Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT FIXATION FUSEFORCE 18X16MM

Facility

$6,975.00

Hospital Charge Code	27069233
Hospital Revenue Code	278
Min. Negotiated Rate	$168.10
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,650.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,534.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Community & State	$168.10
Rate for Payer: Wellpoint Medicaid Managed Care	$184.84

KIT FIXATION FUSEFORCE 18X16MM

Facility

$6,975.00

Hospital Charge Code	27069233
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,534.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

KIT FIX SALUTE SHORT DISP 3043

Facility

$868.00

Hospital Charge Code	270632785
Hospital Revenue Code	272
Min. Negotiated Rate	$130.20
Max. Negotiated Rate	$130.20
Rate for Payer: Qualcare PPO/HMO/WC	$130.20

KIT FIX SALUTE SHORT DISP 3043

Facility

$868.00

Hospital Charge Code	270632785
Hospital Revenue Code	272
Min. Negotiated Rate	$20.92
Max. Negotiated Rate	$434.00
Rate for Payer: Aetna Commercial	$329.84
Rate for Payer: Aetna Medicare Advantage	$260.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.34
Rate for Payer: Cigna Commercial	$434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.40
Rate for Payer: Oxford Commercial	$173.60
Rate for Payer: Qualcare PPO/HMO/WC	$130.20
Rate for Payer: UnitedHealthcare Commercial	$173.60
Rate for Payer: UnitedHealthcare Community & State	$20.92
Rate for Payer: Wellpoint Medicaid Managed Care	$23.00

KIT FLEXIFLO INVERTA PEG 20FR

Facility

$1,124.85

Hospital Charge Code	270600963
Hospital Revenue Code	270
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.42
Rate for Payer: Aetna Commercial	$427.44
Rate for Payer: Aetna Medicare Advantage	$337.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.84
Rate for Payer: Cigna Commercial	$562.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.45
Rate for Payer: Oxford Commercial	$224.97
Rate for Payer: Qualcare PPO/HMO/WC	$168.73
Rate for Payer: UnitedHealthcare Commercial	$224.97
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

KIT FLEXIFLO INVERTA PEG 20FR

Facility

$1,124.85

Hospital Charge Code	270600963
Hospital Revenue Code	270
Min. Negotiated Rate	$168.73
Max. Negotiated Rate	$168.73
Rate for Payer: Qualcare PPO/HMO/WC	$168.73

KIT FLIPCUTTER II T ROPE RT IM

Facility

$3,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270682534
Hospital Revenue Code	278
Min. Negotiated Rate	$506.25
Max. Negotiated Rate	$816.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$816.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$742.50
Rate for Payer: Qualcare PPO/HMO/WC	$506.25

KIT FLIPCUTTER II T ROPE RT IM

Facility

$3,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270682534
Hospital Revenue Code	278
Min. Negotiated Rate	$81.34
Max. Negotiated Rate	$1,687.50
Rate for Payer: Aetna Commercial	$1,282.50
Rate for Payer: Aetna Medicare Advantage	$1,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.62
Rate for Payer: Cigna Commercial	$1,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$816.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$742.50
Rate for Payer: Qualcare PPO/HMO/WC	$506.25
Rate for Payer: UnitedHealthcare Community & State	$81.34
Rate for Payer: Wellpoint Medicaid Managed Care	$89.44

KIT FOR WILSON FRAME 5326

Facility

$143.50

Hospital Charge Code	270629122
Hospital Revenue Code	272
Min. Negotiated Rate	$21.52
Max. Negotiated Rate	$21.52
Rate for Payer: Qualcare PPO/HMO/WC	$21.52

KIT FOR WILSON FRAME 5326

Facility

$143.50

Hospital Charge Code	270629122
Hospital Revenue Code	272
Min. Negotiated Rate	$3.46
Max. Negotiated Rate	$71.75
Rate for Payer: Aetna Commercial	$54.53
Rate for Payer: Aetna Medicare Advantage	$43.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.59
Rate for Payer: Cigna Commercial	$71.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.05
Rate for Payer: Oxford Commercial	$28.70
Rate for Payer: Qualcare PPO/HMO/WC	$21.52
Rate for Payer: UnitedHealthcare Commercial	$28.70
Rate for Payer: UnitedHealthcare Community & State	$3.46
Rate for Payer: Wellpoint Medicaid Managed Care	$3.80

KIT FRACTURE IVAS 11G

Facility

$13,705.00

Hospital Charge Code	270692056
Hospital Revenue Code	272
Min. Negotiated Rate	$2,055.75
Max. Negotiated Rate	$2,055.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,055.75

KIT FRACTURE IVAS 11G

Facility

$13,705.00

Hospital Charge Code	270692056
Hospital Revenue Code	272
Min. Negotiated Rate	$330.29
Max. Negotiated Rate	$6,852.50
Rate for Payer: Aetna Commercial	$5,207.90
Rate for Payer: Aetna Medicare Advantage	$4,111.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,494.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,494.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,494.78
Rate for Payer: Cigna Commercial	$6,852.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,111.50
Rate for Payer: Oxford Commercial	$2,741.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,055.75
Rate for Payer: UnitedHealthcare Commercial	$2,741.00
Rate for Payer: UnitedHealthcare Community & State	$330.29
Rate for Payer: Wellpoint Medicaid Managed Care	$363.18

KIT FRACTURE STABILIT LONG

Facility

$16,125.00

Hospital Charge Code	270670687
Hospital Revenue Code	272
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$2,418.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

KIT FRACTURE STABILIT LONG

Facility

$16,125.00

Hospital Charge Code	270670687
Hospital Revenue Code	272
Min. Negotiated Rate	$388.61
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,837.50
Rate for Payer: Oxford Commercial	$3,225.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Commercial	$3,225.00
Rate for Payer: UnitedHealthcare Community & State	$388.61
Rate for Payer: Wellpoint Medicaid Managed Care	$427.31

KIT FRACTURE STABILIT SHORT

Facility

$16,125.00

Hospital Charge Code	270670686
Hospital Revenue Code	272
Min. Negotiated Rate	$388.61
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,837.50
Rate for Payer: Oxford Commercial	$3,225.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Commercial	$3,225.00
Rate for Payer: UnitedHealthcare Community & State	$388.61
Rate for Payer: Wellpoint Medicaid Managed Care	$427.31

KIT FRACTURE STABILIT SHORT

Facility

$16,125.00

Hospital Charge Code	270670686
Hospital Revenue Code	272
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$2,418.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

KIT GAST PEG SAFEPULL 20F 6672

Facility

$562.50

Hospital Charge Code	270632927
Hospital Revenue Code	272
Min. Negotiated Rate	$84.38
Max. Negotiated Rate	$84.38
Rate for Payer: Qualcare PPO/HMO/WC	$84.38

KIT GAST PEG SAFEPULL 20F 6672

Facility

$562.50

Hospital Charge Code	270632927
Hospital Revenue Code	272
Min. Negotiated Rate	$13.56
Max. Negotiated Rate	$281.25
Rate for Payer: Aetna Commercial	$213.75
Rate for Payer: Aetna Medicare Advantage	$168.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.44
Rate for Payer: Cigna Commercial	$281.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.75
Rate for Payer: Oxford Commercial	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$84.38
Rate for Payer: UnitedHealthcare Commercial	$112.50
Rate for Payer: UnitedHealthcare Community & State	$13.56
Rate for Payer: Wellpoint Medicaid Managed Care	$14.91

KIT GAST PEG SAFEPUSH 20F 6673

Facility

$585.00

Hospital Charge Code	270632928
Hospital Revenue Code	272
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$87.75
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

KIT GAST PEG SAFEPUSH 20F 6673

Facility

$585.00

Hospital Charge Code	270632928
Hospital Revenue Code	272
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.50
Rate for Payer: Oxford Commercial	$117.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Commercial	$117.00
Rate for Payer: UnitedHealthcare Community & State	$14.10
Rate for Payer: Wellpoint Medicaid Managed Care	$15.50

KIT GASTRIC LAVAGE 34F

Facility

$272.54

Hospital Charge Code	270607144
Hospital Revenue Code	272
Min. Negotiated Rate	$40.88
Max. Negotiated Rate	$40.88
Rate for Payer: Qualcare PPO/HMO/WC	$40.88

KIT GASTRIC LAVAGE 34F

Facility

$272.54

Hospital Charge Code	270607144
Hospital Revenue Code	272
Min. Negotiated Rate	$6.57
Max. Negotiated Rate	$136.27
Rate for Payer: Aetna Commercial	$103.57
Rate for Payer: Aetna Medicare Advantage	$81.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.50
Rate for Payer: Cigna Commercial	$136.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.76
Rate for Payer: Oxford Commercial	$54.51
Rate for Payer: Qualcare PPO/HMO/WC	$40.88
Rate for Payer: UnitedHealthcare Commercial	$54.51
Rate for Payer: UnitedHealthcare Community & State	$6.57
Rate for Payer: Wellpoint Medicaid Managed Care	$7.22

KIT GASTRO BALLN 18FR 087418

Facility

$274.45

Hospital Charge Code	270600966
Hospital Revenue Code	272
Min. Negotiated Rate	$6.61
Max. Negotiated Rate	$137.22
Rate for Payer: Aetna Commercial	$104.29
Rate for Payer: Aetna Medicare Advantage	$82.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.98
Rate for Payer: Cigna Commercial	$137.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.33
Rate for Payer: Oxford Commercial	$54.89
Rate for Payer: Qualcare PPO/HMO/WC	$41.17
Rate for Payer: UnitedHealthcare Commercial	$54.89
Rate for Payer: UnitedHealthcare Community & State	$6.61
Rate for Payer: Wellpoint Medicaid Managed Care	$7.27

KIT GASTRO BALLN 18FR 087418

Facility

$274.45

Hospital Charge Code	270600966
Hospital Revenue Code	272
Min. Negotiated Rate	$41.17
Max. Negotiated Rate	$41.17
Rate for Payer: Qualcare PPO/HMO/WC	$41.17

KIT GASTROSTOMY***

Facility

$494.00

Hospital Charge Code	2300515
Hospital Revenue Code	279
Min. Negotiated Rate	$74.10
Max. Negotiated Rate	$74.10
Rate for Payer: Qualcare PPO/HMO/WC	$74.10

Know your out-of-pocket cost for care.

All Charges