Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GLOVE SURG PROTEXIS SZ 9

Facility

$8.17

Hospital Charge Code	270649568
Hospital Revenue Code	270
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$1.23

GLOVE SURG SENSICARE SZ 6.5

Facility

$8.95

Hospital Charge Code	270060925C
Hospital Revenue Code	272
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.47
Rate for Payer: Aetna Commercial	$3.40
Rate for Payer: Aetna Medicare Advantage	$2.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.28
Rate for Payer: Cigna Commercial	$4.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.69
Rate for Payer: Oxford Commercial	$1.79
Rate for Payer: Qualcare PPO/HMO/WC	$1.34
Rate for Payer: UnitedHealthcare Commercial	$1.79
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

GLOVE SURG SENSICARE SZ 6.5

Facility

$8.95

Hospital Charge Code	270060925C
Hospital Revenue Code	272
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$1.34
Rate for Payer: Qualcare PPO/HMO/WC	$1.34

GLOVE SURG SENSICARE SZ 7.5

Facility

$8.94

Hospital Charge Code	270060935C
Hospital Revenue Code	272
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$1.34
Rate for Payer: Qualcare PPO/HMO/WC	$1.34

GLOVE SURG SENSICARE SZ 7.5

Facility

$8.94

Hospital Charge Code	270060935C
Hospital Revenue Code	272
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.47
Rate for Payer: Aetna Commercial	$3.40
Rate for Payer: Aetna Medicare Advantage	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.28
Rate for Payer: Cigna Commercial	$4.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.68
Rate for Payer: Oxford Commercial	$1.79
Rate for Payer: Qualcare PPO/HMO/WC	$1.34
Rate for Payer: UnitedHealthcare Commercial	$1.79
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

GLOVE SURG SENSICARE SZ 8.5

Facility

$8.94

Hospital Charge Code	270060945C
Hospital Revenue Code	272
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$1.34
Rate for Payer: Qualcare PPO/HMO/WC	$1.34

GLOVE SURG SENSICARE SZ 8.5

Facility

$8.94

Hospital Charge Code	270060945C
Hospital Revenue Code	272
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.47
Rate for Payer: Aetna Commercial	$3.40
Rate for Payer: Aetna Medicare Advantage	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.28
Rate for Payer: Cigna Commercial	$4.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.68
Rate for Payer: Oxford Commercial	$1.79
Rate for Payer: Qualcare PPO/HMO/WC	$1.34
Rate for Payer: UnitedHealthcare Commercial	$1.79
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

GLOVE SURG TRIFLEX STER SZ 6

Facility

$1.70

Hospital Charge Code	270649557
Hospital Revenue Code	270
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.26
Rate for Payer: Qualcare PPO/HMO/WC	$0.26

GLOVE SURG TRIFLEX STER SZ 6

Facility

$1.70

Hospital Charge Code	270649557
Hospital Revenue Code	270
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.85
Rate for Payer: Aetna Commercial	$0.65
Rate for Payer: Aetna Medicare Advantage	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.43
Rate for Payer: Cigna Commercial	$0.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.51
Rate for Payer: Oxford Commercial	$0.34
Rate for Payer: Qualcare PPO/HMO/WC	$0.26
Rate for Payer: UnitedHealthcare Commercial	$0.34
Rate for Payer: UnitedHealthcare Community & State	$0.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

GLOVE SURG TRIFLEX STER SZ 6.5

Facility

$1.70

Hospital Charge Code	270649569
Hospital Revenue Code	270
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.85
Rate for Payer: Aetna Commercial	$0.65
Rate for Payer: Aetna Medicare Advantage	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.43
Rate for Payer: Cigna Commercial	$0.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.51
Rate for Payer: Oxford Commercial	$0.34
Rate for Payer: Qualcare PPO/HMO/WC	$0.26
Rate for Payer: UnitedHealthcare Commercial	$0.34
Rate for Payer: UnitedHealthcare Community & State	$0.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

GLOVE SURG TRIFLEX STER SZ 6.5

Facility

$1.70

Hospital Charge Code	270649569
Hospital Revenue Code	270
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.26
Rate for Payer: Qualcare PPO/HMO/WC	$0.26

GLOVE SURG TRIFLEX STER SZ 7

Facility

$1.70

Hospital Charge Code	270649558
Hospital Revenue Code	270
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.26
Rate for Payer: Qualcare PPO/HMO/WC	$0.26

GLOVE SURG TRIFLEX STER SZ 7

Facility

$1.70

Hospital Charge Code	270649558
Hospital Revenue Code	270
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.85
Rate for Payer: Aetna Commercial	$0.65
Rate for Payer: Aetna Medicare Advantage	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.43
Rate for Payer: Cigna Commercial	$0.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.51
Rate for Payer: Oxford Commercial	$0.34
Rate for Payer: Qualcare PPO/HMO/WC	$0.26
Rate for Payer: UnitedHealthcare Commercial	$0.34
Rate for Payer: UnitedHealthcare Community & State	$0.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

GLOVE SURG TRIFLEX STER SZ 7.5

Facility

$1.70

Hospital Charge Code	270650502
Hospital Revenue Code	270
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.85
Rate for Payer: Aetna Commercial	$0.65
Rate for Payer: Aetna Medicare Advantage	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.43
Rate for Payer: Cigna Commercial	$0.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.51
Rate for Payer: Oxford Commercial	$0.34
Rate for Payer: Qualcare PPO/HMO/WC	$0.26
Rate for Payer: UnitedHealthcare Commercial	$0.34
Rate for Payer: UnitedHealthcare Community & State	$0.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

GLOVE SURG TRIFLEX STER SZ 7.5

Facility

$1.70

Hospital Charge Code	270650502
Hospital Revenue Code	270
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.26
Rate for Payer: Qualcare PPO/HMO/WC	$0.26

GLOVE SURG TRIFLEX STER SZ 8

Facility

$1.70

Hospital Charge Code	270649559
Hospital Revenue Code	270
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.85
Rate for Payer: Aetna Commercial	$0.65
Rate for Payer: Aetna Medicare Advantage	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.43
Rate for Payer: Cigna Commercial	$0.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.51
Rate for Payer: Oxford Commercial	$0.34
Rate for Payer: Qualcare PPO/HMO/WC	$0.26
Rate for Payer: UnitedHealthcare Commercial	$0.34
Rate for Payer: UnitedHealthcare Community & State	$0.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

GLOVE SURG TRIFLEX STER SZ 8

Facility

$1.70

Hospital Charge Code	270649559
Hospital Revenue Code	270
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.26
Rate for Payer: Qualcare PPO/HMO/WC	$0.26

GLOVE SURG TRIFLEX STER SZ 8.5

Facility

$1.70

Hospital Charge Code	270649561
Hospital Revenue Code	270
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.85
Rate for Payer: Aetna Commercial	$0.65
Rate for Payer: Aetna Medicare Advantage	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.43
Rate for Payer: Cigna Commercial	$0.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.51
Rate for Payer: Oxford Commercial	$0.34
Rate for Payer: Qualcare PPO/HMO/WC	$0.26
Rate for Payer: UnitedHealthcare Commercial	$0.34
Rate for Payer: UnitedHealthcare Community & State	$0.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

GLOVE SURG TRIFLEX STER SZ 8.5

Facility

$1.70

Hospital Charge Code	270649561
Hospital Revenue Code	270
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.26
Rate for Payer: Qualcare PPO/HMO/WC	$0.26

GLOVE SURG TRIFLEX STER SZ 9

Facility

$67.85

Hospital Charge Code	270649570
Hospital Revenue Code	270
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$33.92
Rate for Payer: Aetna Commercial	$25.78
Rate for Payer: Aetna Medicare Advantage	$20.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.30
Rate for Payer: Cigna Commercial	$33.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.36
Rate for Payer: Oxford Commercial	$13.57
Rate for Payer: Qualcare PPO/HMO/WC	$10.18
Rate for Payer: UnitedHealthcare Commercial	$13.57
Rate for Payer: UnitedHealthcare Community & State	$1.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.80

GLOVE SURG TRIFLEX STER SZ 9

Facility

$67.85

Hospital Charge Code	270649570
Hospital Revenue Code	270
Min. Negotiated Rate	$10.18
Max. Negotiated Rate	$10.18
Rate for Payer: Qualcare PPO/HMO/WC	$10.18

GLOVE SZ 6 1/2 TRIFLEX ORTHO

Facility

$203.80

Hospital Charge Code	270665432
Hospital Revenue Code	270
Min. Negotiated Rate	$30.57
Max. Negotiated Rate	$30.57
Rate for Payer: Qualcare PPO/HMO/WC	$30.57

GLOVE SZ 6 1/2 TRIFLEX ORTHO

Facility

$203.80

Hospital Charge Code	270665432
Hospital Revenue Code	270
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$101.90
Rate for Payer: Aetna Commercial	$77.44
Rate for Payer: Aetna Medicare Advantage	$61.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.97
Rate for Payer: Cigna Commercial	$101.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.14
Rate for Payer: Oxford Commercial	$40.76
Rate for Payer: Qualcare PPO/HMO/WC	$30.57
Rate for Payer: UnitedHealthcare Commercial	$40.76
Rate for Payer: UnitedHealthcare Community & State	$4.91
Rate for Payer: Wellpoint Medicaid Managed Care	$5.40

GLOVE SZ 7 1/2 TRIFLEX ORTHO

Facility

$203.80

Hospital Charge Code	270665430
Hospital Revenue Code	270
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$101.90
Rate for Payer: Aetna Commercial	$77.44
Rate for Payer: Aetna Medicare Advantage	$61.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.97
Rate for Payer: Cigna Commercial	$101.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.14
Rate for Payer: Oxford Commercial	$40.76
Rate for Payer: Qualcare PPO/HMO/WC	$30.57
Rate for Payer: UnitedHealthcare Commercial	$40.76
Rate for Payer: UnitedHealthcare Community & State	$4.91
Rate for Payer: Wellpoint Medicaid Managed Care	$5.40

GLOVE SZ 7 1/2 TRIFLEX ORTHO

Facility

$203.80

Hospital Charge Code	270665430
Hospital Revenue Code	270
Min. Negotiated Rate	$30.57
Max. Negotiated Rate	$30.57
Rate for Payer: Qualcare PPO/HMO/WC	$30.57

Know your out-of-pocket cost for care.

All Charges