Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LIFEPORT X-PORT ISP

Facility

$1,250.00

Hospital Charge Code	270660381
Hospital Revenue Code	270
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

LIF GUIDEWIRE

Facility

$383.75

Hospital Charge Code	270702576
Hospital Revenue Code	278
Min. Negotiated Rate	$57.56
Max. Negotiated Rate	$92.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.42
Rate for Payer: Qualcare PPO/HMO/WC	$57.56

LIF GUIDEWIRE

Facility

$383.75

Hospital Charge Code	270702576
Hospital Revenue Code	278
Min. Negotiated Rate	$9.25
Max. Negotiated Rate	$191.88
Rate for Payer: Aetna Commercial	$145.82
Rate for Payer: Aetna Medicare Advantage	$115.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.86
Rate for Payer: Cigna Commercial	$191.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$84.42
Rate for Payer: Qualcare PPO/HMO/WC	$57.56
Rate for Payer: UnitedHealthcare Community & State	$9.25
Rate for Payer: Wellpoint Medicaid Managed Care	$10.17

LIGACLIP APPLIER

Facility

$101.00

Hospital Charge Code	270338713
Hospital Revenue Code	272
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$15.15
Rate for Payer: Qualcare PPO/HMO/WC	$15.15

LIGACLIP APPLIER

Facility

$101.00

Hospital Charge Code	270338713
Hospital Revenue Code	272
Min. Negotiated Rate	$2.43
Max. Negotiated Rate	$50.50
Rate for Payer: Aetna Commercial	$38.38
Rate for Payer: Aetna Medicare Advantage	$30.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.75
Rate for Payer: Cigna Commercial	$50.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.30
Rate for Payer: Oxford Commercial	$20.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.15
Rate for Payer: UnitedHealthcare Commercial	$20.20
Rate for Payer: UnitedHealthcare Community & State	$2.43
Rate for Payer: Wellpoint Medicaid Managed Care	$2.68

LIGACLIP APPLIER 5MM

Facility

$1,924.30

Hospital Charge Code	270655946
Hospital Revenue Code	272
Min. Negotiated Rate	$46.38
Max. Negotiated Rate	$962.15
Rate for Payer: Aetna Commercial	$731.23
Rate for Payer: Aetna Medicare Advantage	$577.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$490.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$490.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$490.70
Rate for Payer: Cigna Commercial	$962.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$577.29
Rate for Payer: Oxford Commercial	$384.86
Rate for Payer: Qualcare PPO/HMO/WC	$288.64
Rate for Payer: UnitedHealthcare Commercial	$384.86
Rate for Payer: UnitedHealthcare Community & State	$46.38
Rate for Payer: Wellpoint Medicaid Managed Care	$50.99

LIGACLIP APPLIER 5MM

Facility

$1,924.30

Hospital Charge Code	270655946
Hospital Revenue Code	272
Min. Negotiated Rate	$288.64
Max. Negotiated Rate	$288.64
Rate for Payer: Qualcare PPO/HMO/WC	$288.64

LIGACLIP APPLIER LG 13-1/4 IN

Facility

$245.56

Hospital Charge Code	270608749
Hospital Revenue Code	272
Min. Negotiated Rate	$36.83
Max. Negotiated Rate	$36.83
Rate for Payer: Qualcare PPO/HMO/WC	$36.83

LIGACLIP APPLIER LG 13-1/4 IN

Facility

$245.56

Hospital Charge Code	270608749
Hospital Revenue Code	272
Min. Negotiated Rate	$5.92
Max. Negotiated Rate	$122.78
Rate for Payer: Aetna Commercial	$93.31
Rate for Payer: Aetna Medicare Advantage	$73.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.62
Rate for Payer: Cigna Commercial	$122.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.67
Rate for Payer: Oxford Commercial	$49.11
Rate for Payer: Qualcare PPO/HMO/WC	$36.83
Rate for Payer: UnitedHealthcare Commercial	$49.11
Rate for Payer: UnitedHealthcare Community & State	$5.92
Rate for Payer: Wellpoint Medicaid Managed Care	$6.51

LIGACLIP APPLIER MED 11-1/2

Facility

$810.39

Hospital Charge Code	270655919
Hospital Revenue Code	271
Min. Negotiated Rate	$19.53
Max. Negotiated Rate	$405.19
Rate for Payer: Aetna Commercial	$307.95
Rate for Payer: Aetna Medicare Advantage	$243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.65
Rate for Payer: Cigna Commercial	$405.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.12
Rate for Payer: Oxford Commercial	$162.08
Rate for Payer: Qualcare PPO/HMO/WC	$121.56
Rate for Payer: UnitedHealthcare Commercial	$162.08
Rate for Payer: UnitedHealthcare Community & State	$19.53
Rate for Payer: Wellpoint Medicaid Managed Care	$21.48

LIGACLIP APPLIER MED 11-1/2

Facility

$810.39

Hospital Charge Code	270655919
Hospital Revenue Code	271
Min. Negotiated Rate	$121.56
Max. Negotiated Rate	$121.56
Rate for Payer: Qualcare PPO/HMO/WC	$121.56

LIGACLIP APPLIER SML 9-3/8

Facility

$791.05

Hospital Charge Code	270658411
Hospital Revenue Code	270
Min. Negotiated Rate	$118.66
Max. Negotiated Rate	$118.66
Rate for Payer: Qualcare PPO/HMO/WC	$118.66

LIGACLIP APPLIER SML 9-3/8

Facility

$22.50

Hospital Charge Code	270608739
Hospital Revenue Code	272
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

LIGACLIP APPLIER SML 9-3/8

Facility

$22.50

Hospital Charge Code	270608739
Hospital Revenue Code	272
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.75
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$4.50
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.60

LIGACLIP APPLIER SML 9-3/8

Facility

$791.05

Hospital Charge Code	270658411
Hospital Revenue Code	270
Min. Negotiated Rate	$19.06
Max. Negotiated Rate	$395.52
Rate for Payer: Aetna Commercial	$300.60
Rate for Payer: Aetna Medicare Advantage	$237.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.72
Rate for Payer: Cigna Commercial	$395.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.31
Rate for Payer: Oxford Commercial	$158.21
Rate for Payer: Qualcare PPO/HMO/WC	$118.66
Rate for Payer: UnitedHealthcare Commercial	$158.21
Rate for Payer: UnitedHealthcare Community & State	$19.06
Rate for Payer: Wellpoint Medicaid Managed Care	$20.96

LIGAMENT AUGMENTATION REP KIT

Facility

$6,965.00

Hospital Charge Code	270665751
Hospital Revenue Code	272
Min. Negotiated Rate	$1,044.75
Max. Negotiated Rate	$1,044.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,044.75

LIGAMENT AUGMENTATION REP KIT

Facility

$6,965.00

Hospital Charge Code	270665751
Hospital Revenue Code	272
Min. Negotiated Rate	$167.86
Max. Negotiated Rate	$3,482.50
Rate for Payer: Aetna Commercial	$2,646.70
Rate for Payer: Aetna Medicare Advantage	$2,089.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,776.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,776.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,776.08
Rate for Payer: Cigna Commercial	$3,482.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,089.50
Rate for Payer: Oxford Commercial	$1,393.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,044.75
Rate for Payer: UnitedHealthcare Commercial	$1,393.00
Rate for Payer: UnitedHealthcare Community & State	$167.86
Rate for Payer: Wellpoint Medicaid Managed Care	$184.57

LIGAMENT CHISEL

Facility

$418.00

Hospital Charge Code	270335492
Hospital Revenue Code	272
Min. Negotiated Rate	$62.70
Max. Negotiated Rate	$62.70
Rate for Payer: Qualcare PPO/HMO/WC	$62.70

LIGAMENT CHISEL

Facility

$418.00

Hospital Charge Code	270335492
Hospital Revenue Code	272
Min. Negotiated Rate	$10.07
Max. Negotiated Rate	$209.00
Rate for Payer: Aetna Commercial	$158.84
Rate for Payer: Aetna Medicare Advantage	$125.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.59
Rate for Payer: Cigna Commercial	$209.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.40
Rate for Payer: Oxford Commercial	$83.60
Rate for Payer: Qualcare PPO/HMO/WC	$62.70
Rate for Payer: UnitedHealthcare Commercial	$83.60
Rate for Payer: UnitedHealthcare Community & State	$10.07
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

LIGAMENT DEVICE ARTIFICAL

Facility

$2,905.00

Hospital Charge Code	270648890
Hospital Revenue Code	278
Min. Negotiated Rate	$70.01
Max. Negotiated Rate	$1,452.50
Rate for Payer: Aetna Commercial	$1,103.90
Rate for Payer: Aetna Medicare Advantage	$871.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$740.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$740.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$740.77
Rate for Payer: Cigna Commercial	$1,452.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$703.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$639.10
Rate for Payer: Qualcare PPO/HMO/WC	$435.75
Rate for Payer: UnitedHealthcare Community & State	$70.01
Rate for Payer: Wellpoint Medicaid Managed Care	$76.98

LIGAMENT DEVICE ARTIFICAL

Facility

$2,905.00

Hospital Charge Code	270648890
Hospital Revenue Code	278
Min. Negotiated Rate	$435.75
Max. Negotiated Rate	$703.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$581.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$703.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$639.10
Rate for Payer: Qualcare PPO/HMO/WC	$435.75

LIGASURE ADVANCE PISTOL 44CM

Facility

$3,423.63

Hospital Charge Code	270663053
Hospital Revenue Code	272
Min. Negotiated Rate	$513.54
Max. Negotiated Rate	$513.54
Rate for Payer: Qualcare PPO/HMO/WC	$513.54

LIGASURE ADVANCE PISTOL 44CM

Facility

$3,423.63

Hospital Charge Code	270663053
Hospital Revenue Code	272
Min. Negotiated Rate	$82.51
Max. Negotiated Rate	$1,711.82
Rate for Payer: Aetna Commercial	$1,300.98
Rate for Payer: Aetna Medicare Advantage	$1,027.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$873.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$873.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$873.03
Rate for Payer: Cigna Commercial	$1,711.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,027.09
Rate for Payer: Oxford Commercial	$684.73
Rate for Payer: Qualcare PPO/HMO/WC	$513.54
Rate for Payer: UnitedHealthcare Commercial	$684.73
Rate for Payer: UnitedHealthcare Community & State	$82.51
Rate for Payer: Wellpoint Medicaid Managed Care	$90.73

LIGASURE ATLAS 20cm LS1120

Facility

$1,570.75

Hospital Charge Code	270632825
Hospital Revenue Code	272
Min. Negotiated Rate	$235.61
Max. Negotiated Rate	$235.61
Rate for Payer: Qualcare PPO/HMO/WC	$235.61

LIGASURE ATLAS 20cm LS1120

Facility

$1,570.75

Hospital Charge Code	270632825
Hospital Revenue Code	272
Min. Negotiated Rate	$37.86
Max. Negotiated Rate	$785.38
Rate for Payer: Aetna Commercial	$596.88
Rate for Payer: Aetna Medicare Advantage	$471.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$400.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$400.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$400.54
Rate for Payer: Cigna Commercial	$785.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.23
Rate for Payer: Oxford Commercial	$314.15
Rate for Payer: Qualcare PPO/HMO/WC	$235.61
Rate for Payer: UnitedHealthcare Commercial	$314.15
Rate for Payer: UnitedHealthcare Community & State	$37.86
Rate for Payer: Wellpoint Medicaid Managed Care	$41.62

Know your out-of-pocket cost for care.

All Charges