Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MENISCAL REPAIR-PLA 228320

Facility

$1,025.00

Hospital Charge Code	270638398
Hospital Revenue Code	271
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$153.75
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

MENISCAL REPAIR-PLA 228320

Facility

$1,025.00

Hospital Charge Code	270638398
Hospital Revenue Code	271
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.50
Rate for Payer: Oxford Commercial	$205.00
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Commercial	$205.00
Rate for Payer: UnitedHealthcare Community & State	$24.70
Rate for Payer: Wellpoint Medicaid Managed Care	$27.16

MENISCAL REPAIR SYS PDS W/12DE

Facility

$1,050.00

Hospital Charge Code	270637280
Hospital Revenue Code	272
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$315.00
Rate for Payer: Oxford Commercial	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Commercial	$210.00
Rate for Payer: UnitedHealthcare Community & State	$25.30
Rate for Payer: Wellpoint Medicaid Managed Care	$27.82

MENISCAL REPAIR SYS PDS W/12DE

Facility

$1,050.00

Hospital Charge Code	270637280
Hospital Revenue Code	272
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$157.50
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

MENISCAL ROOT KIT

Facility

$4,975.00

Hospital Charge Code	270682555
Hospital Revenue Code	272
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$746.25
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

MENISCAL ROOT KIT

Facility

$4,975.00

Hospital Charge Code	270682555
Hospital Revenue Code	272
Min. Negotiated Rate	$119.90
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,890.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,492.50
Rate for Payer: Oxford Commercial	$995.00
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Commercial	$995.00
Rate for Payer: UnitedHealthcare Community & State	$119.90
Rate for Payer: Wellpoint Medicaid Managed Care	$131.84

MENISCAL ROOT REP PK W ULTRABR

Facility

$4,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270688719
Hospital Revenue Code	278
Min. Negotiated Rate	$738.75
Max. Negotiated Rate	$1,191.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$985.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,191.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,083.50
Rate for Payer: Qualcare PPO/HMO/WC	$738.75

MENISCAL ROOT REP PK W ULTRABR

Facility

$4,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270688719
Hospital Revenue Code	278
Min. Negotiated Rate	$118.69
Max. Negotiated Rate	$2,462.50
Rate for Payer: Aetna Commercial	$1,871.50
Rate for Payer: Aetna Medicare Advantage	$1,477.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,255.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,255.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$985.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,255.88
Rate for Payer: Cigna Commercial	$2,462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,191.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,083.50
Rate for Payer: Qualcare PPO/HMO/WC	$738.75
Rate for Payer: UnitedHealthcare Community & State	$118.69
Rate for Payer: Wellpoint Medicaid Managed Care	$130.51

MENISCAL ULTRA SYSTEM FIXATION

Facility

$1,595.00

Hospital Charge Code	270658618
Hospital Revenue Code	272
Min. Negotiated Rate	$239.25
Max. Negotiated Rate	$239.25
Rate for Payer: Qualcare PPO/HMO/WC	$239.25

MENISCAL ULTRA SYSTEM FIXATION

Facility

$1,595.00

Hospital Charge Code	270658618
Hospital Revenue Code	272
Min. Negotiated Rate	$38.44
Max. Negotiated Rate	$797.50
Rate for Payer: Aetna Commercial	$606.10
Rate for Payer: Aetna Medicare Advantage	$478.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$406.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$406.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$406.73
Rate for Payer: Cigna Commercial	$797.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$478.50
Rate for Payer: Oxford Commercial	$319.00
Rate for Payer: Qualcare PPO/HMO/WC	$239.25
Rate for Payer: UnitedHealthcare Commercial	$319.00
Rate for Payer: UnitedHealthcare Community & State	$38.44
Rate for Payer: Wellpoint Medicaid Managed Care	$42.27

MENISC REP.SYS.PDSW/STR 228310

Facility

$1,050.00

Hospital Charge Code	270637281
Hospital Revenue Code	272
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$157.50
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

MENISC REP.SYS.PDSW/STR 228310

Facility

$1,050.00

Hospital Charge Code	270637281
Hospital Revenue Code	272
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$315.00
Rate for Payer: Oxford Commercial	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Commercial	$210.00
Rate for Payer: UnitedHealthcare Community & State	$25.30
Rate for Payer: Wellpoint Medicaid Managed Care	$27.82

MENISCUS LAT FF 3.3CM X 3.2CM

Facility

$23,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270676521
Hospital Revenue Code	278
Min. Negotiated Rate	$3,562.50
Max. Negotiated Rate	$5,747.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,747.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,225.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,562.50

MENISCUS LAT FF 3.3CM X 3.2CM

Facility

$23,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270676521
Hospital Revenue Code	278
Min. Negotiated Rate	$572.38
Max. Negotiated Rate	$11,875.00
Rate for Payer: Aetna Commercial	$9,025.00
Rate for Payer: Aetna Medicare Advantage	$7,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,056.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,056.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,056.25
Rate for Payer: Cigna Commercial	$11,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,747.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,225.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,562.50
Rate for Payer: UnitedHealthcare Community & State	$572.38
Rate for Payer: Wellpoint Medicaid Managed Care	$629.38

MENISCUS RT MEDIAL FMNRM

Facility

$23,538.75

Service Code	HCPCS C1762
Hospital Charge Code	270697840
Hospital Revenue Code	278
Min. Negotiated Rate	$3,530.81
Max. Negotiated Rate	$5,696.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,707.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,696.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,178.52
Rate for Payer: Qualcare PPO/HMO/WC	$3,530.81

MENISCUS RT MEDIAL FMNRM

Facility

$23,538.75

Service Code	HCPCS C1762
Hospital Charge Code	270697840
Hospital Revenue Code	278
Min. Negotiated Rate	$567.28
Max. Negotiated Rate	$11,769.38
Rate for Payer: Aetna Commercial	$8,944.73
Rate for Payer: Aetna Medicare Advantage	$7,061.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,002.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,002.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,707.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,002.38
Rate for Payer: Cigna Commercial	$11,769.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,696.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,178.52
Rate for Payer: Qualcare PPO/HMO/WC	$3,530.81
Rate for Payer: UnitedHealthcare Community & State	$567.28
Rate for Payer: Wellpoint Medicaid Managed Care	$623.78

MENISUCUS RIGHT LATERAL 36 MM

Facility

$23,523.75

Service Code	HCPCS C1762
Hospital Charge Code	270684974
Hospital Revenue Code	278
Min. Negotiated Rate	$3,528.56
Max. Negotiated Rate	$5,692.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,704.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,692.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,175.23
Rate for Payer: Qualcare PPO/HMO/WC	$3,528.56

MENISUCUS RIGHT LATERAL 36 MM

Facility

$23,523.75

Service Code	HCPCS C1762
Hospital Charge Code	270684974
Hospital Revenue Code	278
Min. Negotiated Rate	$566.92
Max. Negotiated Rate	$11,761.88
Rate for Payer: Aetna Commercial	$8,939.02
Rate for Payer: Aetna Medicare Advantage	$7,057.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,998.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,998.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,704.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,998.56
Rate for Payer: Cigna Commercial	$11,761.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,692.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,175.23
Rate for Payer: Qualcare PPO/HMO/WC	$3,528.56
Rate for Payer: UnitedHealthcare Community & State	$566.92
Rate for Payer: Wellpoint Medicaid Managed Care	$623.38

MENSICAL KNOT PUSHER & SUTURE

Facility

$200.00

Hospital Charge Code	270339440
Hospital Revenue Code	272
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

MENSICAL KNOT PUSHER & SUTURE

Facility

$200.00

Hospital Charge Code	270339440
Hospital Revenue Code	272
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.00
Rate for Payer: Oxford Commercial	$40.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$40.00
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$5,067.26

Service Code	APR-DRG 5321
Min. Negotiated Rate	$4,967.90
Max. Negotiated Rate	$5,067.26
Rate for Payer: UnitedHealthcare Community & State	$4,967.90
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,067.26
Rate for Payer: Wellpoint Medicaid Managed Care	$4,967.90

MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$9,914.95

Service Code	APR-DRG 5323
Min. Negotiated Rate	$9,720.54
Max. Negotiated Rate	$9,914.95
Rate for Payer: UnitedHealthcare Community & State	$9,720.54
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,914.95
Rate for Payer: Wellpoint Medicaid Managed Care	$9,720.54

MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$17,368.33

Service Code	APR-DRG 5324
Min. Negotiated Rate	$17,027.77
Max. Negotiated Rate	$17,368.33
Rate for Payer: UnitedHealthcare Community & State	$17,027.77
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,368.33
Rate for Payer: Wellpoint Medicaid Managed Care	$17,027.77

MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$6,392.48

Service Code	APR-DRG 5322
Min. Negotiated Rate	$6,267.14
Max. Negotiated Rate	$6,392.48
Rate for Payer: UnitedHealthcare Community & State	$6,267.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,392.48
Rate for Payer: Wellpoint Medicaid Managed Care	$6,267.14

MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC

Facility

$34,698.14

Service Code	MSDRG 760
Min. Negotiated Rate	$10,565.14
Max. Negotiated Rate	$34,698.14
Rate for Payer: Aetna Commercial	$24,098.89
Rate for Payer: Aetna Medicare Advantage	$34,698.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,261.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,261.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,121.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,261.00
Rate for Payer: Cigna Commercial	$18,854.35
Rate for Payer: Cigna Medicare Advantage	$11,121.20
Rate for Payer: Clover Medicare Advantage	$10,565.14
Rate for Payer: EmblemHealth Commercial	$33,363.60
Rate for Payer: Humana Medicare Advantage	$11,454.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11,121.20
Rate for Payer: Oxford Commercial	$13,550.88
Rate for Payer: UnitedHealthcare Commercial	$23,761.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,121.20
Rate for Payer: Wellcare Medicare Advantage	$11,121.20

Know your out-of-pocket cost for care.

All Charges