Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FORCEPS BIPOLAR SNGL SITE 5MM

Facility

$1,500.00

Hospital Charge Code	270677925
Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

FORCEPS BIPOLAR SNGL SITE 5MM

Facility

$1,500.00

Hospital Charge Code	270677925
Hospital Revenue Code	272
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$450.00
Rate for Payer: Oxford Commercial	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Commercial	$300.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

FORCEPS BITE SPYGLASS

Facility

$2,580.00

Hospital Charge Code	270664633
Hospital Revenue Code	272
Min. Negotiated Rate	$62.18
Max. Negotiated Rate	$1,290.00
Rate for Payer: Aetna Commercial	$980.40
Rate for Payer: Aetna Medicare Advantage	$774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$657.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$657.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$657.90
Rate for Payer: Cigna Commercial	$1,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$774.00
Rate for Payer: Oxford Commercial	$516.00
Rate for Payer: Qualcare PPO/HMO/WC	$387.00
Rate for Payer: UnitedHealthcare Commercial	$516.00
Rate for Payer: UnitedHealthcare Community & State	$62.18
Rate for Payer: Wellpoint Medicaid Managed Care	$68.37

FORCEPS BITE SPYGLASS

Facility

$2,580.00

Hospital Charge Code	270664633
Hospital Revenue Code	272
Min. Negotiated Rate	$387.00
Max. Negotiated Rate	$387.00
Rate for Payer: Qualcare PPO/HMO/WC	$387.00

FORCEPS CADIERE

Facility

$10,500.00

Hospital Charge Code	270675536
Hospital Revenue Code	272
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$1,575.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

FORCEPS CADIERE

Facility

$10,500.00

Hospital Charge Code	270675536
Hospital Revenue Code	272
Min. Negotiated Rate	$253.05
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,150.00
Rate for Payer: Oxford Commercial	$2,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Commercial	$2,100.00
Rate for Payer: UnitedHealthcare Community & State	$253.05
Rate for Payer: Wellpoint Medicaid Managed Care	$278.25

FORCEPS CHILD MAGILL

Facility

$75.00

Hospital Charge Code	270665162
Hospital Revenue Code	270
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

FORCEPS CHILD MAGILL

Facility

$75.00

Hospital Charge Code	270665162
Hospital Revenue Code	270
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

FORCEPS GYR 10 15 3015PK

Facility

$1,424.00

Hospital Charge Code	270629602
Hospital Revenue Code	272
Min. Negotiated Rate	$34.32
Max. Negotiated Rate	$712.00
Rate for Payer: Aetna Commercial	$541.12
Rate for Payer: Aetna Medicare Advantage	$427.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.12
Rate for Payer: Cigna Commercial	$712.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$427.20
Rate for Payer: Oxford Commercial	$284.80
Rate for Payer: Qualcare PPO/HMO/WC	$213.60
Rate for Payer: UnitedHealthcare Commercial	$284.80
Rate for Payer: UnitedHealthcare Community & State	$34.32
Rate for Payer: Wellpoint Medicaid Managed Care	$37.74

FORCEPS GYR 10 15 3015PK

Facility

$1,424.00

Hospital Charge Code	270629602
Hospital Revenue Code	272
Min. Negotiated Rate	$213.60
Max. Negotiated Rate	$213.60
Rate for Payer: Qualcare PPO/HMO/WC	$213.60

FORCEPS HARTMAN ALLIGATOR

Facility

$103.75

Hospital Charge Code	270666969
Hospital Revenue Code	270
Min. Negotiated Rate	$15.56
Max. Negotiated Rate	$15.56
Rate for Payer: Qualcare PPO/HMO/WC	$15.56

FORCEPS HARTMAN ALLIGATOR

Facility

$103.75

Hospital Charge Code	270666969
Hospital Revenue Code	270
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$51.88
Rate for Payer: Aetna Commercial	$39.42
Rate for Payer: Aetna Medicare Advantage	$31.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.46
Rate for Payer: Cigna Commercial	$51.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.12
Rate for Payer: Oxford Commercial	$20.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.56
Rate for Payer: UnitedHealthcare Commercial	$20.75
Rate for Payer: UnitedHealthcare Community & State	$2.50
Rate for Payer: Wellpoint Medicaid Managed Care	$2.75

FORCEP SINGLE USE PULM BIOPSY

Facility

$440.00

Hospital Charge Code	270663359
Hospital Revenue Code	272
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

FORCEP SINGLE USE PULM BIOPSY

Facility

$440.00

Hospital Charge Code	270663359
Hospital Revenue Code	272
Min. Negotiated Rate	$10.60
Max. Negotiated Rate	$220.00
Rate for Payer: Aetna Commercial	$167.20
Rate for Payer: Aetna Medicare Advantage	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.20
Rate for Payer: Cigna Commercial	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.00
Rate for Payer: Oxford Commercial	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00
Rate for Payer: UnitedHealthcare Commercial	$88.00
Rate for Payer: UnitedHealthcare Community & State	$10.60
Rate for Payer: Wellpoint Medicaid Managed Care	$11.66

FORCEPS INSORB SINGLE PAT 9100

Facility

$495.00

Hospital Charge Code	270639061
Hospital Revenue Code	272
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$74.25
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

FORCEPS INSORB SINGLE PAT 9100

Facility

$495.00

Hospital Charge Code	270639061
Hospital Revenue Code	272
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.50
Rate for Payer: Oxford Commercial	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Commercial	$99.00
Rate for Payer: UnitedHealthcare Community & State	$11.93
Rate for Payer: Wellpoint Medicaid Managed Care	$13.12

FORCEPS JUMBO RJ4 1337-20

Facility

$190.00

Hospital Charge Code	270637471
Hospital Revenue Code	272
Min. Negotiated Rate	$4.58
Max. Negotiated Rate	$95.00
Rate for Payer: Aetna Commercial	$72.20
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.00
Rate for Payer: Oxford Commercial	$38.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$38.00
Rate for Payer: UnitedHealthcare Community & State	$4.58
Rate for Payer: Wellpoint Medicaid Managed Care	$5.04

FORCEPS JUMBO RJ4 1337-20

Facility

$190.00

Hospital Charge Code	270637471
Hospital Revenue Code	272
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

FORCEPS MICRO BLACK DIAMOND

Facility

$1,041.67

Hospital Charge Code	270675210
Hospital Revenue Code	272
Min. Negotiated Rate	$156.25
Max. Negotiated Rate	$156.25
Rate for Payer: Qualcare PPO/HMO/WC	$156.25

FORCEPS MICRO BLACK DIAMOND

Facility

$1,041.67

Hospital Charge Code	270675210
Hospital Revenue Code	272
Min. Negotiated Rate	$25.10
Max. Negotiated Rate	$520.84
Rate for Payer: Aetna Commercial	$395.83
Rate for Payer: Aetna Medicare Advantage	$312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$265.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$265.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$265.63
Rate for Payer: Cigna Commercial	$520.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.50
Rate for Payer: Oxford Commercial	$208.33
Rate for Payer: Qualcare PPO/HMO/WC	$156.25
Rate for Payer: UnitedHealthcare Commercial	$208.33
Rate for Payer: UnitedHealthcare Community & State	$25.10
Rate for Payer: Wellpoint Medicaid Managed Care	$27.60

FORCEPS MICRO L4 3/8 IN 5 MM C

Facility

$3,117.35

Hospital Charge Code	270683686
Hospital Revenue Code	272
Min. Negotiated Rate	$467.60
Max. Negotiated Rate	$467.60
Rate for Payer: Qualcare PPO/HMO/WC	$467.60

FORCEPS MICRO L4 3/8 IN 5 MM C

Facility

$3,117.35

Hospital Charge Code	270683686
Hospital Revenue Code	272
Min. Negotiated Rate	$75.13
Max. Negotiated Rate	$1,558.67
Rate for Payer: Aetna Commercial	$1,184.59
Rate for Payer: Aetna Medicare Advantage	$935.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$794.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$794.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$794.92
Rate for Payer: Cigna Commercial	$1,558.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.21
Rate for Payer: Oxford Commercial	$623.47
Rate for Payer: Qualcare PPO/HMO/WC	$467.60
Rate for Payer: UnitedHealthcare Commercial	$623.47
Rate for Payer: UnitedHealthcare Community & State	$75.13
Rate for Payer: Wellpoint Medicaid Managed Care	$82.61

FORCEPS PERIARTIC REDUCT 6.5MM

Facility

$6,600.25

Hospital Charge Code	270677658
Hospital Revenue Code	272
Min. Negotiated Rate	$159.07
Max. Negotiated Rate	$3,300.12
Rate for Payer: Aetna Commercial	$2,508.09
Rate for Payer: Aetna Medicare Advantage	$1,980.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.06
Rate for Payer: Cigna Commercial	$3,300.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.08
Rate for Payer: Oxford Commercial	$1,320.05
Rate for Payer: Qualcare PPO/HMO/WC	$990.04
Rate for Payer: UnitedHealthcare Commercial	$1,320.05
Rate for Payer: UnitedHealthcare Community & State	$159.07
Rate for Payer: Wellpoint Medicaid Managed Care	$174.91

FORCEPS PERIARTIC REDUCT 6.5MM

Facility

$6,600.25

Hospital Charge Code	270677658
Hospital Revenue Code	272
Min. Negotiated Rate	$990.04
Max. Negotiated Rate	$990.04
Rate for Payer: Qualcare PPO/HMO/WC	$990.04

FORCEPS RADIAL JAW 160cm

Facility

$87.50

Hospital Charge Code	270650907
Hospital Revenue Code	272
Min. Negotiated Rate	$13.12
Max. Negotiated Rate	$13.12
Rate for Payer: Qualcare PPO/HMO/WC	$13.12

Know your out-of-pocket cost for care.

All Charges