Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MESH HERNIA MED RIGHT 3DMAX

Facility

$1,442.00

Service Code	HCPCS C1781
Hospital Charge Code	270685502
Hospital Revenue Code	278
Min. Negotiated Rate	$216.30
Max. Negotiated Rate	$348.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$288.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$348.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$317.24
Rate for Payer: Qualcare PPO/HMO/WC	$216.30

MESH HERNIA MED RIGHT 3DMAX

Facility

$1,442.00

Service Code	HCPCS C1781
Hospital Charge Code	270685502
Hospital Revenue Code	278
Min. Negotiated Rate	$34.75
Max. Negotiated Rate	$721.00
Rate for Payer: Aetna Commercial	$547.96
Rate for Payer: Aetna Medicare Advantage	$432.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$367.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$367.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$288.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$367.71
Rate for Payer: Cigna Commercial	$721.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$348.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$317.24
Rate for Payer: Qualcare PPO/HMO/WC	$216.30
Rate for Payer: UnitedHealthcare Community & State	$34.75
Rate for Payer: Wellpoint Medicaid Managed Care	$38.21

MESH HERNIA SYMBOTEX 20X15CM

Facility

$5,585.35

Service Code	HCPCS C1781
Hospital Charge Code	270686534
Hospital Revenue Code	278
Min. Negotiated Rate	$134.61
Max. Negotiated Rate	$2,792.68
Rate for Payer: Aetna Commercial	$2,122.43
Rate for Payer: Aetna Medicare Advantage	$1,675.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,424.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,424.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,424.26
Rate for Payer: Cigna Commercial	$2,792.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,351.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,228.78
Rate for Payer: Qualcare PPO/HMO/WC	$837.80
Rate for Payer: UnitedHealthcare Community & State	$134.61
Rate for Payer: Wellpoint Medicaid Managed Care	$148.01

MESH HERNIA SYMBOTEX 20X15CM

Facility

$5,585.35

Service Code	HCPCS C1781
Hospital Charge Code	270686534
Hospital Revenue Code	278
Min. Negotiated Rate	$837.80
Max. Negotiated Rate	$1,351.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,117.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,351.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,228.78
Rate for Payer: Qualcare PPO/HMO/WC	$837.80

MESH HERNIA SYSTEM MED

Facility

$1,448.75

Service Code	HCPCS C1781
Hospital Charge Code	270650897
Hospital Revenue Code	278
Min. Negotiated Rate	$34.91
Max. Negotiated Rate	$724.38
Rate for Payer: Aetna Commercial	$550.52
Rate for Payer: Aetna Medicare Advantage	$434.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.43
Rate for Payer: Cigna Commercial	$724.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$318.73
Rate for Payer: Qualcare PPO/HMO/WC	$217.31
Rate for Payer: UnitedHealthcare Community & State	$34.91
Rate for Payer: Wellpoint Medicaid Managed Care	$38.39

MESH HERNIA SYSTEM MED

Facility

$1,448.75

Service Code	HCPCS C1781
Hospital Charge Code	270650897
Hospital Revenue Code	278
Min. Negotiated Rate	$217.31
Max. Negotiated Rate	$350.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$318.73
Rate for Payer: Qualcare PPO/HMO/WC	$217.31

MESH INGUINAL 3DMAX LARGE 4X6

Facility

$1,235.00

Service Code	HCPCS C1781
Hospital Charge Code	270685691
Hospital Revenue Code	278
Min. Negotiated Rate	$185.25
Max. Negotiated Rate	$298.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$298.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$271.70
Rate for Payer: Qualcare PPO/HMO/WC	$185.25

MESH INGUINAL 3DMAX LARGE 4X6

Facility

$1,235.00

Service Code	HCPCS C1781
Hospital Charge Code	270685691
Hospital Revenue Code	278
Min. Negotiated Rate	$29.76
Max. Negotiated Rate	$617.50
Rate for Payer: Aetna Commercial	$469.30
Rate for Payer: Aetna Medicare Advantage	$370.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$314.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$314.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$314.93
Rate for Payer: Cigna Commercial	$617.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$298.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$271.70
Rate for Payer: Qualcare PPO/HMO/WC	$185.25
Rate for Payer: UnitedHealthcare Community & State	$29.76
Rate for Payer: Wellpoint Medicaid Managed Care	$32.73

MESH INTERPROY SLING SYSTEM

Facility

$4,550.00

Hospital Charge Code	270669200
Hospital Revenue Code	278
Min. Negotiated Rate	$109.66
Max. Negotiated Rate	$2,275.00
Rate for Payer: Aetna Commercial	$1,729.00
Rate for Payer: Aetna Medicare Advantage	$1,365.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,160.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,160.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$910.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,160.25
Rate for Payer: Cigna Commercial	$2,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,101.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,001.00
Rate for Payer: Qualcare PPO/HMO/WC	$682.50
Rate for Payer: UnitedHealthcare Community & State	$109.66
Rate for Payer: Wellpoint Medicaid Managed Care	$120.58

MESH INTERPROY SLING SYSTEM

Facility

$4,550.00

Hospital Charge Code	270669200
Hospital Revenue Code	278
Min. Negotiated Rate	$682.50
Max. Negotiated Rate	$1,101.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$910.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,101.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,001.00
Rate for Payer: Qualcare PPO/HMO/WC	$682.50

MESH LAP PROGRIP 10cmX15cm

Facility

$5,196.20

Service Code	HCPCS C1781
Hospital Charge Code	270678841
Hospital Revenue Code	278
Min. Negotiated Rate	$779.43
Max. Negotiated Rate	$1,257.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,257.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.16
Rate for Payer: Qualcare PPO/HMO/WC	$779.43

MESH LAP PROGRIP 10cmX15cm

Facility

$5,196.20

Service Code	HCPCS C1781
Hospital Charge Code	270678841
Hospital Revenue Code	278
Min. Negotiated Rate	$125.23
Max. Negotiated Rate	$2,598.10
Rate for Payer: Aetna Commercial	$1,974.56
Rate for Payer: Aetna Medicare Advantage	$1,558.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,325.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,325.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,325.03
Rate for Payer: Cigna Commercial	$2,598.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,257.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.16
Rate for Payer: Qualcare PPO/HMO/WC	$779.43
Rate for Payer: UnitedHealthcare Community & State	$125.23
Rate for Payer: Wellpoint Medicaid Managed Care	$137.70

MESH LAP PROGRIP 10 X 15

Facility

$2,125.00

Service Code	HCPCS C1781
Hospital Charge Code	270665624
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.50
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

MESH LAP PROGRIP 10 X 15

Facility

$2,155.00

Service Code	HCPCS C1781
Hospital Charge Code	270665623
Hospital Revenue Code	278
Min. Negotiated Rate	$323.25
Max. Negotiated Rate	$521.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$431.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$521.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$474.10
Rate for Payer: Qualcare PPO/HMO/WC	$323.25

MESH LAP PROGRIP 10 X 15

Facility

$2,155.00

Service Code	HCPCS C1781
Hospital Charge Code	270665623
Hospital Revenue Code	278
Min. Negotiated Rate	$51.94
Max. Negotiated Rate	$1,077.50
Rate for Payer: Aetna Commercial	$818.90
Rate for Payer: Aetna Medicare Advantage	$646.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$549.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$549.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$431.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$549.52
Rate for Payer: Cigna Commercial	$1,077.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$521.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$474.10
Rate for Payer: Qualcare PPO/HMO/WC	$323.25
Rate for Payer: UnitedHealthcare Community & State	$51.94
Rate for Payer: Wellpoint Medicaid Managed Care	$57.11

MESH LAP PROGRIP 10 X 15

Facility

$2,125.00

Service Code	HCPCS C1781
Hospital Charge Code	270665624
Hospital Revenue Code	278
Min. Negotiated Rate	$51.21
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$467.50
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Community & State	$51.21
Rate for Payer: Wellpoint Medicaid Managed Care	$56.31

MESH LARGE 3D MAX RIGHT

Facility

$1,528.50

Service Code	HCPCS C1781
Hospital Charge Code	270689458
Hospital Revenue Code	278
Min. Negotiated Rate	$36.84
Max. Negotiated Rate	$764.25
Rate for Payer: Aetna Commercial	$580.83
Rate for Payer: Aetna Medicare Advantage	$458.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$389.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$389.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$389.77
Rate for Payer: Cigna Commercial	$764.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$336.27
Rate for Payer: Qualcare PPO/HMO/WC	$229.28
Rate for Payer: UnitedHealthcare Community & State	$36.84
Rate for Payer: Wellpoint Medicaid Managed Care	$40.51

MESH LARGE 3D MAX RIGHT

Facility

$1,528.50

Service Code	HCPCS C1781
Hospital Charge Code	270689458
Hospital Revenue Code	278
Min. Negotiated Rate	$229.28
Max. Negotiated Rate	$369.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$336.27
Rate for Payer: Qualcare PPO/HMO/WC	$229.28

MESH LARGE LEFT MAX 3D

Facility

$1,204.30

Hospital Charge Code	270655772
Hospital Revenue Code	278
Min. Negotiated Rate	$180.65
Max. Negotiated Rate	$291.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.95
Rate for Payer: Qualcare PPO/HMO/WC	$180.65

MESH LARGE LEFT MAX 3D

Facility

$1,204.30

Hospital Charge Code	270655772
Hospital Revenue Code	278
Min. Negotiated Rate	$29.02
Max. Negotiated Rate	$602.15
Rate for Payer: Aetna Commercial	$457.63
Rate for Payer: Aetna Medicare Advantage	$361.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.10
Rate for Payer: Cigna Commercial	$602.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.95
Rate for Payer: Qualcare PPO/HMO/WC	$180.65
Rate for Payer: UnitedHealthcare Community & State	$29.02
Rate for Payer: Wellpoint Medicaid Managed Care	$31.91

MESH LARGE LIGHT 3DMAX LEFT

Facility

$1,528.50

Service Code	HCPCS C1781
Hospital Charge Code	270689455
Hospital Revenue Code	278
Min. Negotiated Rate	$36.84
Max. Negotiated Rate	$764.25
Rate for Payer: Aetna Commercial	$580.83
Rate for Payer: Aetna Medicare Advantage	$458.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$389.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$389.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$389.77
Rate for Payer: Cigna Commercial	$764.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$336.27
Rate for Payer: Qualcare PPO/HMO/WC	$229.28
Rate for Payer: UnitedHealthcare Community & State	$36.84
Rate for Payer: Wellpoint Medicaid Managed Care	$40.51

MESH LARGE LIGHT 3DMAX LEFT

Facility

$1,528.50

Service Code	HCPCS C1781
Hospital Charge Code	270689455
Hospital Revenue Code	278
Min. Negotiated Rate	$229.28
Max. Negotiated Rate	$369.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$336.27
Rate for Payer: Qualcare PPO/HMO/WC	$229.28

MESH LARGE RIGHT MAX 3D

Facility

$1,204.30

Hospital Charge Code	270655781
Hospital Revenue Code	278
Min. Negotiated Rate	$180.65
Max. Negotiated Rate	$291.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.95
Rate for Payer: Qualcare PPO/HMO/WC	$180.65

MESH LARGE RIGHT MAX 3D

Facility

$1,204.30

Hospital Charge Code	270655781
Hospital Revenue Code	278
Min. Negotiated Rate	$29.02
Max. Negotiated Rate	$602.15
Rate for Payer: Aetna Commercial	$457.63
Rate for Payer: Aetna Medicare Advantage	$361.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.10
Rate for Payer: Cigna Commercial	$602.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.95
Rate for Payer: Qualcare PPO/HMO/WC	$180.65
Rate for Payer: UnitedHealthcare Community & State	$29.02
Rate for Payer: Wellpoint Medicaid Managed Care	$31.91

MESH LEFT 3DMAX MEDIUM 3X5

Facility

$1,130.00

Hospital Charge Code	270655769
Hospital Revenue Code	278
Min. Negotiated Rate	$169.50
Max. Negotiated Rate	$273.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$226.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$248.60
Rate for Payer: Qualcare PPO/HMO/WC	$169.50

Know your out-of-pocket cost for care.

All Charges