Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HEAD RADIAL LT SYSTEM 20MM

Facility

$21,765.00

Service Code	HCPCS C1776
Hospital Charge Code	270693319
Hospital Revenue Code	278
Min. Negotiated Rate	$3,264.75
Max. Negotiated Rate	$5,267.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,353.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,267.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,788.30
Rate for Payer: Qualcare PPO/HMO/WC	$3,264.75

HEADREST 7 PILLOW GENTLE 1937

Facility

$35.10

Hospital Charge Code	270631284
Hospital Revenue Code	270
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$17.55
Rate for Payer: Aetna Commercial	$13.34
Rate for Payer: Aetna Medicare Advantage	$10.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.95
Rate for Payer: Cigna Commercial	$17.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.53
Rate for Payer: Oxford Commercial	$7.02
Rate for Payer: Qualcare PPO/HMO/WC	$5.26
Rate for Payer: UnitedHealthcare Commercial	$7.02
Rate for Payer: UnitedHealthcare Community & State	$0.85
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

HEADREST 7 PILLOW GENTLE 1937

Facility

$35.10

Hospital Charge Code	270631284
Hospital Revenue Code	270
Min. Negotiated Rate	$5.26
Max. Negotiated Rate	$5.26
Rate for Payer: Qualcare PPO/HMO/WC	$5.26

HEAD RIGHT 22MM TR ANGLED

Facility

$16,125.00

Hospital Charge Code	270666835
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,547.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

HEAD RIGHT 22MM TR ANGLED

Facility

$16,125.00

Hospital Charge Code	270666835
Hospital Revenue Code	278
Min. Negotiated Rate	$388.61
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,547.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$388.61
Rate for Payer: Wellpoint Medicaid Managed Care	$427.31

HEAD RIGHT 24MM TR ANGLED

Facility

$16,125.00

Hospital Charge Code	270666833
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,547.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

HEAD RIGHT 24MM TR ANGLED

Facility

$16,125.00

Hospital Charge Code	270666833
Hospital Revenue Code	278
Min. Negotiated Rate	$388.61
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,547.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$388.61
Rate for Payer: Wellpoint Medicaid Managed Care	$427.31

HEAD ROTATING 35W PRW35

Facility

$508.00

Hospital Charge Code	270608740
Hospital Revenue Code	278
Min. Negotiated Rate	$76.20
Max. Negotiated Rate	$122.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.76
Rate for Payer: Qualcare PPO/HMO/WC	$76.20

HEAD ROTATING 35W PRW35

Facility

$508.00

Hospital Charge Code	270608740
Hospital Revenue Code	278
Min. Negotiated Rate	$12.24
Max. Negotiated Rate	$254.00
Rate for Payer: Aetna Commercial	$193.04
Rate for Payer: Aetna Medicare Advantage	$152.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$129.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$129.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$129.54
Rate for Payer: Cigna Commercial	$254.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.76
Rate for Payer: Qualcare PPO/HMO/WC	$76.20
Rate for Payer: UnitedHealthcare Community & State	$12.24
Rate for Payer: Wellpoint Medicaid Managed Care	$13.46

HEAD SCREW 4.0MM X 40 MM DART

Facility

$1,085.00

Service Code	HCPCS C1713
Hospital Charge Code	270704254
Hospital Revenue Code	278
Min. Negotiated Rate	$162.75
Max. Negotiated Rate	$262.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$238.70
Rate for Payer: Qualcare PPO/HMO/WC	$162.75

HEAD SCREW 4.0MM X 40 MM DART

Facility

$1,085.00

Service Code	HCPCS C1713
Hospital Charge Code	270704254
Hospital Revenue Code	278
Min. Negotiated Rate	$26.15
Max. Negotiated Rate	$542.50
Rate for Payer: Aetna Commercial	$412.30
Rate for Payer: Aetna Medicare Advantage	$325.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$276.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$276.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$276.68
Rate for Payer: Cigna Commercial	$542.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$238.70
Rate for Payer: Qualcare PPO/HMO/WC	$162.75
Rate for Payer: UnitedHealthcare Community & State	$26.15
Rate for Payer: Wellpoint Medicaid Managed Care	$28.75

HEAD SECTION PAD

Facility

$840.50

Hospital Charge Code	270656359
Hospital Revenue Code	271
Min. Negotiated Rate	$126.08
Max. Negotiated Rate	$126.08
Rate for Payer: Qualcare PPO/HMO/WC	$126.08

HEAD SECTION PAD

Facility

$840.50

Hospital Charge Code	270656359
Hospital Revenue Code	271
Min. Negotiated Rate	$20.26
Max. Negotiated Rate	$420.25
Rate for Payer: Aetna Commercial	$319.39
Rate for Payer: Aetna Medicare Advantage	$252.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.33
Rate for Payer: Cigna Commercial	$420.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.15
Rate for Payer: Oxford Commercial	$168.10
Rate for Payer: Qualcare PPO/HMO/WC	$126.08
Rate for Payer: UnitedHealthcare Commercial	$168.10
Rate for Payer: UnitedHealthcare Community & State	$20.26
Rate for Payer: Wellpoint Medicaid Managed Care	$22.27

HEADSET AUTO REGISTRATION ADUL

Facility

$260.00

Hospital Charge Code	270653840
Hospital Revenue Code	270
Min. Negotiated Rate	$6.27
Max. Negotiated Rate	$130.00
Rate for Payer: Aetna Commercial	$98.80
Rate for Payer: Aetna Medicare Advantage	$78.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.30
Rate for Payer: Cigna Commercial	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.00
Rate for Payer: Oxford Commercial	$52.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00
Rate for Payer: UnitedHealthcare Commercial	$52.00
Rate for Payer: UnitedHealthcare Community & State	$6.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.89

HEADSET AUTO REGISTRATION ADUL

Facility

$260.00

Hospital Charge Code	270653840
Hospital Revenue Code	270
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00

HEAD, SHOULDER RESURF. DIA. 4

Facility

$21,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270680383
Hospital Revenue Code	278
Min. Negotiated Rate	$3,168.75
Max. Negotiated Rate	$5,112.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,112.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,647.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,168.75

HEAD, SHOULDER RESURF. DIA. 4

Facility

$21,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270680383
Hospital Revenue Code	278
Min. Negotiated Rate	$509.11
Max. Negotiated Rate	$10,562.50
Rate for Payer: Aetna Commercial	$8,027.50
Rate for Payer: Aetna Medicare Advantage	$6,337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,386.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,386.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,386.88
Rate for Payer: Cigna Commercial	$10,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,112.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,647.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,168.75
Rate for Payer: UnitedHealthcare Community & State	$509.11
Rate for Payer: Wellpoint Medicaid Managed Care	$559.81

HEAD SHOUL TOT 27mX46m43014621

Facility

$610.15

Hospital Charge Code	270635867
Hospital Revenue Code	278
Min. Negotiated Rate	$91.52
Max. Negotiated Rate	$147.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.23
Rate for Payer: Qualcare PPO/HMO/WC	$91.52

HEAD SHOUL TOT 27mX46m43014621

Facility

$610.15

Hospital Charge Code	270635867
Hospital Revenue Code	278
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$305.07
Rate for Payer: Aetna Commercial	$231.86
Rate for Payer: Aetna Medicare Advantage	$183.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.59
Rate for Payer: Cigna Commercial	$305.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.23
Rate for Payer: Qualcare PPO/HMO/WC	$91.52
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: Wellpoint Medicaid Managed Care	$16.17

HEAD SIZ 40 MM LDH PROVISIONAL

Facility

$2,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270698604
Hospital Revenue Code	278
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$580.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$528.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

HEAD SIZ 40 MM LDH PROVISIONAL

Facility

$2,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270698604
Hospital Revenue Code	278
Min. Negotiated Rate	$57.84
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$912.00
Rate for Payer: Aetna Medicare Advantage	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.00
Rate for Payer: Cigna Commercial	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$528.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00
Rate for Payer: UnitedHealthcare Community & State	$57.84
Rate for Payer: Wellpoint Medicaid Managed Care	$63.60

HEAD SMR SHOULDER 50MM `

Facility

$21,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270679034
Hospital Revenue Code	278
Min. Negotiated Rate	$509.11
Max. Negotiated Rate	$10,562.50
Rate for Payer: Aetna Commercial	$8,027.50
Rate for Payer: Aetna Medicare Advantage	$6,337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,386.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,386.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,386.88
Rate for Payer: Cigna Commercial	$10,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,112.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,647.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,168.75
Rate for Payer: UnitedHealthcare Community & State	$509.11
Rate for Payer: Wellpoint Medicaid Managed Care	$559.81

HEAD SMR SHOULDER 50MM `

Facility

$21,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270679034
Hospital Revenue Code	278
Min. Negotiated Rate	$3,168.75
Max. Negotiated Rate	$5,112.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,112.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,647.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,168.75

HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE

Facility

$16,673.86

Service Code	APR-DRG 0553
Min. Negotiated Rate	$16,346.92
Max. Negotiated Rate	$16,673.86
Rate for Payer: UnitedHealthcare Community & State	$16,346.92
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,673.86
Rate for Payer: Wellpoint Medicaid Managed Care	$16,346.92

HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE

Facility

$11,044.80

Service Code	APR-DRG 0552
Min. Negotiated Rate	$10,828.24
Max. Negotiated Rate	$11,044.80
Rate for Payer: UnitedHealthcare Community & State	$10,828.24
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,044.80
Rate for Payer: Wellpoint Medicaid Managed Care	$10,828.24

Know your out-of-pocket cost for care.

All Charges