Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HOFFMAN HEXAPO STRUTXS89-109MM

Facility

$15,730.75

Service Code	HCPCS C1713
Hospital Charge Code	270700235
Hospital Revenue Code	278
Min. Negotiated Rate	$2,359.61
Max. Negotiated Rate	$3,806.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,146.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,806.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,460.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,359.61

HOFFMAN HINGE BOLTLNGLRF6X16MM

Facility

$595.90

Service Code	HCPCS C1713
Hospital Charge Code	270700231
Hospital Revenue Code	278
Min. Negotiated Rate	$89.39
Max. Negotiated Rate	$144.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$131.10
Rate for Payer: Qualcare PPO/HMO/WC	$89.39

HOFFMAN HINGE BOLTLNGLRF6X16MM

Facility

$595.90

Service Code	HCPCS C1713
Hospital Charge Code	270700231
Hospital Revenue Code	278
Min. Negotiated Rate	$14.36
Max. Negotiated Rate	$297.95
Rate for Payer: Aetna Commercial	$226.44
Rate for Payer: Aetna Medicare Advantage	$178.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.95
Rate for Payer: Cigna Commercial	$297.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$131.10
Rate for Payer: Qualcare PPO/HMO/WC	$89.39
Rate for Payer: UnitedHealthcare Community & State	$14.36
Rate for Payer: Wellpoint Medicaid Managed Care	$15.79

HOFFMAN STATIC STRUTMEDLRF40MM

Facility

$474.70

Service Code	HCPCS C1713
Hospital Charge Code	270700227
Hospital Revenue Code	278
Min. Negotiated Rate	$71.20
Max. Negotiated Rate	$114.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.43
Rate for Payer: Qualcare PPO/HMO/WC	$71.20

HOFFMAN STATIC STRUTMEDLRF40MM

Facility

$474.70

Service Code	HCPCS C1713
Hospital Charge Code	270700227
Hospital Revenue Code	278
Min. Negotiated Rate	$11.44
Max. Negotiated Rate	$237.35
Rate for Payer: Aetna Commercial	$180.39
Rate for Payer: Aetna Medicare Advantage	$142.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.05
Rate for Payer: Cigna Commercial	$237.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.43
Rate for Payer: Qualcare PPO/HMO/WC	$71.20
Rate for Payer: UnitedHealthcare Community & State	$11.44
Rate for Payer: Wellpoint Medicaid Managed Care	$12.58

HOFFMANTELESTRUTXSLRF100-125MM

Facility

$16,310.00

Service Code	HCPCS C1713
Hospital Charge Code	270700226
Hospital Revenue Code	278
Min. Negotiated Rate	$2,446.50
Max. Negotiated Rate	$3,947.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,262.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,947.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,588.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,446.50

HOFFMANTELESTRUTXSLRF100-125MM

Facility

$16,310.00

Service Code	HCPCS C1713
Hospital Charge Code	270700226
Hospital Revenue Code	278
Min. Negotiated Rate	$393.07
Max. Negotiated Rate	$8,155.00
Rate for Payer: Aetna Commercial	$6,197.80
Rate for Payer: Aetna Medicare Advantage	$4,893.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,159.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,159.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,262.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,159.05
Rate for Payer: Cigna Commercial	$8,155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,947.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,588.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,446.50
Rate for Payer: UnitedHealthcare Community & State	$393.07
Rate for Payer: Wellpoint Medicaid Managed Care	$432.21

HOFFMAN WASHER LRF 2MM YELLOW

Facility

$287.85

Service Code	HCPCS C1713
Hospital Charge Code	270700228
Hospital Revenue Code	278
Min. Negotiated Rate	$43.18
Max. Negotiated Rate	$69.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$63.33
Rate for Payer: Qualcare PPO/HMO/WC	$43.18

HOFFMAN WASHER LRF 2MM YELLOW

Facility

$287.85

Service Code	HCPCS C1713
Hospital Charge Code	270700228
Hospital Revenue Code	278
Min. Negotiated Rate	$6.94
Max. Negotiated Rate	$143.93
Rate for Payer: Aetna Commercial	$109.38
Rate for Payer: Aetna Medicare Advantage	$86.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.40
Rate for Payer: Cigna Commercial	$143.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$63.33
Rate for Payer: Qualcare PPO/HMO/WC	$43.18
Rate for Payer: UnitedHealthcare Community & State	$6.94
Rate for Payer: Wellpoint Medicaid Managed Care	$7.63

HOHMANN-STYLE RETRACTOR

Facility

$1,158.00

Hospital Charge Code	270659360
Hospital Revenue Code	272
Min. Negotiated Rate	$27.91
Max. Negotiated Rate	$579.00
Rate for Payer: Aetna Commercial	$440.04
Rate for Payer: Aetna Medicare Advantage	$347.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$295.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$295.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$295.29
Rate for Payer: Cigna Commercial	$579.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.40
Rate for Payer: Oxford Commercial	$231.60
Rate for Payer: Qualcare PPO/HMO/WC	$173.70
Rate for Payer: UnitedHealthcare Commercial	$231.60
Rate for Payer: UnitedHealthcare Community & State	$27.91
Rate for Payer: Wellpoint Medicaid Managed Care	$30.69

HOHMANN-STYLE RETRACTOR

Facility

$1,158.00

Hospital Charge Code	270659360
Hospital Revenue Code	272
Min. Negotiated Rate	$173.70
Max. Negotiated Rate	$173.70
Rate for Payer: Qualcare PPO/HMO/WC	$173.70

HOLDER BACKSTOP MINI SHARP

Facility

$30.75

Hospital Charge Code	270662069
Hospital Revenue Code	272
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$15.38
Rate for Payer: Aetna Commercial	$11.69
Rate for Payer: Aetna Medicare Advantage	$9.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.84
Rate for Payer: Cigna Commercial	$15.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.22
Rate for Payer: Oxford Commercial	$6.15
Rate for Payer: Qualcare PPO/HMO/WC	$4.61
Rate for Payer: UnitedHealthcare Commercial	$6.15
Rate for Payer: UnitedHealthcare Community & State	$0.74
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

HOLDER BACKSTOP MINI SHARP

Facility

$30.75

Hospital Charge Code	270662069
Hospital Revenue Code	272
Min. Negotiated Rate	$4.61
Max. Negotiated Rate	$4.61
Rate for Payer: Qualcare PPO/HMO/WC	$4.61

HOLDER BAG BLOOD

Facility

$40.00

Hospital Charge Code	270665717
Hospital Revenue Code	270
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

HOLDER BAG BLOOD

Facility

$40.00

Hospital Charge Code	270665717
Hospital Revenue Code	270
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.00
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

HOLDER DPY 1 PIN FA10355

Facility

$1,444.00

Hospital Charge Code	270612443
Hospital Revenue Code	272
Min. Negotiated Rate	$34.80
Max. Negotiated Rate	$722.00
Rate for Payer: Aetna Commercial	$548.72
Rate for Payer: Aetna Medicare Advantage	$433.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$368.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$368.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$368.22
Rate for Payer: Cigna Commercial	$722.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.20
Rate for Payer: Oxford Commercial	$288.80
Rate for Payer: Qualcare PPO/HMO/WC	$216.60
Rate for Payer: UnitedHealthcare Commercial	$288.80
Rate for Payer: UnitedHealthcare Community & State	$34.80
Rate for Payer: Wellpoint Medicaid Managed Care	$38.27

HOLDER DPY 1 PIN FA10355

Facility

$1,444.00

Hospital Charge Code	270612443
Hospital Revenue Code	272
Min. Negotiated Rate	$216.60
Max. Negotiated Rate	$216.60
Rate for Payer: Qualcare PPO/HMO/WC	$216.60

HOLDER DPY 2 PIN FA10360

Facility

$2,323.25

Hospital Charge Code	270612487
Hospital Revenue Code	272
Min. Negotiated Rate	$55.99
Max. Negotiated Rate	$1,161.62
Rate for Payer: Aetna Commercial	$882.84
Rate for Payer: Aetna Medicare Advantage	$696.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.43
Rate for Payer: Cigna Commercial	$1,161.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$696.98
Rate for Payer: Oxford Commercial	$464.65
Rate for Payer: Qualcare PPO/HMO/WC	$348.49
Rate for Payer: UnitedHealthcare Commercial	$464.65
Rate for Payer: UnitedHealthcare Community & State	$55.99
Rate for Payer: Wellpoint Medicaid Managed Care	$61.57

HOLDER DPY 2 PIN FA10360

Facility

$2,323.25

Hospital Charge Code	270612487
Hospital Revenue Code	272
Min. Negotiated Rate	$348.49
Max. Negotiated Rate	$348.49
Rate for Payer: Qualcare PPO/HMO/WC	$348.49

HOLDER DPY 3 PIN FA10365

Facility

$2,348.85

Hospital Charge Code	270612444
Hospital Revenue Code	272
Min. Negotiated Rate	$352.33
Max. Negotiated Rate	$352.33
Rate for Payer: Qualcare PPO/HMO/WC	$352.33

HOLDER DPY 3 PIN FA10365

Facility

$2,348.85

Hospital Charge Code	270612444
Hospital Revenue Code	272
Min. Negotiated Rate	$56.61
Max. Negotiated Rate	$1,174.42
Rate for Payer: Aetna Commercial	$892.56
Rate for Payer: Aetna Medicare Advantage	$704.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$598.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$598.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$598.96
Rate for Payer: Cigna Commercial	$1,174.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$704.65
Rate for Payer: Oxford Commercial	$469.77
Rate for Payer: Qualcare PPO/HMO/WC	$352.33
Rate for Payer: UnitedHealthcare Commercial	$469.77
Rate for Payer: UnitedHealthcare Community & State	$56.61
Rate for Payer: Wellpoint Medicaid Managed Care	$62.24

HOLDER ENDOTRACH*****

Facility

$43.00

Hospital Charge Code	8000622
Hospital Revenue Code	279
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

HOLDER ENDOTRACH*****

Facility

$43.00

Hospital Charge Code	8000622
Hospital Revenue Code	279
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

HOLDER ET TUBE ADHESIVE

Facility

$38.70

Hospital Charge Code	270302217
Hospital Revenue Code	270
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$19.35
Rate for Payer: Aetna Commercial	$14.71
Rate for Payer: Aetna Medicare Advantage	$11.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.87
Rate for Payer: Cigna Commercial	$19.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.61
Rate for Payer: Oxford Commercial	$7.74
Rate for Payer: Qualcare PPO/HMO/WC	$5.80
Rate for Payer: UnitedHealthcare Commercial	$7.74
Rate for Payer: UnitedHealthcare Community & State	$0.93
Rate for Payer: Wellpoint Medicaid Managed Care	$1.03

HOLDER ET TUBE ADHESIVE

Facility

$38.70

Hospital Charge Code	270302217
Hospital Revenue Code	270
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$5.80
Rate for Payer: Qualcare PPO/HMO/WC	$5.80

Know your out-of-pocket cost for care.

All Charges