Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT EXTENSION

Facility

$3,475.00

Hospital Charge Code	270663407
Hospital Revenue Code	278
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) NJ Health	$695.00
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	$840.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$764.50
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Community & State	$83.75
Rate for Payer: Wellpoint Medicaid Managed Care	$92.09

KIT EXTENSION 37082-40

Facility

$7,950.00

Hospital Charge Code	270639948
Hospital Revenue Code	272
Min. Negotiated Rate	$1,192.50
Max. Negotiated Rate	$1,192.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.50

KIT EXTENSION 37082-40

Facility

$7,950.00

Hospital Charge Code	270639948
Hospital Revenue Code	272
Min. Negotiated Rate	$191.59
Max. Negotiated Rate	$3,975.00
Rate for Payer: Aetna Commercial	$3,021.00
Rate for Payer: Aetna Medicare Advantage	$2,385.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,027.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,027.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,027.25
Rate for Payer: Cigna Commercial	$3,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,385.00
Rate for Payer: Oxford Commercial	$1,590.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.50
Rate for Payer: UnitedHealthcare Commercial	$1,590.00
Rate for Payer: UnitedHealthcare Community & State	$191.59
Rate for Payer: Wellpoint Medicaid Managed Care	$210.68

KIT F4:H19RESORABLE MIN BEAD

Facility

$3,490.00

Service Code	HCPCS C1713
Hospital Charge Code	270656808
Hospital Revenue Code	278
Min. Negotiated Rate	$523.50
Max. Negotiated Rate	$844.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$767.80
Rate for Payer: Qualcare PPO/HMO/WC	$523.50

KIT F4:H19RESORABLE MIN BEAD

Facility

$3,490.00

Service Code	HCPCS C1713
Hospital Charge Code	270656808
Hospital Revenue Code	278
Min. Negotiated Rate	$84.11
Max. Negotiated Rate	$1,745.00
Rate for Payer: Aetna Commercial	$1,326.20
Rate for Payer: Aetna Medicare Advantage	$1,047.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$889.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$889.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$889.95
Rate for Payer: Cigna Commercial	$1,745.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$767.80
Rate for Payer: Qualcare PPO/HMO/WC	$523.50
Rate for Payer: UnitedHealthcare Community & State	$84.11
Rate for Payer: Wellpoint Medicaid Managed Care	$92.48

KIT FDL IMPLANT SYSTEM 4.75MM

Facility

$7,475.00

Hospital Charge Code	270690930
Hospital Revenue Code	272
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,242.50
Rate for Payer: Oxford Commercial	$1,495.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Commercial	$1,495.00
Rate for Payer: UnitedHealthcare Community & State	$180.15
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

KIT FDL IMPLANT SYSTEM 4.75MM

Facility

$7,475.00

Hospital Charge Code	270690930
Hospital Revenue Code	272
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,121.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

KIT FDL IMPLANT SYSTEM 5.5MM

Facility

$7,475.00

Hospital Charge Code	270690929
Hospital Revenue Code	272
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,242.50
Rate for Payer: Oxford Commercial	$1,495.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Commercial	$1,495.00
Rate for Payer: UnitedHealthcare Community & State	$180.15
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

KIT FDL IMPLANT SYSTEM 5.5MM

Facility

$7,475.00

Hospital Charge Code	270690929
Hospital Revenue Code	272
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,121.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

KIT FEMORAL PREP SZ 5 CR

Facility

$2,340.00

Hospital Charge Code	270698152
Hospital Revenue Code	272
Min. Negotiated Rate	$351.00
Max. Negotiated Rate	$351.00
Rate for Payer: Qualcare PPO/HMO/WC	$351.00

KIT FEMORAL PREP SZ 5 CR

Facility

$2,340.00

Hospital Charge Code	270698152
Hospital Revenue Code	272
Min. Negotiated Rate	$56.39
Max. Negotiated Rate	$1,170.00
Rate for Payer: Aetna Commercial	$889.20
Rate for Payer: Aetna Medicare Advantage	$702.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$596.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$596.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$596.70
Rate for Payer: Cigna Commercial	$1,170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$702.00
Rate for Payer: Oxford Commercial	$468.00
Rate for Payer: Qualcare PPO/HMO/WC	$351.00
Rate for Payer: UnitedHealthcare Commercial	$468.00
Rate for Payer: UnitedHealthcare Community & State	$56.39
Rate for Payer: Wellpoint Medicaid Managed Care	$62.01

KIT FEMORAL/TIBIAL CHECKPT

Facility

$252.50

Hospital Charge Code	270668482
Hospital Revenue Code	272
Min. Negotiated Rate	$6.09
Max. Negotiated Rate	$126.25
Rate for Payer: Aetna Commercial	$95.95
Rate for Payer: Aetna Medicare Advantage	$75.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.39
Rate for Payer: Cigna Commercial	$126.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.75
Rate for Payer: Oxford Commercial	$50.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.88
Rate for Payer: UnitedHealthcare Commercial	$50.50
Rate for Payer: UnitedHealthcare Community & State	$6.09
Rate for Payer: Wellpoint Medicaid Managed Care	$6.69

KIT FEMORAL/TIBIAL CHECKPT

Facility

$252.50

Hospital Charge Code	270668482
Hospital Revenue Code	272
Min. Negotiated Rate	$37.88
Max. Negotiated Rate	$37.88
Rate for Payer: Qualcare PPO/HMO/WC	$37.88

KIT FHL IMPLANT 6.25 MM SUTURE

Facility

$1,245.83

Hospital Charge Code	270692400
Hospital Revenue Code	272
Min. Negotiated Rate	$30.02
Max. Negotiated Rate	$622.91
Rate for Payer: Aetna Commercial	$473.42
Rate for Payer: Aetna Medicare Advantage	$373.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.69
Rate for Payer: Cigna Commercial	$622.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.75
Rate for Payer: Oxford Commercial	$249.17
Rate for Payer: Qualcare PPO/HMO/WC	$186.87
Rate for Payer: UnitedHealthcare Commercial	$249.17
Rate for Payer: UnitedHealthcare Community & State	$30.02
Rate for Payer: Wellpoint Medicaid Managed Care	$33.01

KIT FHL IMPLANT 6.25 MM SUTURE

Facility

$1,245.83

Hospital Charge Code	270692400
Hospital Revenue Code	272
Min. Negotiated Rate	$186.87
Max. Negotiated Rate	$186.87
Rate for Payer: Qualcare PPO/HMO/WC	$186.87

KIT FHL IMPLANT SYSTEM 7.0MM

Facility

$1,245.83

Hospital Charge Code	270692401
Hospital Revenue Code	272
Min. Negotiated Rate	$30.02
Max. Negotiated Rate	$622.91
Rate for Payer: Aetna Commercial	$473.42
Rate for Payer: Aetna Medicare Advantage	$373.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.69
Rate for Payer: Cigna Commercial	$622.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.75
Rate for Payer: Oxford Commercial	$249.17
Rate for Payer: Qualcare PPO/HMO/WC	$186.87
Rate for Payer: UnitedHealthcare Commercial	$249.17
Rate for Payer: UnitedHealthcare Community & State	$30.02
Rate for Payer: Wellpoint Medicaid Managed Care	$33.01

KIT FHL IMPLANT SYSTEM 7.0MM

Facility

$1,245.83

Hospital Charge Code	270692401
Hospital Revenue Code	272
Min. Negotiated Rate	$186.87
Max. Negotiated Rate	$186.87
Rate for Payer: Qualcare PPO/HMO/WC	$186.87

KIT FIBRIJET RATIO APPL SA4400

Facility

$158.75

Hospital Charge Code	270639733
Hospital Revenue Code	272
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$79.38
Rate for Payer: Aetna Commercial	$60.33
Rate for Payer: Aetna Medicare Advantage	$47.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.48
Rate for Payer: Cigna Commercial	$79.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.62
Rate for Payer: Oxford Commercial	$31.75
Rate for Payer: Qualcare PPO/HMO/WC	$23.81
Rate for Payer: UnitedHealthcare Commercial	$31.75
Rate for Payer: UnitedHealthcare Community & State	$3.83
Rate for Payer: Wellpoint Medicaid Managed Care	$4.21

KIT FIBRIJET RATIO APPL SA4400

Facility

$158.75

Hospital Charge Code	270639733
Hospital Revenue Code	272
Min. Negotiated Rate	$23.81
Max. Negotiated Rate	$23.81
Rate for Payer: Qualcare PPO/HMO/WC	$23.81

KIT FIRST FRACTURE LNG BLIS-PK

Facility

$15,750.00

Hospital Charge Code	270670663
Hospital Revenue Code	272
Min. Negotiated Rate	$2,362.50
Max. Negotiated Rate	$2,362.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,362.50

KIT FIRST FRACTURE LNG BLIS-PK

Facility

$15,750.00

Hospital Charge Code	270670663
Hospital Revenue Code	272
Min. Negotiated Rate	$379.57
Max. Negotiated Rate	$7,875.00
Rate for Payer: Aetna Commercial	$5,985.00
Rate for Payer: Aetna Medicare Advantage	$4,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,016.25
Rate for Payer: Cigna Commercial	$7,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,725.00
Rate for Payer: Oxford Commercial	$3,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,362.50
Rate for Payer: UnitedHealthcare Commercial	$3,150.00
Rate for Payer: UnitedHealthcare Community & State	$379.57
Rate for Payer: Wellpoint Medicaid Managed Care	$417.38

KIT FIRST FRACTURE SH BLIS-PK

Facility

$15,750.00

Hospital Charge Code	270670664
Hospital Revenue Code	272
Min. Negotiated Rate	$379.57
Max. Negotiated Rate	$7,875.00
Rate for Payer: Aetna Commercial	$5,985.00
Rate for Payer: Aetna Medicare Advantage	$4,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,016.25
Rate for Payer: Cigna Commercial	$7,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,725.00
Rate for Payer: Oxford Commercial	$3,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,362.50
Rate for Payer: UnitedHealthcare Commercial	$3,150.00
Rate for Payer: UnitedHealthcare Community & State	$379.57
Rate for Payer: Wellpoint Medicaid Managed Care	$417.38

KIT FIRST FRACTURE SH BLIS-PK

Facility

$15,750.00

Hospital Charge Code	270670664
Hospital Revenue Code	272
Min. Negotiated Rate	$2,362.50
Max. Negotiated Rate	$2,362.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,362.50

KIT FIRSTPASS PASSER STR

Facility

$5,830.00

Hospital Charge Code	270681093
Hospital Revenue Code	272
Min. Negotiated Rate	$874.50
Max. Negotiated Rate	$874.50
Rate for Payer: Qualcare PPO/HMO/WC	$874.50

KIT FIRSTPASS PASSER STR

Facility

$5,830.00

Hospital Charge Code	270681093
Hospital Revenue Code	272
Min. Negotiated Rate	$140.50
Max. Negotiated Rate	$2,915.00
Rate for Payer: Aetna Commercial	$2,215.40
Rate for Payer: Aetna Medicare Advantage	$1,749.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,486.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,486.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,486.65
Rate for Payer: Cigna Commercial	$2,915.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,749.00
Rate for Payer: Oxford Commercial	$1,166.00
Rate for Payer: Qualcare PPO/HMO/WC	$874.50
Rate for Payer: UnitedHealthcare Commercial	$1,166.00
Rate for Payer: UnitedHealthcare Community & State	$140.50
Rate for Payer: Wellpoint Medicaid Managed Care	$154.50

Know your out-of-pocket cost for care.

All Charges