Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MICRO DRILL 1.5 MM

Facility

$1,925.00

Hospital Charge Code	270682454
Hospital Revenue Code	272
Min. Negotiated Rate	$46.39
Max. Negotiated Rate	$962.50
Rate for Payer: Aetna Commercial	$731.50
Rate for Payer: Aetna Medicare Advantage	$577.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$490.88
Rate for Payer: Cigna Commercial	$962.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$577.50
Rate for Payer: Oxford Commercial	$385.00
Rate for Payer: Qualcare PPO/HMO/WC	$288.75
Rate for Payer: UnitedHealthcare Commercial	$385.00
Rate for Payer: UnitedHealthcare Community & State	$46.39
Rate for Payer: Wellpoint Medicaid Managed Care	$51.01

MICRO DRILL 1.5 MM

Facility

$1,925.00

Hospital Charge Code	270682454
Hospital Revenue Code	272
Min. Negotiated Rate	$288.75
Max. Negotiated Rate	$288.75
Rate for Payer: Qualcare PPO/HMO/WC	$288.75

MICROFILARIAE DETECTION

Facility

$45.90

Service Code	HCPCS 87015
Hospital Charge Code	39990163A
Hospital Revenue Code	309
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$18.17
Rate for Payer: Aetna Medicare Advantage	$21.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.11
Rate for Payer: Cigna Commercial	$22.95
Rate for Payer: Cigna Medicare Advantage	$6.68
Rate for Payer: Clover Medicare Advantage	$6.35
Rate for Payer: EmblemHealth Commercial	$20.04
Rate for Payer: Humana Medicare Advantage	$6.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.88
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.68
Rate for Payer: Wellcare Medicare Advantage	$6.68
Rate for Payer: Wellpoint Medicaid Managed Care	$1.22

MICROFILARIAE DETECTION

Facility

$29.35

Service Code	HCPCS 87210
Hospital Charge Code	39990163B
Hospital Revenue Code	309
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$4.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.40

MICROFILARIAE DETECTION

Facility

$29.35

Service Code	HCPCS 87210
Hospital Charge Code	39990163B
Hospital Revenue Code	309
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.83
Rate for Payer: Aetna Medicare Advantage	$18.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.01
Rate for Payer: Cigna Commercial	$14.68
Rate for Payer: Cigna Medicare Advantage	$5.82
Rate for Payer: Clover Medicare Advantage	$5.53
Rate for Payer: EmblemHealth Commercial	$17.46
Rate for Payer: Humana Medicare Advantage	$5.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.82
Rate for Payer: Wellcare Medicare Advantage	$5.82
Rate for Payer: Wellpoint Medicaid Managed Care	$0.78

MICROFILARIAE DETECTION

Facility

$45.90

Service Code	HCPCS 87015
Hospital Charge Code	39990163A
Hospital Revenue Code	309
Min. Negotiated Rate	$6.88
Max. Negotiated Rate	$6.88
Rate for Payer: Qualcare PPO/HMO/WC	$6.88

Micro Filter (cell Saver )

Facility

$82.50

Hospital Charge Code	270661411
Hospital Revenue Code	272
Min. Negotiated Rate	$12.38
Max. Negotiated Rate	$12.38
Rate for Payer: Qualcare PPO/HMO/WC	$12.38

Micro Filter (cell Saver )

Facility

$82.50

Hospital Charge Code	270661411
Hospital Revenue Code	272
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$41.25
Rate for Payer: Aetna Commercial	$31.35
Rate for Payer: Aetna Medicare Advantage	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.04
Rate for Payer: Cigna Commercial	$41.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.75
Rate for Payer: Oxford Commercial	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$12.38
Rate for Payer: UnitedHealthcare Commercial	$16.50
Rate for Payer: UnitedHealthcare Community & State	$1.99
Rate for Payer: Wellpoint Medicaid Managed Care	$2.19

MICRO HOOK MIS SHAVER SH SET

Facility

$3,775.90

Hospital Charge Code	270695989
Hospital Revenue Code	272
Min. Negotiated Rate	$566.38
Max. Negotiated Rate	$566.38
Rate for Payer: Qualcare PPO/HMO/WC	$566.38

MICRO HOOK MIS SHAVER SH SET

Facility

$3,775.90

Hospital Charge Code	270695989
Hospital Revenue Code	272
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$1,887.95
Rate for Payer: Aetna Commercial	$1,434.84
Rate for Payer: Aetna Medicare Advantage	$1,132.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$962.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$962.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$962.85
Rate for Payer: Cigna Commercial	$1,887.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,132.77
Rate for Payer: Oxford Commercial	$755.18
Rate for Payer: Qualcare PPO/HMO/WC	$566.38
Rate for Payer: UnitedHealthcare Commercial	$755.18
Rate for Payer: UnitedHealthcare Community & State	$91.00
Rate for Payer: Wellpoint Medicaid Managed Care	$100.06

MICRO-K 10 EXTENCAPS/10ME

Facility

$4.00

Hospital Charge Code	60633424
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MICRO-K 10 EXTENCAPS/10ME

Facility

$4.00

Hospital Charge Code	60633424
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

MICRO-K/8MEQ/CAP

Facility

$4.00

Hospital Charge Code	60633423
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

MICRO-K/8MEQ/CAP

Facility

$4.00

Hospital Charge Code	60633423
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MICROKNIFE MCV 3 LMN 7/5F 3281

Facility

$959.25

Hospital Charge Code	270615489
Hospital Revenue Code	272
Min. Negotiated Rate	$143.89
Max. Negotiated Rate	$143.89
Rate for Payer: Qualcare PPO/HMO/WC	$143.89

MICROKNIFE MCV 3 LMN 7/5F 3281

Facility

$959.25

Hospital Charge Code	270615489
Hospital Revenue Code	272
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) PPO	$244.61
Rate for Payer: Cigna Commercial	$479.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.77
Rate for Payer: Oxford Commercial	$191.85
Rate for Payer: Qualcare PPO/HMO/WC	$143.89
Rate for Payer: UnitedHealthcare Commercial	$191.85
Rate for Payer: UnitedHealthcare Community & State	$23.12
Rate for Payer: Wellpoint Medicaid Managed Care	$25.42

MICRO KOVER ZEISS MD 20X56

Facility

$263.00

Hospital Charge Code	270652779
Hospital Revenue Code	270
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$131.50
Rate for Payer: Aetna Commercial	$99.94
Rate for Payer: Aetna Medicare Advantage	$78.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.06
Rate for Payer: Cigna Commercial	$131.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.90
Rate for Payer: Oxford Commercial	$52.60
Rate for Payer: Qualcare PPO/HMO/WC	$39.45
Rate for Payer: UnitedHealthcare Commercial	$52.60
Rate for Payer: UnitedHealthcare Community & State	$6.34
Rate for Payer: Wellpoint Medicaid Managed Care	$6.97

MICRO KOVER ZEISS MD 20X56

Facility

$263.00

Hospital Charge Code	270652779
Hospital Revenue Code	270
Min. Negotiated Rate	$39.45
Max. Negotiated Rate	$39.45
Rate for Payer: Qualcare PPO/HMO/WC	$39.45

MICROMATRIX 60MG

Facility

$3,793.50

Service Code	HCPCS Q4118
Hospital Charge Code	270662132
Hospital Revenue Code	278
Min. Negotiated Rate	$91.42
Max. Negotiated Rate	$1,896.75
Rate for Payer: Aetna Commercial	$1,441.53
Rate for Payer: Aetna Medicare Advantage	$1,138.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$967.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$967.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$967.34
Rate for Payer: Cigna Commercial	$1,896.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$834.57
Rate for Payer: Qualcare PPO/HMO/WC	$569.02
Rate for Payer: UnitedHealthcare Community & State	$91.42
Rate for Payer: Wellpoint Medicaid Managed Care	$100.53

MICROMATRIX 60MG

Facility

$3,793.50

Service Code	HCPCS Q4118
Hospital Charge Code	270662132
Hospital Revenue Code	278
Min. Negotiated Rate	$569.02
Max. Negotiated Rate	$918.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$834.57
Rate for Payer: Qualcare PPO/HMO/WC	$569.02

MICROMATRIX 60MG/1MG JW

Facility

$63.23

Hospital Charge Code	270662132W
Hospital Revenue Code	636
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$15.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.48

MICROMATRIX 60MG/1MG JW

Facility

$63.23

Hospital Charge Code	270662132W
Hospital Revenue Code	636
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$31.61
Rate for Payer: Aetna Commercial	$24.03
Rate for Payer: Aetna Medicare Advantage	$18.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.12
Rate for Payer: Cigna Commercial	$31.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.48
Rate for Payer: UnitedHealthcare Community & State	$1.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1.68

MICROMATRIX MATRISTEM (GRAFT)

Facility

$7,375.00

Service Code	HCPCS Q4118
Hospital Charge Code	270662059
Hospital Revenue Code	278
Min. Negotiated Rate	$177.74
Max. Negotiated Rate	$3,687.50
Rate for Payer: Aetna Commercial	$2,802.50
Rate for Payer: Aetna Medicare Advantage	$2,212.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,880.62
Rate for Payer: Cigna Commercial	$3,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,622.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25
Rate for Payer: UnitedHealthcare Community & State	$177.74
Rate for Payer: Wellpoint Medicaid Managed Care	$195.44

MICROMATRIX MATRISTEM (GRAFT)

Facility

$7,375.00

Service Code	HCPCS Q4118
Hospital Charge Code	270662059
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$1,784.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,622.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

MICRONASE/1.25MG/TAB

Facility

$4.00

Service Code	NDC 23155005601
Hospital Charge Code	60634880
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

Know your out-of-pocket cost for care.

All Charges