Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ANT LUM CAGE 14X25X33MMX15DEG

Facility

$42,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704779
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

ANT LUM CAGE 14X25X33MMX15DEG

Facility

$42,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704779
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

ANT LUM CAGE 16X28X36MM 15DEG

Facility

$42,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270706020
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

ANT LUM CAGE 16X28X36MM 15DEG

Facility

$42,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270706020
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

ANTOMIC FX HEAD 40

Facility

$11,133.95

Hospital Charge Code	270656950
Hospital Revenue Code	278
Min. Negotiated Rate	$268.33
Max. Negotiated Rate	$5,566.98
Rate for Payer: Aetna Commercial	$4,230.90
Rate for Payer: Aetna Medicare Advantage	$3,340.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,839.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,839.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,226.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,839.16
Rate for Payer: Cigna Commercial	$5,566.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,694.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,449.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,670.09
Rate for Payer: UnitedHealthcare Community & State	$268.33
Rate for Payer: Wellpoint Medicaid Managed Care	$295.05

ANTOMIC FX HEAD 40

Facility

$11,133.95

Hospital Charge Code	270656950
Hospital Revenue Code	278
Min. Negotiated Rate	$1,670.09
Max. Negotiated Rate	$2,694.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,226.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,694.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,449.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,670.09

ANTOMIC FX STEM 11-130MM

Facility

$24,409.90

Hospital Charge Code	270656954
Hospital Revenue Code	278
Min. Negotiated Rate	$588.28
Max. Negotiated Rate	$12,204.95
Rate for Payer: Aetna Commercial	$9,275.76
Rate for Payer: Aetna Medicare Advantage	$7,322.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,224.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,224.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,881.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,224.52
Rate for Payer: Cigna Commercial	$12,204.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,907.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,370.18
Rate for Payer: Qualcare PPO/HMO/WC	$3,661.49
Rate for Payer: UnitedHealthcare Community & State	$588.28
Rate for Payer: Wellpoint Medicaid Managed Care	$646.86

ANTOMIC FX STEM 11-130MM

Facility

$24,409.90

Hospital Charge Code	270656954
Hospital Revenue Code	278
Min. Negotiated Rate	$3,661.49
Max. Negotiated Rate	$5,907.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,881.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,907.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,370.18
Rate for Payer: Qualcare PPO/HMO/WC	$3,661.49

ANTURANCE/250MG/TAB

Facility

$3.00

Hospital Charge Code	60634348
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ANTURANCE/250MG/TAB

Facility

$3.00

Hospital Charge Code	60634348
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

ANUSOL/30GM

Facility

$7.00

Hospital Charge Code	60632470
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.66
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.40
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

ANUSOL/30GM

Facility

$7.00

Hospital Charge Code	60632470
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

ANUSOL HC 1%/30GM

Facility

$90.00

Hospital Charge Code	60632472
Hospital Revenue Code	250
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.00
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

ANUSOL HC 1%/30GM

Facility

$90.00

Hospital Charge Code	60632472
Hospital Revenue Code	250
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

ANUSOL HC 2.5% CREAM

Facility

$70.00

Hospital Charge Code	60635351
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$35.00
Rate for Payer: Aetna Commercial	$26.60
Rate for Payer: Aetna Medicare Advantage	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.85
Rate for Payer: Cigna Commercial	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.00
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.50
Rate for Payer: UnitedHealthcare Commercial	$14.00
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

ANUSOL HC 2.5% CREAM

Facility

$70.00

Hospital Charge Code	60635351
Hospital Revenue Code	250
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.50

ANUSOL HC/25MG/EACH

Facility

$3.00

Hospital Charge Code	60632471
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ANUSOL HC/25MG/EACH

Facility

$3.00

Hospital Charge Code	60632471
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

ANUSOL HC CREAM 2.5%

Facility

$12.00

Hospital Charge Code	60635379
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

ANUSOL HC CREAM 2.5%

Facility

$12.00

Hospital Charge Code	60635379
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

ANUSOL SUPPOSITORY

Facility

$1.00

Hospital Charge Code	60634789
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.38
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.30
Rate for Payer: Oxford Commercial	$0.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.20
Rate for Payer: UnitedHealthcare Community & State	$0.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.03

ANUSOL SUPPOSITORY

Facility

$1.00

Hospital Charge Code	60634789
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

ANUS SURGERY PROCEDURE

Facility

$3,908.52

Service Code	HCPCS 46999
Hospital Charge Code	1600000588
Hospital Revenue Code	360
Min. Negotiated Rate	$94.20
Max. Negotiated Rate	$3,988.03
Rate for Payer: Aetna Commercial	$3,005.08
Rate for Payer: Aetna Medicare Advantage	$3,579.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,988.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,988.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,104.81
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	$3,988.03
Rate for Payer: Cigna Commercial	$2,214.60
Rate for Payer: Cigna Medicare Advantage	$1,104.81
Rate for Payer: Clover Medicare Advantage	$1,049.57
Rate for Payer: EmblemHealth Commercial	$3,314.43
Rate for Payer: Humana Medicare Advantage	$1,137.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,104.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,172.56
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$586.28
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$94.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,104.81
Rate for Payer: Wellcare Medicare Advantage	$1,104.81
Rate for Payer: Wellpoint Medicaid Managed Care	$103.58

ANUS SURGERY PROCEDURE

Facility

$3,908.52

Service Code	HCPCS 46999
Hospital Charge Code	1600000588
Hospital Revenue Code	360
Min. Negotiated Rate	$586.28
Max. Negotiated Rate	$586.28
Rate for Payer: Qualcare PPO/HMO/WC	$586.28

ANZEMET100MG VIAL INJ 5ML

Facility

$779.00

Hospital Charge Code	60635300
Hospital Revenue Code	636
Min. Negotiated Rate	$116.85
Max. Negotiated Rate	$188.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.52
Rate for Payer: Qualcare PPO/HMO/WC	$116.85

Know your out-of-pocket cost for care.

All Charges