Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT RIGHT HEART (CUSTOM)

Facility

$112.50

Hospital Charge Code	2709002684
Hospital Revenue Code	272
Min. Negotiated Rate	$2.71
Max. Negotiated Rate	$56.25
Rate for Payer: Aetna Commercial	$42.75
Rate for Payer: Aetna Medicare Advantage	$33.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.69
Rate for Payer: Cigna Commercial	$56.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.75
Rate for Payer: Oxford Commercial	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.88
Rate for Payer: UnitedHealthcare Commercial	$22.50
Rate for Payer: UnitedHealthcare Community & State	$2.71
Rate for Payer: Wellpoint Medicaid Managed Care	$2.98

KIT RIOLCENT WILSON FRAME 5322

Facility

$133.79

Hospital Charge Code	270627620
Hospital Revenue Code	272
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$66.89
Rate for Payer: Aetna Commercial	$50.84
Rate for Payer: Aetna Medicare Advantage	$40.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.12
Rate for Payer: Cigna Commercial	$66.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.14
Rate for Payer: Oxford Commercial	$26.76
Rate for Payer: Qualcare PPO/HMO/WC	$20.07
Rate for Payer: UnitedHealthcare Commercial	$26.76
Rate for Payer: UnitedHealthcare Community & State	$3.22
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

KIT RIOLCENT WILSON FRAME 5322

Facility

$133.79

Hospital Charge Code	270627620
Hospital Revenue Code	272
Min. Negotiated Rate	$20.07
Max. Negotiated Rate	$20.07
Rate for Payer: Qualcare PPO/HMO/WC	$20.07

KIT SAFESHEATH II 7FR

Facility

$292.50

Hospital Charge Code	270676908
Hospital Revenue Code	272
Min. Negotiated Rate	$43.88
Max. Negotiated Rate	$43.88
Rate for Payer: Qualcare PPO/HMO/WC	$43.88

KIT SAFESHEATH II 7FR

Facility

$292.50

Hospital Charge Code	270676908S
Hospital Revenue Code	272
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$146.25
Rate for Payer: Aetna Commercial	$111.15
Rate for Payer: Aetna Medicare Advantage	$87.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.59
Rate for Payer: Cigna Commercial	$146.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.75
Rate for Payer: Oxford Commercial	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.88
Rate for Payer: UnitedHealthcare Commercial	$58.50
Rate for Payer: UnitedHealthcare Community & State	$7.05
Rate for Payer: Wellpoint Medicaid Managed Care	$7.75

KIT SAFESHEATH II 7FR

Facility

$292.50

Hospital Charge Code	270676908
Hospital Revenue Code	272
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$146.25
Rate for Payer: Aetna Commercial	$111.15
Rate for Payer: Aetna Medicare Advantage	$87.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.59
Rate for Payer: Cigna Commercial	$146.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.75
Rate for Payer: Oxford Commercial	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.88
Rate for Payer: UnitedHealthcare Commercial	$58.50
Rate for Payer: UnitedHealthcare Community & State	$7.05
Rate for Payer: Wellpoint Medicaid Managed Care	$7.75

KIT SAFESHEATH II 7FR

Facility

$292.50

Hospital Charge Code	270676908S
Hospital Revenue Code	272
Min. Negotiated Rate	$43.88
Max. Negotiated Rate	$43.88
Rate for Payer: Qualcare PPO/HMO/WC	$43.88

KIT SAFESHEATH II 9FR

Facility

$292.50

Hospital Charge Code	270676907
Hospital Revenue Code	272
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$146.25
Rate for Payer: Aetna Commercial	$111.15
Rate for Payer: Aetna Medicare Advantage	$87.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.59
Rate for Payer: Cigna Commercial	$146.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.75
Rate for Payer: Oxford Commercial	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.88
Rate for Payer: UnitedHealthcare Commercial	$58.50
Rate for Payer: UnitedHealthcare Community & State	$7.05
Rate for Payer: Wellpoint Medicaid Managed Care	$7.75

KIT SAFESHEATH II 9FR

Facility

$292.50

Hospital Charge Code	270676907
Hospital Revenue Code	272
Min. Negotiated Rate	$43.88
Max. Negotiated Rate	$43.88
Rate for Payer: Qualcare PPO/HMO/WC	$43.88

KIT SCP FOOT AND ANKLE

Facility

$15,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270688551
Hospital Revenue Code	278
Min. Negotiated Rate	$383.19
Max. Negotiated Rate	$7,950.00
Rate for Payer: Aetna Commercial	$6,042.00
Rate for Payer: Aetna Medicare Advantage	$4,770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,054.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,054.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,054.50
Rate for Payer: Cigna Commercial	$7,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,847.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,498.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,385.00
Rate for Payer: UnitedHealthcare Community & State	$383.19
Rate for Payer: Wellpoint Medicaid Managed Care	$421.35

KIT SCP FOOT AND ANKLE

Facility

$15,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270688551
Hospital Revenue Code	278
Min. Negotiated Rate	$2,385.00
Max. Negotiated Rate	$3,847.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,847.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,498.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,385.00

KIT SCP FOOT & ANKLE

Facility

$10,000.00

Hospital Charge Code	270677705
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

KIT SCP FOOT & ANKLE

Facility

$10,000.00

Hospital Charge Code	270677705
Hospital Revenue Code	278
Min. Negotiated Rate	$241.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$241.00
Rate for Payer: Wellpoint Medicaid Managed Care	$265.00

KIT SCP KNEE

Facility

$20,375.00

Hospital Charge Code	270678971
Hospital Revenue Code	272
Min. Negotiated Rate	$491.04
Max. Negotiated Rate	$10,187.50
Rate for Payer: Aetna Commercial	$7,742.50
Rate for Payer: Aetna Medicare Advantage	$6,112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,195.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,195.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,195.62
Rate for Payer: Cigna Commercial	$10,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,112.50
Rate for Payer: Oxford Commercial	$4,075.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,056.25
Rate for Payer: UnitedHealthcare Commercial	$4,075.00
Rate for Payer: UnitedHealthcare Community & State	$491.04
Rate for Payer: Wellpoint Medicaid Managed Care	$539.94

KIT SCP KNEE

Facility

$20,375.00

Hospital Charge Code	270678971
Hospital Revenue Code	272
Min. Negotiated Rate	$3,056.25
Max. Negotiated Rate	$3,056.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,056.25

KIT SCREW LOCKING CAP 4.5X22MM

Facility

$601.60

Service Code	HCPCS C1713
Hospital Charge Code	270668812
Hospital Revenue Code	278
Min. Negotiated Rate	$90.24
Max. Negotiated Rate	$145.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.35
Rate for Payer: Qualcare PPO/HMO/WC	$90.24

KIT SCREW LOCKING CAP 4.5X22MM

Facility

$601.60

Service Code	HCPCS C1713
Hospital Charge Code	270668812
Hospital Revenue Code	278
Min. Negotiated Rate	$14.50
Max. Negotiated Rate	$300.80
Rate for Payer: Aetna Commercial	$228.61
Rate for Payer: Aetna Medicare Advantage	$180.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.41
Rate for Payer: Cigna Commercial	$300.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.35
Rate for Payer: Qualcare PPO/HMO/WC	$90.24
Rate for Payer: UnitedHealthcare Community & State	$14.50
Rate for Payer: Wellpoint Medicaid Managed Care	$15.94

KIT SDK BONE GRAFT 7510200

Facility

$17,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270629242
Hospital Revenue Code	278
Min. Negotiated Rate	$421.75
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$6,650.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Community & State	$421.75
Rate for Payer: Wellpoint Medicaid Managed Care	$463.75

KIT SDK BONE GRAFT 7510200

Facility

$17,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270629242
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

KIT SEPARATION PLATE 8001001A

Facility

$2,505.00

Hospital Charge Code	270633430
Hospital Revenue Code	272
Min. Negotiated Rate	$375.75
Max. Negotiated Rate	$375.75
Rate for Payer: Qualcare PPO/HMO/WC	$375.75

KIT SEPARATION PLATE 8001001A

Facility

$2,505.00

Hospital Charge Code	270633430
Hospital Revenue Code	272
Min. Negotiated Rate	$60.37
Max. Negotiated Rate	$1,252.50
Rate for Payer: Aetna Commercial	$951.90
Rate for Payer: Aetna Medicare Advantage	$751.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$638.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$638.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$638.77
Rate for Payer: Cigna Commercial	$1,252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$751.50
Rate for Payer: Oxford Commercial	$501.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.75
Rate for Payer: UnitedHealthcare Commercial	$501.00
Rate for Payer: UnitedHealthcare Community & State	$60.37
Rate for Payer: Wellpoint Medicaid Managed Care	$66.38

KIT SEPS W/5MM TROCAR SPSKT-01

Facility

$2,559.25

Hospital Charge Code	270614817
Hospital Revenue Code	272
Min. Negotiated Rate	$61.68
Max. Negotiated Rate	$1,279.62
Rate for Payer: Aetna Commercial	$972.51
Rate for Payer: Aetna Medicare Advantage	$767.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$652.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$652.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$652.61
Rate for Payer: Cigna Commercial	$1,279.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.77
Rate for Payer: Oxford Commercial	$511.85
Rate for Payer: Qualcare PPO/HMO/WC	$383.89
Rate for Payer: UnitedHealthcare Commercial	$511.85
Rate for Payer: UnitedHealthcare Community & State	$61.68
Rate for Payer: Wellpoint Medicaid Managed Care	$67.82

KIT SEPS W/5MM TROCAR SPSKT-01

Facility

$2,559.25

Hospital Charge Code	270614817
Hospital Revenue Code	272
Min. Negotiated Rate	$383.89
Max. Negotiated Rate	$383.89
Rate for Payer: Qualcare PPO/HMO/WC	$383.89

KIT SERVICE PACEMAKER 5873C

Facility

$346.45

Hospital Charge Code	270608505
Hospital Revenue Code	270
Min. Negotiated Rate	$51.97
Max. Negotiated Rate	$51.97
Rate for Payer: Qualcare PPO/HMO/WC	$51.97

KIT SERVICE PACEMAKER 5873C

Facility

$346.45

Hospital Charge Code	270608505
Hospital Revenue Code	270
Min. Negotiated Rate	$8.35
Max. Negotiated Rate	$173.22
Rate for Payer: Aetna Commercial	$131.65
Rate for Payer: Aetna Medicare Advantage	$103.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.34
Rate for Payer: Cigna Commercial	$173.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.94
Rate for Payer: Oxford Commercial	$69.29
Rate for Payer: Qualcare PPO/HMO/WC	$51.97
Rate for Payer: UnitedHealthcare Commercial	$69.29
Rate for Payer: UnitedHealthcare Community & State	$8.35
Rate for Payer: Wellpoint Medicaid Managed Care	$9.18

Know your out-of-pocket cost for care.

All Charges