Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 CIRCLE 6 IN VENTRALIGHT

Facility

$5,594.00

Service Code	HCPCS C1781
Hospital Charge Code	270690921
Hospital Revenue Code	278
Min. Negotiated Rate	$839.10
Max. Negotiated Rate	$1,353.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,118.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,353.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,230.68
Rate for Payer: Qualcare PPO/HMO/WC	$839.10

MESH CIRCLE 6 IN VENTRALIGHT

Facility

$5,594.00

Service Code	HCPCS C1781
Hospital Charge Code	270690921
Hospital Revenue Code	278
Min. Negotiated Rate	$134.82
Max. Negotiated Rate	$2,797.00
Rate for Payer: Aetna Commercial	$2,125.72
Rate for Payer: Aetna Medicare Advantage	$1,678.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,426.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,426.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,118.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,426.47
Rate for Payer: Cigna Commercial	$2,797.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,353.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,230.68
Rate for Payer: Qualcare PPO/HMO/WC	$839.10
Rate for Payer: UnitedHealthcare Community & State	$134.82
Rate for Payer: Wellpoint Medicaid Managed Care	$148.24

MESH CIRCLE 8 IN VENTRALIGHT

Facility

$9,251.00

Service Code	HCPCS C1781
Hospital Charge Code	270690922
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.65
Max. Negotiated Rate	$2,238.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,035.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.65

MESH CIRCLE 8 IN VENTRALIGHT

Facility

$9,251.00

Service Code	HCPCS C1781
Hospital Charge Code	270690922
Hospital Revenue Code	278
Min. Negotiated Rate	$222.95
Max. Negotiated Rate	$4,625.50
Rate for Payer: Aetna Commercial	$3,515.38
Rate for Payer: Aetna Medicare Advantage	$2,775.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,359.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,359.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,359.01
Rate for Payer: Cigna Commercial	$4,625.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,035.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.65
Rate for Payer: UnitedHealthcare Community & State	$222.95
Rate for Payer: Wellpoint Medicaid Managed Care	$245.15

MESH CMT DERMATRIX 72403671

Facility

$2,232.00

Hospital Charge Code	270628319
Hospital Revenue Code	278
Min. Negotiated Rate	$334.80
Max. Negotiated Rate	$540.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$446.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$540.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$491.04
Rate for Payer: Qualcare PPO/HMO/WC	$334.80

MESH CMT DERMATRIX 72403671

Facility

$2,232.00

Hospital Charge Code	270628319
Hospital Revenue Code	278
Min. Negotiated Rate	$53.79
Max. Negotiated Rate	$1,116.00
Rate for Payer: Aetna Commercial	$848.16
Rate for Payer: Aetna Medicare Advantage	$669.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$569.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$569.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$446.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$569.16
Rate for Payer: Cigna Commercial	$1,116.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$540.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$491.04
Rate for Payer: Qualcare PPO/HMO/WC	$334.80
Rate for Payer: UnitedHealthcare Community & State	$53.79
Rate for Payer: Wellpoint Medicaid Managed Care	$59.15

MESH COMP KUG XL 10X13 0010207

Facility

$10,733.65

Hospital Charge Code	270630865
Hospital Revenue Code	278
Min. Negotiated Rate	$258.68
Max. Negotiated Rate	$5,366.82
Rate for Payer: Aetna Commercial	$4,078.79
Rate for Payer: Aetna Medicare Advantage	$3,220.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,737.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,737.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,146.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,737.08
Rate for Payer: Cigna Commercial	$5,366.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,597.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,361.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,610.05
Rate for Payer: UnitedHealthcare Community & State	$258.68
Rate for Payer: Wellpoint Medicaid Managed Care	$284.44

MESH COMP KUG XL 10X13 0010207

Facility

$10,733.65

Hospital Charge Code	270630865
Hospital Revenue Code	278
Min. Negotiated Rate	$1,610.05
Max. Negotiated Rate	$2,597.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,146.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,597.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,361.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,610.05

MESH COMPOSIX 3 X 6 0113360

Facility

$2,068.85

Hospital Charge Code	270609157
Hospital Revenue Code	278
Min. Negotiated Rate	$49.86
Max. Negotiated Rate	$1,034.42
Rate for Payer: Aetna Commercial	$786.16
Rate for Payer: Aetna Medicare Advantage	$620.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$527.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$527.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$413.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$527.56
Rate for Payer: Cigna Commercial	$1,034.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$455.15
Rate for Payer: Qualcare PPO/HMO/WC	$310.33
Rate for Payer: UnitedHealthcare Community & State	$49.86
Rate for Payer: Wellpoint Medicaid Managed Care	$54.82

MESH COMPOSIX 3 X 6 0113360

Facility

$2,068.85

Hospital Charge Code	270609157
Hospital Revenue Code	278
Min. Negotiated Rate	$310.33
Max. Negotiated Rate	$500.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$413.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$455.15
Rate for Payer: Qualcare PPO/HMO/WC	$310.33

MESH COMPOSIX 4x6 ELLIPTICAL

Facility

$2,511.50

Service Code	HCPCS C1781
Hospital Charge Code	270644629
Hospital Revenue Code	278
Min. Negotiated Rate	$60.53
Max. Negotiated Rate	$1,255.75
Rate for Payer: Aetna Commercial	$954.37
Rate for Payer: Aetna Medicare Advantage	$753.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$640.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$640.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$502.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$640.43
Rate for Payer: Cigna Commercial	$1,255.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$607.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$552.53
Rate for Payer: Qualcare PPO/HMO/WC	$376.73
Rate for Payer: UnitedHealthcare Community & State	$60.53
Rate for Payer: Wellpoint Medicaid Managed Care	$66.55

MESH COMPOSIX 4x6 ELLIPTICAL

Facility

$2,511.50

Service Code	HCPCS C1781
Hospital Charge Code	270644629
Hospital Revenue Code	278
Min. Negotiated Rate	$376.73
Max. Negotiated Rate	$607.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$502.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$607.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$552.53
Rate for Payer: Qualcare PPO/HMO/WC	$376.73

MESH COMPOSIX 4 X 8 0113480

Facility

$3,218.45

Hospital Charge Code	270614252
Hospital Revenue Code	278
Min. Negotiated Rate	$77.56
Max. Negotiated Rate	$1,609.22
Rate for Payer: Aetna Commercial	$1,223.01
Rate for Payer: Aetna Medicare Advantage	$965.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$820.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$820.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$820.70
Rate for Payer: Cigna Commercial	$1,609.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$708.06
Rate for Payer: Qualcare PPO/HMO/WC	$482.77
Rate for Payer: UnitedHealthcare Community & State	$77.56
Rate for Payer: Wellpoint Medicaid Managed Care	$85.29

MESH COMPOSIX 4 X 8 0113480

Facility

$3,218.45

Hospital Charge Code	270614252
Hospital Revenue Code	278
Min. Negotiated Rate	$482.77
Max. Negotiated Rate	$778.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$708.06
Rate for Payer: Qualcare PPO/HMO/WC	$482.77

MESH COMPOSIX 6 X 8 0113680

Facility

$3,936.35

Hospital Charge Code	270608983
Hospital Revenue Code	278
Min. Negotiated Rate	$94.87
Max. Negotiated Rate	$1,968.17
Rate for Payer: Aetna Commercial	$1,495.81
Rate for Payer: Aetna Medicare Advantage	$1,180.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,003.77
Rate for Payer: Cigna Commercial	$1,968.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$866.00
Rate for Payer: Qualcare PPO/HMO/WC	$590.45
Rate for Payer: UnitedHealthcare Community & State	$94.87
Rate for Payer: Wellpoint Medicaid Managed Care	$104.31

MESH COMPOSIX 6 X 8 0113680

Facility

$3,936.35

Hospital Charge Code	270608983
Hospital Revenue Code	278
Min. Negotiated Rate	$590.45
Max. Negotiated Rate	$952.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$866.00
Rate for Payer: Qualcare PPO/HMO/WC	$590.45

MESH COMPOSIX 8 X 10 0113810

Facility

$7,638.75

Hospital Charge Code	270611937
Hospital Revenue Code	278
Min. Negotiated Rate	$184.09
Max. Negotiated Rate	$3,819.38
Rate for Payer: Aetna Commercial	$2,902.72
Rate for Payer: Aetna Medicare Advantage	$2,291.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,947.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,947.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,527.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,947.88
Rate for Payer: Cigna Commercial	$3,819.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,848.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,680.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,145.81
Rate for Payer: UnitedHealthcare Community & State	$184.09
Rate for Payer: Wellpoint Medicaid Managed Care	$202.43

MESH COMPOSIX 8 X 10 0113810

Facility

$7,638.75

Hospital Charge Code	270611937
Hospital Revenue Code	278
Min. Negotiated Rate	$1,145.81
Max. Negotiated Rate	$1,848.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,527.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,848.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,680.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,145.81

MESH COMPOSIX KUGEL 0010209

Facility

$8,184.00

Hospital Charge Code	270630866
Hospital Revenue Code	278
Min. Negotiated Rate	$197.23
Max. Negotiated Rate	$4,092.00
Rate for Payer: Aetna Commercial	$3,109.92
Rate for Payer: Aetna Medicare Advantage	$2,455.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,086.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,086.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,636.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,086.92
Rate for Payer: Cigna Commercial	$4,092.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,800.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,227.60
Rate for Payer: UnitedHealthcare Community & State	$197.23
Rate for Payer: Wellpoint Medicaid Managed Care	$216.88

MESH COMPOSIX KUGEL 0010209

Facility

$8,184.00

Hospital Charge Code	270630866
Hospital Revenue Code	278
Min. Negotiated Rate	$1,227.60
Max. Negotiated Rate	$1,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,636.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,980.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,800.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,227.60

MESH COMPOSIX LP ELLIPSE 6x8

Facility

$5,288.00

Service Code	HCPCS C1781
Hospital Charge Code	270643867
Hospital Revenue Code	278
Min. Negotiated Rate	$127.44
Max. Negotiated Rate	$2,644.00
Rate for Payer: Aetna Commercial	$2,009.44
Rate for Payer: Aetna Medicare Advantage	$1,586.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,348.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,348.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,057.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,348.44
Rate for Payer: Cigna Commercial	$2,644.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,279.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,163.36
Rate for Payer: Qualcare PPO/HMO/WC	$793.20
Rate for Payer: UnitedHealthcare Community & State	$127.44
Rate for Payer: Wellpoint Medicaid Managed Care	$140.13

MESH COMPOSIX LP ELLIPSE 6x8

Facility

$5,288.00

Service Code	HCPCS C1781
Hospital Charge Code	270643867
Hospital Revenue Code	278
Min. Negotiated Rate	$793.20
Max. Negotiated Rate	$1,279.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,057.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,279.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,163.36
Rate for Payer: Qualcare PPO/HMO/WC	$793.20

MESH COMPOSIX PS 6.2x8.2

Facility

$6,825.55

Service Code	HCPCS C1781
Hospital Charge Code	270647905
Hospital Revenue Code	278
Min. Negotiated Rate	$164.50
Max. Negotiated Rate	$3,412.78
Rate for Payer: Aetna Commercial	$2,593.71
Rate for Payer: Aetna Medicare Advantage	$2,047.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,740.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,740.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,365.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,740.52
Rate for Payer: Cigna Commercial	$3,412.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,651.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,501.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.83
Rate for Payer: UnitedHealthcare Community & State	$164.50
Rate for Payer: Wellpoint Medicaid Managed Care	$180.88

MESH COMPOSIX PS 6.2x8.2

Facility

$6,825.55

Service Code	HCPCS C1781
Hospital Charge Code	270647905
Hospital Revenue Code	278
Min. Negotiated Rate	$1,023.83
Max. Negotiated Rate	$1,651.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,365.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,651.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,501.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.83

Know your out-of-pocket cost for care.

All Charges