Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT SGL TOE IMPLANT 70 B

Facility

$2,681.65

Hospital Charge Code	270611426
Hospital Revenue Code	278
Min. Negotiated Rate	$402.25
Max. Negotiated Rate	$648.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$536.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$589.96
Rate for Payer: Qualcare PPO/HMO/WC	$402.25

KIT SGL TOE IMPLANT 70 B

Facility

$2,681.65

Hospital Charge Code	270611426
Hospital Revenue Code	278
Min. Negotiated Rate	$64.63
Max. Negotiated Rate	$1,340.83
Rate for Payer: Aetna Commercial	$1,019.03
Rate for Payer: Aetna Medicare Advantage	$804.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$683.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$683.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$536.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$683.82
Rate for Payer: Cigna Commercial	$1,340.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$589.96
Rate for Payer: Qualcare PPO/HMO/WC	$402.25
Rate for Payer: UnitedHealthcare Community & State	$64.63
Rate for Payer: Wellpoint Medicaid Managed Care	$71.06

KIT SHOULDER STABILIZATION

Facility

$333.38

Hospital Charge Code	270652581
Hospital Revenue Code	270
Min. Negotiated Rate	$50.01
Max. Negotiated Rate	$50.01
Rate for Payer: Qualcare PPO/HMO/WC	$50.01

KIT SHOULDER STABILIZATION

Facility

$333.38

Hospital Charge Code	270652581
Hospital Revenue Code	270
Min. Negotiated Rate	$8.03
Max. Negotiated Rate	$166.69
Rate for Payer: Aetna Commercial	$126.68
Rate for Payer: Aetna Medicare Advantage	$100.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.01
Rate for Payer: Cigna Commercial	$166.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.01
Rate for Payer: Oxford Commercial	$66.68
Rate for Payer: Qualcare PPO/HMO/WC	$50.01
Rate for Payer: UnitedHealthcare Commercial	$66.68
Rate for Payer: UnitedHealthcare Community & State	$8.03
Rate for Payer: Wellpoint Medicaid Managed Care	$8.83

KIT SHOULDER SUSPENSION ******

Facility

$135.00

Hospital Charge Code	1606623
Hospital Revenue Code	272
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$20.25
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

KIT SHOULDER SUSPENSION ******

Facility

$135.00

Hospital Charge Code	1606623
Hospital Revenue Code	272
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.50
Rate for Payer: Oxford Commercial	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Commercial	$27.00
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

KIT SHOULDER SUSPENSION 3583

Facility

$415.63

Hospital Charge Code	270605461
Hospital Revenue Code	272
Min. Negotiated Rate	$62.34
Max. Negotiated Rate	$62.34
Rate for Payer: Qualcare PPO/HMO/WC	$62.34

KIT SHOULDER SUSPENSION 3583

Facility

$415.63

Hospital Charge Code	270605461
Hospital Revenue Code	272
Min. Negotiated Rate	$10.02
Max. Negotiated Rate	$207.81
Rate for Payer: Aetna Commercial	$157.94
Rate for Payer: Aetna Medicare Advantage	$124.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.99
Rate for Payer: Cigna Commercial	$207.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.69
Rate for Payer: Oxford Commercial	$83.13
Rate for Payer: Qualcare PPO/HMO/WC	$62.34
Rate for Payer: UnitedHealthcare Commercial	$83.13
Rate for Payer: UnitedHealthcare Community & State	$10.02
Rate for Payer: Wellpoint Medicaid Managed Care	$11.01

KIT SKINTE REGENERATE HARVEST

Facility

$28,625.00

Hospital Charge Code	270690741
Hospital Revenue Code	272
Min. Negotiated Rate	$689.86
Max. Negotiated Rate	$14,312.50
Rate for Payer: Aetna Commercial	$10,877.50
Rate for Payer: Aetna Medicare Advantage	$8,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,299.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,299.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,299.38
Rate for Payer: Cigna Commercial	$14,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,587.50
Rate for Payer: Oxford Commercial	$5,725.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,293.75
Rate for Payer: UnitedHealthcare Commercial	$5,725.00
Rate for Payer: UnitedHealthcare Community & State	$689.86
Rate for Payer: Wellpoint Medicaid Managed Care	$758.56

KIT SKINTE REGENERATE HARVEST

Facility

$300.00

Service Code	HCPCS Q4200
Hospital Charge Code	270685478
Hospital Revenue Code	636
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

KIT SKINTE REGENERATE HARVEST

Facility

$300.00

Service Code	HCPCS Q4200
Hospital Charge Code	270685478
Hospital Revenue Code	636
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$533.66
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$533.66
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

KIT SKINTE REGENERATE HARVEST

Facility

$28,625.00

Hospital Charge Code	270690741
Hospital Revenue Code	272
Min. Negotiated Rate	$4,293.75
Max. Negotiated Rate	$4,293.75
Rate for Payer: Qualcare PPO/HMO/WC	$4,293.75

KIT SLING TRIANGLE INFLUENCE

Facility

$3,752.00

Hospital Charge Code	270610604
Hospital Revenue Code	270
Min. Negotiated Rate	$562.80
Max. Negotiated Rate	$562.80
Rate for Payer: Qualcare PPO/HMO/WC	$562.80

KIT SLING TRIANGLE INFLUENCE

Facility

$3,752.00

Hospital Charge Code	270610604
Hospital Revenue Code	270
Min. Negotiated Rate	$90.42
Max. Negotiated Rate	$1,876.00
Rate for Payer: Aetna Commercial	$1,425.76
Rate for Payer: Aetna Medicare Advantage	$1,125.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.76
Rate for Payer: Cigna Commercial	$1,876.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.60
Rate for Payer: Oxford Commercial	$750.40
Rate for Payer: Qualcare PPO/HMO/WC	$562.80
Rate for Payer: UnitedHealthcare Commercial	$750.40
Rate for Payer: UnitedHealthcare Community & State	$90.42
Rate for Payer: Wellpoint Medicaid Managed Care	$99.43

KIT SM FEM ART CATH UM04018

Facility

$123.25

Hospital Charge Code	270617332
Hospital Revenue Code	272
Min. Negotiated Rate	$18.49
Max. Negotiated Rate	$18.49
Rate for Payer: Qualcare PPO/HMO/WC	$18.49

KIT SM FEM ART CATH UM04018

Facility

$123.25

Hospital Charge Code	270617332
Hospital Revenue Code	272
Min. Negotiated Rate	$2.97
Max. Negotiated Rate	$61.62
Rate for Payer: Aetna Commercial	$46.84
Rate for Payer: Aetna Medicare Advantage	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.43
Rate for Payer: Cigna Commercial	$61.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.98
Rate for Payer: Oxford Commercial	$24.65
Rate for Payer: Qualcare PPO/HMO/WC	$18.49
Rate for Payer: UnitedHealthcare Commercial	$24.65
Rate for Payer: UnitedHealthcare Community & State	$2.97
Rate for Payer: Wellpoint Medicaid Managed Care	$3.27

KIT SMOKE EVACUATION PENCIL

Facility

$139.30

Hospital Charge Code	270677420
Hospital Revenue Code	272
Min. Negotiated Rate	$3.36
Max. Negotiated Rate	$69.65
Rate for Payer: Aetna Commercial	$52.93
Rate for Payer: Aetna Medicare Advantage	$41.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.52
Rate for Payer: Cigna Commercial	$69.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.79
Rate for Payer: Oxford Commercial	$27.86
Rate for Payer: Qualcare PPO/HMO/WC	$20.89
Rate for Payer: UnitedHealthcare Commercial	$27.86
Rate for Payer: UnitedHealthcare Community & State	$3.36
Rate for Payer: Wellpoint Medicaid Managed Care	$3.69

KIT SMOKE EVACUATION PENCIL

Facility

$139.30

Hospital Charge Code	270677420
Hospital Revenue Code	272
Min. Negotiated Rate	$20.89
Max. Negotiated Rate	$20.89
Rate for Payer: Qualcare PPO/HMO/WC	$20.89

KIT SONIC ANCHOR 2.5x10mm

Facility

$2,544.00

Service Code	HCPCS C1713
Hospital Charge Code	270680908
Hospital Revenue Code	278
Min. Negotiated Rate	$381.60
Max. Negotiated Rate	$615.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$508.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$615.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$559.68
Rate for Payer: Qualcare PPO/HMO/WC	$381.60

KIT SONIC ANCHOR 2.5x10mm

Facility

$2,544.00

Service Code	HCPCS C1713
Hospital Charge Code	270680908
Hospital Revenue Code	278
Min. Negotiated Rate	$61.31
Max. Negotiated Rate	$1,272.00
Rate for Payer: Aetna Commercial	$966.72
Rate for Payer: Aetna Medicare Advantage	$763.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$648.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$648.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$508.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$648.72
Rate for Payer: Cigna Commercial	$1,272.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$615.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$559.68
Rate for Payer: Qualcare PPO/HMO/WC	$381.60
Rate for Payer: UnitedHealthcare Community & State	$61.31
Rate for Payer: Wellpoint Medicaid Managed Care	$67.42

KIT SPEED ARC IMPLANT 9BRIDGE

Facility

$7,000.00

Hospital Charge Code	270672146
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

KIT SPEED ARC IMPLANT 9BRIDGE

Facility

$7,000.00

Hospital Charge Code	270672146
Hospital Revenue Code	278
Min. Negotiated Rate	$168.70
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,660.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00
Rate for Payer: UnitedHealthcare Community & State	$168.70
Rate for Payer: Wellpoint Medicaid Managed Care	$185.50

KIT SPINE MAZOR X DISP

Facility

$7,500.00

Hospital Charge Code	270698617
Hospital Revenue Code	272
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

KIT SPINE MAZOR X DISP

Facility

$7,500.00

Hospital Charge Code	270698617
Hospital Revenue Code	272
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,250.00
Rate for Payer: Oxford Commercial	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Commercial	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$180.75
Rate for Payer: Wellpoint Medicaid Managed Care	$198.75

KIT SPRAY ACCESSORY 934500

Facility

$208.00

Hospital Charge Code	270635992
Hospital Revenue Code	272
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$31.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.20

Know your out-of-pocket cost for care.

All Charges