Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MESH LEFT 3DMAX MEDIUM 3X5

Facility

$1,130.00

Hospital Charge Code	270655769
Hospital Revenue Code	278
Min. Negotiated Rate	$27.23
Max. Negotiated Rate	$565.00
Rate for Payer: Aetna Commercial	$429.40
Rate for Payer: Aetna Medicare Advantage	$339.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$288.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$288.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$226.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$288.15
Rate for Payer: Cigna Commercial	$565.00
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
Rate for Payer: UnitedHealthcare Community & State	$27.23
Rate for Payer: Wellpoint Medicaid Managed Care	$29.95

MESH L/P CIRCLE 4.5 IN/11.4cm

Facility

$3,500.00

Service Code	HCPCS C1781
Hospital Charge Code	270644531
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$770.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

MESH L/P CIRCLE 4.5 IN/11.4cm

Facility

$3,500.00

Service Code	HCPCS C1781
Hospital Charge Code	270644531
Hospital Revenue Code	278
Min. Negotiated Rate	$84.35
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$770.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Community & State	$84.35
Rate for Payer: Wellpoint Medicaid Managed Care	$92.75

MESH LP PRGRP FLAT SHT 10x15CM

Facility

$2,201.35

Service Code	HCPCS C1781
Hospital Charge Code	270665625
Hospital Revenue Code	278
Min. Negotiated Rate	$330.20
Max. Negotiated Rate	$532.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.30
Rate for Payer: Qualcare PPO/HMO/WC	$330.20

MESH LP PRGRP FLAT SHT 10x15CM

Facility

$2,201.35

Service Code	HCPCS C1781
Hospital Charge Code	270665625
Hospital Revenue Code	278
Min. Negotiated Rate	$53.05
Max. Negotiated Rate	$1,100.67
Rate for Payer: Aetna Commercial	$836.51
Rate for Payer: Aetna Medicare Advantage	$660.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.34
Rate for Payer: Cigna Commercial	$1,100.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.30
Rate for Payer: Qualcare PPO/HMO/WC	$330.20
Rate for Payer: UnitedHealthcare Community & State	$53.05
Rate for Payer: Wellpoint Medicaid Managed Care	$58.34

MESH MALLEABLE L/PRO 100x100MM

Facility

$13,430.00

Hospital Charge Code	270660972
Hospital Revenue Code	278
Min. Negotiated Rate	$323.66
Max. Negotiated Rate	$6,715.00
Rate for Payer: Aetna Commercial	$5,103.40
Rate for Payer: Aetna Medicare Advantage	$4,029.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,424.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,424.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,686.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,424.65
Rate for Payer: Cigna Commercial	$6,715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,250.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,954.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,014.50
Rate for Payer: UnitedHealthcare Community & State	$323.66
Rate for Payer: Wellpoint Medicaid Managed Care	$355.89

MESH MALLEABLE L/PRO 100x100MM

Facility

$13,430.00

Hospital Charge Code	270660972
Hospital Revenue Code	278
Min. Negotiated Rate	$2,014.50
Max. Negotiated Rate	$3,250.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,686.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,250.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,954.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,014.50

MESH MARLEX **********

Facility

$655.00

Hospital Charge Code	1601251
Hospital Revenue Code	272
Min. Negotiated Rate	$15.79
Max. Negotiated Rate	$327.50
Rate for Payer: Aetna Commercial	$248.90
Rate for Payer: Aetna Medicare Advantage	$196.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.03
Rate for Payer: Cigna Commercial	$327.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.50
Rate for Payer: Oxford Commercial	$131.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.25
Rate for Payer: UnitedHealthcare Commercial	$131.00
Rate for Payer: UnitedHealthcare Community & State	$15.79
Rate for Payer: Wellpoint Medicaid Managed Care	$17.36

MESH MARLEX **********

Facility

$655.00

Hospital Charge Code	1601251
Hospital Revenue Code	272
Min. Negotiated Rate	$98.25
Max. Negotiated Rate	$98.25
Rate for Payer: Qualcare PPO/HMO/WC	$98.25

MESH MARLEX 10 X 14 011266

Facility

$1,956.00

Hospital Charge Code	270061030
Hospital Revenue Code	278
Min. Negotiated Rate	$47.14
Max. Negotiated Rate	$978.00
Rate for Payer: Aetna Commercial	$743.28
Rate for Payer: Aetna Medicare Advantage	$586.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$498.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$498.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$391.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$498.78
Rate for Payer: Cigna Commercial	$978.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$473.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$430.32
Rate for Payer: Qualcare PPO/HMO/WC	$293.40
Rate for Payer: UnitedHealthcare Community & State	$47.14
Rate for Payer: Wellpoint Medicaid Managed Care	$51.83

MESH MARLEX 10 X 14 011266

Facility

$1,956.00

Hospital Charge Code	270061030
Hospital Revenue Code	278
Min. Negotiated Rate	$293.40
Max. Negotiated Rate	$473.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$391.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$473.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$430.32
Rate for Payer: Qualcare PPO/HMO/WC	$293.40

MESH MARLEX 10x14 0112660

Facility

$697.50

Service Code	HCPCS C1781
Hospital Charge Code	270626940
Hospital Revenue Code	278
Min. Negotiated Rate	$16.81
Max. Negotiated Rate	$348.75
Rate for Payer: Aetna Commercial	$265.05
Rate for Payer: Aetna Medicare Advantage	$209.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.86
Rate for Payer: Cigna Commercial	$348.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$153.45
Rate for Payer: Qualcare PPO/HMO/WC	$104.62
Rate for Payer: UnitedHealthcare Community & State	$16.81
Rate for Payer: Wellpoint Medicaid Managed Care	$18.48

MESH MARLEX 10x14 0112660

Facility

$697.50

Service Code	HCPCS C1781
Hospital Charge Code	270626940
Hospital Revenue Code	278
Min. Negotiated Rate	$104.62
Max. Negotiated Rate	$168.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$153.45
Rate for Payer: Qualcare PPO/HMO/WC	$104.62

MESH MARLEX 3 X 6 *******

Facility

$449.00

Hospital Charge Code	1605617
Hospital Revenue Code	272
Min. Negotiated Rate	$10.82
Max. Negotiated Rate	$224.50
Rate for Payer: Aetna Commercial	$170.62
Rate for Payer: Aetna Medicare Advantage	$134.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.50
Rate for Payer: Cigna Commercial	$224.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.70
Rate for Payer: Oxford Commercial	$89.80
Rate for Payer: Qualcare PPO/HMO/WC	$67.35
Rate for Payer: UnitedHealthcare Commercial	$89.80
Rate for Payer: UnitedHealthcare Community & State	$10.82
Rate for Payer: Wellpoint Medicaid Managed Care	$11.90

MESH MARLEX 3 X 6 *******

Facility

$449.00

Hospital Charge Code	1605617
Hospital Revenue Code	272
Min. Negotiated Rate	$67.35
Max. Negotiated Rate	$67.35
Rate for Payer: Qualcare PPO/HMO/WC	$67.35

MESH MARLEX 6 X 6 *******

Facility

$548.00

Hospital Charge Code	1605609
Hospital Revenue Code	272
Min. Negotiated Rate	$13.21
Max. Negotiated Rate	$274.00
Rate for Payer: Aetna Commercial	$208.24
Rate for Payer: Aetna Medicare Advantage	$164.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.74
Rate for Payer: Cigna Commercial	$274.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.40
Rate for Payer: Oxford Commercial	$109.60
Rate for Payer: Qualcare PPO/HMO/WC	$82.20
Rate for Payer: UnitedHealthcare Commercial	$109.60
Rate for Payer: UnitedHealthcare Community & State	$13.21
Rate for Payer: Wellpoint Medicaid Managed Care	$14.52

MESH MARLEX 6 X 6 *******

Facility

$548.00

Hospital Charge Code	1605609
Hospital Revenue Code	272
Min. Negotiated Rate	$82.20
Max. Negotiated Rate	$82.20
Rate for Payer: Qualcare PPO/HMO/WC	$82.20

MESH MARLEX 6 X 6 011272

Facility

$828.85

Service Code	HCPCS C1781
Hospital Charge Code	270600418
Hospital Revenue Code	278
Min. Negotiated Rate	$124.33
Max. Negotiated Rate	$200.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.35
Rate for Payer: Qualcare PPO/HMO/WC	$124.33

MESH MARLEX 6 X 6 011272

Facility

$828.85

Service Code	HCPCS C1781
Hospital Charge Code	270600418
Hospital Revenue Code	278
Min. Negotiated Rate	$19.98
Max. Negotiated Rate	$414.43
Rate for Payer: Aetna Commercial	$314.96
Rate for Payer: Aetna Medicare Advantage	$248.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.36
Rate for Payer: Cigna Commercial	$414.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$182.35
Rate for Payer: Qualcare PPO/HMO/WC	$124.33
Rate for Payer: UnitedHealthcare Community & State	$19.98
Rate for Payer: Wellpoint Medicaid Managed Care	$21.96

MESH MARLEX PLUG PERFIX LARGE

Facility

$1,293.50

Hospital Charge Code	270654347
Hospital Revenue Code	278
Min. Negotiated Rate	$194.03
Max. Negotiated Rate	$313.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.57
Rate for Payer: Qualcare PPO/HMO/WC	$194.03

MESH MARLEX PLUG PERFIX LARGE

Facility

$1,293.50

Hospital Charge Code	270654347
Hospital Revenue Code	278
Min. Negotiated Rate	$31.17
Max. Negotiated Rate	$646.75
Rate for Payer: Aetna Commercial	$491.53
Rate for Payer: Aetna Medicare Advantage	$388.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.84
Rate for Payer: Cigna Commercial	$646.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$284.57
Rate for Payer: Qualcare PPO/HMO/WC	$194.03
Rate for Payer: UnitedHealthcare Community & State	$31.17
Rate for Payer: Wellpoint Medicaid Managed Care	$34.28

MESH MARLEX PLUG PERFIX SMALL

Facility

$2,535.50

Service Code	HCPCS C1781
Hospital Charge Code	270657712
Hospital Revenue Code	278
Min. Negotiated Rate	$380.32
Max. Negotiated Rate	$613.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$507.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$613.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$557.81
Rate for Payer: Qualcare PPO/HMO/WC	$380.32

MESH MARLEX PLUG PERFIX SMALL

Facility

$2,535.50

Service Code	HCPCS C1781
Hospital Charge Code	270657712
Hospital Revenue Code	278
Min. Negotiated Rate	$61.11
Max. Negotiated Rate	$1,267.75
Rate for Payer: Aetna Commercial	$963.49
Rate for Payer: Aetna Medicare Advantage	$760.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$646.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$646.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$507.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$646.55
Rate for Payer: Cigna Commercial	$1,267.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$613.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$557.81
Rate for Payer: Qualcare PPO/HMO/WC	$380.32
Rate for Payer: UnitedHealthcare Community & State	$61.11
Rate for Payer: Wellpoint Medicaid Managed Care	$67.19

MESH MARLEX PLUG XL

Facility

$1,698.50

Service Code	HCPCS C1781
Hospital Charge Code	270653977
Hospital Revenue Code	278
Min. Negotiated Rate	$40.93
Max. Negotiated Rate	$849.25
Rate for Payer: Aetna Commercial	$645.43
Rate for Payer: Aetna Medicare Advantage	$509.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$339.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.12
Rate for Payer: Cigna Commercial	$849.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$373.67
Rate for Payer: Qualcare PPO/HMO/WC	$254.78
Rate for Payer: UnitedHealthcare Community & State	$40.93
Rate for Payer: Wellpoint Medicaid Managed Care	$45.01

MESH MARLEX PLUG XL

Facility

$1,698.50

Service Code	HCPCS C1781
Hospital Charge Code	270653977
Hospital Revenue Code	278
Min. Negotiated Rate	$254.78
Max. Negotiated Rate	$411.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$339.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$373.67
Rate for Payer: Qualcare PPO/HMO/WC	$254.78

Know your out-of-pocket cost for care.

All Charges