Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KNIFE ACL GRAFT 10mm

Facility

$603.50

Hospital Charge Code	270657638
Hospital Revenue Code	272
Min. Negotiated Rate	$14.54
Max. Negotiated Rate	$301.75
Rate for Payer: Aetna Commercial	$229.33
Rate for Payer: Aetna Medicare Advantage	$181.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.89
Rate for Payer: Cigna Commercial	$301.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.05
Rate for Payer: Oxford Commercial	$120.70
Rate for Payer: Qualcare PPO/HMO/WC	$90.53
Rate for Payer: UnitedHealthcare Commercial	$120.70
Rate for Payer: UnitedHealthcare Community & State	$14.54
Rate for Payer: Wellpoint Medicaid Managed Care	$15.99

KNIFE ACL GRAFT 10mm

Facility

$603.50

Hospital Charge Code	270657638
Hospital Revenue Code	272
Min. Negotiated Rate	$90.53
Max. Negotiated Rate	$90.53
Rate for Payer: Qualcare PPO/HMO/WC	$90.53

KNIFE ACL GRAFT 10MM

Facility

$775.00

Hospital Charge Code	270664041
Hospital Revenue Code	270
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.50
Rate for Payer: Oxford Commercial	$155.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Commercial	$155.00
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

KNIFE ACL GRAFT 10MM

Facility

$775.00

Hospital Charge Code	270664041
Hospital Revenue Code	270
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$116.25
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

KNIFE ACL GRAFT 9mm

Facility

$603.50

Hospital Charge Code	270657630
Hospital Revenue Code	272
Min. Negotiated Rate	$90.53
Max. Negotiated Rate	$90.53
Rate for Payer: Qualcare PPO/HMO/WC	$90.53

KNIFE ACL GRAFT 9mm

Facility

$603.50

Hospital Charge Code	270657630
Hospital Revenue Code	272
Min. Negotiated Rate	$14.54
Max. Negotiated Rate	$301.75
Rate for Payer: Aetna Commercial	$229.33
Rate for Payer: Aetna Medicare Advantage	$181.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.89
Rate for Payer: Cigna Commercial	$301.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.05
Rate for Payer: Oxford Commercial	$120.70
Rate for Payer: Qualcare PPO/HMO/WC	$90.53
Rate for Payer: UnitedHealthcare Commercial	$120.70
Rate for Payer: UnitedHealthcare Community & State	$14.54
Rate for Payer: Wellpoint Medicaid Managed Care	$15.99

KNIFE ACL GRAFT 9MM

Facility

$873.00

Hospital Charge Code	270645584
Hospital Revenue Code	272
Min. Negotiated Rate	$21.04
Max. Negotiated Rate	$436.50
Rate for Payer: Aetna Commercial	$331.74
Rate for Payer: Aetna Medicare Advantage	$261.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$222.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$222.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$222.62
Rate for Payer: Cigna Commercial	$436.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.90
Rate for Payer: Oxford Commercial	$174.60
Rate for Payer: Qualcare PPO/HMO/WC	$130.95
Rate for Payer: UnitedHealthcare Commercial	$174.60
Rate for Payer: UnitedHealthcare Community & State	$21.04
Rate for Payer: Wellpoint Medicaid Managed Care	$23.13

KNIFE ACL GRAFT 9MM

Facility

$873.00

Hospital Charge Code	270645584
Hospital Revenue Code	272
Min. Negotiated Rate	$130.95
Max. Negotiated Rate	$130.95
Rate for Payer: Qualcare PPO/HMO/WC	$130.95

KNIFE ALC CRESCENT 990001

Facility

$287.25

Hospital Charge Code	270600189
Hospital Revenue Code	272
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$143.62
Rate for Payer: Aetna Commercial	$109.16
Rate for Payer: Aetna Medicare Advantage	$86.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.25
Rate for Payer: Cigna Commercial	$143.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.17
Rate for Payer: Oxford Commercial	$57.45
Rate for Payer: Qualcare PPO/HMO/WC	$43.09
Rate for Payer: UnitedHealthcare Commercial	$57.45
Rate for Payer: UnitedHealthcare Community & State	$6.92
Rate for Payer: Wellpoint Medicaid Managed Care	$7.61

KNIFE ALC CRESCENT 990001

Facility

$287.25

Hospital Charge Code	270600189
Hospital Revenue Code	272
Min. Negotiated Rate	$43.09
Max. Negotiated Rate	$43.09
Rate for Payer: Qualcare PPO/HMO/WC	$43.09

KNIFE ALC SLIT 2.75MM 992701

Facility

$261.65

Hospital Charge Code	270600238
Hospital Revenue Code	272
Min. Negotiated Rate	$6.31
Max. Negotiated Rate	$130.82
Rate for Payer: Aetna Commercial	$99.43
Rate for Payer: Aetna Medicare Advantage	$78.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.72
Rate for Payer: Cigna Commercial	$130.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.50
Rate for Payer: Oxford Commercial	$52.33
Rate for Payer: Qualcare PPO/HMO/WC	$39.25
Rate for Payer: UnitedHealthcare Commercial	$52.33
Rate for Payer: UnitedHealthcare Community & State	$6.31
Rate for Payer: Wellpoint Medicaid Managed Care	$6.93

KNIFE ALC SLIT 2.75MM 992701

Facility

$261.65

Hospital Charge Code	270600238
Hospital Revenue Code	272
Min. Negotiated Rate	$39.25
Max. Negotiated Rate	$39.25
Rate for Payer: Qualcare PPO/HMO/WC	$39.25

KNIFE ALC SLIT 3.2 MM 993261

Facility

$256.00

Hospital Charge Code	270061009
Hospital Revenue Code	272
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

KNIFE ALC SLIT 3.2 MM 993261

Facility

$256.00

Hospital Charge Code	270061009
Hospital Revenue Code	272
Min. Negotiated Rate	$6.17
Max. Negotiated Rate	$128.00
Rate for Payer: Aetna Commercial	$97.28
Rate for Payer: Aetna Medicare Advantage	$76.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.28
Rate for Payer: Cigna Commercial	$128.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.80
Rate for Payer: Oxford Commercial	$51.20
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$51.20
Rate for Payer: UnitedHealthcare Community & State	$6.17
Rate for Payer: Wellpoint Medicaid Managed Care	$6.78

KNIFE AMP LISTON 13 IN

Facility

$776.65

Hospital Charge Code	270689511
Hospital Revenue Code	272
Min. Negotiated Rate	$18.72
Max. Negotiated Rate	$388.32
Rate for Payer: Aetna Commercial	$295.13
Rate for Payer: Aetna Medicare Advantage	$233.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.05
Rate for Payer: Cigna Commercial	$388.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.00
Rate for Payer: Oxford Commercial	$155.33
Rate for Payer: Qualcare PPO/HMO/WC	$116.50
Rate for Payer: UnitedHealthcare Commercial	$155.33
Rate for Payer: UnitedHealthcare Community & State	$18.72
Rate for Payer: Wellpoint Medicaid Managed Care	$20.58

KNIFE AMP LISTON 13 IN

Facility

$776.65

Hospital Charge Code	270689511
Hospital Revenue Code	272
Min. Negotiated Rate	$116.50
Max. Negotiated Rate	$116.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.50

KNIFE ARTHRO 3MM 700071113***

Facility

$209.00

Hospital Charge Code	1606144
Hospital Revenue Code	272
Min. Negotiated Rate	$5.04
Max. Negotiated Rate	$104.50
Rate for Payer: Aetna Commercial	$79.42
Rate for Payer: Aetna Medicare Advantage	$62.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.30
Rate for Payer: Cigna Commercial	$104.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.70
Rate for Payer: Oxford Commercial	$41.80
Rate for Payer: Qualcare PPO/HMO/WC	$31.35
Rate for Payer: UnitedHealthcare Commercial	$41.80
Rate for Payer: UnitedHealthcare Community & State	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$5.54

KNIFE ARTHRO 3MM 700071113***

Facility

$209.00

Hospital Charge Code	1606144
Hospital Revenue Code	272
Min. Negotiated Rate	$31.35
Max. Negotiated Rate	$31.35
Rate for Payer: Qualcare PPO/HMO/WC	$31.35

KNIFE ARTHRO BANANA LT 3MM****

Facility

$209.00

Hospital Charge Code	1606201
Hospital Revenue Code	272
Min. Negotiated Rate	$31.35
Max. Negotiated Rate	$31.35
Rate for Payer: Qualcare PPO/HMO/WC	$31.35

KNIFE ARTHRO BANANA LT 3MM****

Facility

$209.00

Hospital Charge Code	1606201
Hospital Revenue Code	272
Min. Negotiated Rate	$5.04
Max. Negotiated Rate	$104.50
Rate for Payer: Aetna Commercial	$79.42
Rate for Payer: Aetna Medicare Advantage	$62.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.30
Rate for Payer: Cigna Commercial	$104.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.70
Rate for Payer: Oxford Commercial	$41.80
Rate for Payer: Qualcare PPO/HMO/WC	$31.35
Rate for Payer: UnitedHealthcare Commercial	$41.80
Rate for Payer: UnitedHealthcare Community & State	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$5.54

KNIFE ARTHROSCOPY SMALL JOINT

Facility

$504.00

Hospital Charge Code	270335280
Hospital Revenue Code	272
Min. Negotiated Rate	$75.60
Max. Negotiated Rate	$75.60
Rate for Payer: Qualcare PPO/HMO/WC	$75.60

KNIFE ARTHROSCOPY SMALL JOINT

Facility

$504.00

Hospital Charge Code	270335280
Hospital Revenue Code	272
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$252.00
Rate for Payer: Aetna Commercial	$191.52
Rate for Payer: Aetna Medicare Advantage	$151.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.52
Rate for Payer: Cigna Commercial	$252.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.20
Rate for Payer: Oxford Commercial	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$75.60
Rate for Payer: UnitedHealthcare Commercial	$100.80
Rate for Payer: UnitedHealthcare Community & State	$12.15
Rate for Payer: Wellpoint Medicaid Managed Care	$13.36

KNIFE BLADE SPECIAL 66-60 STER

Facility

$957.80

Hospital Charge Code	270655874
Hospital Revenue Code	271
Min. Negotiated Rate	$23.08
Max. Negotiated Rate	$478.90
Rate for Payer: Aetna Commercial	$363.96
Rate for Payer: Aetna Medicare Advantage	$287.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.24
Rate for Payer: Cigna Commercial	$478.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.34
Rate for Payer: Oxford Commercial	$191.56
Rate for Payer: Qualcare PPO/HMO/WC	$143.67
Rate for Payer: UnitedHealthcare Commercial	$191.56
Rate for Payer: UnitedHealthcare Community & State	$23.08
Rate for Payer: Wellpoint Medicaid Managed Care	$25.38

KNIFE BLADE SPECIAL 66-60 STER

Facility

$957.80

Hospital Charge Code	270655874
Hospital Revenue Code	271
Min. Negotiated Rate	$143.67
Max. Negotiated Rate	$143.67
Rate for Payer: Qualcare PPO/HMO/WC	$143.67

KNIFE BZ STAINLESS STEEL DOM

Facility

$3.13

Hospital Charge Code	270602949
Hospital Revenue Code	272
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$0.47
Rate for Payer: Qualcare PPO/HMO/WC	$0.47

Know your out-of-pocket cost for care.

All Charges