Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT NAIL IM VALOR LT 10X250MM

Facility

$16,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270700406
Hospital Revenue Code	278
Min. Negotiated Rate	$390.54
Max. Negotiated Rate	$8,102.50
Rate for Payer: Aetna Commercial	$6,157.90
Rate for Payer: Aetna Medicare Advantage	$4,861.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,132.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,132.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,132.27
Rate for Payer: Cigna Commercial	$8,102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,921.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,565.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,430.75
Rate for Payer: UnitedHealthcare Community & State	$390.54
Rate for Payer: Wellpoint Medicaid Managed Care	$429.43

KIT NAIL IM VALOR LT 10X250MM

Facility

$16,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270700406
Hospital Revenue Code	278
Min. Negotiated Rate	$2,430.75
Max. Negotiated Rate	$3,921.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,921.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,565.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,430.75

KIT NAIL LONG R1.5 TI LEFT

Facility

$13,061.10

Service Code	HCPCS C1713
Hospital Charge Code	270672766
Hospital Revenue Code	278
Min. Negotiated Rate	$314.77
Max. Negotiated Rate	$6,530.55
Rate for Payer: Aetna Commercial	$4,963.22
Rate for Payer: Aetna Medicare Advantage	$3,918.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,330.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,330.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,612.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,330.58
Rate for Payer: Cigna Commercial	$6,530.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,160.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,873.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,959.16
Rate for Payer: UnitedHealthcare Community & State	$314.77
Rate for Payer: Wellpoint Medicaid Managed Care	$346.12

KIT NAIL LONG R1.5 TI LEFT

Facility

$13,061.10

Service Code	HCPCS C1713
Hospital Charge Code	270672766
Hospital Revenue Code	278
Min. Negotiated Rate	$1,959.16
Max. Negotiated Rate	$3,160.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,612.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,160.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,873.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,959.16

KIT NAIL TI 10X170MM 125 DEG

Facility

$12,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270647251
Hospital Revenue Code	278
Min. Negotiated Rate	$1,818.75
Max. Negotiated Rate	$2,934.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,934.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,667.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,818.75

KIT NAIL TI 10X170MM 125 DEG

Facility

$12,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270647251
Hospital Revenue Code	278
Min. Negotiated Rate	$292.21
Max. Negotiated Rate	$6,062.50
Rate for Payer: Aetna Commercial	$4,607.50
Rate for Payer: Aetna Medicare Advantage	$3,637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,091.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,091.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,091.88
Rate for Payer: Cigna Commercial	$6,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,934.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,667.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,818.75
Rate for Payer: UnitedHealthcare Community & State	$292.21
Rate for Payer: Wellpoint Medicaid Managed Care	$321.31

KIT NAIL Ti LONG 1.5 RIGHT

Facility

$16,175.00

Hospital Charge Code	270648350
Hospital Revenue Code	278
Min. Negotiated Rate	$389.82
Max. Negotiated Rate	$8,087.50
Rate for Payer: Aetna Commercial	$6,146.50
Rate for Payer: Aetna Medicare Advantage	$4,852.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,124.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,124.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,124.62
Rate for Payer: Cigna Commercial	$8,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,914.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,558.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,426.25
Rate for Payer: UnitedHealthcare Community & State	$389.82
Rate for Payer: Wellpoint Medicaid Managed Care	$428.64

KIT NAIL Ti LONG 1.5 RIGHT

Facility

$16,175.00

Hospital Charge Code	270648350
Hospital Revenue Code	278
Min. Negotiated Rate	$2,426.25
Max. Negotiated Rate	$3,914.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,914.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,558.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,426.25

KIT NANONEEDLE HIGHFLOW 125MM

Facility

$960.00

Service Code	HCPCS A4649
Hospital Charge Code	270699065
Hospital Revenue Code	272
Min. Negotiated Rate	$23.14
Max. Negotiated Rate	$480.00
Rate for Payer: Aetna Commercial	$364.80
Rate for Payer: Aetna Medicare Advantage	$288.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.80
Rate for Payer: Cigna Commercial	$480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$288.00
Rate for Payer: Oxford Commercial	$192.00
Rate for Payer: Qualcare PPO/HMO/WC	$144.00
Rate for Payer: UnitedHealthcare Commercial	$192.00
Rate for Payer: UnitedHealthcare Community & State	$23.14
Rate for Payer: Wellpoint Medicaid Managed Care	$25.44

KIT NANONEEDLE HIGHFLOW 125MM

Facility

$960.00

Service Code	HCPCS A4649
Hospital Charge Code	270699065
Hospital Revenue Code	272
Min. Negotiated Rate	$144.00
Max. Negotiated Rate	$144.00
Rate for Payer: Qualcare PPO/HMO/WC	$144.00

KIT NERVE BLOCK 22X8

Facility

$75.35

Hospital Charge Code	270669572
Hospital Revenue Code	272
Min. Negotiated Rate	$11.30
Max. Negotiated Rate	$11.30
Rate for Payer: Qualcare PPO/HMO/WC	$11.30

KIT NERVE BLOCK 22X8

Facility

$75.35

Hospital Charge Code	270669572
Hospital Revenue Code	272
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$37.67
Rate for Payer: Aetna Commercial	$28.63
Rate for Payer: Aetna Medicare Advantage	$22.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.21
Rate for Payer: Cigna Commercial	$37.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.61
Rate for Payer: Oxford Commercial	$15.07
Rate for Payer: Qualcare PPO/HMO/WC	$11.30
Rate for Payer: UnitedHealthcare Commercial	$15.07
Rate for Payer: UnitedHealthcare Community & State	$1.82
Rate for Payer: Wellpoint Medicaid Managed Care	$2.00

KIT NERVE STIM NERVEANA DRAGON

Facility

$5,750.00

Service Code	HCPCS A4649
Hospital Charge Code	270695163
Hospital Revenue Code	272
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$862.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

KIT NERVE STIM NERVEANA DRAGON

Facility

$5,750.00

Service Code	HCPCS A4649
Hospital Charge Code	270695163
Hospital Revenue Code	272
Min. Negotiated Rate	$138.57
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$2,185.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,725.00
Rate for Payer: Oxford Commercial	$1,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Commercial	$1,150.00
Rate for Payer: UnitedHealthcare Community & State	$138.57
Rate for Payer: Wellpoint Medicaid Managed Care	$152.38

KIT OB TAPE PROCED OBRT 934300

Facility

$4,960.00

Hospital Charge Code	270634440
Hospital Revenue Code	272
Min. Negotiated Rate	$119.54
Max. Negotiated Rate	$2,480.00
Rate for Payer: Aetna Commercial	$1,884.80
Rate for Payer: Aetna Medicare Advantage	$1,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,264.80
Rate for Payer: Cigna Commercial	$2,480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,488.00
Rate for Payer: Oxford Commercial	$992.00
Rate for Payer: Qualcare PPO/HMO/WC	$744.00
Rate for Payer: UnitedHealthcare Commercial	$992.00
Rate for Payer: UnitedHealthcare Community & State	$119.54
Rate for Payer: Wellpoint Medicaid Managed Care	$131.44

KIT OB TAPE PROCED OBRT 934300

Facility

$4,960.00

Hospital Charge Code	270634440
Hospital Revenue Code	272
Min. Negotiated Rate	$744.00
Max. Negotiated Rate	$744.00
Rate for Payer: Qualcare PPO/HMO/WC	$744.00

KIT ONYX 18 AVM

Facility

$15,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270685187S
Hospital Revenue Code	278
Min. Negotiated Rate	$372.95
Max. Negotiated Rate	$7,737.50
Rate for Payer: Aetna Commercial	$5,880.50
Rate for Payer: Aetna Medicare Advantage	$4,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,946.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,946.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,095.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,946.12
Rate for Payer: Cigna Commercial	$7,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,744.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,404.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.25
Rate for Payer: UnitedHealthcare Community & State	$372.95
Rate for Payer: Wellpoint Medicaid Managed Care	$410.09

KIT ONYX 18 AVM

Facility

$15,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270685187
Hospital Revenue Code	278
Min. Negotiated Rate	$372.95
Max. Negotiated Rate	$7,737.50
Rate for Payer: Aetna Commercial	$5,880.50
Rate for Payer: Aetna Medicare Advantage	$4,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,946.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,946.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,095.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,946.12
Rate for Payer: Cigna Commercial	$7,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,744.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,404.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.25
Rate for Payer: UnitedHealthcare Community & State	$372.95
Rate for Payer: Wellpoint Medicaid Managed Care	$410.09

KIT ONYX 18 AVM

Facility

$15,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270685187S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,321.25
Max. Negotiated Rate	$3,744.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,744.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,404.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.25

KIT ONYX 18 AVM

Facility

$15,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270685187
Hospital Revenue Code	278
Min. Negotiated Rate	$2,321.25
Max. Negotiated Rate	$3,744.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,744.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,404.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.25

KIT ONYX 34 AVM US

Facility

$15,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270685188
Hospital Revenue Code	278
Min. Negotiated Rate	$372.95
Max. Negotiated Rate	$7,737.50
Rate for Payer: Aetna Commercial	$5,880.50
Rate for Payer: Aetna Medicare Advantage	$4,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,946.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,946.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,095.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,946.12
Rate for Payer: Cigna Commercial	$7,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,744.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,404.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.25
Rate for Payer: UnitedHealthcare Community & State	$372.95
Rate for Payer: Wellpoint Medicaid Managed Care	$410.09

KIT ONYX 34 AVM US

Facility

$15,475.00

Service Code	HCPCS C1887
Hospital Charge Code	270685188
Hospital Revenue Code	278
Min. Negotiated Rate	$2,321.25
Max. Negotiated Rate	$3,744.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,744.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,404.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.25

KIT OPTIVAC 41700

Facility

$850.00

Hospital Charge Code	270629379
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

KIT OPTIVAC 41700

Facility

$850.00

Hospital Charge Code	270629379
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.00
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$170.00
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

KIT OPTIVAC 80G CEMENT 417800

Facility

$755.25

Hospital Charge Code	270621912
Hospital Revenue Code	272
Min. Negotiated Rate	$18.20
Max. Negotiated Rate	$377.62
Rate for Payer: Aetna Commercial	$287.00
Rate for Payer: Aetna Medicare Advantage	$226.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.59
Rate for Payer: Cigna Commercial	$377.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.57
Rate for Payer: Oxford Commercial	$151.05
Rate for Payer: Qualcare PPO/HMO/WC	$113.29
Rate for Payer: UnitedHealthcare Commercial	$151.05
Rate for Payer: UnitedHealthcare Community & State	$18.20
Rate for Payer: Wellpoint Medicaid Managed Care	$20.01

Know your out-of-pocket cost for care.

All Charges