Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT ATHX ACL DISP AR18985

Facility

$1,331.25

Hospital Charge Code	270610587
Hospital Revenue Code	272
Min. Negotiated Rate	$199.69
Max. Negotiated Rate	$199.69
Rate for Payer: Qualcare PPO/HMO/WC	$199.69

KIT ATHX ACL & SAW BLD AR1897S

Facility

$1,125.00

Hospital Charge Code	270601361
Hospital Revenue Code	272
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

KIT ATHX ACL & SAW BLD AR1897S

Facility

$1,125.00

Hospital Charge Code	270601361
Hospital Revenue Code	272
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Commercial	$225.00
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

KIT ATK ACL ORTHO 999999

Facility

$2,046.45

Hospital Charge Code	270609653
Hospital Revenue Code	272
Min. Negotiated Rate	$49.32
Max. Negotiated Rate	$1,023.23
Rate for Payer: Aetna Commercial	$777.65
Rate for Payer: Aetna Medicare Advantage	$613.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$521.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$521.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$521.84
Rate for Payer: Cigna Commercial	$1,023.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$613.93
Rate for Payer: Oxford Commercial	$409.29
Rate for Payer: Qualcare PPO/HMO/WC	$306.97
Rate for Payer: UnitedHealthcare Commercial	$409.29
Rate for Payer: UnitedHealthcare Community & State	$49.32
Rate for Payer: Wellpoint Medicaid Managed Care	$54.23

KIT ATK ACL ORTHO 999999

Facility

$2,046.45

Hospital Charge Code	270609653
Hospital Revenue Code	272
Min. Negotiated Rate	$306.97
Max. Negotiated Rate	$306.97
Rate for Payer: Qualcare PPO/HMO/WC	$306.97

KIT ATK SCREW 909826

Facility

$2,559.25

Hospital Charge Code	270620355
Hospital Revenue Code	272
Min. Negotiated Rate	$61.68
Max. Negotiated Rate	$1,279.62
Rate for Payer: Aetna Commercial	$972.51
Rate for Payer: Aetna Medicare Advantage	$767.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$652.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$652.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$652.61
Rate for Payer: Cigna Commercial	$1,279.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.77
Rate for Payer: Oxford Commercial	$511.85
Rate for Payer: Qualcare PPO/HMO/WC	$383.89
Rate for Payer: UnitedHealthcare Commercial	$511.85
Rate for Payer: UnitedHealthcare Community & State	$61.68
Rate for Payer: Wellpoint Medicaid Managed Care	$67.82

KIT ATK SCREW 909826

Facility

$2,559.25

Hospital Charge Code	270620355
Hospital Revenue Code	272
Min. Negotiated Rate	$383.89
Max. Negotiated Rate	$383.89
Rate for Payer: Qualcare PPO/HMO/WC	$383.89

KIT ATK SCREW BONE MULCH909825

Facility

$3,064.85

Hospital Charge Code	270620205
Hospital Revenue Code	272
Min. Negotiated Rate	$73.86
Max. Negotiated Rate	$1,532.42
Rate for Payer: Aetna Commercial	$1,164.64
Rate for Payer: Aetna Medicare Advantage	$919.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$781.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$781.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$781.54
Rate for Payer: Cigna Commercial	$1,532.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$919.46
Rate for Payer: Oxford Commercial	$612.97
Rate for Payer: Qualcare PPO/HMO/WC	$459.73
Rate for Payer: UnitedHealthcare Commercial	$612.97
Rate for Payer: UnitedHealthcare Community & State	$73.86
Rate for Payer: Wellpoint Medicaid Managed Care	$81.22

KIT ATK SCREW BONE MULCH909825

Facility

$3,064.85

Hospital Charge Code	270620205
Hospital Revenue Code	272
Min. Negotiated Rate	$459.73
Max. Negotiated Rate	$459.73
Rate for Payer: Qualcare PPO/HMO/WC	$459.73

KIT AUTOSUTURE CUSTOM #3310***

Facility

$3,553.00

Hospital Charge Code	1603208
Hospital Revenue Code	272
Min. Negotiated Rate	$532.95
Max. Negotiated Rate	$532.95
Rate for Payer: Qualcare PPO/HMO/WC	$532.95

KIT AUTOSUTURE CUSTOM #3310***

Facility

$3,553.00

Hospital Charge Code	1603208
Hospital Revenue Code	272
Min. Negotiated Rate	$85.63
Max. Negotiated Rate	$1,776.50
Rate for Payer: Aetna Commercial	$1,350.14
Rate for Payer: Aetna Medicare Advantage	$1,065.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$906.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$906.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$906.01
Rate for Payer: Cigna Commercial	$1,776.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,065.90
Rate for Payer: Oxford Commercial	$710.60
Rate for Payer: Qualcare PPO/HMO/WC	$532.95
Rate for Payer: UnitedHealthcare Commercial	$710.60
Rate for Payer: UnitedHealthcare Community & State	$85.63
Rate for Payer: Wellpoint Medicaid Managed Care	$94.15

KIT AUTOSUTURE CUSTOM #3311***

Facility

$2,073.00

Hospital Charge Code	1603216
Hospital Revenue Code	272
Min. Negotiated Rate	$49.96
Max. Negotiated Rate	$1,036.50
Rate for Payer: Aetna Commercial	$787.74
Rate for Payer: Aetna Medicare Advantage	$621.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$528.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$528.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$528.62
Rate for Payer: Cigna Commercial	$1,036.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$621.90
Rate for Payer: Oxford Commercial	$414.60
Rate for Payer: Qualcare PPO/HMO/WC	$310.95
Rate for Payer: UnitedHealthcare Commercial	$414.60
Rate for Payer: UnitedHealthcare Community & State	$49.96
Rate for Payer: Wellpoint Medicaid Managed Care	$54.93

KIT AUTOSUTURE CUSTOM #3311***

Facility

$2,073.00

Hospital Charge Code	1603216
Hospital Revenue Code	272
Min. Negotiated Rate	$310.95
Max. Negotiated Rate	$310.95
Rate for Payer: Qualcare PPO/HMO/WC	$310.95

KIT BAG POST MORTEM

Facility

$28.43

Hospital Charge Code	270649535
Hospital Revenue Code	272
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$4.26
Rate for Payer: Qualcare PPO/HMO/WC	$4.26

KIT BAG POST MORTEM

Facility

$28.43

Hospital Charge Code	270649535
Hospital Revenue Code	272
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$14.21
Rate for Payer: Aetna Commercial	$10.80
Rate for Payer: Aetna Medicare Advantage	$8.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.25
Rate for Payer: Cigna Commercial	$14.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.53
Rate for Payer: Oxford Commercial	$5.69
Rate for Payer: Qualcare PPO/HMO/WC	$4.26
Rate for Payer: UnitedHealthcare Commercial	$5.69
Rate for Payer: UnitedHealthcare Community & State	$0.69
Rate for Payer: Wellpoint Medicaid Managed Care	$0.75

KIT BALECTRODE PAC 5FR

Facility

$1,066.45

Hospital Charge Code	270110095
Hospital Revenue Code	270
Min. Negotiated Rate	$25.70
Max. Negotiated Rate	$533.23
Rate for Payer: Aetna Commercial	$405.25
Rate for Payer: Aetna Medicare Advantage	$319.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.94
Rate for Payer: Cigna Commercial	$533.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.94
Rate for Payer: Oxford Commercial	$213.29
Rate for Payer: Qualcare PPO/HMO/WC	$159.97
Rate for Payer: UnitedHealthcare Commercial	$213.29
Rate for Payer: UnitedHealthcare Community & State	$25.70
Rate for Payer: Wellpoint Medicaid Managed Care	$28.26

KIT BALECTRODE PAC 5FR

Facility

$1,066.45

Hospital Charge Code	270110095
Hospital Revenue Code	270
Min. Negotiated Rate	$159.97
Max. Negotiated Rate	$159.97
Rate for Payer: Qualcare PPO/HMO/WC	$159.97

KIT BALECTRODE PACING 5FR*****

Facility

$208.00

Hospital Charge Code	8003196
Hospital Revenue Code	279
Min. Negotiated Rate	$5.01
Max. Negotiated Rate	$104.00
Rate for Payer: Aetna Commercial	$79.04
Rate for Payer: Aetna Medicare Advantage	$62.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.04
Rate for Payer: Cigna Commercial	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.40
Rate for Payer: Oxford Commercial	$41.60
Rate for Payer: Qualcare PPO/HMO/WC	$31.20
Rate for Payer: UnitedHealthcare Commercial	$41.60
Rate for Payer: UnitedHealthcare Community & State	$5.01
Rate for Payer: Wellpoint Medicaid Managed Care	$5.51

KIT BALECTRODE PACING 5FR*****

Facility

$208.00

Hospital Charge Code	8003196
Hospital Revenue Code	279
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$31.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.20

KIT BALLOON W/O RING OF-A38/42

Facility

$80.00

Hospital Charge Code	270619417
Hospital Revenue Code	272
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$30.40
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.00
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Commercial	$16.00
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

KIT BALLOON W/O RING OF-A38/42

Facility

$80.00

Hospital Charge Code	270619417
Hospital Revenue Code	272
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

KIT BD DECOMPR JEJUNAL 000319

Facility

$422.45

Hospital Charge Code	270618519
Hospital Revenue Code	272
Min. Negotiated Rate	$10.18
Max. Negotiated Rate	$211.22
Rate for Payer: Aetna Commercial	$160.53
Rate for Payer: Aetna Medicare Advantage	$126.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.72
Rate for Payer: Cigna Commercial	$211.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.73
Rate for Payer: Oxford Commercial	$84.49
Rate for Payer: Qualcare PPO/HMO/WC	$63.37
Rate for Payer: UnitedHealthcare Commercial	$84.49
Rate for Payer: UnitedHealthcare Community & State	$10.18
Rate for Payer: Wellpoint Medicaid Managed Care	$11.19

KIT BD DECOMPR JEJUNAL 000319

Facility

$422.45

Hospital Charge Code	270618519
Hospital Revenue Code	272
Min. Negotiated Rate	$63.37
Max. Negotiated Rate	$63.37
Rate for Payer: Qualcare PPO/HMO/WC	$63.37

KIT BIOINDUCTIVE IMPLANT ARTH

Facility

$14,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688654
Hospital Revenue Code	278
Min. Negotiated Rate	$337.40
Max. Negotiated Rate	$7,000.00
Rate for Payer: Aetna Commercial	$5,320.00
Rate for Payer: Aetna Medicare Advantage	$4,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,570.00
Rate for Payer: Cigna Commercial	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,080.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00
Rate for Payer: UnitedHealthcare Community & State	$337.40
Rate for Payer: Wellpoint Medicaid Managed Care	$371.00

KIT BIOINDUCTIVE IMPLANT ARTH

Facility

$14,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688654
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$3,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,080.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00

Know your out-of-pocket cost for care.

All Charges