Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MESH 3D MAX XL LEFT 7X5IN

Facility

$1,585.00

Service Code	HCPCS C1781
Hospital Charge Code	270693173
Hospital Revenue Code	278
Min. Negotiated Rate	$237.75
Max. Negotiated Rate	$383.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$317.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$348.70
Rate for Payer: Qualcare PPO/HMO/WC	$237.75

MESH 3D MAX XL LEFT 7X5IN

Facility

$1,585.00

Service Code	HCPCS C1781
Hospital Charge Code	270693173
Hospital Revenue Code	278
Min. Negotiated Rate	$38.20
Max. Negotiated Rate	$792.50
Rate for Payer: Aetna Commercial	$602.30
Rate for Payer: Aetna Medicare Advantage	$475.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$404.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$404.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$317.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$404.18
Rate for Payer: Cigna Commercial	$792.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$348.70
Rate for Payer: Qualcare PPO/HMO/WC	$237.75
Rate for Payer: UnitedHealthcare Community & State	$38.20
Rate for Payer: Wellpoint Medicaid Managed Care	$42.00

MESH 3D MAX XL RIGHT 7X5IN

Facility

$1,585.00

Service Code	HCPCS C1781
Hospital Charge Code	270693174
Hospital Revenue Code	278
Min. Negotiated Rate	$38.20
Max. Negotiated Rate	$792.50
Rate for Payer: Aetna Commercial	$602.30
Rate for Payer: Aetna Medicare Advantage	$475.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$404.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$404.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$317.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$404.18
Rate for Payer: Cigna Commercial	$792.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$348.70
Rate for Payer: Qualcare PPO/HMO/WC	$237.75
Rate for Payer: UnitedHealthcare Community & State	$38.20
Rate for Payer: Wellpoint Medicaid Managed Care	$42.00

MESH 3D MAX XL RIGHT 7X5IN

Facility

$1,585.00

Service Code	HCPCS C1781
Hospital Charge Code	270693174
Hospital Revenue Code	278
Min. Negotiated Rate	$237.75
Max. Negotiated Rate	$383.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$317.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$348.70
Rate for Payer: Qualcare PPO/HMO/WC	$237.75

MESH 3D MID LEFT XL

Facility

$2,285.00

Service Code	HCPCS C1781
Hospital Charge Code	270694711
Hospital Revenue Code	278
Min. Negotiated Rate	$55.07
Max. Negotiated Rate	$1,142.50
Rate for Payer: Aetna Commercial	$868.30
Rate for Payer: Aetna Medicare Advantage	$685.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$582.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$582.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$457.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$582.67
Rate for Payer: Cigna Commercial	$1,142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$502.70
Rate for Payer: Qualcare PPO/HMO/WC	$342.75
Rate for Payer: UnitedHealthcare Community & State	$55.07
Rate for Payer: Wellpoint Medicaid Managed Care	$60.55

MESH 3D MID LEFT XL

Facility

$2,285.00

Service Code	HCPCS C1781
Hospital Charge Code	270694711
Hospital Revenue Code	278
Min. Negotiated Rate	$342.75
Max. Negotiated Rate	$552.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$457.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$502.70
Rate for Payer: Qualcare PPO/HMO/WC	$342.75

MESH 3D MID MED LT 3.1X5.3IN

Facility

$412.89

Service Code	HCPCS C1781
Hospital Charge Code	270695723
Hospital Revenue Code	278
Min. Negotiated Rate	$61.93
Max. Negotiated Rate	$99.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$90.84
Rate for Payer: Qualcare PPO/HMO/WC	$61.93

MESH 3D MID MED LT 3.1X5.3IN

Facility

$412.89

Service Code	HCPCS C1781
Hospital Charge Code	270695723
Hospital Revenue Code	278
Min. Negotiated Rate	$9.95
Max. Negotiated Rate	$206.44
Rate for Payer: Aetna Commercial	$156.90
Rate for Payer: Aetna Medicare Advantage	$123.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.29
Rate for Payer: Cigna Commercial	$206.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$90.84
Rate for Payer: Qualcare PPO/HMO/WC	$61.93
Rate for Payer: UnitedHealthcare Community & State	$9.95
Rate for Payer: Wellpoint Medicaid Managed Care	$10.94

MESH 3D MID RIGHT XL

Facility

$2,285.00

Service Code	HCPCS C1781
Hospital Charge Code	270694710
Hospital Revenue Code	278
Min. Negotiated Rate	$342.75
Max. Negotiated Rate	$552.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$457.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$502.70
Rate for Payer: Qualcare PPO/HMO/WC	$342.75

MESH 3D MID RIGHT XL

Facility

$2,285.00

Service Code	HCPCS C1781
Hospital Charge Code	270694710
Hospital Revenue Code	278
Min. Negotiated Rate	$55.07
Max. Negotiated Rate	$1,142.50
Rate for Payer: Aetna Commercial	$868.30
Rate for Payer: Aetna Medicare Advantage	$685.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$582.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$582.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$457.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$582.67
Rate for Payer: Cigna Commercial	$1,142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$502.70
Rate for Payer: Qualcare PPO/HMO/WC	$342.75
Rate for Payer: UnitedHealthcare Community & State	$55.07
Rate for Payer: Wellpoint Medicaid Managed Care	$60.55

MESH 6.1x10.1 OVAL 0010219

Facility

$10,500.00

Service Code	HCPCS C1781
Hospital Charge Code	270647200
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

MESH 6.1x10.1 OVAL 0010219

Facility

$10,500.00

Service Code	HCPCS C1781
Hospital Charge Code	270647200
Hospital Revenue Code	278
Min. Negotiated Rate	$253.05
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,310.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$253.05
Rate for Payer: Wellpoint Medicaid Managed Care	$278.25

MESH APOG W/ INTERPRO 72404025

Facility

$6,975.00

Hospital Charge Code	270634315
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,534.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

MESH APOG W/ INTERPRO 72404025

Facility

$6,975.00

Hospital Charge Code	270634315
Hospital Revenue Code	278
Min. Negotiated Rate	$168.10
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,650.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,534.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Community & State	$168.10
Rate for Payer: Wellpoint Medicaid Managed Care	$184.84

MESH BARD COMPOSIT 10X14

Facility

$9,625.00

Hospital Charge Code	270657719
Hospital Revenue Code	278
Min. Negotiated Rate	$1,443.75
Max. Negotiated Rate	$2,329.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,329.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,443.75

MESH BARD COMPOSIT 10X14

Facility

$9,625.00

Hospital Charge Code	270657719
Hospital Revenue Code	278
Min. Negotiated Rate	$231.96
Max. Negotiated Rate	$4,812.50
Rate for Payer: Aetna Commercial	$3,657.50
Rate for Payer: Aetna Medicare Advantage	$2,887.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,454.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,454.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,454.38
Rate for Payer: Cigna Commercial	$4,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,329.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,443.75
Rate for Payer: UnitedHealthcare Community & State	$231.96
Rate for Payer: Wellpoint Medicaid Managed Care	$255.06

MESH BILAYER 4x5INTEGRA/SQCMJW

Facility

$952.50

Hospital Charge Code	270648773W
Hospital Revenue Code	636
Min. Negotiated Rate	$142.88
Max. Negotiated Rate	$230.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.50
Rate for Payer: Qualcare PPO/HMO/WC	$142.88

MESH BILAYER 4x5INTEGRA/SQCMJW

Facility

$952.50

Hospital Charge Code	270648773W
Hospital Revenue Code	636
Min. Negotiated Rate	$22.96
Max. Negotiated Rate	$476.25
Rate for Payer: Aetna Commercial	$361.95
Rate for Payer: Aetna Medicare Advantage	$285.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.89
Rate for Payer: Cigna Commercial	$476.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.50
Rate for Payer: Qualcare PPO/HMO/WC	$142.88
Rate for Payer: UnitedHealthcare Community & State	$22.96
Rate for Payer: Wellpoint Medicaid Managed Care	$25.24

MESH BILAYER GRAFT 2x2IN

Facility

$9,555.00

Service Code	HCPCS Q4104
Hospital Charge Code	270648094
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$2,312.31
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,911.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$533.66
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,312.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,102.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,433.25
Rate for Payer: UnitedHealthcare Community & State	$230.28
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$253.21

MESH BILAYER GRAFT 2x2IN

Facility

$9,555.00

Service Code	HCPCS Q4104
Hospital Charge Code	270648094
Hospital Revenue Code	278
Min. Negotiated Rate	$1,433.25
Max. Negotiated Rate	$2,312.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,911.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,312.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,102.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,433.25

MESH BIO-A TISSU 8 CM X8 CM

Facility

$2,005.00

Service Code	HCPCS C1781
Hospital Charge Code	270683492
Hospital Revenue Code	278
Min. Negotiated Rate	$300.75
Max. Negotiated Rate	$485.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$401.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$485.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$441.10
Rate for Payer: Qualcare PPO/HMO/WC	$300.75

MESH BIO-A TISSU 8 CM X8 CM

Facility

$2,005.00

Service Code	HCPCS C1781
Hospital Charge Code	270683492
Hospital Revenue Code	278
Min. Negotiated Rate	$48.32
Max. Negotiated Rate	$1,002.50
Rate for Payer: Aetna Commercial	$761.90
Rate for Payer: Aetna Medicare Advantage	$601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$511.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$511.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$401.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$511.27
Rate for Payer: Cigna Commercial	$1,002.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$485.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$441.10
Rate for Payer: Qualcare PPO/HMO/WC	$300.75
Rate for Payer: UnitedHealthcare Community & State	$48.32
Rate for Payer: Wellpoint Medicaid Managed Care	$53.13

MESH BIOD HERN PRESHAPE 7X10-U

Facility

$10,242.10

Service Code	HCPCS C1763
Hospital Charge Code	270692874
Hospital Revenue Code	278
Min. Negotiated Rate	$246.83
Max. Negotiated Rate	$5,121.05
Rate for Payer: Aetna Commercial	$3,892.00
Rate for Payer: Aetna Medicare Advantage	$3,072.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,611.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,611.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,048.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,611.74
Rate for Payer: Cigna Commercial	$5,121.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,478.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,253.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,536.32
Rate for Payer: UnitedHealthcare Community & State	$246.83
Rate for Payer: Wellpoint Medicaid Managed Care	$271.42

MESH BIOD HERN PRESHAPE 7X10-U

Facility

$10,242.10

Service Code	HCPCS C1763
Hospital Charge Code	270692874
Hospital Revenue Code	278
Min. Negotiated Rate	$1,536.32
Max. Negotiated Rate	$2,478.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,048.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,478.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,253.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,536.32

MESH BIOD HIAT HERN STD 7X10ST

Facility

$10,242.10

Service Code	HCPCS C1763
Hospital Charge Code	270692875
Hospital Revenue Code	278
Min. Negotiated Rate	$246.83
Max. Negotiated Rate	$5,121.05
Rate for Payer: Aetna Commercial	$3,892.00
Rate for Payer: Aetna Medicare Advantage	$3,072.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,611.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,611.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,048.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,611.74
Rate for Payer: Cigna Commercial	$5,121.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,478.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,253.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,536.32
Rate for Payer: UnitedHealthcare Community & State	$246.83
Rate for Payer: Wellpoint Medicaid Managed Care	$271.42

Know your out-of-pocket cost for care.

All Charges