Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

APPLICATOR ENDOSCOPIC 360

Facility

$3,278.20

Hospital Charge Code	270680888
Hospital Revenue Code	272
Min. Negotiated Rate	$79.00
Max. Negotiated Rate	$1,639.10
Rate for Payer: Aetna Commercial	$1,245.72
Rate for Payer: Aetna Medicare Advantage	$983.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$835.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$835.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$835.94
Rate for Payer: Cigna Commercial	$1,639.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$983.46
Rate for Payer: Oxford Commercial	$655.64
Rate for Payer: Qualcare PPO/HMO/WC	$491.73
Rate for Payer: UnitedHealthcare Commercial	$655.64
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$86.87

APPLICATOR ENDOSCOP SUGICEL

Facility

$104.00

Hospital Charge Code	270688737
Hospital Revenue Code	272
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

APPLICATOR ENDOSCOP SUGICEL

Facility

$104.00

Hospital Charge Code	270688737
Hospital Revenue Code	272
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$52.00
Rate for Payer: Aetna Commercial	$39.52
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$20.80
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$20.80
Rate for Payer: UnitedHealthcare Community & State	$2.51
Rate for Payer: Wellpoint Medicaid Managed Care	$2.76

APPLICATOR FLEXIBLE 45 CM TIP

Facility

$319.70

Hospital Charge Code	270689526
Hospital Revenue Code	272
Min. Negotiated Rate	$47.95
Max. Negotiated Rate	$47.95
Rate for Payer: Qualcare PPO/HMO/WC	$47.95

APPLICATOR FLEXIBLE 45 CM TIP

Facility

$319.70

Hospital Charge Code	270689526
Hospital Revenue Code	272
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$159.85
Rate for Payer: Aetna Commercial	$121.49
Rate for Payer: Aetna Medicare Advantage	$95.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.52
Rate for Payer: Cigna Commercial	$159.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.91
Rate for Payer: Oxford Commercial	$63.94
Rate for Payer: Qualcare PPO/HMO/WC	$47.95
Rate for Payer: UnitedHealthcare Commercial	$63.94
Rate for Payer: UnitedHealthcare Community & State	$7.70
Rate for Payer: Wellpoint Medicaid Managed Care	$8.47

APPLICATOR FLEXTIP RIGID 38 CM

Facility

$207.50

Hospital Charge Code	270687376
Hospital Revenue Code	272
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$103.75
Rate for Payer: Aetna Commercial	$78.85
Rate for Payer: Aetna Medicare Advantage	$62.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.91
Rate for Payer: Cigna Commercial	$103.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.25
Rate for Payer: Oxford Commercial	$41.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.12
Rate for Payer: UnitedHealthcare Commercial	$41.50
Rate for Payer: UnitedHealthcare Community & State	$5.00
Rate for Payer: Wellpoint Medicaid Managed Care	$5.50

APPLICATOR FLEXTIP RIGID 38 CM

Facility

$207.50

Hospital Charge Code	270687376
Hospital Revenue Code	272
Min. Negotiated Rate	$31.12
Max. Negotiated Rate	$31.12
Rate for Payer: Qualcare PPO/HMO/WC	$31.12

APPLICATOR FLEXTIP XL ARISTA

Facility

$71.50

Hospital Charge Code	270687375
Hospital Revenue Code	272
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$35.75
Rate for Payer: Aetna Commercial	$27.17
Rate for Payer: Aetna Medicare Advantage	$21.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.23
Rate for Payer: Cigna Commercial	$35.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.45
Rate for Payer: Oxford Commercial	$14.30
Rate for Payer: Qualcare PPO/HMO/WC	$10.72
Rate for Payer: UnitedHealthcare Commercial	$14.30
Rate for Payer: UnitedHealthcare Community & State	$1.72
Rate for Payer: Wellpoint Medicaid Managed Care	$1.89

APPLICATOR FLEXTIP XL ARISTA

Facility

$71.50

Hospital Charge Code	270687375
Hospital Revenue Code	272
Min. Negotiated Rate	$10.72
Max. Negotiated Rate	$10.72
Rate for Payer: Qualcare PPO/HMO/WC	$10.72

APPLICATOR PROCTOSCOPE

Facility

$0.51

Hospital Charge Code	270651081
Hospital Revenue Code	270
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.26
Rate for Payer: Aetna Commercial	$0.19
Rate for Payer: Aetna Medicare Advantage	$0.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.13
Rate for Payer: Cigna Commercial	$0.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.15
Rate for Payer: Oxford Commercial	$0.10
Rate for Payer: Qualcare PPO/HMO/WC	$0.08
Rate for Payer: UnitedHealthcare Commercial	$0.10
Rate for Payer: UnitedHealthcare Community & State	$0.01
Rate for Payer: Wellpoint Medicaid Managed Care	$0.01

APPLICATOR PROCTOSCOPE

Facility

$0.51

Hospital Charge Code	270651081
Hospital Revenue Code	270
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.08
Rate for Payer: Qualcare PPO/HMO/WC	$0.08

APPLICATOR PROGEL EXTED 6

Facility

$300.00

Hospital Charge Code	270678576
Hospital Revenue Code	272
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

APPLICATOR PROGEL EXTED 6

Facility

$300.00

Hospital Charge Code	270678576
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

APPLICATORS SILVER NITRATE***

Facility

$11.00

Hospital Charge Code	8002610
Hospital Revenue Code	279
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.50
Rate for Payer: Aetna Commercial	$4.18
Rate for Payer: Aetna Medicare Advantage	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.81
Rate for Payer: Cigna Commercial	$5.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.30
Rate for Payer: Oxford Commercial	$2.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.65
Rate for Payer: UnitedHealthcare Commercial	$2.20
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

APPLICATORS SILVER NITRATE***

Facility

$11.00

Hospital Charge Code	8002610
Hospital Revenue Code	279
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

APPLICATOR SURGIFLO

Facility

$257.87

Hospital Charge Code	270688803
Hospital Revenue Code	272
Min. Negotiated Rate	$38.68
Max. Negotiated Rate	$38.68
Rate for Payer: Qualcare PPO/HMO/WC	$38.68

APPLICATOR SURGIFLO

Facility

$257.87

Hospital Charge Code	270688803
Hospital Revenue Code	272
Min. Negotiated Rate	$6.21
Max. Negotiated Rate	$128.94
Rate for Payer: Aetna Commercial	$97.99
Rate for Payer: Aetna Medicare Advantage	$77.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.76
Rate for Payer: Cigna Commercial	$128.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.36
Rate for Payer: Oxford Commercial	$51.57
Rate for Payer: Qualcare PPO/HMO/WC	$38.68
Rate for Payer: UnitedHealthcare Commercial	$51.57
Rate for Payer: UnitedHealthcare Community & State	$6.21
Rate for Payer: Wellpoint Medicaid Managed Care	$6.83

APPLICATOR ULTRAMIST

Facility

$270.00

Hospital Charge Code	270677093
Hospital Revenue Code	270
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.00
Rate for Payer: Oxford Commercial	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Commercial	$54.00
Rate for Payer: UnitedHealthcare Community & State	$6.51
Rate for Payer: Wellpoint Medicaid Managed Care	$7.16

APPLICATOR ULTRAMIST

Facility

$270.00

Hospital Charge Code	270677093
Hospital Revenue Code	270
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

APPLIC SHORT ARM SPLINT STATIC

Facility

$348.85

Service Code	HCPCS 29125
Hospital Charge Code	2500372
Hospital Revenue Code	761
Min. Negotiated Rate	$8.41
Max. Negotiated Rate	$570.55
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	$56.14
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	$104.66
Rate for Payer: Oxford Commercial	$69.77
Rate for Payer: Qualcare PPO/HMO/WC	$52.33
Rate for Payer: UnitedHealthcare Commercial	$69.77
Rate for Payer: UnitedHealthcare Community & State	$8.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$9.24

APPLIC SHORT ARM SPLINT STATIC

Facility

$348.85

Service Code	HCPCS 29125
Hospital Charge Code	2500372
Hospital Revenue Code	761
Min. Negotiated Rate	$52.33
Max. Negotiated Rate	$52.33
Rate for Payer: Qualcare PPO/HMO/WC	$52.33

APPLIC SHORT LEG SPLINT CF FT

Facility

$348.85

Service Code	HCPCS 29515
Hospital Charge Code	2500371
Hospital Revenue Code	761
Min. Negotiated Rate	$52.33
Max. Negotiated Rate	$52.33
Rate for Payer: Qualcare PPO/HMO/WC	$52.33

APPLIC SHORT LEG SPLINT CF FT

Facility

$348.85

Service Code	HCPCS 29515
Hospital Charge Code	2500371
Hospital Revenue Code	761
Min. Negotiated Rate	$8.41
Max. Negotiated Rate	$696.85
Rate for Payer: Aetna Commercial	$525.10
Rate for Payer: Aetna Medicare Advantage	$625.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$193.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.85
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: Cigna Medicare Advantage	$193.05
Rate for Payer: Clover Medicare Advantage	$183.40
Rate for Payer: EmblemHealth Commercial	$579.15
Rate for Payer: Humana Medicare Advantage	$198.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$193.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.66
Rate for Payer: Oxford Commercial	$69.77
Rate for Payer: Qualcare PPO/HMO/WC	$52.33
Rate for Payer: UnitedHealthcare Commercial	$69.77
Rate for Payer: UnitedHealthcare Community & State	$8.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$193.05
Rate for Payer: Wellcare Medicare Advantage	$193.05
Rate for Payer: Wellpoint Medicaid Managed Care	$9.24

APPLIER CLIP 10mm LAP CA090

Facility

$340.00

Hospital Charge Code	270642077
Hospital Revenue Code	272
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

APPLIER CLIP 10mm LAP CA090

Facility

$340.00

Hospital Charge Code	270642077
Hospital Revenue Code	272
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$129.20
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.00
Rate for Payer: Oxford Commercial	$68.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Commercial	$68.00
Rate for Payer: UnitedHealthcare Community & State	$8.19
Rate for Payer: Wellpoint Medicaid Managed Care	$9.01

Know your out-of-pocket cost for care.

All Charges