for Payer: Qualcare PPO/HMO/WC	$11.93

FORCEPS 1x2 TEETH, 6 1/4 IN OC

Facility

$79.55

Hospital Charge Code	270608501
Hospital Revenue Code	270
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$39.77
Rate for Payer: Aetna Commercial	$30.23
Rate for Payer: Aetna Medicare Advantage	$23.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.29
Rate for Payer: Cigna Commercial	$39.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.86
Rate for Payer: Oxford Commercial	$15.91
Rate for Payer: Qualcare PPO/HMO/WC	$11.93
Rate for Payer: UnitedHealthcare Commercial	$15.91
Rate for Payer: UnitedHealthcare Community & State	$1.92
Rate for Payer: Wellpoint Medicaid Managed Care	$2.11

FORCEPS ADSON 1 X 2 TEETH SERR

Facility

$23.65

Hospital Charge Code	270604503
Hospital Revenue Code	272
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$3.55
Rate for Payer: Qualcare PPO/HMO/WC	$3.55

FORCEPS ADSON 1 X 2 TEETH SERR

Facility

$23.65

Hospital Charge Code	270604503
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.82
Rate for Payer: Aetna Commercial	$8.99
Rate for Payer: Aetna Medicare Advantage	$7.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.03
Rate for Payer: Cigna Commercial	$11.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.09
Rate for Payer: Oxford Commercial	$4.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.55
Rate for Payer: UnitedHealthcare Commercial	$4.73
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.63

FORCEPS ADSON BI-POLAR FORCEPS

Facility

$531.30

Hospital Charge Code	270665575
Hospital Revenue Code	272
Min. Negotiated Rate	$79.69
Max. Negotiated Rate	$79.69
Rate for Payer: Qualcare PPO/HMO/WC	$79.69

FORCEPS ADSON BI-POLAR FORCEPS

Facility

$531.30

Hospital Charge Code	270665575
Hospital Revenue Code	272
Min. Negotiated Rate	$12.80
Max. Negotiated Rate	$265.65
Rate for Payer: Aetna Commercial	$201.89
Rate for Payer: Aetna Medicare Advantage	$159.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.48
Rate for Payer: Cigna Commercial	$265.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.39
Rate for Payer: Oxford Commercial	$106.26
Rate for Payer: Qualcare PPO/HMO/WC	$79.69
Rate for Payer: UnitedHealthcare Commercial	$106.26
Rate for Payer: UnitedHealthcare Community & State	$12.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.08

FORCEPS ADULT MAGILL

Facility

$80.00

Hospital Charge Code	270665163
Hospital Revenue Code	270
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$30.40
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.00
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Commercial	$16.00
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

FORCEPS ADULT MAGILL

Facility

$80.00

Hospital Charge Code	270665163
Hospital Revenue Code	270
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

FORCEPS ARTERY PEAN CVD 6.25

Facility

$59.90

Hospital Charge Code	270601026
Hospital Revenue Code	270
Min. Negotiated Rate	$8.98
Max. Negotiated Rate	$8.98
Rate for Payer: Qualcare PPO/HMO/WC	$8.98

FORCEPS ARTERY PEAN CVD 6.25

Facility

$59.90

Hospital Charge Code	270601026
Hospital Revenue Code	270
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$29.95
Rate for Payer: Aetna Commercial	$22.76
Rate for Payer: Aetna Medicare Advantage	$17.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.27
Rate for Payer: Cigna Commercial	$29.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.97
Rate for Payer: Oxford Commercial	$11.98
Rate for Payer: Qualcare PPO/HMO/WC	$8.98
Rate for Payer: UnitedHealthcare Commercial	$11.98
Rate for Payer: UnitedHealthcare Community & State	$1.44
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

FORCEPS BIOPSY HOT 2.0mm

Facility

$2,979.50

Hospital Charge Code	270678683
Hospital Revenue Code	272
Min. Negotiated Rate	$71.81
Max. Negotiated Rate	$1,489.75
Rate for Payer: Aetna Commercial	$1,132.21
Rate for Payer: Aetna Medicare Advantage	$893.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$759.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$759.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$759.77
Rate for Payer: Cigna Commercial	$1,489.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$893.85
Rate for Payer: Oxford Commercial	$595.90
Rate for Payer: Qualcare PPO/HMO/WC	$446.93
Rate for Payer: UnitedHealthcare Commercial	$595.90
Rate for Payer: UnitedHealthcare Community & State	$71.81
Rate for Payer: Wellpoint Medicaid Managed Care	$78.96

FORCEPS BIOPSY HOT 2.0mm

Facility

$2,979.50

Hospital Charge Code	270678683
Hospital Revenue Code	272
Min. Negotiated Rate	$446.93
Max. Negotiated Rate	$446.93
Rate for Payer: Qualcare PPO/HMO/WC	$446.93

FORCEPS BIPOLAR

Facility

$1,250.00

Hospital Charge Code	270692669
Hospital Revenue Code	270
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

FORCEPS BIPOLAR

Facility

$1,250.00

Hospital Charge Code	270692669
Hospital Revenue Code	270
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$250.00
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

FORCEPS BIPOLAR DISP 1.0MM TIP

Facility

$2,196.00

Hospital Charge Code	270692063
Hospital Revenue Code	272
Min. Negotiated Rate	$52.92
Max. Negotiated Rate	$1,098.00
Rate for Payer: Aetna Commercial	$834.48
Rate for Payer: Aetna Medicare Advantage	$658.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$559.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$559.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$559.98
Rate for Payer: Cigna Commercial	$1,098.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$658.80
Rate for Payer: Oxford Commercial	$439.20
Rate for Payer: Qualcare PPO/HMO/WC	$329.40
Rate for Payer: UnitedHealthcare Commercial	$439.20
Rate for Payer: UnitedHealthcare Community & State	$52.92
Rate for Payer: Wellpoint Medicaid Managed Care	$58.19

FORCEPS BIPOLAR DISP 1.0MM TIP

Facility

$2,196.00

Hospital Charge Code	270692063
Hospital Revenue Code	272
Min. Negotiated Rate	$329.40
Max. Negotiated Rate	$329.40
Rate for Payer: Qualcare PPO/HMO/WC	$329.40

FORCEPS BIPOLAR NON IRRIGATING

Facility

$2,835.00

Hospital Charge Code	270620022
Hospital Revenue Code	272
Min. Negotiated Rate	$68.32
Max. Negotiated Rate	$1,417.50
Rate for Payer: Aetna Commercial	$1,077.30
Rate for Payer: Aetna Medicare Advantage	$850.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$722.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$722.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$722.92
Rate for Payer: Cigna Commercial	$1,417.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$850.50
Rate for Payer: Oxford Commercial	$567.00
Rate for Payer: Qualcare PPO/HMO/WC	$425.25
Rate for Payer: UnitedHealthcare Commercial	$567.00
Rate for Payer: UnitedHealthcare Community & State	$68.32
Rate for Payer: Wellpoint Medicaid Managed Care	$75.13

FORCEPS BIPOLAR NON IRRIGATING

Facility

$2,835.00

Hospital Charge Code	270620022
Hospital Revenue Code	272
Min. Negotiated Rate	$425.25
Max. Negotiated Rate	$425.25
Rate for Payer: Qualcare PPO/HMO/WC	$425.25

Know your out-of-pocket cost for care.

All Charges