Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

JOINT SMALL 3.5mm

Facility

$238.76

Service Code	HCPCS C1776
Hospital Charge Code	270665087
Hospital Revenue Code	278
Min. Negotiated Rate	$5.75
Max. Negotiated Rate	$119.38
Rate for Payer: Aetna Commercial	$90.73
Rate for Payer: Aetna Medicare Advantage	$71.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.88
Rate for Payer: Cigna Commercial	$119.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.53
Rate for Payer: Qualcare PPO/HMO/WC	$35.81
Rate for Payer: UnitedHealthcare Community & State	$5.75
Rate for Payer: Wellpoint Medicaid Managed Care	$6.33

JOINT SMALL 3.5mm

Facility

$238.76

Service Code	HCPCS C1776
Hospital Charge Code	270665087
Hospital Revenue Code	278
Min. Negotiated Rate	$35.81
Max. Negotiated Rate	$57.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$52.53
Rate for Payer: Qualcare PPO/HMO/WC	$35.81

JOINT SURVEY, SGL VM, 1 OR > J

Facility

$331.25

Service Code	HCPCS 77077
Hospital Charge Code	2011187
Hospital Revenue Code	320
Min. Negotiated Rate	$7.98
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.38
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.69
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$7.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$8.78

JOINT SURVEY, SGL VM, 1 OR > J

Facility

$331.25

Service Code	HCPCS 77077
Hospital Charge Code	2011187
Hospital Revenue Code	320
Min. Negotiated Rate	$49.69
Max. Negotiated Rate	$49.69
Rate for Payer: Qualcare PPO/HMO/WC	$49.69

JOINT SURVEY SNGL VIEW-26

Facility

$90.45

Service Code	HCPCS 7707726
Hospital Charge Code	85000290
Hospital Revenue Code	320
Min. Negotiated Rate	$2.18
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$34.37
Rate for Payer: Aetna Medicare Advantage	$27.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.06
Rate for Payer: Cigna Commercial	$45.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.14
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.57
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$2.18
Rate for Payer: Wellpoint Medicaid Managed Care	$2.40

JOINT SURVEY SNGL VIEW-26

Facility

$90.45

Service Code	HCPCS 7707726
Hospital Charge Code	85000290
Hospital Revenue Code	320
Min. Negotiated Rate	$13.57
Max. Negotiated Rate	$13.57
Rate for Payer: Qualcare PPO/HMO/WC	$13.57

JOINT SURVEY SNGL VIEW-GL

Facility

$298.01

Service Code	HCPCS 77077
Hospital Charge Code	85000280
Hospital Revenue Code	320
Min. Negotiated Rate	$7.18
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.70
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$7.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$7.90

JOINT SURVEY SNGL VIEW-GL

Facility

$298.01

Service Code	HCPCS 77077
Hospital Charge Code	85000280
Hospital Revenue Code	320
Min. Negotiated Rate	$44.70
Max. Negotiated Rate	$44.70
Rate for Payer: Qualcare PPO/HMO/WC	$44.70

JOINT SURVEY SNGL VIEW-TC

Facility

$153.15

Service Code	HCPCS 77077TC
Hospital Charge Code	85000285
Hospital Revenue Code	320
Min. Negotiated Rate	$22.97
Max. Negotiated Rate	$22.97
Rate for Payer: Qualcare PPO/HMO/WC	$22.97

JOINT SURVEY SNGL VIEW-TC

Facility

$153.15

Service Code	HCPCS 77077TC
Hospital Charge Code	85000285
Hospital Revenue Code	320
Min. Negotiated Rate	$3.69
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$58.20
Rate for Payer: Aetna Medicare Advantage	$45.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.05
Rate for Payer: Cigna Commercial	$76.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.95
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.97
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$3.69
Rate for Payer: Wellpoint Medicaid Managed Care	$4.06

JOINT UNIVERSAL FOR TWO TUBES

Facility

$3,380.45

Service Code	HCPCS C1776
Hospital Charge Code	270639891
Hospital Revenue Code	278
Min. Negotiated Rate	$507.07
Max. Negotiated Rate	$818.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$676.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$818.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$743.70
Rate for Payer: Qualcare PPO/HMO/WC	$507.07

JOINT UNIVERSAL FOR TWO TUBES

Facility

$3,380.45

Service Code	HCPCS C1776
Hospital Charge Code	270639891
Hospital Revenue Code	278
Min. Negotiated Rate	$81.47
Max. Negotiated Rate	$1,690.22
Rate for Payer: Aetna Commercial	$1,284.57
Rate for Payer: Aetna Medicare Advantage	$1,014.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$862.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$862.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$676.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$862.01
Rate for Payer: Cigna Commercial	$1,690.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$818.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$743.70
Rate for Payer: Qualcare PPO/HMO/WC	$507.07
Rate for Payer: UnitedHealthcare Community & State	$81.47
Rate for Payer: Wellpoint Medicaid Managed Care	$89.58

JOYSTICK REDUCTION 2.8MM

Facility

$318.25

Hospital Charge Code	270678309
Hospital Revenue Code	272
Min. Negotiated Rate	$7.67
Max. Negotiated Rate	$159.12
Rate for Payer: Aetna Commercial	$120.94
Rate for Payer: Aetna Medicare Advantage	$95.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.15
Rate for Payer: Cigna Commercial	$159.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.47
Rate for Payer: Oxford Commercial	$63.65
Rate for Payer: Qualcare PPO/HMO/WC	$47.74
Rate for Payer: UnitedHealthcare Commercial	$63.65
Rate for Payer: UnitedHealthcare Community & State	$7.67
Rate for Payer: Wellpoint Medicaid Managed Care	$8.43

JOYSTICK REDUCTION 2.8MM

Facility

$318.25

Hospital Charge Code	270678309
Hospital Revenue Code	272
Min. Negotiated Rate	$47.74
Max. Negotiated Rate	$47.74
Rate for Payer: Qualcare PPO/HMO/WC	$47.74

JOYSTICK REDUCTION 5.0 MM

Facility

$1,591.35

Service Code	HCPCS C1713
Hospital Charge Code	270680137
Hospital Revenue Code	278
Min. Negotiated Rate	$38.35
Max. Negotiated Rate	$795.67
Rate for Payer: Aetna Commercial	$604.71
Rate for Payer: Aetna Medicare Advantage	$477.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$405.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$405.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$318.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$405.79
Rate for Payer: Cigna Commercial	$795.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$385.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$350.10
Rate for Payer: Qualcare PPO/HMO/WC	$238.70
Rate for Payer: UnitedHealthcare Community & State	$38.35
Rate for Payer: Wellpoint Medicaid Managed Care	$42.17

JOYSTICK REDUCTION 5.0 MM

Facility

$1,591.35

Service Code	HCPCS C1713
Hospital Charge Code	270680137
Hospital Revenue Code	278
Min. Negotiated Rate	$238.70
Max. Negotiated Rate	$385.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$318.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$385.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$350.10
Rate for Payer: Qualcare PPO/HMO/WC	$238.70

JOYSTICK REDUCTION 6.5MM

Facility

$1,545.55

Hospital Charge Code	270677510
Hospital Revenue Code	272
Min. Negotiated Rate	$37.25
Max. Negotiated Rate	$772.77
Rate for Payer: Aetna Commercial	$587.31
Rate for Payer: Aetna Medicare Advantage	$463.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.12
Rate for Payer: Cigna Commercial	$772.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$463.67
Rate for Payer: Oxford Commercial	$309.11
Rate for Payer: Qualcare PPO/HMO/WC	$231.83
Rate for Payer: UnitedHealthcare Commercial	$309.11
Rate for Payer: UnitedHealthcare Community & State	$37.25
Rate for Payer: Wellpoint Medicaid Managed Care	$40.96

JOYSTICK REDUCTION 6.5MM

Facility

$1,545.55

Hospital Charge Code	270677510
Hospital Revenue Code	272
Min. Negotiated Rate	$231.83
Max. Negotiated Rate	$231.83
Rate for Payer: Qualcare PPO/HMO/WC	$231.83

JUGGERKNOT 2.0 DISP KIT

Facility

$2,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270681525
Hospital Revenue Code	278
Min. Negotiated Rate	$397.50
Max. Negotiated Rate	$641.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$641.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$583.00
Rate for Payer: Qualcare PPO/HMO/WC	$397.50

JUGGERKNOT 2.0 DISP KIT

Facility

$2,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270681525
Hospital Revenue Code	278
Min. Negotiated Rate	$63.87
Max. Negotiated Rate	$1,325.00
Rate for Payer: Aetna Commercial	$1,007.00
Rate for Payer: Aetna Medicare Advantage	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$675.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$675.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$675.75
Rate for Payer: Cigna Commercial	$1,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$641.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$583.00
Rate for Payer: Qualcare PPO/HMO/WC	$397.50
Rate for Payer: UnitedHealthcare Community & State	$63.87
Rate for Payer: Wellpoint Medicaid Managed Care	$70.22

JUGS OMNI W/SPECIMEN CAP

Facility

$131.25

Hospital Charge Code	270666017
Hospital Revenue Code	270
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$19.69
Rate for Payer: Qualcare PPO/HMO/WC	$19.69

JUGS OMNI W/SPECIMEN CAP

Facility

$131.25

Hospital Charge Code	270666017
Hospital Revenue Code	270
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$65.62
Rate for Payer: Aetna Commercial	$49.88
Rate for Payer: Aetna Medicare Advantage	$39.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.47
Rate for Payer: Cigna Commercial	$65.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.38
Rate for Payer: Oxford Commercial	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$19.69
Rate for Payer: UnitedHealthcare Commercial	$26.25
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$3.48

JUMBO BIOSPY FORCEPS

Facility

$35.00

Hospital Charge Code	270701121
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$17.50
Rate for Payer: Aetna Commercial	$13.30
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.50
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$7.00
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

JUMBO BIOSPY FORCEPS

Facility

$35.00

Hospital Charge Code	270701121
Hospital Revenue Code	272
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

JUMBO FORCEPS

Facility

$116.00

Hospital Charge Code	270325681
Hospital Revenue Code	272
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

Know your out-of-pocket cost for care.

All Charges