Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IMPLANT MTR MAMMARY SALIN 2913

Facility

$3,407.25

Hospital Charge Code	270614095
Hospital Revenue Code	278
Min. Negotiated Rate	$511.09
Max. Negotiated Rate	$824.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$681.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$824.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$749.60
Rate for Payer: Qualcare PPO/HMO/WC	$511.09

IMPLANT MTR MAMMARY SALIN 2913

Facility

$3,407.25

Hospital Charge Code	270614095
Hospital Revenue Code	278
Min. Negotiated Rate	$82.11
Max. Negotiated Rate	$1,703.62
Rate for Payer: Aetna Commercial	$1,294.76
Rate for Payer: Aetna Medicare Advantage	$1,022.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$868.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$868.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$681.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$868.85
Rate for Payer: Cigna Commercial	$1,703.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$824.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$749.60
Rate for Payer: Qualcare PPO/HMO/WC	$511.09
Rate for Payer: UnitedHealthcare Community & State	$82.11
Rate for Payer: Wellpoint Medicaid Managed Care	$90.29

IMPLANT NASAL STYLE 1 N-1

Facility

$725.00

Hospital Charge Code	270639085
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

IMPLANT NASAL STYLE 1 N-1

Facility

$725.00

Hospital Charge Code	270639085
Hospital Revenue Code	278
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) NJ Health	$145.00
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	$175.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$159.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

IMPLANT NASAL STYLE 2

Facility

$725.00

Hospital Charge Code	270639086
Hospital Revenue Code	272
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$108.75
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

IMPLANT NASAL STYLE 2

Facility

$725.00

Hospital Charge Code	270639086
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

IMPLANT NEUROELECTRODES

Facility

$28,012.44

Service Code	HCPCS 64561
Hospital Charge Code	160000227
Hospital Revenue Code	360
Min. Negotiated Rate	$675.10
Max. Negotiated Rate	$27,330.09
Rate for Payer: Aetna Commercial	$20,593.91
Rate for Payer: Aetna Medicare Advantage	$24,530.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,330.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,330.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,571.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,330.09
Rate for Payer: Cigna Commercial	$15,176.62
Rate for Payer: Cigna Medicare Advantage	$7,571.29
Rate for Payer: Clover Medicare Advantage	$7,192.73
Rate for Payer: EmblemHealth Commercial	$22,713.87
Rate for Payer: Humana Medicare Advantage	$7,798.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,571.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,403.73
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,201.87
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$675.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,571.29
Rate for Payer: Wellcare Medicare Advantage	$7,571.29
Rate for Payer: Wellpoint Medicaid Managed Care	$742.33

IMPLANT NEUROELECTRODES

Facility

$28,012.45

Service Code	HCPCS 64581
Hospital Charge Code	16001043
Hospital Revenue Code	360
Min. Negotiated Rate	$4,201.87
Max. Negotiated Rate	$4,201.87
Rate for Payer: Qualcare PPO/HMO/WC	$4,201.87

IMPLANT NEUROELECTRODES

Facility

$28,012.45

Service Code	HCPCS 64581
Hospital Charge Code	16001043
Hospital Revenue Code	360
Min. Negotiated Rate	$675.10
Max. Negotiated Rate	$27,330.09
Rate for Payer: Aetna Commercial	$20,593.91
Rate for Payer: Aetna Medicare Advantage	$24,530.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,330.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,330.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,571.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,330.09
Rate for Payer: Cigna Commercial	$15,176.62
Rate for Payer: Cigna Medicare Advantage	$7,571.29
Rate for Payer: Clover Medicare Advantage	$7,192.73
Rate for Payer: EmblemHealth Commercial	$22,713.87
Rate for Payer: Humana Medicare Advantage	$7,798.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,571.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,403.74
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,201.87
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$675.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,571.29
Rate for Payer: Wellcare Medicare Advantage	$7,571.29
Rate for Payer: Wellpoint Medicaid Managed Care	$742.33

IMPLANT NEUROELECTRODES

Facility

$28,012.44

Service Code	HCPCS 64561
Hospital Charge Code	1600000291
Hospital Revenue Code	360
Min. Negotiated Rate	$4,201.87
Max. Negotiated Rate	$4,201.87
Rate for Payer: Qualcare PPO/HMO/WC	$4,201.87

IMPLANT NEUROELECTRODES

Facility

$28,012.44

Service Code	HCPCS 64561
Hospital Charge Code	1600000291
Hospital Revenue Code	360
Min. Negotiated Rate	$675.10
Max. Negotiated Rate	$27,330.09
Rate for Payer: Aetna Commercial	$20,593.91
Rate for Payer: Aetna Medicare Advantage	$24,530.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,330.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,330.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,571.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,330.09
Rate for Payer: Cigna Commercial	$15,176.62
Rate for Payer: Cigna Medicare Advantage	$7,571.29
Rate for Payer: Clover Medicare Advantage	$7,192.73
Rate for Payer: EmblemHealth Commercial	$22,713.87
Rate for Payer: Humana Medicare Advantage	$7,798.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,571.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,403.73
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,201.87
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$675.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,571.29
Rate for Payer: Wellcare Medicare Advantage	$7,571.29
Rate for Payer: Wellpoint Medicaid Managed Care	$742.33

IMPLANT NEUROELECTRODES

Facility

$28,012.44

Service Code	HCPCS 64561
Hospital Charge Code	160000227
Hospital Revenue Code	360
Min. Negotiated Rate	$4,201.87
Max. Negotiated Rate	$4,201.87
Rate for Payer: Qualcare PPO/HMO/WC	$4,201.87

IMPLANT NEUROELECTRODES

Facility

$39,614.51

Service Code	HCPCS 63650
Hospital Charge Code	321563650
Hospital Revenue Code	361
Min. Negotiated Rate	$5,942.18
Max. Negotiated Rate	$5,942.18
Rate for Payer: Qualcare PPO/HMO/WC	$5,942.18

IMPLANT NEUROELECTRODES

Facility

$39,614.51

Service Code	HCPCS 63650
Hospital Charge Code	321563650
Hospital Revenue Code	361
Min. Negotiated Rate	$954.71
Max. Negotiated Rate	$27,330.09
Rate for Payer: Aetna Commercial	$20,593.91
Rate for Payer: Aetna Medicare Advantage	$24,530.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,330.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,330.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,571.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,330.09
Rate for Payer: Cigna Commercial	$15,176.62
Rate for Payer: Cigna Medicare Advantage	$7,571.29
Rate for Payer: Clover Medicare Advantage	$7,192.73
Rate for Payer: EmblemHealth Commercial	$22,713.87
Rate for Payer: Humana Medicare Advantage	$7,798.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,571.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,884.35
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,942.18
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$954.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,571.29
Rate for Payer: Wellcare Medicare Advantage	$7,571.29
Rate for Payer: Wellpoint Medicaid Managed Care	$1,049.78

IMPLANTOFBRAININTRACHEMOANGENT

Facility

$150,015.70

Service Code	HCPCS 61517
Hospital Charge Code	270663209
Hospital Revenue Code	360
Min. Negotiated Rate	$1,626.00
Max. Negotiated Rate	$75,007.85
Rate for Payer: Aetna Commercial	$57,005.97
Rate for Payer: Aetna Medicare Advantage	$45,004.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38,254.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38,254.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38,254.00
Rate for Payer: Cigna Commercial	$75,007.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45,004.71
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$22,502.35
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$3,615.38
Rate for Payer: Wellpoint Medicaid Managed Care	$3,975.42

IMPLANTOFBRAININTRACHEMOANGENT

Facility

$150,015.70

Service Code	HCPCS 61517
Hospital Charge Code	270663209
Hospital Revenue Code	360
Min. Negotiated Rate	$22,502.35
Max. Negotiated Rate	$22,502.35
Rate for Payer: Qualcare PPO/HMO/WC	$22,502.35

IMPLANT ON 10 90 1197-090-10

Facility

$15,624.00

Hospital Charge Code	270635996
Hospital Revenue Code	278
Min. Negotiated Rate	$376.54
Max. Negotiated Rate	$7,812.00
Rate for Payer: Aetna Commercial	$5,937.12
Rate for Payer: Aetna Medicare Advantage	$4,687.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,984.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,984.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,124.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,984.12
Rate for Payer: Cigna Commercial	$7,812.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,781.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,437.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.60
Rate for Payer: UnitedHealthcare Community & State	$376.54
Rate for Payer: Wellpoint Medicaid Managed Care	$414.04

IMPLANT ON 10 90 1197-090-10

Facility

$15,624.00

Hospital Charge Code	270635996
Hospital Revenue Code	278
Min. Negotiated Rate	$2,343.60
Max. Negotiated Rate	$3,781.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,124.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,781.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,437.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.60

IMPLANT OSSEOTITE 4 15 OSS415

Facility

$1,288.00

Hospital Charge Code	270620301
Hospital Revenue Code	278
Min. Negotiated Rate	$193.20
Max. Negotiated Rate	$311.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$283.36
Rate for Payer: Qualcare PPO/HMO/WC	$193.20

IMPLANT OSSEOTITE 4 15 OSS415

Facility

$1,288.00

Hospital Charge Code	270620301
Hospital Revenue Code	278
Min. Negotiated Rate	$31.04
Max. Negotiated Rate	$644.00
Rate for Payer: Aetna Commercial	$489.44
Rate for Payer: Aetna Medicare Advantage	$386.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.44
Rate for Payer: Cigna Commercial	$644.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$283.36
Rate for Payer: Qualcare PPO/HMO/WC	$193.20
Rate for Payer: UnitedHealthcare Community & State	$31.04
Rate for Payer: Wellpoint Medicaid Managed Care	$34.13

IMPLANT PAT-ACTIVE HT RECODER

Facility

$34,718.90

Service Code	HCPCS 33282
Hospital Charge Code	5100815
Hospital Revenue Code	480
Min. Negotiated Rate	$836.73
Max. Negotiated Rate	$17,359.45
Rate for Payer: Aetna Commercial	$13,193.18
Rate for Payer: Aetna Medicare Advantage	$10,415.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,853.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,853.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,853.32
Rate for Payer: Cigna Commercial	$17,359.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,415.67
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,207.84
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$836.73
Rate for Payer: Wellpoint Medicaid Managed Care	$920.05

IMPLANT PAT-ACTIVE HT RECODER

Facility

$34,718.90

Service Code	HCPCS 33282
Hospital Charge Code	5100815
Hospital Revenue Code	480
Min. Negotiated Rate	$5,207.84
Max. Negotiated Rate	$5,207.84
Rate for Payer: Qualcare PPO/HMO/WC	$5,207.84

IMPLANT PEEK MED CONTOUR

Facility

$42,000.00

Hospital Charge Code	270677110
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.20
Max. Negotiated Rate	$21,000.00
Rate for Payer: Aetna Commercial	$15,960.00
Rate for Payer: Aetna Medicare Advantage	$12,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,710.00
Rate for Payer: Cigna Commercial	$21,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,164.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,240.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,300.00
Rate for Payer: UnitedHealthcare Community & State	$1,012.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1,113.00

IMPLANT PEEK MED CONTOUR

Facility

$42,000.00

Hospital Charge Code	270677110
Hospital Revenue Code	278
Min. Negotiated Rate	$6,300.00
Max. Negotiated Rate	$10,164.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,164.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,240.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,300.00

IMPLANT PRODISC-C VIVO MED 5MM

Facility

$42,500.00

Service Code	HCPCS L8699
Hospital Charge Code	270698936
Hospital Revenue Code	278
Min. Negotiated Rate	$6,375.00
Max. Negotiated Rate	$10,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,285.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,350.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,375.00

Know your out-of-pocket cost for care.

All Charges