Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT ACCESSORY 355531

Facility

$1,500.00

Hospital Charge Code	270647431
Hospital Revenue Code	270
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$450.00
Rate for Payer: Oxford Commercial	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Commercial	$300.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

KIT ACCESSORY 355531

Facility

$1,500.00

Hospital Charge Code	270647431
Hospital Revenue Code	270
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

KIT ACCESSORY DISPOSABLE 3 AM

Facility

$1,000.00

Hospital Charge Code	270664259
Hospital Revenue Code	270
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

KIT ACCESSORY DISPOSABLE 3 AM

Facility

$1,000.00

Hospital Charge Code	270664259
Hospital Revenue Code	270
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

KIT ACCESSRY PACEMAKERS 355031

Facility

$1,500.00

Hospital Charge Code	270639469
Hospital Revenue Code	272
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$450.00
Rate for Payer: Oxford Commercial	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Commercial	$300.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

KIT ACCESSRY PACEMAKERS 355031

Facility

$1,500.00

Hospital Charge Code	270639469
Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

KIT ACHILLIES SPEEDBRIDGE

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270683376
Hospital Revenue Code	278
Min. Negotiated Rate	$240.40
Max. Negotiated Rate	$4,987.50
Rate for Payer: Aetna Commercial	$3,790.50
Rate for Payer: Aetna Medicare Advantage	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,194.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25
Rate for Payer: UnitedHealthcare Community & State	$240.40
Rate for Payer: Wellpoint Medicaid Managed Care	$264.34

KIT ACHILLIES SPEEDBRIDGE

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270683376
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$2,413.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,194.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

KIT ACL CROSSPIN DISP 909820

Facility

$2,301.50

Hospital Charge Code	270630823
Hospital Revenue Code	272
Min. Negotiated Rate	$55.47
Max. Negotiated Rate	$1,150.75
Rate for Payer: Aetna Commercial	$874.57
Rate for Payer: Aetna Medicare Advantage	$690.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.88
Rate for Payer: Cigna Commercial	$1,150.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$690.45
Rate for Payer: Oxford Commercial	$460.30
Rate for Payer: Qualcare PPO/HMO/WC	$345.23
Rate for Payer: UnitedHealthcare Commercial	$460.30
Rate for Payer: UnitedHealthcare Community & State	$55.47
Rate for Payer: Wellpoint Medicaid Managed Care	$60.99

KIT ACL CROSSPIN DISP 909820

Facility

$2,301.50

Hospital Charge Code	270630823
Hospital Revenue Code	272
Min. Negotiated Rate	$345.23
Max. Negotiated Rate	$345.23
Rate for Payer: Qualcare PPO/HMO/WC	$345.23

KIT ACL DISPOSABLE

Facility

$662.65

Hospital Charge Code	270680781
Hospital Revenue Code	272
Min. Negotiated Rate	$99.40
Max. Negotiated Rate	$99.40
Rate for Payer: Qualcare PPO/HMO/WC	$99.40

KIT ACL DISPOSABLE

Facility

$662.65

Hospital Charge Code	270680781
Hospital Revenue Code	272
Min. Negotiated Rate	$15.97
Max. Negotiated Rate	$331.32
Rate for Payer: Aetna Commercial	$251.81
Rate for Payer: Aetna Medicare Advantage	$198.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.98
Rate for Payer: Cigna Commercial	$331.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.79
Rate for Payer: Oxford Commercial	$132.53
Rate for Payer: Qualcare PPO/HMO/WC	$99.40
Rate for Payer: UnitedHealthcare Commercial	$132.53
Rate for Payer: UnitedHealthcare Community & State	$15.97
Rate for Payer: Wellpoint Medicaid Managed Care	$17.56

KIT ACL/PCL FIXATION KIT

Facility

$3,000.00

Hospital Charge Code	270686861
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

KIT ACL/PCL FIXATION KIT

Facility

$3,000.00

Hospital Charge Code	270686861
Hospital Revenue Code	272
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

KIT ACP SERIES

Facility

$875.00

Hospital Charge Code	270663948
Hospital Revenue Code	270
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

KIT ACP SERIES

Facility

$875.00

Hospital Charge Code	270663948
Hospital Revenue Code	270
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

KIT ACP SERIES II

Facility

$1,250.00

Hospital Charge Code	270676127
Hospital Revenue Code	272
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$250.00
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

KIT ACP SERIES II

Facility

$1,250.00

Hospital Charge Code	270676127
Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

KIT ACTRIL RENAL 78270

Facility

$200.85

Hospital Charge Code	270605606
Hospital Revenue Code	272
Min. Negotiated Rate	$4.84
Max. Negotiated Rate	$100.42
Rate for Payer: Aetna Commercial	$76.32
Rate for Payer: Aetna Medicare Advantage	$60.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.22
Rate for Payer: Cigna Commercial	$100.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.26
Rate for Payer: Oxford Commercial	$40.17
Rate for Payer: Qualcare PPO/HMO/WC	$30.13
Rate for Payer: UnitedHealthcare Commercial	$40.17
Rate for Payer: UnitedHealthcare Community & State	$4.84
Rate for Payer: Wellpoint Medicaid Managed Care	$5.32

KIT ACTRIL RENAL 78270

Facility

$200.85

Hospital Charge Code	270605606
Hospital Revenue Code	272
Min. Negotiated Rate	$30.13
Max. Negotiated Rate	$30.13
Rate for Payer: Qualcare PPO/HMO/WC	$30.13

KIT ACUFEX UNIV CANN 5/76MM***

Facility

$52.00

Hospital Charge Code	1606631
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

KIT ACUFEX UNIV CANN 5/76MM***

Facility

$52.00

Hospital Charge Code	1606631
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

KIT ACUFEX UNIV CANN 7/76MM***

Facility

$56.00

Hospital Charge Code	1606649
Hospital Revenue Code	272
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

KIT ACUFEX UNIV CANN 7/76MM***

Facility

$56.00

Hospital Charge Code	1606649
Hospital Revenue Code	272
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$28.00
Rate for Payer: Aetna Commercial	$21.28
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.28
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.80
Rate for Payer: Oxford Commercial	$11.20
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$11.20
Rate for Payer: UnitedHealthcare Community & State	$1.35
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

KIT ADCON-L ADHESION CONTROL

Facility

$3,796.00

Hospital Charge Code	270610203
Hospital Revenue Code	272
Min. Negotiated Rate	$91.48
Max. Negotiated Rate	$1,898.00
Rate for Payer: Aetna Commercial	$1,442.48
Rate for Payer: Aetna Medicare Advantage	$1,138.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$967.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$967.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$967.98
Rate for Payer: Cigna Commercial	$1,898.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,138.80
Rate for Payer: Oxford Commercial	$759.20
Rate for Payer: Qualcare PPO/HMO/WC	$569.40
Rate for Payer: UnitedHealthcare Commercial	$759.20
Rate for Payer: UnitedHealthcare Community & State	$91.48
Rate for Payer: Wellpoint Medicaid Managed Care	$100.59

Know your out-of-pocket cost for care.

All Charges