Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ANCHOR SWIVELOCK 5.2MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270689195
Hospital Revenue Code	272
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.50
Rate for Payer: Oxford Commercial	$145.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Commercial	$145.00
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

ANCHOR SYST FLEXBAND 3.85X17MM

Facility

$18,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270697465
Hospital Revenue Code	278
Min. Negotiated Rate	$457.30
Max. Negotiated Rate	$9,487.50
Rate for Payer: Aetna Commercial	$7,210.50
Rate for Payer: Aetna Medicare Advantage	$5,692.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,838.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,838.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,838.62
Rate for Payer: Cigna Commercial	$9,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,591.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,846.25
Rate for Payer: UnitedHealthcare Community & State	$457.30
Rate for Payer: Wellpoint Medicaid Managed Care	$502.84

ANCHOR SYST FLEXBAND 3.85X17MM

Facility

$18,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270697465
Hospital Revenue Code	278
Min. Negotiated Rate	$2,846.25
Max. Negotiated Rate	$4,591.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,591.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,846.25

ANCHOR TAPE XBRAID 1.2

Facility

$619.05

Service Code	HCPCS C1713
Hospital Charge Code	270697226
Hospital Revenue Code	278
Min. Negotiated Rate	$92.86
Max. Negotiated Rate	$149.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.19
Rate for Payer: Qualcare PPO/HMO/WC	$92.86

ANCHOR TAPE XBRAID 1.2

Facility

$619.05

Service Code	HCPCS C1713
Hospital Charge Code	270697226
Hospital Revenue Code	278
Min. Negotiated Rate	$14.92
Max. Negotiated Rate	$309.52
Rate for Payer: Aetna Commercial	$235.24
Rate for Payer: Aetna Medicare Advantage	$185.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.86
Rate for Payer: Cigna Commercial	$309.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$136.19
Rate for Payer: Qualcare PPO/HMO/WC	$92.86
Rate for Payer: UnitedHealthcare Community & State	$14.92
Rate for Payer: Wellpoint Medicaid Managed Care	$16.40

ANCHOR TIGHT ROPE PCL

Facility

$1,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270666958
Hospital Revenue Code	278
Min. Negotiated Rate	$261.75
Max. Negotiated Rate	$422.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$349.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$422.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$383.90
Rate for Payer: Qualcare PPO/HMO/WC	$261.75

ANCHOR TIGHT ROPE PCL

Facility

$1,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270666958
Hospital Revenue Code	278
Min. Negotiated Rate	$42.05
Max. Negotiated Rate	$872.50
Rate for Payer: Aetna Commercial	$663.10
Rate for Payer: Aetna Medicare Advantage	$523.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$444.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$444.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$349.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$444.98
Rate for Payer: Cigna Commercial	$872.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$422.29
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$383.90
Rate for Payer: Qualcare PPO/HMO/WC	$261.75
Rate for Payer: UnitedHealthcare Community & State	$42.05
Rate for Payer: Wellpoint Medicaid Managed Care	$46.24

ANCHOR TITAN W/TWO#2 B 222990

Facility

$1,315.00

Hospital Charge Code	270637282
Hospital Revenue Code	278
Min. Negotiated Rate	$31.69
Max. Negotiated Rate	$657.50
Rate for Payer: Aetna Commercial	$499.70
Rate for Payer: Aetna Medicare Advantage	$394.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.32
Rate for Payer: Cigna Commercial	$657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.30
Rate for Payer: Qualcare PPO/HMO/WC	$197.25
Rate for Payer: UnitedHealthcare Community & State	$31.69
Rate for Payer: Wellpoint Medicaid Managed Care	$34.85

ANCHOR TITAN W/TWO#2 B 222990

Facility

$1,315.00

Hospital Charge Code	270637282
Hospital Revenue Code	278
Min. Negotiated Rate	$197.25
Max. Negotiated Rate	$318.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$289.30
Rate for Payer: Qualcare PPO/HMO/WC	$197.25

ANCHOR TITM FAST 5.0 RC 222993

Facility

$1,510.00

Hospital Charge Code	270642288
Hospital Revenue Code	278
Min. Negotiated Rate	$226.50
Max. Negotiated Rate	$365.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$302.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$365.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$332.20
Rate for Payer: Qualcare PPO/HMO/WC	$226.50

ANCHOR TITM FAST 5.0 RC 222993

Facility

$1,510.00

Hospital Charge Code	270642288
Hospital Revenue Code	278
Min. Negotiated Rate	$36.39
Max. Negotiated Rate	$755.00
Rate for Payer: Aetna Commercial	$573.80
Rate for Payer: Aetna Medicare Advantage	$453.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$385.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$385.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$302.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$385.05
Rate for Payer: Cigna Commercial	$755.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$365.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$332.20
Rate for Payer: Qualcare PPO/HMO/WC	$226.50
Rate for Payer: UnitedHealthcare Community & State	$36.39
Rate for Payer: Wellpoint Medicaid Managed Care	$40.02

ANCHOR WORTHCD BIOKLESS 212727

Facility

$1,550.00

Hospital Charge Code	270637608
Hospital Revenue Code	278
Min. Negotiated Rate	$37.35
Max. Negotiated Rate	$775.00
Rate for Payer: Aetna Commercial	$589.00
Rate for Payer: Aetna Medicare Advantage	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.25
Rate for Payer: Cigna Commercial	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$341.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.50
Rate for Payer: UnitedHealthcare Community & State	$37.35
Rate for Payer: Wellpoint Medicaid Managed Care	$41.08

ANCHOR WORTHCD BIOKLESS 212727

Facility

$1,550.00

Hospital Charge Code	270637608
Hospital Revenue Code	278
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$375.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$341.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

ANCHOR XX BRAID TT 1.2MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270692395
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

ANCHOR XX BRAID TT 1.2MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270692395
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

ANCHR ICONIX 2.3MM W/X-BRAID

Facility

$2,590.00

Hospital Charge Code	270683343
Hospital Revenue Code	272
Min. Negotiated Rate	$62.42
Max. Negotiated Rate	$1,295.00
Rate for Payer: Aetna Commercial	$984.20
Rate for Payer: Aetna Medicare Advantage	$777.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$660.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$660.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$660.45
Rate for Payer: Cigna Commercial	$1,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$777.00
Rate for Payer: Oxford Commercial	$518.00
Rate for Payer: Qualcare PPO/HMO/WC	$388.50
Rate for Payer: UnitedHealthcare Commercial	$518.00
Rate for Payer: UnitedHealthcare Community & State	$62.42
Rate for Payer: Wellpoint Medicaid Managed Care	$68.64

ANCHR ICONIX 2.3MM W/X-BRAID

Facility

$2,590.00

Hospital Charge Code	270683343
Hospital Revenue Code	272
Min. Negotiated Rate	$388.50
Max. Negotiated Rate	$388.50
Rate for Payer: Qualcare PPO/HMO/WC	$388.50

ANCHR LOOP SZE2 LUPNE 222980

Facility

$1,383.90

Hospital Charge Code	270635853
Hospital Revenue Code	278
Min. Negotiated Rate	$33.35
Max. Negotiated Rate	$691.95
Rate for Payer: Aetna Commercial	$525.88
Rate for Payer: Aetna Medicare Advantage	$415.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$352.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$352.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$352.89
Rate for Payer: Cigna Commercial	$691.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$304.46
Rate for Payer: Qualcare PPO/HMO/WC	$207.59
Rate for Payer: UnitedHealthcare Community & State	$33.35
Rate for Payer: Wellpoint Medicaid Managed Care	$36.67

ANCHR LOOP SZE2 LUPNE 222980

Facility

$1,383.90

Hospital Charge Code	270635853
Hospital Revenue Code	278
Min. Negotiated Rate	$207.59
Max. Negotiated Rate	$334.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$304.46
Rate for Payer: Qualcare PPO/HMO/WC	$207.59

ANCHR WPANCRYL BIKNTLS 212729

Facility

$1,507.90

Hospital Charge Code	270635852
Hospital Revenue Code	278
Min. Negotiated Rate	$36.34
Max. Negotiated Rate	$753.95
Rate for Payer: Aetna Commercial	$573.00
Rate for Payer: Aetna Medicare Advantage	$452.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$384.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$384.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$384.51
Rate for Payer: Cigna Commercial	$753.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$331.74
Rate for Payer: Qualcare PPO/HMO/WC	$226.19
Rate for Payer: UnitedHealthcare Community & State	$36.34
Rate for Payer: Wellpoint Medicaid Managed Care	$39.96

ANCHR WPANCRYL BIKNTLS 212729

Facility

$1,507.90

Hospital Charge Code	270635852
Hospital Revenue Code	278
Min. Negotiated Rate	$226.19
Max. Negotiated Rate	$364.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$331.74
Rate for Payer: Qualcare PPO/HMO/WC	$226.19

ANCH SUT CORSCRW 5.5mAR-1927BF

Facility

$1,785.65

Hospital Charge Code	270636062
Hospital Revenue Code	278
Min. Negotiated Rate	$43.03
Max. Negotiated Rate	$892.83
Rate for Payer: Aetna Commercial	$678.55
Rate for Payer: Aetna Medicare Advantage	$535.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$455.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$455.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$455.34
Rate for Payer: Cigna Commercial	$892.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$392.84
Rate for Payer: Qualcare PPO/HMO/WC	$267.85
Rate for Payer: UnitedHealthcare Community & State	$43.03
Rate for Payer: Wellpoint Medicaid Managed Care	$47.32

ANCH SUT CORSCRW 5.5mAR-1927BF

Facility

$1,785.65

Hospital Charge Code	270636062
Hospital Revenue Code	278
Min. Negotiated Rate	$267.85
Max. Negotiated Rate	$432.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$392.84
Rate for Payer: Qualcare PPO/HMO/WC	$267.85

ANCOBAN 500MG CAP

Facility

$46.00

Hospital Charge Code	60635565
Hospital Revenue Code	250
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$6.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.90

ANCOBAN 500MG CAP

Facility

$46.00

Hospital Charge Code	60635565
Hospital Revenue Code	250
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$23.00
Rate for Payer: Aetna Commercial	$17.48
Rate for Payer: Aetna Medicare Advantage	$13.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.73
Rate for Payer: Cigna Commercial	$23.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.80
Rate for Payer: Oxford Commercial	$9.20
Rate for Payer: Qualcare PPO/HMO/WC	$6.90
Rate for Payer: UnitedHealthcare Commercial	$9.20
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$1.22

Know your out-of-pocket cost for care.

All Charges