Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MESH PTEX PCOX SKIRT 20X15CM

Facility

$4,919.50

Service Code	HCPCS C1781
Hospital Charge Code	270656079
Hospital Revenue Code	278
Min. Negotiated Rate	$737.92
Max. Negotiated Rate	$1,190.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$983.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,190.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,082.29
Rate for Payer: Qualcare PPO/HMO/WC	$737.92

MESH PTEX PCOX SKIRT 25X20CM

Facility

$5,282.00

Service Code	HCPCS C1781
Hospital Charge Code	270659454
Hospital Revenue Code	278
Min. Negotiated Rate	$127.30
Max. Negotiated Rate	$2,641.00
Rate for Payer: Aetna Commercial	$2,007.16
Rate for Payer: Aetna Medicare Advantage	$1,584.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,346.91
Rate for Payer: Cigna Commercial	$2,641.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,278.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,162.04
Rate for Payer: Qualcare PPO/HMO/WC	$792.30
Rate for Payer: UnitedHealthcare Community & State	$127.30
Rate for Payer: Wellpoint Medicaid Managed Care	$139.97

MESH PTEX PCOX SKIRT 25X20CM

Facility

$5,282.00

Service Code	HCPCS C1781
Hospital Charge Code	270659454
Hospital Revenue Code	278
Min. Negotiated Rate	$792.30
Max. Negotiated Rate	$1,278.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,278.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,162.04
Rate for Payer: Qualcare PPO/HMO/WC	$792.30

MESH RIGHT 3D MAX

Facility

$1,162.50

Service Code	HCPCS C1781
Hospital Charge Code	270687580
Hospital Revenue Code	278
Min. Negotiated Rate	$174.38
Max. Negotiated Rate	$281.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$255.75
Rate for Payer: Qualcare PPO/HMO/WC	$174.38

MESH RIGHT 3D MAX

Facility

$1,162.50

Service Code	HCPCS C1781
Hospital Charge Code	270687580
Hospital Revenue Code	278
Min. Negotiated Rate	$28.02
Max. Negotiated Rate	$581.25
Rate for Payer: Aetna Commercial	$441.75
Rate for Payer: Aetna Medicare Advantage	$348.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$296.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$296.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$296.44
Rate for Payer: Cigna Commercial	$581.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$255.75
Rate for Payer: Qualcare PPO/HMO/WC	$174.38
Rate for Payer: UnitedHealthcare Community & State	$28.02
Rate for Payer: Wellpoint Medicaid Managed Care	$30.81

MESH RIGHT 3D MAX 3X5

Facility

$1,130.00

Hospital Charge Code	270655785
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

MESH RIGHT 3D MAX 3X5

Facility

$1,130.00

Hospital Charge Code	270655785
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 RIGID L/PRO 100x100MM

Facility

$13,430.00

Hospital Charge Code	270674576
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 RIGID L/PRO 100x100MM

Facility

$13,430.00

Hospital Charge Code	270674576
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 SHEET 6X6

Facility

$2,029.05

Service Code	HCPCS C1781
Hospital Charge Code	270657707
Hospital Revenue Code	278
Min. Negotiated Rate	$48.90
Max. Negotiated Rate	$1,014.52
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$608.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$517.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$517.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$517.41
Rate for Payer: Cigna Commercial	$1,014.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$491.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$446.39
Rate for Payer: Qualcare PPO/HMO/WC	$304.36
Rate for Payer: UnitedHealthcare Community & State	$48.90
Rate for Payer: Wellpoint Medicaid Managed Care	$53.77

MESH SHEET 6X6

Facility

$2,029.05

Service Code	HCPCS C1781
Hospital Charge Code	270657707
Hospital Revenue Code	278
Min. Negotiated Rate	$304.36
Max. Negotiated Rate	$491.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$491.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$446.39
Rate for Payer: Qualcare PPO/HMO/WC	$304.36

MESH SHEET FLAT 16X12

Facility

$2,186.35

Service Code	HCPCS C1781
Hospital Charge Code	270690295
Hospital Revenue Code	278
Min. Negotiated Rate	$52.69
Max. Negotiated Rate	$1,093.17
Rate for Payer: Aetna Commercial	$830.81
Rate for Payer: Aetna Medicare Advantage	$655.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$557.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$557.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$437.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$557.52
Rate for Payer: Cigna Commercial	$1,093.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$529.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$481.00
Rate for Payer: Qualcare PPO/HMO/WC	$327.95
Rate for Payer: UnitedHealthcare Community & State	$52.69
Rate for Payer: Wellpoint Medicaid Managed Care	$57.94

MESH SHEET FLAT 16X12

Facility

$2,186.35

Service Code	HCPCS C1781
Hospital Charge Code	270690295
Hospital Revenue Code	278
Min. Negotiated Rate	$327.95
Max. Negotiated Rate	$529.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$437.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$529.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$481.00
Rate for Payer: Qualcare PPO/HMO/WC	$327.95

MESH SKIRT 20 CMX15 CM

Facility

$5,627.95

Hospital Charge Code	270683623
Hospital Revenue Code	272
Min. Negotiated Rate	$135.63
Max. Negotiated Rate	$2,813.97
Rate for Payer: Aetna Commercial	$2,138.62
Rate for Payer: Aetna Medicare Advantage	$1,688.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,435.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,435.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,435.13
Rate for Payer: Cigna Commercial	$2,813.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,688.38
Rate for Payer: Oxford Commercial	$1,125.59
Rate for Payer: Qualcare PPO/HMO/WC	$844.19
Rate for Payer: UnitedHealthcare Commercial	$1,125.59
Rate for Payer: UnitedHealthcare Community & State	$135.63
Rate for Payer: Wellpoint Medicaid Managed Care	$149.14

MESH SKIRT 20 CMX15 CM

Facility

$5,627.95

Hospital Charge Code	270683623
Hospital Revenue Code	272
Min. Negotiated Rate	$844.19
Max. Negotiated Rate	$844.19
Rate for Payer: Qualcare PPO/HMO/WC	$844.19

MESH SOFT 2X4

Facility

$959.25

Service Code	HCPCS C1781
Hospital Charge Code	270691535
Hospital Revenue Code	278
Min. Negotiated Rate	$23.12
Max. Negotiated Rate	$479.62
Rate for Payer: Aetna Commercial	$364.51
Rate for Payer: Aetna Medicare Advantage	$287.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.61
Rate for Payer: Cigna Commercial	$479.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89
Rate for Payer: UnitedHealthcare Community & State	$23.12
Rate for Payer: Wellpoint Medicaid Managed Care	$25.42

MESH SOFT 2X4

Facility

$959.25

Service Code	HCPCS C1781
Hospital Charge Code	270691535
Hospital Revenue Code	278
Min. Negotiated Rate	$143.89
Max. Negotiated Rate	$232.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.03
Rate for Payer: Qualcare PPO/HMO/WC	$143.89

MESH SOFT 3X6

Facility

$1,016.25

Service Code	HCPCS C1781
Hospital Charge Code	270691536
Hospital Revenue Code	278
Min. Negotiated Rate	$152.44
Max. Negotiated Rate	$245.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$223.57
Rate for Payer: Qualcare PPO/HMO/WC	$152.44

MESH SOFT 3X6

Facility

$1,016.25

Service Code	HCPCS C1781
Hospital Charge Code	270691536
Hospital Revenue Code	278
Min. Negotiated Rate	$24.49
Max. Negotiated Rate	$508.12
Rate for Payer: Aetna Commercial	$386.18
Rate for Payer: Aetna Medicare Advantage	$304.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$259.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$259.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$259.14
Rate for Payer: Cigna Commercial	$508.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$223.57
Rate for Payer: Qualcare PPO/HMO/WC	$152.44
Rate for Payer: UnitedHealthcare Community & State	$24.49
Rate for Payer: Wellpoint Medicaid Managed Care	$26.93

MESH SOFT 4X6

Facility

$1,101.20

Service Code	HCPCS C1781
Hospital Charge Code	270691538
Hospital Revenue Code	278
Min. Negotiated Rate	$165.18
Max. Negotiated Rate	$266.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.26
Rate for Payer: Qualcare PPO/HMO/WC	$165.18

MESH SOFT 4X6

Facility

$1,101.20

Service Code	HCPCS C1781
Hospital Charge Code	270691538
Hospital Revenue Code	278
Min. Negotiated Rate	$26.54
Max. Negotiated Rate	$550.60
Rate for Payer: Aetna Commercial	$418.46
Rate for Payer: Aetna Medicare Advantage	$330.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.81
Rate for Payer: Cigna Commercial	$550.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.26
Rate for Payer: Qualcare PPO/HMO/WC	$165.18
Rate for Payer: UnitedHealthcare Community & State	$26.54
Rate for Payer: Wellpoint Medicaid Managed Care	$29.18

MESH SOFT 6X6

Facility

$1,242.00

Service Code	HCPCS C1781
Hospital Charge Code	270691537
Hospital Revenue Code	278
Min. Negotiated Rate	$29.93
Max. Negotiated Rate	$621.00
Rate for Payer: Aetna Commercial	$471.96
Rate for Payer: Aetna Medicare Advantage	$372.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.71
Rate for Payer: Cigna Commercial	$621.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.24
Rate for Payer: Qualcare PPO/HMO/WC	$186.30
Rate for Payer: UnitedHealthcare Community & State	$29.93
Rate for Payer: Wellpoint Medicaid Managed Care	$32.91

MESH SOFT 6X6

Facility

$1,242.00

Service Code	HCPCS C1781
Hospital Charge Code	270691537
Hospital Revenue Code	278
Min. Negotiated Rate	$186.30
Max. Negotiated Rate	$300.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$273.24
Rate for Payer: Qualcare PPO/HMO/WC	$186.30

MESH SOFT VENTRAL 12X12INCH

Facility

$2,394.00

Service Code	HCPCS C1781
Hospital Charge Code	270697073
Hospital Revenue Code	278
Min. Negotiated Rate	$359.10
Max. Negotiated Rate	$579.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$579.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$526.68
Rate for Payer: Qualcare PPO/HMO/WC	$359.10

MESH SOFT VENTRAL 12X12INCH

Facility

$2,394.00

Service Code	HCPCS C1781
Hospital Charge Code	270697073
Hospital Revenue Code	278
Min. Negotiated Rate	$57.70
Max. Negotiated Rate	$1,197.00
Rate for Payer: Aetna Commercial	$909.72
Rate for Payer: Aetna Medicare Advantage	$718.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$610.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$610.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$610.47
Rate for Payer: Cigna Commercial	$1,197.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$579.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$526.68
Rate for Payer: Qualcare PPO/HMO/WC	$359.10
Rate for Payer: UnitedHealthcare Community & State	$57.70
Rate for Payer: Wellpoint Medicaid Managed Care	$63.44

Know your out-of-pocket cost for care.

All Charges