Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MESH STEX 15x10CM

Facility

$2,637.70

Service Code	HCPCS C1781
Hospital Charge Code	270665533
Hospital Revenue Code	278
Min. Negotiated Rate	$63.57
Max. Negotiated Rate	$1,318.85
Rate for Payer: Aetna Commercial	$1,002.33
Rate for Payer: Aetna Medicare Advantage	$791.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$672.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$672.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$527.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$672.61
Rate for Payer: Cigna Commercial	$1,318.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$638.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$580.29
Rate for Payer: Qualcare PPO/HMO/WC	$395.65
Rate for Payer: UnitedHealthcare Community & State	$63.57
Rate for Payer: Wellpoint Medicaid Managed Care	$69.90

MESH STEX 15x10CM

Facility

$2,637.70

Service Code	HCPCS C1781
Hospital Charge Code	270665533
Hospital Revenue Code	278
Min. Negotiated Rate	$395.65
Max. Negotiated Rate	$638.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$527.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$638.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$580.29
Rate for Payer: Qualcare PPO/HMO/WC	$395.65

MESH STEX 20x15CM

Facility

$4,231.35

Service Code	HCPCS C1781
Hospital Charge Code	270665534
Hospital Revenue Code	278
Min. Negotiated Rate	$634.70
Max. Negotiated Rate	$1,023.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,023.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$930.90
Rate for Payer: Qualcare PPO/HMO/WC	$634.70

MESH STEX 20x15CM

Facility

$4,231.35

Service Code	HCPCS C1781
Hospital Charge Code	270665534
Hospital Revenue Code	278
Min. Negotiated Rate	$101.98
Max. Negotiated Rate	$2,115.68
Rate for Payer: Aetna Commercial	$1,607.91
Rate for Payer: Aetna Medicare Advantage	$1,269.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,078.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,078.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$846.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,078.99
Rate for Payer: Cigna Commercial	$2,115.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,023.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$930.90
Rate for Payer: Qualcare PPO/HMO/WC	$634.70
Rate for Payer: UnitedHealthcare Community & State	$101.98
Rate for Payer: Wellpoint Medicaid Managed Care	$112.13

MESH STEX 25x20CM

Facility

$6,752.65

Service Code	HCPCS C1781
Hospital Charge Code	270667413
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.90
Max. Negotiated Rate	$1,634.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,634.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.90

MESH STEX 25x20CM

Facility

$6,752.65

Service Code	HCPCS C1781
Hospital Charge Code	270667413
Hospital Revenue Code	278
Min. Negotiated Rate	$162.74
Max. Negotiated Rate	$3,376.32
Rate for Payer: Aetna Commercial	$2,566.01
Rate for Payer: Aetna Medicare Advantage	$2,025.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.93
Rate for Payer: Cigna Commercial	$3,376.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,634.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.90
Rate for Payer: UnitedHealthcare Community & State	$162.74
Rate for Payer: Wellpoint Medicaid Managed Care	$178.95

MESH STEX ELIP 17x10CM

Facility

$2,371.40

Service Code	HCPCS C1781
Hospital Charge Code	270671732
Hospital Revenue Code	278
Min. Negotiated Rate	$57.15
Max. Negotiated Rate	$1,185.70
Rate for Payer: Aetna Commercial	$901.13
Rate for Payer: Aetna Medicare Advantage	$711.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$604.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$604.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$604.71
Rate for Payer: Cigna Commercial	$1,185.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$521.71
Rate for Payer: Qualcare PPO/HMO/WC	$355.71
Rate for Payer: UnitedHealthcare Community & State	$57.15
Rate for Payer: Wellpoint Medicaid Managed Care	$62.84

MESH STEX ELIP 17x10CM

Facility

$2,371.40

Service Code	HCPCS C1781
Hospital Charge Code	270671732
Hospital Revenue Code	278
Min. Negotiated Rate	$355.71
Max. Negotiated Rate	$573.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$521.71
Rate for Payer: Qualcare PPO/HMO/WC	$355.71

MESH STEX ELIP 20x12CM

Facility

$9,435.20

Hospital Charge Code	270677505
Hospital Revenue Code	278
Min. Negotiated Rate	$227.39
Max. Negotiated Rate	$4,717.60
Rate for Payer: Aetna Commercial	$3,585.38
Rate for Payer: Aetna Medicare Advantage	$2,830.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,405.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,405.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,887.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,405.98
Rate for Payer: Cigna Commercial	$4,717.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,283.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,075.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,415.28
Rate for Payer: UnitedHealthcare Community & State	$227.39
Rate for Payer: Wellpoint Medicaid Managed Care	$250.03

MESH STEX ELIP 20x12CM

Facility

$9,435.20

Hospital Charge Code	270677505
Hospital Revenue Code	278
Min. Negotiated Rate	$1,415.28
Max. Negotiated Rate	$2,283.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,887.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,283.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,075.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,415.28

MESH STEX ROUND 12CM

Facility

$2,901.45

Service Code	HCPCS C1781
Hospital Charge Code	270665531
Hospital Revenue Code	278
Min. Negotiated Rate	$69.92
Max. Negotiated Rate	$1,450.72
Rate for Payer: Aetna Commercial	$1,102.55
Rate for Payer: Aetna Medicare Advantage	$870.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$739.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$739.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$739.87
Rate for Payer: Cigna Commercial	$1,450.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$702.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$638.32
Rate for Payer: Qualcare PPO/HMO/WC	$435.22
Rate for Payer: UnitedHealthcare Community & State	$69.92
Rate for Payer: Wellpoint Medicaid Managed Care	$76.89

MESH STEX ROUND 12CM

Facility

$2,901.45

Service Code	HCPCS C1781
Hospital Charge Code	270665531
Hospital Revenue Code	278
Min. Negotiated Rate	$435.22
Max. Negotiated Rate	$702.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$702.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$638.32
Rate for Payer: Qualcare PPO/HMO/WC	$435.22

MESH STEX ROUND 15CM

Facility

$3,761.60

Service Code	HCPCS C1781
Hospital Charge Code	270665532
Hospital Revenue Code	278
Min. Negotiated Rate	$564.24
Max. Negotiated Rate	$910.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$752.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$910.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$827.55
Rate for Payer: Qualcare PPO/HMO/WC	$564.24

MESH STEX ROUND 15CM

Facility

$3,761.60

Service Code	HCPCS C1781
Hospital Charge Code	270665532
Hospital Revenue Code	278
Min. Negotiated Rate	$90.65
Max. Negotiated Rate	$1,880.80
Rate for Payer: Aetna Commercial	$1,429.41
Rate for Payer: Aetna Medicare Advantage	$1,128.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$959.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$959.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$752.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$959.21
Rate for Payer: Cigna Commercial	$1,880.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$910.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$827.55
Rate for Payer: Qualcare PPO/HMO/WC	$564.24
Rate for Payer: UnitedHealthcare Community & State	$90.65
Rate for Payer: Wellpoint Medicaid Managed Care	$99.68

MESH STEX ROUND 9CM

Facility

$2,115.65

Service Code	HCPCS C1781
Hospital Charge Code	270665530
Hospital Revenue Code	278
Min. Negotiated Rate	$50.99
Max. Negotiated Rate	$1,057.83
Rate for Payer: Aetna Commercial	$803.95
Rate for Payer: Aetna Medicare Advantage	$634.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$539.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$539.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$423.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$539.49
Rate for Payer: Cigna Commercial	$1,057.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$511.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$465.44
Rate for Payer: Qualcare PPO/HMO/WC	$317.35
Rate for Payer: UnitedHealthcare Community & State	$50.99
Rate for Payer: Wellpoint Medicaid Managed Care	$56.06

MESH STEX ROUND 9CM

Facility

$2,115.65

Service Code	HCPCS C1781
Hospital Charge Code	270665530
Hospital Revenue Code	278
Min. Negotiated Rate	$317.35
Max. Negotiated Rate	$511.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$423.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$511.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$465.44
Rate for Payer: Qualcare PPO/HMO/WC	$317.35

MESH STEX SKIRT 15x10CM 6X4

Facility

$3,582.00

Service Code	HCPCS C1781
Hospital Charge Code	270679903
Hospital Revenue Code	278
Min. Negotiated Rate	$537.30
Max. Negotiated Rate	$866.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$716.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$866.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$788.04
Rate for Payer: Qualcare PPO/HMO/WC	$537.30

MESH STEX SKIRT 15x10CM 6X4

Facility

$3,582.00

Service Code	HCPCS C1781
Hospital Charge Code	270679903
Hospital Revenue Code	278
Min. Negotiated Rate	$86.33
Max. Negotiated Rate	$1,791.00
Rate for Payer: Aetna Commercial	$1,361.16
Rate for Payer: Aetna Medicare Advantage	$1,074.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$913.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$913.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$716.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$913.41
Rate for Payer: Cigna Commercial	$1,791.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$866.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$788.04
Rate for Payer: Qualcare PPO/HMO/WC	$537.30
Rate for Payer: UnitedHealthcare Community & State	$86.33
Rate for Payer: Wellpoint Medicaid Managed Care	$94.92

MESH STRATTICE 10x16CM

Facility

$27,385.00

Service Code	HCPCS Q4130
Hospital Charge Code	270677283
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$6,627.17
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	$5,477.00
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	$6,627.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,024.70
Rate for Payer: Qualcare PPO/HMO/WC	$4,107.75
Rate for Payer: UnitedHealthcare Community & State	$659.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$725.70

MESH STRATTICE 10x16CM

Facility

$27,385.00

Service Code	HCPCS Q4130
Hospital Charge Code	270677283
Hospital Revenue Code	278
Min. Negotiated Rate	$4,107.75
Max. Negotiated Rate	$6,627.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,477.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,627.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,024.70
Rate for Payer: Qualcare PPO/HMO/WC	$4,107.75

MESH STRATTICE 16x20CM

Facility

$54,750.00

Service Code	HCPCS Q4130
Hospital Charge Code	270677096
Hospital Revenue Code	278
Min. Negotiated Rate	$8,212.50
Max. Negotiated Rate	$13,249.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,249.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,212.50

MESH STRATTICE 16x20CM

Facility

$54,750.00

Service Code	HCPCS Q4130
Hospital Charge Code	270677096
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$13,249.50
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	$10,950.00
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	$13,249.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,212.50
Rate for Payer: UnitedHealthcare Community & State	$1,319.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$1,450.88

MESH STRATTICE 16x20CM

Facility

$99,655.00

Hospital Charge Code	270677284
Hospital Revenue Code	636
Min. Negotiated Rate	$14,948.25
Max. Negotiated Rate	$24,116.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24,116.51
Rate for Payer: Qualcare PPO/HMO/WC	$14,948.25

MESH STRATTICE 16x20CM

Facility

$99,655.00

Hospital Charge Code	270677284
Hospital Revenue Code	636
Min. Negotiated Rate	$2,401.69
Max. Negotiated Rate	$49,827.50
Rate for Payer: Aetna Commercial	$37,868.90
Rate for Payer: Aetna Medicare Advantage	$29,896.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,412.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,412.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,412.03
Rate for Payer: Cigna Commercial	$49,827.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24,116.51
Rate for Payer: Qualcare PPO/HMO/WC	$14,948.25
Rate for Payer: UnitedHealthcare Community & State	$2,401.69
Rate for Payer: Wellpoint Medicaid Managed Care	$2,640.86

MESH STRATTICE 6x10CM

Facility

$10,815.00

Service Code	HCPCS C1781
Hospital Charge Code	270683760
Hospital Revenue Code	278
Min. Negotiated Rate	$260.64
Max. Negotiated Rate	$5,407.50
Rate for Payer: Aetna Commercial	$4,109.70
Rate for Payer: Aetna Medicare Advantage	$3,244.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,757.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,757.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,163.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,757.82
Rate for Payer: Cigna Commercial	$5,407.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,617.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,379.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,622.25
Rate for Payer: UnitedHealthcare Community & State	$260.64
Rate for Payer: Wellpoint Medicaid Managed Care	$286.60

Know your out-of-pocket cost for care.

All Charges