Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MESH PROGRIP 16X12 RIGHT

Facility

$2,329.75

Service Code	HCPCS C1781
Hospital Charge Code	270691302
Hospital Revenue Code	278
Min. Negotiated Rate	$56.15
Max. Negotiated Rate	$1,164.88
Rate for Payer: Aetna Commercial	$885.30
Rate for Payer: Aetna Medicare Advantage	$698.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$594.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$594.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$594.09
Rate for Payer: Cigna Commercial	$1,164.88
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
Rate for Payer: UnitedHealthcare Community & State	$56.15
Rate for Payer: Wellpoint Medicaid Managed Care	$61.74

MESH PROGRIP 16X12 RIGHT

Facility

$2,609.30

Service Code	HCPCS C1781
Hospital Charge Code	270690863
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 RIGHT

Facility

$2,609.30

Service Code	HCPCS C1781
Hospital Charge Code	270690863
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 PROLE HERNIA 4IN D/S PHSL

Facility

$1,489.45

Service Code	HCPCS C1781
Hospital Charge Code	270637980
Hospital Revenue Code	278
Min. Negotiated Rate	$223.42
Max. Negotiated Rate	$360.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$297.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$327.68
Rate for Payer: Qualcare PPO/HMO/WC	$223.42

MESH PROLE HERNIA 4IN D/S PHSL

Facility

$1,489.45

Service Code	HCPCS C1781
Hospital Charge Code	270637980
Hospital Revenue Code	278
Min. Negotiated Rate	$35.90
Max. Negotiated Rate	$744.73
Rate for Payer: Aetna Commercial	$565.99
Rate for Payer: Aetna Medicare Advantage	$446.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$379.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$379.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$297.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$379.81
Rate for Payer: Cigna Commercial	$744.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$327.68
Rate for Payer: Qualcare PPO/HMO/WC	$223.42
Rate for Payer: UnitedHealthcare Community & State	$35.90
Rate for Payer: Wellpoint Medicaid Managed Care	$39.47

MESH PROLENE 12 X 12 23000PML

Facility

$592.65

Service Code	HCPCS C1781
Hospital Charge Code	270611263
Hospital Revenue Code	278
Min. Negotiated Rate	$88.90
Max. Negotiated Rate	$143.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$130.38
Rate for Payer: Qualcare PPO/HMO/WC	$88.90

MESH PROLENE 12 X 12 23000PML

Facility

$592.65

Service Code	HCPCS C1781
Hospital Charge Code	270611263
Hospital Revenue Code	278
Min. Negotiated Rate	$14.28
Max. Negotiated Rate	$296.32
Rate for Payer: Aetna Commercial	$225.21
Rate for Payer: Aetna Medicare Advantage	$177.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.13
Rate for Payer: Cigna Commercial	$296.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$130.38
Rate for Payer: Qualcare PPO/HMO/WC	$88.90
Rate for Payer: UnitedHealthcare Community & State	$14.28
Rate for Payer: Wellpoint Medicaid Managed Care	$15.71

MESH PROLENE 3 HRN 230000PHSM

Facility

$2,148.82

Service Code	HCPCS C1781
Hospital Charge Code	270612392
Hospital Revenue Code	278
Min. Negotiated Rate	$322.32
Max. Negotiated Rate	$520.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$429.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$472.74
Rate for Payer: Qualcare PPO/HMO/WC	$322.32

MESH PROLENE 3 HRN 230000PHSM

Facility

$2,148.82

Service Code	HCPCS C1781
Hospital Charge Code	270612392
Hospital Revenue Code	278
Min. Negotiated Rate	$51.79
Max. Negotiated Rate	$1,074.41
Rate for Payer: Aetna Commercial	$816.55
Rate for Payer: Aetna Medicare Advantage	$644.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$547.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$547.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$429.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$547.95
Rate for Payer: Cigna Commercial	$1,074.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$472.74
Rate for Payer: Qualcare PPO/HMO/WC	$322.32
Rate for Payer: UnitedHealthcare Community & State	$51.79
Rate for Payer: Wellpoint Medicaid Managed Care	$56.94

MESH PROLENE 3x6

Facility

$604.91

Service Code	HCPCS C1781
Hospital Charge Code	270652755
Hospital Revenue Code	278
Min. Negotiated Rate	$14.58
Max. Negotiated Rate	$302.45
Rate for Payer: Aetna Commercial	$229.87
Rate for Payer: Aetna Medicare Advantage	$181.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.25
Rate for Payer: Cigna Commercial	$302.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$133.08
Rate for Payer: Qualcare PPO/HMO/WC	$90.74
Rate for Payer: UnitedHealthcare Community & State	$14.58
Rate for Payer: Wellpoint Medicaid Managed Care	$16.03

MESH PROLENE 3x6

Facility

$604.91

Service Code	HCPCS C1781
Hospital Charge Code	270652755
Hospital Revenue Code	278
Min. Negotiated Rate	$90.74
Max. Negotiated Rate	$146.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$133.08
Rate for Payer: Qualcare PPO/HMO/WC	$90.74

MESH PROLENE 6 IN X 6 IN

Facility

$271.31

Service Code	HCPCS C1781
Hospital Charge Code	270665964
Hospital Revenue Code	278
Min. Negotiated Rate	$40.70
Max. Negotiated Rate	$65.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.69
Rate for Payer: Qualcare PPO/HMO/WC	$40.70

MESH PROLENE 6 IN X 6 IN

Facility

$271.31

Service Code	HCPCS C1781
Hospital Charge Code	270665964
Hospital Revenue Code	278
Min. Negotiated Rate	$6.54
Max. Negotiated Rate	$135.66
Rate for Payer: Aetna Commercial	$103.10
Rate for Payer: Aetna Medicare Advantage	$81.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.18
Rate for Payer: Cigna Commercial	$135.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.69
Rate for Payer: Qualcare PPO/HMO/WC	$40.70
Rate for Payer: UnitedHealthcare Community & State	$6.54
Rate for Payer: Wellpoint Medicaid Managed Care	$7.19

MESH PROLENE EXTENDED 6

Facility

$1,448.78

Service Code	HCPCS C1781
Hospital Charge Code	270651826
Hospital Revenue Code	278
Min. Negotiated Rate	$217.32
Max. Negotiated Rate	$350.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.76
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	$217.32

MESH PROLENE EXTENDED 6

Facility

$1,448.78

Service Code	HCPCS C1781
Hospital Charge Code	270651826
Hospital Revenue Code	278
Min. Negotiated Rate	$34.92
Max. Negotiated Rate	$724.39
Rate for Payer: Aetna Commercial	$550.54
Rate for Payer: Aetna Medicare Advantage	$434.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.44
Rate for Payer: Cigna Commercial	$724.39
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	$217.32
Rate for Payer: UnitedHealthcare Community & State	$34.92
Rate for Payer: Wellpoint Medicaid Managed Care	$38.39

MESH PROLENE HERNIA SYSTEM LG

Facility

$2,198.46

Service Code	HCPCS C1781
Hospital Charge Code	270659431
Hospital Revenue Code	278
Min. Negotiated Rate	$52.98
Max. Negotiated Rate	$1,099.23
Rate for Payer: Aetna Commercial	$835.41
Rate for Payer: Aetna Medicare Advantage	$659.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$560.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$560.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$439.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$560.61
Rate for Payer: Cigna Commercial	$1,099.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$483.66
Rate for Payer: Qualcare PPO/HMO/WC	$329.77
Rate for Payer: UnitedHealthcare Community & State	$52.98
Rate for Payer: Wellpoint Medicaid Managed Care	$58.26

MESH PROLENE HERNIA SYSTEM LG

Facility

$2,198.46

Service Code	HCPCS C1781
Hospital Charge Code	270659431
Hospital Revenue Code	278
Min. Negotiated Rate	$329.77
Max. Negotiated Rate	$532.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$439.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$483.66
Rate for Payer: Qualcare PPO/HMO/WC	$329.77

MESH PROLITE 1010303-05

Facility

$585.90

Service Code	HCPCS C1781
Hospital Charge Code	270661162
Hospital Revenue Code	278
Min. Negotiated Rate	$87.89
Max. Negotiated Rate	$141.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.90
Rate for Payer: Qualcare PPO/HMO/WC	$87.89

MESH PROLITE 1010303-05

Facility

$585.90

Service Code	HCPCS C1781
Hospital Charge Code	270661162
Hospital Revenue Code	278
Min. Negotiated Rate	$14.12
Max. Negotiated Rate	$292.95
Rate for Payer: Aetna Commercial	$222.64
Rate for Payer: Aetna Medicare Advantage	$175.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.40
Rate for Payer: Cigna Commercial	$292.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.90
Rate for Payer: Qualcare PPO/HMO/WC	$87.89
Rate for Payer: UnitedHealthcare Community & State	$14.12
Rate for Payer: Wellpoint Medicaid Managed Care	$15.53

MESH PROLOOP LARGE 30902

Facility

$1,244.60

Service Code	HCPCS C1781
Hospital Charge Code	270651871
Hospital Revenue Code	278
Min. Negotiated Rate	$186.69
Max. Negotiated Rate	$301.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.81
Rate for Payer: Qualcare PPO/HMO/WC	$186.69

MESH PROLOOP LARGE 30902

Facility

$1,244.60

Service Code	HCPCS C1781
Hospital Charge Code	270651871
Hospital Revenue Code	278
Min. Negotiated Rate	$29.99
Max. Negotiated Rate	$622.30
Rate for Payer: Aetna Commercial	$472.95
Rate for Payer: Aetna Medicare Advantage	$373.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.37
Rate for Payer: Cigna Commercial	$622.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.81
Rate for Payer: Qualcare PPO/HMO/WC	$186.69
Rate for Payer: UnitedHealthcare Community & State	$29.99
Rate for Payer: Wellpoint Medicaid Managed Care	$32.98

MESH PROLOOP LARGE POLYPROPYLE

Facility

$615.90

Service Code	HCPCS C1780
Hospital Charge Code	270653355
Hospital Revenue Code	278
Min. Negotiated Rate	$14.84
Max. Negotiated Rate	$307.95
Rate for Payer: Aetna Commercial	$234.04
Rate for Payer: Aetna Medicare Advantage	$184.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.05
Rate for Payer: Cigna Commercial	$307.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.50
Rate for Payer: Qualcare PPO/HMO/WC	$92.39
Rate for Payer: UnitedHealthcare Community & State	$14.84
Rate for Payer: Wellpoint Medicaid Managed Care	$16.32

MESH PROLOOP LARGE POLYPROPYLE

Facility

$615.90

Service Code	HCPCS C1780
Hospital Charge Code	270653355
Hospital Revenue Code	278
Min. Negotiated Rate	$92.39
Max. Negotiated Rate	$149.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.50
Rate for Payer: Qualcare PPO/HMO/WC	$92.39

MESH PROLOOP PLUG LG. 2/BOX

Facility

$673.75

Service Code	HCPCS C1781
Hospital Charge Code	270653907
Hospital Revenue Code	278
Min. Negotiated Rate	$101.06
Max. Negotiated Rate	$163.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.22
Rate for Payer: Qualcare PPO/HMO/WC	$101.06

MESH PROLOOP PLUG LG. 2/BOX

Facility

$673.75

Service Code	HCPCS C1781
Hospital Charge Code	270653907
Hospital Revenue Code	278
Min. Negotiated Rate	$16.24
Max. Negotiated Rate	$336.88
Rate for Payer: Aetna Commercial	$256.02
Rate for Payer: Aetna Medicare Advantage	$202.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.81
Rate for Payer: Cigna Commercial	$336.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.22
Rate for Payer: Qualcare PPO/HMO/WC	$101.06
Rate for Payer: UnitedHealthcare Community & State	$16.24
Rate for Payer: Wellpoint Medicaid Managed Care	$17.85

Know your out-of-pocket cost for care.

All Charges