Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT Q-IX SHOULDER 1.8MM

Facility

$2,500.00

Hospital Charge Code	270681092
Hospital Revenue Code	272
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) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$500.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

KIT RAD ANGIO FLUSH 600230231

Facility

$75.00

Hospital Charge Code	270632555V
Hospital Revenue Code	272
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

KIT RAD ANGIO FLUSH 600230231

Facility

$74.45

Hospital Charge Code	270632555
Hospital Revenue Code	272
Min. Negotiated Rate	$11.17
Max. Negotiated Rate	$11.17
Rate for Payer: Qualcare PPO/HMO/WC	$11.17

KIT RAD ANGIO FLUSH 600230231

Facility

$74.45

Hospital Charge Code	270632555
Hospital Revenue Code	272
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$37.23
Rate for Payer: Aetna Commercial	$28.29
Rate for Payer: Aetna Medicare Advantage	$22.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.98
Rate for Payer: Cigna Commercial	$37.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.34
Rate for Payer: Oxford Commercial	$14.89
Rate for Payer: Qualcare PPO/HMO/WC	$11.17
Rate for Payer: UnitedHealthcare Commercial	$14.89
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.97

KIT RAD ANGIO FLUSH 600230231

Facility

$75.00

Hospital Charge Code	270632555V
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

KIT RADIAL HEAD REPLACEMENT

Facility

$1,770.30

Hospital Charge Code	270695504
Hospital Revenue Code	272
Min. Negotiated Rate	$42.66
Max. Negotiated Rate	$885.15
Rate for Payer: Aetna Commercial	$672.71
Rate for Payer: Aetna Medicare Advantage	$531.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$451.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$451.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$451.43
Rate for Payer: Cigna Commercial	$885.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$531.09
Rate for Payer: Oxford Commercial	$354.06
Rate for Payer: Qualcare PPO/HMO/WC	$265.55
Rate for Payer: UnitedHealthcare Commercial	$354.06
Rate for Payer: UnitedHealthcare Community & State	$42.66
Rate for Payer: Wellpoint Medicaid Managed Care	$46.91

KIT RADIAL HEAD REPLACEMENT

Facility

$1,770.30

Hospital Charge Code	270695504
Hospital Revenue Code	272
Min. Negotiated Rate	$265.55
Max. Negotiated Rate	$265.55
Rate for Payer: Qualcare PPO/HMO/WC	$265.55

KIT RAPR-ROUND LARGE 46-56

Facility

$680.00

Hospital Charge Code	270660605
Hospital Revenue Code	272
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$102.00
Rate for Payer: Qualcare PPO/HMO/WC	$102.00

KIT RAPR-ROUND LARGE 46-56

Facility

$680.00

Hospital Charge Code	270660605
Hospital Revenue Code	272
Min. Negotiated Rate	$16.39
Max. Negotiated Rate	$340.00
Rate for Payer: Aetna Commercial	$258.40
Rate for Payer: Aetna Medicare Advantage	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.40
Rate for Payer: Cigna Commercial	$340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$204.00
Rate for Payer: Oxford Commercial	$136.00
Rate for Payer: Qualcare PPO/HMO/WC	$102.00
Rate for Payer: UnitedHealthcare Commercial	$136.00
Rate for Payer: UnitedHealthcare Community & State	$16.39
Rate for Payer: Wellpoint Medicaid Managed Care	$18.02

KIT RAPR-ROUND SM/MED 32-46

Facility

$655.00

Hospital Charge Code	270660604
Hospital Revenue Code	272
Min. Negotiated Rate	$15.79
Max. Negotiated Rate	$327.50
Rate for Payer: Aetna Commercial	$248.90
Rate for Payer: Aetna Medicare Advantage	$196.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.03
Rate for Payer: Cigna Commercial	$327.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.50
Rate for Payer: Oxford Commercial	$131.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.25
Rate for Payer: UnitedHealthcare Commercial	$131.00
Rate for Payer: UnitedHealthcare Community & State	$15.79
Rate for Payer: Wellpoint Medicaid Managed Care	$17.36

KIT RAPR-ROUND SM/MED 32-46

Facility

$655.00

Hospital Charge Code	270660604
Hospital Revenue Code	272
Min. Negotiated Rate	$98.25
Max. Negotiated Rate	$98.25
Rate for Payer: Qualcare PPO/HMO/WC	$98.25

KIT READY CARE BALLARD 121

Facility

$33.65

Hospital Charge Code	270600636
Hospital Revenue Code	272
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$16.82
Rate for Payer: Aetna Commercial	$12.79
Rate for Payer: Aetna Medicare Advantage	$10.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.58
Rate for Payer: Cigna Commercial	$16.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.10
Rate for Payer: Oxford Commercial	$6.73
Rate for Payer: Qualcare PPO/HMO/WC	$5.05
Rate for Payer: UnitedHealthcare Commercial	$6.73
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.89

KIT READY CARE BALLARD 121

Facility

$33.65

Hospital Charge Code	270600636
Hospital Revenue Code	272
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$5.05
Rate for Payer: Qualcare PPO/HMO/WC	$5.05

KIT REAMER MINIBUNION

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270690786
Hospital Revenue Code	278
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

KIT REAMER MINIBUNION

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270690786
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

KIT RENEGADE HI FLOW 150/10

Facility

$1,638.15

Service Code	HCPCS C1887
Hospital Charge Code	270645209C
Hospital Revenue Code	278
Min. Negotiated Rate	$245.72
Max. Negotiated Rate	$396.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$327.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$360.39
Rate for Payer: Qualcare PPO/HMO/WC	$245.72

KIT RENEGADE HI FLOW 150/10

Facility

$1,799.20

Hospital Charge Code	270645209
Hospital Revenue Code	278
Min. Negotiated Rate	$269.88
Max. Negotiated Rate	$435.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$395.82
Rate for Payer: Qualcare PPO/HMO/WC	$269.88

KIT RENEGADE HI FLOW 150/10

Facility

$1,799.20

Hospital Charge Code	270645209
Hospital Revenue Code	278
Min. Negotiated Rate	$43.36
Max. Negotiated Rate	$899.60
Rate for Payer: Aetna Commercial	$683.70
Rate for Payer: Aetna Medicare Advantage	$539.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$458.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$458.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$458.80
Rate for Payer: Cigna Commercial	$899.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$395.82
Rate for Payer: Qualcare PPO/HMO/WC	$269.88
Rate for Payer: UnitedHealthcare Community & State	$43.36
Rate for Payer: Wellpoint Medicaid Managed Care	$47.68

KIT RENEGADE HI FLOW 150/10

Facility

$1,638.15

Service Code	HCPCS C1887
Hospital Charge Code	270645209C
Hospital Revenue Code	278
Min. Negotiated Rate	$39.48
Max. Negotiated Rate	$819.08
Rate for Payer: Aetna Commercial	$622.50
Rate for Payer: Aetna Medicare Advantage	$491.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$417.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$417.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$327.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$417.73
Rate for Payer: Cigna Commercial	$819.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$360.39
Rate for Payer: Qualcare PPO/HMO/WC	$245.72
Rate for Payer: UnitedHealthcare Community & State	$39.48
Rate for Payer: Wellpoint Medicaid Managed Care	$43.41

KIT RENEGADE HI FLOW 35

Facility

$2,455.70

Service Code	HCPCS C1887
Hospital Charge Code	270630465
Hospital Revenue Code	278
Min. Negotiated Rate	$59.18
Max. Negotiated Rate	$1,227.85
Rate for Payer: Aetna Commercial	$933.17
Rate for Payer: Aetna Medicare Advantage	$736.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$626.20
Rate for Payer: Cigna Commercial	$1,227.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$540.25
Rate for Payer: Qualcare PPO/HMO/WC	$368.36
Rate for Payer: UnitedHealthcare Community & State	$59.18
Rate for Payer: Wellpoint Medicaid Managed Care	$65.08

KIT RENEGADE HI FLOW 35

Facility

$2,455.70

Service Code	HCPCS C1887
Hospital Charge Code	270630465
Hospital Revenue Code	278
Min. Negotiated Rate	$368.36
Max. Negotiated Rate	$594.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$540.25
Rate for Payer: Qualcare PPO/HMO/WC	$368.36

KIT RENEGADE HI FLOW 35 18-302

Facility

$2,455.70

Service Code	HCPCS C1887
Hospital Charge Code	270630465C
Hospital Revenue Code	278
Min. Negotiated Rate	$59.18
Max. Negotiated Rate	$1,227.85
Rate for Payer: Aetna Commercial	$933.17
Rate for Payer: Aetna Medicare Advantage	$736.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$626.20
Rate for Payer: Cigna Commercial	$1,227.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$540.25
Rate for Payer: Qualcare PPO/HMO/WC	$368.36
Rate for Payer: UnitedHealthcare Community & State	$59.18
Rate for Payer: Wellpoint Medicaid Managed Care	$65.08

KIT RENEGADE HI FLOW 35 18-302

Facility

$2,455.70

Service Code	HCPCS C1887
Hospital Charge Code	270630465C
Hospital Revenue Code	278
Min. Negotiated Rate	$368.36
Max. Negotiated Rate	$594.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$540.25
Rate for Payer: Qualcare PPO/HMO/WC	$368.36

KIT RENEGADE HI FLOW 35 18-302

Facility

$2,995.00

Hospital Charge Code	270630465V
Hospital Revenue Code	278
Min. Negotiated Rate	$72.18
Max. Negotiated Rate	$1,497.50
Rate for Payer: Aetna Commercial	$1,138.10
Rate for Payer: Aetna Medicare Advantage	$898.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$763.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$763.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$599.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$763.73
Rate for Payer: Cigna Commercial	$1,497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$724.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$658.90
Rate for Payer: Qualcare PPO/HMO/WC	$449.25
Rate for Payer: UnitedHealthcare Community & State	$72.18
Rate for Payer: Wellpoint Medicaid Managed Care	$79.37

KIT RENEGADE HI FLOW 35 18-302

Facility

$2,995.00

Hospital Charge Code	270630465V
Hospital Revenue Code	278
Min. Negotiated Rate	$449.25
Max. Negotiated Rate	$724.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$599.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$724.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$658.90
Rate for Payer: Qualcare PPO/HMO/WC	$449.25

Know your out-of-pocket cost for care.

All Charges