Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT DISP. UCL SUTURE PASSING

Facility

$3,475.00

Hospital Charge Code	270680852
Hospital Revenue Code	272
Min. Negotiated Rate	$83.75
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,320.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,042.50
Rate for Payer: Oxford Commercial	$695.00
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Commercial	$695.00
Rate for Payer: UnitedHealthcare Community & State	$83.75
Rate for Payer: Wellpoint Medicaid Managed Care	$92.09

KIT DISTRACTOR HIP MEDIUM

Facility

$5,370.30

Hospital Charge Code	270691821
Hospital Revenue Code	272
Min. Negotiated Rate	$805.54
Max. Negotiated Rate	$805.54
Rate for Payer: Qualcare PPO/HMO/WC	$805.54

KIT DISTRACTOR HIP MEDIUM

Facility

$5,370.30

Hospital Charge Code	270691821
Hospital Revenue Code	272
Min. Negotiated Rate	$129.42
Max. Negotiated Rate	$2,685.15
Rate for Payer: Aetna Commercial	$2,040.71
Rate for Payer: Aetna Medicare Advantage	$1,611.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,369.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,369.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,369.43
Rate for Payer: Cigna Commercial	$2,685.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,611.09
Rate for Payer: Oxford Commercial	$1,074.06
Rate for Payer: Qualcare PPO/HMO/WC	$805.54
Rate for Payer: UnitedHealthcare Commercial	$1,074.06
Rate for Payer: UnitedHealthcare Community & State	$129.42
Rate for Payer: Wellpoint Medicaid Managed Care	$142.31

KIT DIVERTICULOSCOPE WEERDA RE

Facility

$7,500.00

Hospital Charge Code	270639777
Hospital Revenue Code	272
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,250.00
Rate for Payer: Oxford Commercial	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Commercial	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$180.75
Rate for Payer: Wellpoint Medicaid Managed Care	$198.75

KIT DIVERTICULOSCOPE WEERDA RE

Facility

$7,500.00

Hospital Charge Code	270639777
Hospital Revenue Code	272
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

KIT DRAINAGE PLEURAL COMPLETE

Facility

$10,000.00

Hospital Charge Code	270661649V
Hospital Revenue Code	272
Min. Negotiated Rate	$241.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,000.00
Rate for Payer: Oxford Commercial	$2,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Commercial	$2,000.00
Rate for Payer: UnitedHealthcare Community & State	$241.00
Rate for Payer: Wellpoint Medicaid Managed Care	$265.00

KIT DRAINAGE PLEURAL COMPLETE

Facility

$7,000.00

Hospital Charge Code	270661649O
Hospital Revenue Code	272
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

KIT DRAINAGE PLEURAL COMPLETE

Facility

$10,000.00

Hospital Charge Code	270661649
Hospital Revenue Code	272
Min. Negotiated Rate	$241.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,000.00
Rate for Payer: Oxford Commercial	$2,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Commercial	$2,000.00
Rate for Payer: UnitedHealthcare Community & State	$241.00
Rate for Payer: Wellpoint Medicaid Managed Care	$265.00

KIT DRAINAGE PLEURAL COMPLETE

Facility

$7,000.00

Hospital Charge Code	270661649O
Hospital Revenue Code	272
Min. Negotiated Rate	$168.70
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,660.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,100.00
Rate for Payer: Oxford Commercial	$1,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00
Rate for Payer: UnitedHealthcare Commercial	$1,400.00
Rate for Payer: UnitedHealthcare Community & State	$168.70
Rate for Payer: Wellpoint Medicaid Managed Care	$185.50

KIT DRAINAGE PLEURAL COMPLETE

Facility

$10,000.00

Hospital Charge Code	270661649V
Hospital Revenue Code	272
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

KIT DRAINAGE PLEURAL COMPLETE

Facility

$10,000.00

Hospital Charge Code	270661649
Hospital Revenue Code	272
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

KIT DRAINAGE SYST EXT 82-1700

Facility

$1,505.65

Hospital Charge Code	270600730
Hospital Revenue Code	272
Min. Negotiated Rate	$225.85
Max. Negotiated Rate	$225.85
Rate for Payer: Qualcare PPO/HMO/WC	$225.85

KIT DRAINAGE SYST EXT 82-1700

Facility

$1,505.65

Hospital Charge Code	270600730
Hospital Revenue Code	272
Min. Negotiated Rate	$36.29
Max. Negotiated Rate	$752.83
Rate for Payer: Aetna Commercial	$572.15
Rate for Payer: Aetna Medicare Advantage	$451.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$383.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$383.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$383.94
Rate for Payer: Cigna Commercial	$752.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.69
Rate for Payer: Oxford Commercial	$301.13
Rate for Payer: Qualcare PPO/HMO/WC	$225.85
Rate for Payer: UnitedHealthcare Commercial	$301.13
Rate for Payer: UnitedHealthcare Community & State	$36.29
Rate for Payer: Wellpoint Medicaid Managed Care	$39.90

KIT DRILL BIT F/CONTIN. COMPR.

Facility

$2,200.00

Hospital Charge Code	270669835
Hospital Revenue Code	272
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

KIT DRILL BIT F/CONTIN. COMPR.

Facility

$2,200.00

Hospital Charge Code	270669835
Hospital Revenue Code	272
Min. Negotiated Rate	$53.02
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$836.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$660.00
Rate for Payer: Oxford Commercial	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00
Rate for Payer: UnitedHealthcare Commercial	$440.00
Rate for Payer: UnitedHealthcare Community & State	$53.02
Rate for Payer: Wellpoint Medicaid Managed Care	$58.30

KIT DRILL STER.

Facility

$2,002.00

Hospital Charge Code	270679101
Hospital Revenue Code	272
Min. Negotiated Rate	$300.30
Max. Negotiated Rate	$300.30
Rate for Payer: Qualcare PPO/HMO/WC	$300.30

KIT DRILL STER.

Facility

$2,002.00

Hospital Charge Code	270679101
Hospital Revenue Code	272
Min. Negotiated Rate	$48.25
Max. Negotiated Rate	$1,001.00
Rate for Payer: Aetna Commercial	$760.76
Rate for Payer: Aetna Medicare Advantage	$600.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.51
Rate for Payer: Cigna Commercial	$1,001.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.60
Rate for Payer: Oxford Commercial	$400.40
Rate for Payer: Qualcare PPO/HMO/WC	$300.30
Rate for Payer: UnitedHealthcare Commercial	$400.40
Rate for Payer: UnitedHealthcare Community & State	$48.25
Rate for Payer: Wellpoint Medicaid Managed Care	$53.05

KIT DRSG CHG W/BIOPATCH

Facility

$56.29

Hospital Charge Code	270302224
Hospital Revenue Code	272
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$28.14
Rate for Payer: Aetna Commercial	$21.39
Rate for Payer: Aetna Medicare Advantage	$16.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.35
Rate for Payer: Cigna Commercial	$28.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.89
Rate for Payer: Oxford Commercial	$11.26
Rate for Payer: Qualcare PPO/HMO/WC	$8.44
Rate for Payer: UnitedHealthcare Commercial	$11.26
Rate for Payer: UnitedHealthcare Community & State	$1.36
Rate for Payer: Wellpoint Medicaid Managed Care	$1.49

KIT DRSG CHG W/BIOPATCH

Facility

$56.29

Hospital Charge Code	270302224
Hospital Revenue Code	272
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$8.44
Rate for Payer: Qualcare PPO/HMO/WC	$8.44

KIT DUAL TIGHTROPE XP IM SYST

Facility

$19,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693651
Hospital Revenue Code	278
Min. Negotiated Rate	$481.40
Max. Negotiated Rate	$9,987.50
Rate for Payer: Aetna Commercial	$7,590.50
Rate for Payer: Aetna Medicare Advantage	$5,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,093.62
Rate for Payer: Cigna Commercial	$9,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,394.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25
Rate for Payer: UnitedHealthcare Community & State	$481.40
Rate for Payer: Wellpoint Medicaid Managed Care	$529.34

KIT DUAL TIGHTROPE XP IM SYST

Facility

$19,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693651
Hospital Revenue Code	278
Min. Negotiated Rate	$2,996.25
Max. Negotiated Rate	$4,833.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,394.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25

KIT DUO-TRACH

Facility

$17.95

Hospital Charge Code	6014047
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$8.97
Rate for Payer: Aetna Commercial	$6.82
Rate for Payer: Aetna Medicare Advantage	$5.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.58
Rate for Payer: Cigna Commercial	$8.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.38
Rate for Payer: Oxford Commercial	$3.59
Rate for Payer: Qualcare PPO/HMO/WC	$2.69
Rate for Payer: UnitedHealthcare Commercial	$3.59
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

KIT DUO-TRACH

Facility

$17.95

Hospital Charge Code	6014047
Hospital Revenue Code	250
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$2.69
Rate for Payer: Qualcare PPO/HMO/WC	$2.69

KIT DUO-TRACH

Facility

$174.75

Hospital Charge Code	6006837
Hospital Revenue Code	250
Min. Negotiated Rate	$26.21
Max. Negotiated Rate	$26.21
Rate for Payer: Qualcare PPO/HMO/WC	$26.21

KIT DUO-TRACH

Facility

$174.75

Hospital Charge Code	6006837
Hospital Revenue Code	250
Min. Negotiated Rate	$4.21
Max. Negotiated Rate	$87.38
Rate for Payer: Aetna Commercial	$66.41
Rate for Payer: Aetna Medicare Advantage	$52.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.56
Rate for Payer: Cigna Commercial	$87.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.42
Rate for Payer: Oxford Commercial	$34.95
Rate for Payer: Qualcare PPO/HMO/WC	$26.21
Rate for Payer: UnitedHealthcare Commercial	$34.95
Rate for Payer: UnitedHealthcare Community & State	$4.21
Rate for Payer: Wellpoint Medicaid Managed Care	$4.63

Know your out-of-pocket cost for care.

All Charges