Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INSTALL STEEL CATWALKS

Facility

$23,500.00

Hospital Charge Code	270647909
Hospital Revenue Code	272
Min. Negotiated Rate	$3,525.00
Max. Negotiated Rate	$3,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,525.00

INSTAT 3X4

Facility

$336.00

Hospital Charge Code	6006753
Hospital Revenue Code	250
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$168.00
Rate for Payer: Aetna Commercial	$127.68
Rate for Payer: Aetna Medicare Advantage	$100.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.68
Rate for Payer: Cigna Commercial	$168.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.80
Rate for Payer: Oxford Commercial	$67.20
Rate for Payer: Qualcare PPO/HMO/WC	$50.40
Rate for Payer: UnitedHealthcare Commercial	$67.20
Rate for Payer: UnitedHealthcare Community & State	$8.10
Rate for Payer: Wellpoint Medicaid Managed Care	$8.90

INSTAT 3X4

Facility

$336.00

Hospital Charge Code	6006753
Hospital Revenue Code	250
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$50.40
Rate for Payer: Qualcare PPO/HMO/WC	$50.40

INS TEMP BALDDER CATH

Facility

$1,167.00

Service Code	HCPCS 51702
Hospital Charge Code	1600000435
Hospital Revenue Code	360
Min. Negotiated Rate	$175.05
Max. Negotiated Rate	$175.05
Rate for Payer: Qualcare PPO/HMO/WC	$175.05

INS TEMP BALDDER CATH

Facility

$1,167.00

Service Code	HCPCS 51702
Hospital Charge Code	1600000435
Hospital Revenue Code	360
Min. Negotiated Rate	$28.12
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
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	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.10
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$175.05
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$28.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$30.93

INSTIBPSNREVARTSURFVE16MM

Facility

$18,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270694285
Hospital Revenue Code	278
Min. Negotiated Rate	$2,718.75
Max. Negotiated Rate	$4,386.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,386.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75

INSTIBPSNREVARTSURFVE16MM

Facility

$18,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270694285
Hospital Revenue Code	278
Min. Negotiated Rate	$436.81
Max. Negotiated Rate	$9,062.50
Rate for Payer: Aetna Commercial	$6,887.50
Rate for Payer: Aetna Medicare Advantage	$5,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,621.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,621.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,621.88
Rate for Payer: Cigna Commercial	$9,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,386.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75
Rate for Payer: UnitedHealthcare Community & State	$436.81
Rate for Payer: Wellpoint Medicaid Managed Care	$480.31

INST. KIT,INFERIOR,GLENOID

Facility

$3,265.00

Hospital Charge Code	270687344
Hospital Revenue Code	272
Min. Negotiated Rate	$78.69
Max. Negotiated Rate	$1,632.50
Rate for Payer: Aetna Commercial	$1,240.70
Rate for Payer: Aetna Medicare Advantage	$979.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$832.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$832.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$832.58
Rate for Payer: Cigna Commercial	$1,632.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$979.50
Rate for Payer: Oxford Commercial	$653.00
Rate for Payer: Qualcare PPO/HMO/WC	$489.75
Rate for Payer: UnitedHealthcare Commercial	$653.00
Rate for Payer: UnitedHealthcare Community & State	$78.69
Rate for Payer: Wellpoint Medicaid Managed Care	$86.52

INST. KIT,INFERIOR,GLENOID

Facility

$3,265.00

Hospital Charge Code	270687344
Hospital Revenue Code	272
Min. Negotiated Rate	$489.75
Max. Negotiated Rate	$489.75
Rate for Payer: Qualcare PPO/HMO/WC	$489.75

INST KIT MICRO SUTURETAK

Facility

$875.00

Hospital Charge Code	270677969
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

INST KIT MICRO SUTURETAK

Facility

$875.00

Hospital Charge Code	270677969
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

INST. KIT,SUPERIOR,GLENOID

Facility

$1,960.00

Hospital Charge Code	270687343
Hospital Revenue Code	272
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$294.00
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

INST. KIT,SUPERIOR,GLENOID

Facility

$1,960.00

Hospital Charge Code	270687343
Hospital Revenue Code	272
Min. Negotiated Rate	$47.24
Max. Negotiated Rate	$980.00
Rate for Payer: Aetna Commercial	$744.80
Rate for Payer: Aetna Medicare Advantage	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.80
Rate for Payer: Cigna Commercial	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$588.00
Rate for Payer: Oxford Commercial	$392.00
Rate for Payer: Qualcare PPO/HMO/WC	$294.00
Rate for Payer: UnitedHealthcare Commercial	$392.00
Rate for Payer: UnitedHealthcare Community & State	$47.24
Rate for Payer: Wellpoint Medicaid Managed Care	$51.94

INSTRATEK BLADE

Facility

$620.00

Hospital Charge Code	270332654
Hospital Revenue Code	272
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$93.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00

INSTRATEK BLADE

Facility

$620.00

Hospital Charge Code	270332654
Hospital Revenue Code	272
Min. Negotiated Rate	$14.94
Max. Negotiated Rate	$310.00
Rate for Payer: Aetna Commercial	$235.60
Rate for Payer: Aetna Medicare Advantage	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.10
Rate for Payer: Cigna Commercial	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.00
Rate for Payer: Oxford Commercial	$124.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.94
Rate for Payer: Wellpoint Medicaid Managed Care	$16.43

INSTRUMENTATION FEE OR 999880

Facility

$1,724.85

Hospital Charge Code	270612029
Hospital Revenue Code	272
Min. Negotiated Rate	$258.73
Max. Negotiated Rate	$258.73
Rate for Payer: Qualcare PPO/HMO/WC	$258.73

INSTRUMENTATION FEE OR 999880

Facility

$1,724.85

Hospital Charge Code	270612029
Hospital Revenue Code	272
Min. Negotiated Rate	$41.57
Max. Negotiated Rate	$862.42
Rate for Payer: Aetna Commercial	$655.44
Rate for Payer: Aetna Medicare Advantage	$517.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.84
Rate for Payer: Cigna Commercial	$862.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$517.46
Rate for Payer: Oxford Commercial	$344.97
Rate for Payer: Qualcare PPO/HMO/WC	$258.73
Rate for Payer: UnitedHealthcare Commercial	$344.97
Rate for Payer: UnitedHealthcare Community & State	$41.57
Rate for Payer: Wellpoint Medicaid Managed Care	$45.71

INSTRUMENT CANNULA 8MM

Facility

$2,800.00

Hospital Charge Code	270663996
Hospital Revenue Code	272
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INSTRUMENT CANNULA 8MM

Facility

$2,800.00

Hospital Charge Code	270663996
Hospital Revenue Code	272
Min. Negotiated Rate	$67.48
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$1,064.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.00
Rate for Payer: Oxford Commercial	$560.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$560.00
Rate for Payer: UnitedHealthcare Community & State	$67.48
Rate for Payer: Wellpoint Medicaid Managed Care	$74.20

INSTRUMENT CANNULA, LONG 8MM

Facility

$3,000.00

Hospital Charge Code	270663994
Hospital Revenue Code	272
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$900.00
Rate for Payer: Oxford Commercial	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Commercial	$600.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

INSTRUMENT CANNULA, LONG 8MM

Facility

$3,000.00

Hospital Charge Code	270663994
Hospital Revenue Code	272
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

INSTRUMENT KIT PRO-TOE

Facility

$1,135.00

Hospital Charge Code	270661604
Hospital Revenue Code	272
Min. Negotiated Rate	$27.35
Max. Negotiated Rate	$567.50
Rate for Payer: Aetna Commercial	$431.30
Rate for Payer: Aetna Medicare Advantage	$340.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$289.43
Rate for Payer: Cigna Commercial	$567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$340.50
Rate for Payer: Oxford Commercial	$227.00
Rate for Payer: Qualcare PPO/HMO/WC	$170.25
Rate for Payer: UnitedHealthcare Commercial	$227.00
Rate for Payer: UnitedHealthcare Community & State	$27.35
Rate for Payer: Wellpoint Medicaid Managed Care	$30.08

INSTRUMENT KIT PRO-TOE

Facility

$1,135.00

Hospital Charge Code	270661604
Hospital Revenue Code	272
Min. Negotiated Rate	$170.25
Max. Negotiated Rate	$170.25
Rate for Payer: Qualcare PPO/HMO/WC	$170.25

INSTRUMENT PRODTECTION TRAY AN

Facility

$151.30

Hospital Charge Code	270667057
Hospital Revenue Code	270
Min. Negotiated Rate	$22.70
Max. Negotiated Rate	$22.70
Rate for Payer: Qualcare PPO/HMO/WC	$22.70

INSTRUMENT PRODTECTION TRAY AN

Facility

$151.30

Hospital Charge Code	270667057
Hospital Revenue Code	270
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$75.65
Rate for Payer: Aetna Commercial	$57.49
Rate for Payer: Aetna Medicare Advantage	$45.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.58
Rate for Payer: Cigna Commercial	$75.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.39
Rate for Payer: Oxford Commercial	$30.26
Rate for Payer: Qualcare PPO/HMO/WC	$22.70
Rate for Payer: UnitedHealthcare Commercial	$30.26
Rate for Payer: UnitedHealthcare Community & State	$3.65
Rate for Payer: Wellpoint Medicaid Managed Care	$4.01

Know your out-of-pocket cost for care.

All Charges