Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LINEAR RING LOC 36x24 12105994

Facility

$3,734.95

Hospital Charge Code	270632965
Hospital Revenue Code	278
Min. Negotiated Rate	$90.01
Max. Negotiated Rate	$1,867.47
Rate for Payer: Aetna Commercial	$1,419.28
Rate for Payer: Aetna Medicare Advantage	$1,120.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$952.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$952.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$746.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$952.41
Rate for Payer: Cigna Commercial	$1,867.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$903.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$821.69
Rate for Payer: Qualcare PPO/HMO/WC	$560.24
Rate for Payer: UnitedHealthcare Community & State	$90.01
Rate for Payer: Wellpoint Medicaid Managed Care	$98.98

LINEAR RING LOC 36x24 12105994

Facility

$3,734.95

Hospital Charge Code	270632965
Hospital Revenue Code	278
Min. Negotiated Rate	$560.24
Max. Negotiated Rate	$903.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$746.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$903.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$821.69
Rate for Payer: Qualcare PPO/HMO/WC	$560.24

LINEAR STAPLER 30MM

Facility

$170.00

Hospital Charge Code	270338697
Hospital Revenue Code	272
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

LINEAR STAPLER 30MM

Facility

$170.00

Hospital Charge Code	270338697
Hospital Revenue Code	272
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$85.00
Rate for Payer: Aetna Commercial	$64.60
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.00
Rate for Payer: Oxford Commercial	$34.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$34.00
Rate for Payer: UnitedHealthcare Community & State	$4.10
Rate for Payer: Wellpoint Medicaid Managed Care	$4.50

LINEAR STAPLER 60MM

Facility

$174.00

Hospital Charge Code	270338699
Hospital Revenue Code	272
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

LINEAR STAPLER 60MM

Facility

$174.00

Hospital Charge Code	270338699
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$66.12
Rate for Payer: Aetna Medicare Advantage	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.20
Rate for Payer: Oxford Commercial	$34.80
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Commercial	$34.80
Rate for Payer: UnitedHealthcare Community & State	$4.19
Rate for Payer: Wellpoint Medicaid Managed Care	$4.61

LINEAR STAPLER 90MM

Facility

$180.00

Hospital Charge Code	270338705
Hospital Revenue Code	272
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$90.00
Rate for Payer: Aetna Commercial	$68.40
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.00
Rate for Payer: Oxford Commercial	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$36.00
Rate for Payer: UnitedHealthcare Community & State	$4.34
Rate for Payer: Wellpoint Medicaid Managed Care	$4.77

LINEAR STAPLER 90MM

Facility

$180.00

Hospital Charge Code	270338705
Hospital Revenue Code	272
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

LINEARTY SET IMMUNOSSAY

Facility

$1,590.00

Hospital Charge Code	270665489
Hospital Revenue Code	270
Min. Negotiated Rate	$238.50
Max. Negotiated Rate	$238.50
Rate for Payer: Qualcare PPO/HMO/WC	$238.50

LINEARTY SET IMMUNOSSAY

Facility

$1,590.00

Hospital Charge Code	270665489
Hospital Revenue Code	270
Min. Negotiated Rate	$38.32
Max. Negotiated Rate	$795.00
Rate for Payer: Aetna Commercial	$604.20
Rate for Payer: Aetna Medicare Advantage	$477.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$405.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$405.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$405.45
Rate for Payer: Cigna Commercial	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.00
Rate for Payer: Oxford Commercial	$318.00
Rate for Payer: Qualcare PPO/HMO/WC	$238.50
Rate for Payer: UnitedHealthcare Commercial	$318.00
Rate for Payer: UnitedHealthcare Community & State	$38.32
Rate for Payer: Wellpoint Medicaid Managed Care	$42.13

LINE BLOOD C3 RENAL 3-410-510

Facility

$57.65

Hospital Charge Code	270604506
Hospital Revenue Code	272
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$28.82
Rate for Payer: Aetna Commercial	$21.91
Rate for Payer: Aetna Medicare Advantage	$17.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.70
Rate for Payer: Cigna Commercial	$28.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.30
Rate for Payer: Oxford Commercial	$11.53
Rate for Payer: Qualcare PPO/HMO/WC	$8.65
Rate for Payer: UnitedHealthcare Commercial	$11.53
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.53

LINE BLOOD C3 RENAL 3-410-510

Facility

$57.65

Hospital Charge Code	270604506
Hospital Revenue Code	272
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$8.65

LINE BLOOD REDY 2000

Facility

$63.25

Hospital Charge Code	270606195
Hospital Revenue Code	272
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$31.62
Rate for Payer: Aetna Commercial	$24.04
Rate for Payer: Aetna Medicare Advantage	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.13
Rate for Payer: Cigna Commercial	$31.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$12.65
Rate for Payer: Qualcare PPO/HMO/WC	$9.49
Rate for Payer: UnitedHealthcare Commercial	$12.65
Rate for Payer: UnitedHealthcare Community & State	$1.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1.68

LINE BLOOD REDY 2000

Facility

$63.25

Hospital Charge Code	270606195
Hospital Revenue Code	272
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$9.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

LINE NMC INJ HP 91011302

Facility

$124.00

Hospital Charge Code	270600712
Hospital Revenue Code	272
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

LINE NMC INJ HP 91011302

Facility

$124.00

Hospital Charge Code	270600712
Hospital Revenue Code	272
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$62.00
Rate for Payer: Aetna Commercial	$47.12
Rate for Payer: Aetna Medicare Advantage	$37.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.62
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.20
Rate for Payer: Oxford Commercial	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$24.80
Rate for Payer: UnitedHealthcare Community & State	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

LINER

Facility

$6,221.15

Hospital Charge Code	270657033
Hospital Revenue Code	278
Min. Negotiated Rate	$933.17
Max. Negotiated Rate	$1,505.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,244.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,505.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,368.65
Rate for Payer: Qualcare PPO/HMO/WC	$933.17

LINER

Facility

$6,221.15

Hospital Charge Code	270657033
Hospital Revenue Code	278
Min. Negotiated Rate	$149.93
Max. Negotiated Rate	$3,110.57
Rate for Payer: Aetna Commercial	$2,364.04
Rate for Payer: Aetna Medicare Advantage	$1,866.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,586.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,586.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,244.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,586.39
Rate for Payer: Cigna Commercial	$3,110.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,505.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,368.65
Rate for Payer: Qualcare PPO/HMO/WC	$933.17
Rate for Payer: UnitedHealthcare Community & State	$149.93
Rate for Payer: Wellpoint Medicaid Managed Care	$164.86

LINER 10 DEGREE POLYETHYLENE

Facility

$6,220.00

Hospital Charge Code	270658843
Hospital Revenue Code	278
Min. Negotiated Rate	$933.00
Max. Negotiated Rate	$1,505.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,244.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,505.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,368.40
Rate for Payer: Qualcare PPO/HMO/WC	$933.00

LINER 10 DEGREE POLYETHYLENE

Facility

$6,220.00

Hospital Charge Code	270658843
Hospital Revenue Code	278
Min. Negotiated Rate	$149.90
Max. Negotiated Rate	$3,110.00
Rate for Payer: Aetna Commercial	$2,363.60
Rate for Payer: Aetna Medicare Advantage	$1,866.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,586.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,586.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,244.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,586.10
Rate for Payer: Cigna Commercial	$3,110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,505.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,368.40
Rate for Payer: Qualcare PPO/HMO/WC	$933.00
Rate for Payer: UnitedHealthcare Community & State	$149.90
Rate for Payer: Wellpoint Medicaid Managed Care	$164.83

LINER 36 ACETEBR SZ26 XL105916

Facility

$6,060.00

Service Code	HCPCS C1776
Hospital Charge Code	270641540
Hospital Revenue Code	278
Min. Negotiated Rate	$909.00
Max. Negotiated Rate	$1,466.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,212.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,466.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,333.20
Rate for Payer: Qualcare PPO/HMO/WC	$909.00

LINER 36 ACETEBR SZ26 XL105916

Facility

$6,060.00

Service Code	HCPCS C1776
Hospital Charge Code	270641540
Hospital Revenue Code	278
Min. Negotiated Rate	$146.05
Max. Negotiated Rate	$3,030.00
Rate for Payer: Aetna Commercial	$2,302.80
Rate for Payer: Aetna Medicare Advantage	$1,818.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,545.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,545.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,212.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,545.30
Rate for Payer: Cigna Commercial	$3,030.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,466.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,333.20
Rate for Payer: Qualcare PPO/HMO/WC	$909.00
Rate for Payer: UnitedHealthcare Community & State	$146.05
Rate for Payer: Wellpoint Medicaid Managed Care	$160.59

LINER +3 HI WALL 40mm SZ 26

Facility

$9,265.00

Hospital Charge Code	270645623
Hospital Revenue Code	278
Min. Negotiated Rate	$1,389.75
Max. Negotiated Rate	$2,242.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,853.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,242.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,038.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,389.75

LINER +3 HI WALL 40mm SZ 26

Facility

$9,265.00

Hospital Charge Code	270645623
Hospital Revenue Code	278
Min. Negotiated Rate	$223.29
Max. Negotiated Rate	$4,632.50
Rate for Payer: Aetna Commercial	$3,520.70
Rate for Payer: Aetna Medicare Advantage	$2,779.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,362.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,362.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,853.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,362.57
Rate for Payer: Cigna Commercial	$4,632.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,242.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,038.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,389.75
Rate for Payer: UnitedHealthcare Community & State	$223.29
Rate for Payer: Wellpoint Medicaid Managed Care	$245.52

LINER 42MM DUAL MOBILITY

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690602
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

Know your out-of-pocket cost for care.

All Charges