Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MESH PLUG ULTRAPRO MEDIUM 4CM

Facility

$889.85

Service Code	HCPCS C1781
Hospital Charge Code	270698946
Hospital Revenue Code	278
Min. Negotiated Rate	$133.48
Max. Negotiated Rate	$215.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.77
Rate for Payer: Qualcare PPO/HMO/WC	$133.48

MESH PLUG ULTRAPRO MEDIUM 4CM

Facility

$889.85

Service Code	HCPCS C1781
Hospital Charge Code	270698946
Hospital Revenue Code	278
Min. Negotiated Rate	$21.45
Max. Negotiated Rate	$444.93
Rate for Payer: Aetna Commercial	$338.14
Rate for Payer: Aetna Medicare Advantage	$266.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.91
Rate for Payer: Cigna Commercial	$444.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$195.77
Rate for Payer: Qualcare PPO/HMO/WC	$133.48
Rate for Payer: UnitedHealthcare Community & State	$21.45
Rate for Payer: Wellpoint Medicaid Managed Care	$23.58

MESH POUCH PET THREAD 20x25MM

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270674905
Hospital Revenue Code	278
Min. Negotiated Rate	$6,000.00
Max. Negotiated Rate	$9,680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,680.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00

MESH POUCH PET THREAD 20x25MM

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270674905
Hospital Revenue Code	278
Min. Negotiated Rate	$964.00
Max. Negotiated Rate	$20,000.00
Rate for Payer: Aetna Commercial	$15,200.00
Rate for Payer: Aetna Medicare Advantage	$12,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,200.00
Rate for Payer: Cigna Commercial	$20,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,680.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00
Rate for Payer: UnitedHealthcare Community & State	$964.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1,060.00

MESH PRE-CONTOURED 163 X 115MM

Facility

$22,135.00

Hospital Charge Code	270663409
Hospital Revenue Code	278
Min. Negotiated Rate	$533.45
Max. Negotiated Rate	$11,067.50
Rate for Payer: Aetna Commercial	$8,411.30
Rate for Payer: Aetna Medicare Advantage	$6,640.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,644.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,644.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,427.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,644.43
Rate for Payer: Cigna Commercial	$11,067.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,356.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,869.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,320.25
Rate for Payer: UnitedHealthcare Community & State	$533.45
Rate for Payer: Wellpoint Medicaid Managed Care	$586.58

MESH PRE-CONTOURED 163 X 115MM

Facility

$22,135.00

Hospital Charge Code	270663409
Hospital Revenue Code	278
Min. Negotiated Rate	$3,320.25
Max. Negotiated Rate	$5,356.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,427.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,356.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,869.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,320.25

MESH PRGRP ANTMCL LT 10x15CM

Facility

$2,474.95

Service Code	HCPCS C1781
Hospital Charge Code	270665726
Hospital Revenue Code	278
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.47
Rate for Payer: Aetna Commercial	$940.48
Rate for Payer: Aetna Medicare Advantage	$742.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$494.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.11
Rate for Payer: Cigna Commercial	$1,237.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.49
Rate for Payer: Qualcare PPO/HMO/WC	$371.24
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

MESH PRGRP ANTMCL LT 10x15CM

Facility

$2,474.95

Service Code	HCPCS C1781
Hospital Charge Code	270665726
Hospital Revenue Code	278
Min. Negotiated Rate	$371.24
Max. Negotiated Rate	$598.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$494.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.49
Rate for Payer: Qualcare PPO/HMO/WC	$371.24

MESH PRGRP ANTMCL RT 10x15CM

Facility

$2,474.95

Service Code	HCPCS C1781
Hospital Charge Code	270665725
Hospital Revenue Code	278
Min. Negotiated Rate	$371.24
Max. Negotiated Rate	$598.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$494.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.49
Rate for Payer: Qualcare PPO/HMO/WC	$371.24

MESH PRGRP ANTMCL RT 10x15CM

Facility

$2,474.95

Service Code	HCPCS C1781
Hospital Charge Code	270665725
Hospital Revenue Code	278
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.47
Rate for Payer: Aetna Commercial	$940.48
Rate for Payer: Aetna Medicare Advantage	$742.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$494.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.11
Rate for Payer: Cigna Commercial	$1,237.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$544.49
Rate for Payer: Qualcare PPO/HMO/WC	$371.24
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

MESH PRIMATRIX 8X 8 CM

Facility

$12,163.20

Service Code	HCPCS Q4110
Hospital Charge Code	270684335
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.48
Max. Negotiated Rate	$2,943.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,432.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,943.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,675.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.48

MESH PRIMATRIX 8X 8 CM

Facility

$12,163.20

Service Code	HCPCS Q4110
Hospital Charge Code	270684335
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$2,943.49
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	$2,432.64
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	$2,943.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,675.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.48
Rate for Payer: UnitedHealthcare Community & State	$293.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$322.32

MESH PRIMATRIX AG 6X6CM

Facility

$9,904.20

Service Code	HCPCS Q4110
Hospital Charge Code	270697900
Hospital Revenue Code	278
Min. Negotiated Rate	$1,485.63
Max. Negotiated Rate	$2,396.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,396.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,178.92
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.63

MESH PRIMATRIX AG 6X6CM

Facility

$9,904.20

Service Code	HCPCS Q4110
Hospital Charge Code	270697900
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$2,396.82
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	$1,980.84
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	$2,396.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,178.92
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.63
Rate for Payer: UnitedHealthcare Community & State	$238.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$262.46

MESH PRLTE ULTRA175x4.4 30803

Facility

$153.22

Hospital Charge Code	270659485
Hospital Revenue Code	278
Min. Negotiated Rate	$22.98
Max. Negotiated Rate	$37.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.71
Rate for Payer: Qualcare PPO/HMO/WC	$22.98

MESH PRLTE ULTRA175x4.4 30803

Facility

$153.22

Hospital Charge Code	270659485
Hospital Revenue Code	278
Min. Negotiated Rate	$3.69
Max. Negotiated Rate	$76.61
Rate for Payer: Aetna Commercial	$58.22
Rate for Payer: Aetna Medicare Advantage	$45.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.07
Rate for Payer: Cigna Commercial	$76.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.71
Rate for Payer: Qualcare PPO/HMO/WC	$22.98
Rate for Payer: UnitedHealthcare Community & State	$3.69
Rate for Payer: Wellpoint Medicaid Managed Care	$4.06

MESH PROCEED 4x8 SURG RE PCDD1

Facility

$2,411.50

Hospital Charge Code	270633462
Hospital Revenue Code	278
Min. Negotiated Rate	$58.12
Max. Negotiated Rate	$1,205.75
Rate for Payer: Aetna Commercial	$916.37
Rate for Payer: Aetna Medicare Advantage	$723.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$614.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$614.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$482.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$614.93
Rate for Payer: Cigna Commercial	$1,205.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$583.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$530.53
Rate for Payer: Qualcare PPO/HMO/WC	$361.73
Rate for Payer: UnitedHealthcare Community & State	$58.12
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

MESH PROCEED 4x8 SURG RE PCDD1

Facility

$2,411.50

Hospital Charge Code	270633462
Hospital Revenue Code	278
Min. Negotiated Rate	$361.73
Max. Negotiated Rate	$583.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$482.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$583.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$530.53
Rate for Payer: Qualcare PPO/HMO/WC	$361.73

MESH PROGRIP 16X12 LEFT

Facility

$2,609.30

Service Code	HCPCS C1781
Hospital Charge Code	270690862
Hospital Revenue Code	278
Min. Negotiated Rate	$62.88
Max. Negotiated Rate	$1,304.65
Rate for Payer: Aetna Commercial	$991.53
Rate for Payer: Aetna Medicare Advantage	$782.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$665.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$665.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$521.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$665.37
Rate for Payer: Cigna Commercial	$1,304.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$631.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$574.05
Rate for Payer: Qualcare PPO/HMO/WC	$391.39
Rate for Payer: UnitedHealthcare Community & State	$62.88
Rate for Payer: Wellpoint Medicaid Managed Care	$69.15

MESH PROGRIP 16X12 LEFT

Facility

$2,609.30

Service Code	HCPCS C1781
Hospital Charge Code	270690862
Hospital Revenue Code	278
Min. Negotiated Rate	$391.39
Max. Negotiated Rate	$631.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$521.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$631.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$574.05
Rate for Payer: Qualcare PPO/HMO/WC	$391.39

MESH PROGRIP 16X12MM LT

Facility

$2,470.00

Service Code	HCPCS C1781
Hospital Charge Code	270692351
Hospital Revenue Code	278
Min. Negotiated Rate	$59.53
Max. Negotiated Rate	$1,235.00
Rate for Payer: Aetna Commercial	$938.60
Rate for Payer: Aetna Medicare Advantage	$741.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$629.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$629.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$494.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$629.85
Rate for Payer: Cigna Commercial	$1,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$597.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$543.40
Rate for Payer: Qualcare PPO/HMO/WC	$370.50
Rate for Payer: UnitedHealthcare Community & State	$59.53
Rate for Payer: Wellpoint Medicaid Managed Care	$65.45

MESH PROGRIP 16X12MM LT

Facility

$2,470.00

Service Code	HCPCS C1781
Hospital Charge Code	270692351
Hospital Revenue Code	278
Min. Negotiated Rate	$370.50
Max. Negotiated Rate	$597.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$494.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$597.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$543.40
Rate for Payer: Qualcare PPO/HMO/WC	$370.50

MESH PROGRIP 16X12MM RT

Facility

$2,634.90

Service Code	HCPCS C1781
Hospital Charge Code	270692352
Hospital Revenue Code	278
Min. Negotiated Rate	$63.50
Max. Negotiated Rate	$1,317.45
Rate for Payer: Aetna Commercial	$1,001.26
Rate for Payer: Aetna Medicare Advantage	$790.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$671.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$671.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$526.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$671.90
Rate for Payer: Cigna Commercial	$1,317.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$637.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$579.68
Rate for Payer: Qualcare PPO/HMO/WC	$395.24
Rate for Payer: UnitedHealthcare Community & State	$63.50
Rate for Payer: Wellpoint Medicaid Managed Care	$69.82

MESH PROGRIP 16X12MM RT

Facility

$2,634.90

Service Code	HCPCS C1781
Hospital Charge Code	270692352
Hospital Revenue Code	278
Min. Negotiated Rate	$395.24
Max. Negotiated Rate	$637.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$526.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$637.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$579.68
Rate for Payer: Qualcare PPO/HMO/WC	$395.24

MESH PROGRIP 16X12 RIGHT

Facility

$2,329.75

Service Code	HCPCS C1781
Hospital Charge Code	270691302
Hospital Revenue Code	278
Min. Negotiated Rate	$349.46
Max. Negotiated Rate	$563.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$563.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$512.54
Rate for Payer: Qualcare PPO/HMO/WC	$349.46

Know your out-of-pocket cost for care.

All Charges