Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT LEAD (MEDTRONIC) 3778-60

Facility

$12,547.50

Hospital Charge Code	270640282
Hospital Revenue Code	278
Min. Negotiated Rate	$1,882.12
Max. Negotiated Rate	$3,036.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,509.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,036.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,760.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,882.12

KIT LEAD NEUROSTIMULAT 5X50CM

Facility

$2,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270693874
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

KIT LEAD NEUROSTIMULAT 5X50CM

Facility

$2,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270693874
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

KIT LEAD OCTRODE TRIAL 60CML

Facility

$2,500.00

Service Code	HCPCS C1897
Hospital Charge Code	270633761
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

KIT LEAD OCTRODE TRIAL 60CML

Facility

$2,500.00

Service Code	HCPCS C1897
Hospital Charge Code	270633761
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

KIT LMA PEDIATRIC EMERGENCY

Facility

$65.75

Hospital Charge Code	270655290
Hospital Revenue Code	271
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$32.88
Rate for Payer: Aetna Commercial	$24.98
Rate for Payer: Aetna Medicare Advantage	$19.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.77
Rate for Payer: Cigna Commercial	$32.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.73
Rate for Payer: Oxford Commercial	$13.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.86
Rate for Payer: UnitedHealthcare Commercial	$13.15
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.74

KIT LMA PEDIATRIC EMERGENCY

Facility

$65.75

Hospital Charge Code	270655290
Hospital Revenue Code	271
Min. Negotiated Rate	$9.86
Max. Negotiated Rate	$9.86
Rate for Payer: Qualcare PPO/HMO/WC	$9.86

KIT LONG NAIL R1,TI, LEFT

Facility

$15,065.00

Hospital Charge Code	270663905
Hospital Revenue Code	278
Min. Negotiated Rate	$363.07
Max. Negotiated Rate	$7,532.50
Rate for Payer: Aetna Commercial	$5,724.70
Rate for Payer: Aetna Medicare Advantage	$4,519.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,841.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,841.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,013.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,841.57
Rate for Payer: Cigna Commercial	$7,532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,645.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,314.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,259.75
Rate for Payer: UnitedHealthcare Community & State	$363.07
Rate for Payer: Wellpoint Medicaid Managed Care	$399.22

KIT LONG NAIL R1,TI, LEFT

Facility

$7.55

Hospital Charge Code	270663904
Hospital Revenue Code	278
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1.66
Rate for Payer: Qualcare PPO/HMO/WC	$1.13

KIT LONG NAIL R1,TI, LEFT

Facility

$7.55

Hospital Charge Code	270663904
Hospital Revenue Code	278
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.77
Rate for Payer: Aetna Commercial	$2.87
Rate for Payer: Aetna Medicare Advantage	$2.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.93
Rate for Payer: Cigna Commercial	$3.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1.66
Rate for Payer: Qualcare PPO/HMO/WC	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

KIT LONG NAIL R1,TI, LEFT

Facility

$15,065.00

Hospital Charge Code	270663905
Hospital Revenue Code	278
Min. Negotiated Rate	$2,259.75
Max. Negotiated Rate	$3,645.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,013.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,645.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,314.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,259.75

KIT MAHURKAR *******

Facility

$265.00

Hospital Charge Code	8002958
Hospital Revenue Code	279
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$132.50
Rate for Payer: Aetna Commercial	$100.70
Rate for Payer: Aetna Medicare Advantage	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.58
Rate for Payer: Cigna Commercial	$132.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.50
Rate for Payer: Oxford Commercial	$53.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.75
Rate for Payer: UnitedHealthcare Commercial	$53.00
Rate for Payer: UnitedHealthcare Community & State	$6.39
Rate for Payer: Wellpoint Medicaid Managed Care	$7.02

KIT MAHURKAR *******

Facility

$265.00

Hospital Charge Code	8002958
Hospital Revenue Code	279
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$39.75
Rate for Payer: Qualcare PPO/HMO/WC	$39.75

KIT MANIFOLD CUSTOM MERIT

Facility

$88.00

Hospital Charge Code	270612917
Hospital Revenue Code	272
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$44.00
Rate for Payer: Aetna Commercial	$33.44
Rate for Payer: Aetna Medicare Advantage	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.44
Rate for Payer: Cigna Commercial	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.40
Rate for Payer: Oxford Commercial	$17.60
Rate for Payer: Qualcare PPO/HMO/WC	$13.20
Rate for Payer: UnitedHealthcare Commercial	$17.60
Rate for Payer: UnitedHealthcare Community & State	$2.12
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

KIT MANIFOLD CUSTOM MERIT

Facility

$88.00

Hospital Charge Code	270612917
Hospital Revenue Code	272
Min. Negotiated Rate	$13.20
Max. Negotiated Rate	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$13.20

KIT MANIFOLD MERIT

Facility

$413.70

Hospital Charge Code	270690129S
Hospital Revenue Code	272
Min. Negotiated Rate	$62.05
Max. Negotiated Rate	$62.05
Rate for Payer: Qualcare PPO/HMO/WC	$62.05

KIT MANIFOLD MERIT

Facility

$413.70

Hospital Charge Code	270690129S
Hospital Revenue Code	272
Min. Negotiated Rate	$9.97
Max. Negotiated Rate	$206.85
Rate for Payer: Aetna Commercial	$157.21
Rate for Payer: Aetna Medicare Advantage	$124.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.49
Rate for Payer: Cigna Commercial	$206.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.11
Rate for Payer: Oxford Commercial	$82.74
Rate for Payer: Qualcare PPO/HMO/WC	$62.05
Rate for Payer: UnitedHealthcare Commercial	$82.74
Rate for Payer: UnitedHealthcare Community & State	$9.97
Rate for Payer: Wellpoint Medicaid Managed Care	$10.96

KIT MAXCESS4

Facility

$11,750.00

Hospital Charge Code	270657308
Hospital Revenue Code	278
Min. Negotiated Rate	$283.18
Max. Negotiated Rate	$5,875.00
Rate for Payer: Aetna Commercial	$4,465.00
Rate for Payer: Aetna Medicare Advantage	$3,525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,996.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,996.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,996.25
Rate for Payer: Cigna Commercial	$5,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,843.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,585.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,762.50
Rate for Payer: UnitedHealthcare Community & State	$283.18
Rate for Payer: Wellpoint Medicaid Managed Care	$311.38

KIT MAXCESS4

Facility

$11,750.00

Hospital Charge Code	270657308
Hospital Revenue Code	278
Min. Negotiated Rate	$1,762.50
Max. Negotiated Rate	$2,843.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,843.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,585.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,762.50

KIT MAXCESS TLIF 2 RETRACTION

Facility

$13,750.00

Hospital Charge Code	270697096
Hospital Revenue Code	272
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$2,062.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

KIT MAXCESS TLIF 2 RETRACTION

Facility

$13,750.00

Hospital Charge Code	270697096
Hospital Revenue Code	272
Min. Negotiated Rate	$331.38
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$5,225.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,125.00
Rate for Payer: Oxford Commercial	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50
Rate for Payer: UnitedHealthcare Commercial	$2,750.00
Rate for Payer: UnitedHealthcare Community & State	$331.38
Rate for Payer: Wellpoint Medicaid Managed Care	$364.38

KIT MAXFRAME FOOT PLATE SUPP

Facility

$4,505.05

Hospital Charge Code	270693741
Hospital Revenue Code	272
Min. Negotiated Rate	$675.76
Max. Negotiated Rate	$675.76
Rate for Payer: Qualcare PPO/HMO/WC	$675.76

KIT MAXFRAME FOOT PLATE SUPP

Facility

$4,505.05

Hospital Charge Code	270693741
Hospital Revenue Code	272
Min. Negotiated Rate	$108.57
Max. Negotiated Rate	$2,252.53
Rate for Payer: Aetna Commercial	$1,711.92
Rate for Payer: Aetna Medicare Advantage	$1,351.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,148.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,148.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,148.79
Rate for Payer: Cigna Commercial	$2,252.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,351.52
Rate for Payer: Oxford Commercial	$901.01
Rate for Payer: Qualcare PPO/HMO/WC	$675.76
Rate for Payer: UnitedHealthcare Commercial	$901.01
Rate for Payer: UnitedHealthcare Community & State	$108.57
Rate for Payer: Wellpoint Medicaid Managed Care	$119.38

KIT MCN SNARE GOOSENECK GN1500

Facility

$1,494.50

Hospital Charge Code	270623252
Hospital Revenue Code	272
Min. Negotiated Rate	$36.02
Max. Negotiated Rate	$747.25
Rate for Payer: Aetna Commercial	$567.91
Rate for Payer: Aetna Medicare Advantage	$448.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$381.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$381.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$381.10
Rate for Payer: Cigna Commercial	$747.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.35
Rate for Payer: Oxford Commercial	$298.90
Rate for Payer: Qualcare PPO/HMO/WC	$224.18
Rate for Payer: UnitedHealthcare Commercial	$298.90
Rate for Payer: UnitedHealthcare Community & State	$36.02
Rate for Payer: Wellpoint Medicaid Managed Care	$39.60

KIT MCN SNARE GOOSENECK GN1500

Facility

$1,494.50

Hospital Charge Code	270623252
Hospital Revenue Code	272
Min. Negotiated Rate	$224.18
Max. Negotiated Rate	$224.18
Rate for Payer: Qualcare PPO/HMO/WC	$224.18

Know your out-of-pocket cost for care.

All Charges