Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT MESH PROLENE 4 HERNIA PHSE

Facility

$1,663.70

Hospital Charge Code	270633481
Hospital Revenue Code	272
Min. Negotiated Rate	$40.10
Max. Negotiated Rate	$831.85
Rate for Payer: Aetna Commercial	$632.21
Rate for Payer: Aetna Medicare Advantage	$499.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$424.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$424.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$424.24
Rate for Payer: Cigna Commercial	$831.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$499.11
Rate for Payer: Oxford Commercial	$332.74
Rate for Payer: Qualcare PPO/HMO/WC	$249.56
Rate for Payer: UnitedHealthcare Commercial	$332.74
Rate for Payer: UnitedHealthcare Community & State	$40.10
Rate for Payer: Wellpoint Medicaid Managed Care	$44.09

KIT METRA-BT PS PRCDRE MT-009R

Facility

$3,943.25

Hospital Charge Code	270629304
Hospital Revenue Code	272
Min. Negotiated Rate	$591.49
Max. Negotiated Rate	$591.49
Rate for Payer: Qualcare PPO/HMO/WC	$591.49

KIT METRA-BT PS PRCDRE MT-009R

Facility

$3,943.25

Hospital Charge Code	270629304
Hospital Revenue Code	272
Min. Negotiated Rate	$95.03
Max. Negotiated Rate	$1,971.62
Rate for Payer: Aetna Commercial	$1,498.43
Rate for Payer: Aetna Medicare Advantage	$1,182.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,005.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,005.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,005.53
Rate for Payer: Cigna Commercial	$1,971.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,182.97
Rate for Payer: Oxford Commercial	$788.65
Rate for Payer: Qualcare PPO/HMO/WC	$591.49
Rate for Payer: UnitedHealthcare Commercial	$788.65
Rate for Payer: UnitedHealthcare Community & State	$95.03
Rate for Payer: Wellpoint Medicaid Managed Care	$104.50

KIT METRA PS UTER SUSPEN MT009

Facility

$3,936.00

Hospital Charge Code	270624803
Hospital Revenue Code	272
Min. Negotiated Rate	$590.40
Max. Negotiated Rate	$590.40
Rate for Payer: Qualcare PPO/HMO/WC	$590.40

KIT METRA PS UTER SUSPEN MT009

Facility

$3,936.00

Hospital Charge Code	270624803
Hospital Revenue Code	272
Min. Negotiated Rate	$94.86
Max. Negotiated Rate	$1,968.00
Rate for Payer: Aetna Commercial	$1,495.68
Rate for Payer: Aetna Medicare Advantage	$1,180.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,003.68
Rate for Payer: Cigna Commercial	$1,968.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,180.80
Rate for Payer: Oxford Commercial	$787.20
Rate for Payer: Qualcare PPO/HMO/WC	$590.40
Rate for Payer: UnitedHealthcare Commercial	$787.20
Rate for Payer: UnitedHealthcare Community & State	$94.86
Rate for Payer: Wellpoint Medicaid Managed Care	$104.30

KIT MICKEY GASTRO TUBE 16F 2.3

Facility

$729.65

Hospital Charge Code	270621393
Hospital Revenue Code	272
Min. Negotiated Rate	$109.45
Max. Negotiated Rate	$109.45
Rate for Payer: Qualcare PPO/HMO/WC	$109.45

KIT MICKEY GASTRO TUBE 16F 2.3

Facility

$729.65

Hospital Charge Code	270621393
Hospital Revenue Code	272
Min. Negotiated Rate	$17.58
Max. Negotiated Rate	$364.82
Rate for Payer: Aetna Commercial	$277.27
Rate for Payer: Aetna Medicare Advantage	$218.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.06
Rate for Payer: Cigna Commercial	$364.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.90
Rate for Payer: Oxford Commercial	$145.93
Rate for Payer: Qualcare PPO/HMO/WC	$109.45
Rate for Payer: UnitedHealthcare Commercial	$145.93
Rate for Payer: UnitedHealthcare Community & State	$17.58
Rate for Payer: Wellpoint Medicaid Managed Care	$19.34

KIT MICKEY GASTRO TUBE 20F 2

Facility

$533.15

Hospital Charge Code	270609428
Hospital Revenue Code	272
Min. Negotiated Rate	$79.97
Max. Negotiated Rate	$79.97
Rate for Payer: Qualcare PPO/HMO/WC	$79.97

KIT MICKEY GASTRO TUBE 20F 2

Facility

$533.15

Hospital Charge Code	270609428
Hospital Revenue Code	272
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$266.57
Rate for Payer: Aetna Commercial	$202.60
Rate for Payer: Aetna Medicare Advantage	$159.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.95
Rate for Payer: Cigna Commercial	$266.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.94
Rate for Payer: Oxford Commercial	$106.63
Rate for Payer: Qualcare PPO/HMO/WC	$79.97
Rate for Payer: UnitedHealthcare Commercial	$106.63
Rate for Payer: UnitedHealthcare Community & State	$12.85
Rate for Payer: Wellpoint Medicaid Managed Care	$14.13

KIT MICKEY GASTRO TUBE 20F 3

Facility

$455.80

Hospital Charge Code	270617889
Hospital Revenue Code	272
Min. Negotiated Rate	$68.37
Max. Negotiated Rate	$68.37
Rate for Payer: Qualcare PPO/HMO/WC	$68.37

KIT MICKEY GASTRO TUBE 20F 3

Facility

$455.80

Hospital Charge Code	270617889
Hospital Revenue Code	272
Min. Negotiated Rate	$10.98
Max. Negotiated Rate	$227.90
Rate for Payer: Aetna Commercial	$173.20
Rate for Payer: Aetna Medicare Advantage	$136.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.23
Rate for Payer: Cigna Commercial	$227.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.74
Rate for Payer: Oxford Commercial	$91.16
Rate for Payer: Qualcare PPO/HMO/WC	$68.37
Rate for Payer: UnitedHealthcare Commercial	$91.16
Rate for Payer: UnitedHealthcare Community & State	$10.98
Rate for Payer: Wellpoint Medicaid Managed Care	$12.08

KIT MILD DEVICE-MIN IN V

Facility

$12,500.00

Hospital Charge Code	270646012
Hospital Revenue Code	270
Min. Negotiated Rate	$301.25
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,750.00
Rate for Payer: Oxford Commercial	$2,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Commercial	$2,500.00
Rate for Payer: UnitedHealthcare Community & State	$301.25
Rate for Payer: Wellpoint Medicaid Managed Care	$331.25

KIT MILD DEVICE-MIN IN V

Facility

$12,500.00

Hospital Charge Code	270646012
Hospital Revenue Code	270
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$1,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

KIT MINI TIGHTROPE

Facility

$3,150.00

Service Code	HCPCS C1713
Hospital Charge Code	270667601
Hospital Revenue Code	278
Min. Negotiated Rate	$472.50
Max. Negotiated Rate	$762.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$693.00
Rate for Payer: Qualcare PPO/HMO/WC	$472.50

KIT MINI TIGHTROPE

Facility

$3,150.00

Service Code	HCPCS C1713
Hospital Charge Code	270667601
Hospital Revenue Code	278
Min. Negotiated Rate	$75.92
Max. Negotiated Rate	$1,575.00
Rate for Payer: Aetna Commercial	$1,197.00
Rate for Payer: Aetna Medicare Advantage	$945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$803.25
Rate for Payer: Cigna Commercial	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$693.00
Rate for Payer: Qualcare PPO/HMO/WC	$472.50
Rate for Payer: UnitedHealthcare Community & State	$75.92
Rate for Payer: Wellpoint Medicaid Managed Care	$83.47

KIT MIXING SYRINGE 14 CC CAP

Facility

$2,875.00

Hospital Charge Code	270683167
Hospital Revenue Code	272
Min. Negotiated Rate	$69.29
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$1,092.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$862.50
Rate for Payer: Oxford Commercial	$575.00
Rate for Payer: Qualcare PPO/HMO/WC	$431.25
Rate for Payer: UnitedHealthcare Commercial	$575.00
Rate for Payer: UnitedHealthcare Community & State	$69.29
Rate for Payer: Wellpoint Medicaid Managed Care	$76.19

KIT MIXING SYRINGE 14 CC CAP

Facility

$2,875.00

Hospital Charge Code	270683167
Hospital Revenue Code	272
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$431.25
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

KIT MONITORING W/TRANSDUCER

Facility

$34.80

Hospital Charge Code	270657529N
Hospital Revenue Code	270
Min. Negotiated Rate	$5.22
Max. Negotiated Rate	$5.22
Rate for Payer: Qualcare PPO/HMO/WC	$5.22

KIT MONITORING W/TRANSDUCER

Facility

$57.85

Hospital Charge Code	270657529S
Hospital Revenue Code	270
Min. Negotiated Rate	$8.68
Max. Negotiated Rate	$8.68
Rate for Payer: Qualcare PPO/HMO/WC	$8.68

KIT MONITORING W/TRANSDUCER

Facility

$57.85

Hospital Charge Code	270657529
Hospital Revenue Code	270
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$28.93
Rate for Payer: Aetna Commercial	$21.98
Rate for Payer: Aetna Medicare Advantage	$17.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.75
Rate for Payer: Cigna Commercial	$28.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.36
Rate for Payer: Oxford Commercial	$11.57
Rate for Payer: Qualcare PPO/HMO/WC	$8.68
Rate for Payer: UnitedHealthcare Commercial	$11.57
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.53

KIT MONITORING W/TRANSDUCER

Facility

$57.85

Hospital Charge Code	270657529S
Hospital Revenue Code	270
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$28.93
Rate for Payer: Aetna Commercial	$21.98
Rate for Payer: Aetna Medicare Advantage	$17.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.75
Rate for Payer: Cigna Commercial	$28.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.36
Rate for Payer: Oxford Commercial	$11.57
Rate for Payer: Qualcare PPO/HMO/WC	$8.68
Rate for Payer: UnitedHealthcare Commercial	$11.57
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.53

KIT MONITORING W/TRANSDUCER

Facility

$57.85

Hospital Charge Code	270657529
Hospital Revenue Code	270
Min. Negotiated Rate	$8.68
Max. Negotiated Rate	$8.68
Rate for Payer: Qualcare PPO/HMO/WC	$8.68

KIT MONITORING W/TRANSDUCER

Facility

$34.80

Hospital Charge Code	270657529N
Hospital Revenue Code	270
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$17.40
Rate for Payer: Aetna Commercial	$13.22
Rate for Payer: Aetna Medicare Advantage	$10.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.87
Rate for Payer: Cigna Commercial	$17.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.44
Rate for Payer: Oxford Commercial	$6.96
Rate for Payer: Qualcare PPO/HMO/WC	$5.22
Rate for Payer: UnitedHealthcare Commercial	$6.96
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.92

KIT MSP METATARSAL SHORTENING

Facility

$5,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270688567
Hospital Revenue Code	278
Min. Negotiated Rate	$139.78
Max. Negotiated Rate	$2,900.00
Rate for Payer: Aetna Commercial	$2,204.00
Rate for Payer: Aetna Medicare Advantage	$1,740.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,479.00
Rate for Payer: Cigna Commercial	$2,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,403.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,276.00
Rate for Payer: Qualcare PPO/HMO/WC	$870.00
Rate for Payer: UnitedHealthcare Community & State	$139.78
Rate for Payer: Wellpoint Medicaid Managed Care	$153.70

KIT MSP METATARSAL SHORTENING

Facility

$5,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270688567
Hospital Revenue Code	278
Min. Negotiated Rate	$870.00
Max. Negotiated Rate	$1,403.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,403.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,276.00
Rate for Payer: Qualcare PPO/HMO/WC	$870.00

Know your out-of-pocket cost for care.

All Charges