Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT HCG TEST 25/KT POLY STAT

Facility

$4.39

Hospital Charge Code	270658829
Hospital Revenue Code	270
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.19
Rate for Payer: Aetna Commercial	$1.67
Rate for Payer: Aetna Medicare Advantage	$1.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.12
Rate for Payer: Cigna Commercial	$2.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.32
Rate for Payer: Oxford Commercial	$0.88
Rate for Payer: Qualcare PPO/HMO/WC	$0.66
Rate for Payer: UnitedHealthcare Commercial	$0.88
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

KIT HCG TEST 25/KT POLY STAT

Facility

$4.39

Hospital Charge Code	270658829
Hospital Revenue Code	270
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$0.66
Rate for Payer: Qualcare PPO/HMO/WC	$0.66

KIT HEART RIGHT K0903252

Facility

$105.00

Hospital Charge Code	270658338N
Hospital Revenue Code	271
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

KIT HEART RIGHT K0903252

Facility

$105.00

Hospital Charge Code	270658338
Hospital Revenue Code	271
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.50
Rate for Payer: Oxford Commercial	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Community & State	$2.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

KIT HEART RIGHT K0903252

Facility

$105.00

Hospital Charge Code	270658338
Hospital Revenue Code	271
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

KIT HEART RIGHT K0903252

Facility

$105.00

Hospital Charge Code	270658338N
Hospital Revenue Code	271
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.50
Rate for Payer: Oxford Commercial	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Community & State	$2.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

KIT HEART RIGHT K0903252

Facility

$105.00

Hospital Charge Code	270658338S
Hospital Revenue Code	271
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

KIT HEART RIGHT K0903252

Facility

$105.00

Hospital Charge Code	270658338S
Hospital Revenue Code	271
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.50
Rate for Payer: Oxford Commercial	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Community & State	$2.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

KIT HEMOVAC 400CC 1/8 2500-000

Facility

$108.00

Hospital Charge Code	270607623
Hospital Revenue Code	272
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna Commercial	$41.04
Rate for Payer: Aetna Medicare Advantage	$32.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.54
Rate for Payer: Cigna Commercial	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.40
Rate for Payer: Oxford Commercial	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$16.20
Rate for Payer: UnitedHealthcare Commercial	$21.60
Rate for Payer: UnitedHealthcare Community & State	$2.60
Rate for Payer: Wellpoint Medicaid Managed Care	$2.86

KIT HEMOVAC 400CC 1/8 2500-000

Facility

$108.00

Hospital Charge Code	270607623
Hospital Revenue Code	272
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$16.20

KIT HEMOVAC 400CC 5390-040

Facility

$246.45

Hospital Charge Code	270600375
Hospital Revenue Code	272
Min. Negotiated Rate	$5.94
Max. Negotiated Rate	$123.22
Rate for Payer: Aetna Commercial	$93.65
Rate for Payer: Aetna Medicare Advantage	$73.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.84
Rate for Payer: Cigna Commercial	$123.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.94
Rate for Payer: Oxford Commercial	$49.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.97
Rate for Payer: UnitedHealthcare Commercial	$49.29
Rate for Payer: UnitedHealthcare Community & State	$5.94
Rate for Payer: Wellpoint Medicaid Managed Care	$6.53

KIT HEMOVAC 400CC 5390-040

Facility

$246.45

Hospital Charge Code	270600375
Hospital Revenue Code	272
Min. Negotiated Rate	$36.97
Max. Negotiated Rate	$36.97
Rate for Payer: Qualcare PPO/HMO/WC	$36.97

KIT HIP ARTHO W/ BANANA BLADE

Facility

$1,875.00

Service Code	HCPCS C1776
Hospital Charge Code	270681364
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

KIT HIP ARTHO W/ BANANA BLADE

Facility

$1,875.00

Service Code	HCPCS C1776
Hospital Charge Code	270681364
Hospital Revenue Code	278
Min. Negotiated Rate	$45.19
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$49.69

KIT HIP ARTHROSCOPY MSTR W/BLD

Facility

$2,250.00

Hospital Charge Code	270675642
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

KIT HIP ARTHROSCOPY MSTR W/BLD

Facility

$2,250.00

Hospital Charge Code	270675642
Hospital Revenue Code	272
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$675.00
Rate for Payer: Oxford Commercial	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$450.00
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

KIT HVAC 400 EVACTOR 254000010

Facility

$82.75

Hospital Charge Code	270632891
Hospital Revenue Code	272
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$41.38
Rate for Payer: Aetna Commercial	$31.45
Rate for Payer: Aetna Medicare Advantage	$24.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.10
Rate for Payer: Cigna Commercial	$41.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.82
Rate for Payer: Oxford Commercial	$16.55
Rate for Payer: Qualcare PPO/HMO/WC	$12.41
Rate for Payer: UnitedHealthcare Commercial	$16.55
Rate for Payer: UnitedHealthcare Community & State	$1.99
Rate for Payer: Wellpoint Medicaid Managed Care	$2.19

KIT HVAC 400 EVACTOR 254000010

Facility

$82.75

Hospital Charge Code	270632891
Hospital Revenue Code	272
Min. Negotiated Rate	$12.41
Max. Negotiated Rate	$12.41
Rate for Payer: Qualcare PPO/HMO/WC	$12.41

KIT ICP COMPL ADULT 80-1190

Facility

$2,096.85

Hospital Charge Code	270600325
Hospital Revenue Code	272
Min. Negotiated Rate	$314.53
Max. Negotiated Rate	$314.53
Rate for Payer: Qualcare PPO/HMO/WC	$314.53

KIT ICP COMPL ADULT 80-1190

Facility

$2,096.85

Hospital Charge Code	270600325
Hospital Revenue Code	272
Min. Negotiated Rate	$50.53
Max. Negotiated Rate	$1,048.42
Rate for Payer: Aetna Commercial	$796.80
Rate for Payer: Aetna Medicare Advantage	$629.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$534.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$534.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$534.70
Rate for Payer: Cigna Commercial	$1,048.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$629.05
Rate for Payer: Oxford Commercial	$419.37
Rate for Payer: Qualcare PPO/HMO/WC	$314.53
Rate for Payer: UnitedHealthcare Commercial	$419.37
Rate for Payer: UnitedHealthcare Community & State	$50.53
Rate for Payer: Wellpoint Medicaid Managed Care	$55.57

KIT IMPI DRILL W/DT320 DDK320

Facility

$323.25

Hospital Charge Code	270620305
Hospital Revenue Code	272
Min. Negotiated Rate	$48.49
Max. Negotiated Rate	$48.49
Rate for Payer: Qualcare PPO/HMO/WC	$48.49

KIT IMPI DRILL W/DT320 DDK320

Facility

$323.25

Hospital Charge Code	270620305
Hospital Revenue Code	272
Min. Negotiated Rate	$7.79
Max. Negotiated Rate	$161.62
Rate for Payer: Aetna Commercial	$122.83
Rate for Payer: Aetna Medicare Advantage	$96.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.43
Rate for Payer: Cigna Commercial	$161.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.97
Rate for Payer: Oxford Commercial	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.49
Rate for Payer: UnitedHealthcare Commercial	$64.65
Rate for Payer: UnitedHealthcare Community & State	$7.79
Rate for Payer: Wellpoint Medicaid Managed Care	$8.57

KIT IMPLANT ANKLE SYNDESMOSIS

Facility

$425.00

Hospital Charge Code	270655838
Hospital Revenue Code	278
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

KIT IMPLANT ANKLE SYNDESMOSIS

Facility

$425.00

Hospital Charge Code	270655838
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$93.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

KIT IMPLANT BRCE SYST AR1638CP

Facility

$8,099.00

Service Code	HCPCS C1713
Hospital Charge Code	270698671
Hospital Revenue Code	278
Min. Negotiated Rate	$195.19
Max. Negotiated Rate	$4,049.50
Rate for Payer: Aetna Commercial	$3,077.62
Rate for Payer: Aetna Medicare Advantage	$2,429.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,065.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,065.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,619.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,065.24
Rate for Payer: Cigna Commercial	$4,049.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,959.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,781.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,214.85
Rate for Payer: UnitedHealthcare Community & State	$195.19
Rate for Payer: Wellpoint Medicaid Managed Care	$214.62

Know your out-of-pocket cost for care.

All Charges