Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT SUTURE

Facility

$45.75

Hospital Charge Code	270681104S
Hospital Revenue Code	272
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$6.86
Rate for Payer: Qualcare PPO/HMO/WC	$6.86

KIT SUTURE

Facility

$45.75

Hospital Charge Code	270681104
Hospital Revenue Code	272
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$6.86
Rate for Payer: Qualcare PPO/HMO/WC	$6.86

KIT SUTURE

Facility

$45.75

Hospital Charge Code	270681104S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$22.88
Rate for Payer: Aetna Commercial	$17.39
Rate for Payer: Aetna Medicare Advantage	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.67
Rate for Payer: Cigna Commercial	$22.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.72
Rate for Payer: Oxford Commercial	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.86
Rate for Payer: UnitedHealthcare Commercial	$9.15
Rate for Payer: UnitedHealthcare Community & State	$1.10
Rate for Payer: Wellpoint Medicaid Managed Care	$1.21

KIT SUTURE

Facility

$45.75

Hospital Charge Code	270681104N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$22.88
Rate for Payer: Aetna Commercial	$17.39
Rate for Payer: Aetna Medicare Advantage	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.67
Rate for Payer: Cigna Commercial	$22.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.72
Rate for Payer: Oxford Commercial	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.86
Rate for Payer: UnitedHealthcare Commercial	$9.15
Rate for Payer: UnitedHealthcare Community & State	$1.10
Rate for Payer: Wellpoint Medicaid Managed Care	$1.21

KIT SUTURTAK CURVED

Facility

$975.00

Hospital Charge Code	270677688
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

KIT SUTURTAK CURVED

Facility

$975.00

Hospital Charge Code	270677688
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

KIT SWNSN 2ND METATRSL 426BSML

Facility

$8,000.00

Hospital Charge Code	270619432
Hospital Revenue Code	278
Min. Negotiated Rate	$192.80
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$192.80
Rate for Payer: Wellpoint Medicaid Managed Care	$212.00

KIT SWNSN 2ND METATRSL 426BSML

Facility

$8,000.00

Hospital Charge Code	270619432
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

KIT SWNSN TITANUM TOE 2483KITA

Facility

$6,919.25

Hospital Charge Code	270611922
Hospital Revenue Code	278
Min. Negotiated Rate	$1,037.89
Max. Negotiated Rate	$1,674.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,383.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,674.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,522.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,037.89

KIT SWNSN TITANUM TOE 2483KITA

Facility

$6,919.25

Hospital Charge Code	270611922
Hospital Revenue Code	278
Min. Negotiated Rate	$166.75
Max. Negotiated Rate	$3,459.62
Rate for Payer: Aetna Commercial	$2,629.32
Rate for Payer: Aetna Medicare Advantage	$2,075.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,764.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,764.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,383.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,764.41
Rate for Payer: Cigna Commercial	$3,459.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,674.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,522.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,037.89
Rate for Payer: UnitedHealthcare Community & State	$166.75
Rate for Payer: Wellpoint Medicaid Managed Care	$183.36

KIT SYNDEX WITH CONSTRICTOR

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270700499
Hospital Revenue Code	278
Min. Negotiated Rate	$289.20
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$4,560.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,640.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Community & State	$289.20
Rate for Payer: Wellpoint Medicaid Managed Care	$318.00

KIT SYNDEX WITH CONSTRICTOR

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270700499
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,640.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

KIT TESIO REPAIR BLUE MC11V

Facility

$100.85

Hospital Charge Code	270608511
Hospital Revenue Code	272
Min. Negotiated Rate	$2.43
Max. Negotiated Rate	$50.42
Rate for Payer: Aetna Commercial	$38.32
Rate for Payer: Aetna Medicare Advantage	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.72
Rate for Payer: Cigna Commercial	$50.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Oxford Commercial	$20.17
Rate for Payer: Qualcare PPO/HMO/WC	$15.13
Rate for Payer: UnitedHealthcare Commercial	$20.17
Rate for Payer: UnitedHealthcare Community & State	$2.43
Rate for Payer: Wellpoint Medicaid Managed Care	$2.67

KIT TESIO REPAIR BLUE MC11V

Facility

$100.85

Hospital Charge Code	270608511
Hospital Revenue Code	272
Min. Negotiated Rate	$15.13
Max. Negotiated Rate	$15.13
Rate for Payer: Qualcare PPO/HMO/WC	$15.13

KIT TESIO REPAIR RED MC11A

Facility

$100.85

Hospital Charge Code	270608510
Hospital Revenue Code	272
Min. Negotiated Rate	$15.13
Max. Negotiated Rate	$15.13
Rate for Payer: Qualcare PPO/HMO/WC	$15.13

KIT TESIO REPAIR RED MC11A

Facility

$100.85

Hospital Charge Code	270608510
Hospital Revenue Code	272
Min. Negotiated Rate	$2.43
Max. Negotiated Rate	$50.42
Rate for Payer: Aetna Commercial	$38.32
Rate for Payer: Aetna Medicare Advantage	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.72
Rate for Payer: Cigna Commercial	$50.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Oxford Commercial	$20.17
Rate for Payer: Qualcare PPO/HMO/WC	$15.13
Rate for Payer: UnitedHealthcare Commercial	$20.17
Rate for Payer: UnitedHealthcare Community & State	$2.43
Rate for Payer: Wellpoint Medicaid Managed Care	$2.67

KIT TESSYS ACCESS #2

Facility

$3,360.00

Hospital Charge Code	270647009
Hospital Revenue Code	272
Min. Negotiated Rate	$80.98
Max. Negotiated Rate	$1,680.00
Rate for Payer: Aetna Commercial	$1,276.80
Rate for Payer: Aetna Medicare Advantage	$1,008.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$856.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$856.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$856.80
Rate for Payer: Cigna Commercial	$1,680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,008.00
Rate for Payer: Oxford Commercial	$672.00
Rate for Payer: Qualcare PPO/HMO/WC	$504.00
Rate for Payer: UnitedHealthcare Commercial	$672.00
Rate for Payer: UnitedHealthcare Community & State	$80.98
Rate for Payer: Wellpoint Medicaid Managed Care	$89.04

KIT TESSYS ACCESS #2

Facility

$3,360.00

Hospital Charge Code	270647009
Hospital Revenue Code	272
Min. Negotiated Rate	$504.00
Max. Negotiated Rate	$504.00
Rate for Payer: Qualcare PPO/HMO/WC	$504.00

KIT THERAPEUT PHERESIS 11010**

Facility

$1,164.00

Hospital Charge Code	270600822
Hospital Revenue Code	270
Min. Negotiated Rate	$28.05
Max. Negotiated Rate	$582.00
Rate for Payer: Aetna Commercial	$442.32
Rate for Payer: Aetna Medicare Advantage	$349.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$296.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$296.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$296.82
Rate for Payer: Cigna Commercial	$582.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$349.20
Rate for Payer: Oxford Commercial	$232.80
Rate for Payer: Qualcare PPO/HMO/WC	$174.60
Rate for Payer: UnitedHealthcare Commercial	$232.80
Rate for Payer: UnitedHealthcare Community & State	$28.05
Rate for Payer: Wellpoint Medicaid Managed Care	$30.85

KIT THERAPEUT PHERESIS 11010**

Facility

$1,164.00

Hospital Charge Code	270600822
Hospital Revenue Code	270
Min. Negotiated Rate	$174.60
Max. Negotiated Rate	$174.60
Rate for Payer: Qualcare PPO/HMO/WC	$174.60

KIT THERAPEUT PHERESIS 9164***

Facility

$805.00

Hospital Charge Code	270600823
Hospital Revenue Code	270
Min. Negotiated Rate	$120.75
Max. Negotiated Rate	$120.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.75

KIT THERAPEUT PHERESIS 9164***

Facility

$805.00

Hospital Charge Code	270600823
Hospital Revenue Code	270
Min. Negotiated Rate	$19.40
Max. Negotiated Rate	$402.50
Rate for Payer: Aetna Commercial	$305.90
Rate for Payer: Aetna Medicare Advantage	$241.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.28
Rate for Payer: Cigna Commercial	$402.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.50
Rate for Payer: Oxford Commercial	$161.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.75
Rate for Payer: UnitedHealthcare Commercial	$161.00
Rate for Payer: UnitedHealthcare Community & State	$19.40
Rate for Payer: Wellpoint Medicaid Managed Care	$21.33

KIT TIBIA CR SZ 2

Facility

$1,750.00

Hospital Charge Code	270700540
Hospital Revenue Code	272
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$525.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

KIT TIBIA CR SZ 2

Facility

$1,750.00

Hospital Charge Code	270700540
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

KIT TIGHTROPE 8.5 MM FLIPCUT I

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270682535
Hospital Revenue Code	278
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$840.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$764.50
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

Know your out-of-pocket cost for care.

All Charges