Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ASSEMBLY HUML 8.0 REG 3281051

Facility

$12,439.75

Hospital Charge Code	270609044
Hospital Revenue Code	278
Min. Negotiated Rate	$1,865.96
Max. Negotiated Rate	$3,010.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,487.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,010.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,736.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,865.96

ASSEMBLY KIT

Facility

$3,070.00

Hospital Charge Code	270687909
Hospital Revenue Code	272
Min. Negotiated Rate	$460.50
Max. Negotiated Rate	$460.50
Rate for Payer: Qualcare PPO/HMO/WC	$460.50

ASSEMBLY KIT

Facility

$3,070.00

Hospital Charge Code	270687909
Hospital Revenue Code	272
Min. Negotiated Rate	$73.99
Max. Negotiated Rate	$1,535.00
Rate for Payer: Aetna Commercial	$1,166.60
Rate for Payer: Aetna Medicare Advantage	$921.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$782.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$782.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$782.85
Rate for Payer: Cigna Commercial	$1,535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$921.00
Rate for Payer: Oxford Commercial	$614.00
Rate for Payer: Qualcare PPO/HMO/WC	$460.50
Rate for Payer: UnitedHealthcare Commercial	$614.00
Rate for Payer: UnitedHealthcare Community & State	$73.99
Rate for Payer: Wellpoint Medicaid Managed Care	$81.36

ASSEMBLY TUBE 2130

Facility

$39.75

Hospital Charge Code	270634686
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$19.88
Rate for Payer: Aetna Commercial	$15.11
Rate for Payer: Aetna Medicare Advantage	$11.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.14
Rate for Payer: Cigna Commercial	$19.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.93
Rate for Payer: Oxford Commercial	$7.95
Rate for Payer: Qualcare PPO/HMO/WC	$5.96
Rate for Payer: UnitedHealthcare Commercial	$7.95
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.05

ASSEMBLY TUBE 2130

Facility

$39.75

Hospital Charge Code	270634686
Hospital Revenue Code	272
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$5.96
Rate for Payer: Qualcare PPO/HMO/WC	$5.96

ASSEMBLY ZIM SLS CABLE 1.3/559

Facility

$2,417.65

Hospital Charge Code	270607202
Hospital Revenue Code	278
Min. Negotiated Rate	$362.65
Max. Negotiated Rate	$585.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$483.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$531.88
Rate for Payer: Qualcare PPO/HMO/WC	$362.65

ASSEMBLY ZIM SLS CABLE 1.3/559

Facility

$2,417.65

Hospital Charge Code	270607202
Hospital Revenue Code	278
Min. Negotiated Rate	$58.27
Max. Negotiated Rate	$1,208.83
Rate for Payer: Aetna Commercial	$918.71
Rate for Payer: Aetna Medicare Advantage	$725.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$616.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$616.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$483.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$616.50
Rate for Payer: Cigna Commercial	$1,208.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$531.88
Rate for Payer: Qualcare PPO/HMO/WC	$362.65
Rate for Payer: UnitedHealthcare Community & State	$58.27
Rate for Payer: Wellpoint Medicaid Managed Care	$64.07

ASSERT IQ ICM UMRI US

Facility

$19,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270704930
Hospital Revenue Code	278
Min. Negotiated Rate	$2,925.00
Max. Negotiated Rate	$4,719.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,719.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,290.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00

ASSERT IQ ICM UMRI US

Facility

$19,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270704930
Hospital Revenue Code	278
Min. Negotiated Rate	$469.95
Max. Negotiated Rate	$9,750.00
Rate for Payer: Aetna Commercial	$7,410.00
Rate for Payer: Aetna Medicare Advantage	$5,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,972.50
Rate for Payer: Cigna Commercial	$9,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,719.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,290.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00
Rate for Payer: UnitedHealthcare Community & State	$469.95
Rate for Payer: Wellpoint Medicaid Managed Care	$516.75

ASSESSMENT OF APHASIA PER 60M

Facility

$561.00

Service Code	HCPCS 96105GN
Hospital Charge Code	74204005
Hospital Revenue Code	444
Min. Negotiated Rate	$13.52
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$213.18
Rate for Payer: Aetna Medicare Advantage	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.06
Rate for Payer: Cigna Commercial	$280.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.30
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.15
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$13.52
Rate for Payer: Wellpoint Medicaid Managed Care	$14.87

ASSESSMENT OF APHASIA PER 60M

Facility

$561.00

Service Code	HCPCS 96105GN
Hospital Charge Code	74204005
Hospital Revenue Code	444
Min. Negotiated Rate	$84.15
Max. Negotiated Rate	$84.15
Rate for Payer: Qualcare PPO/HMO/WC	$84.15

ASSY ASPIRATION MED A&A

Facility

$67.50

Hospital Charge Code	270612026
Hospital Revenue Code	270
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$10.12
Rate for Payer: Qualcare PPO/HMO/WC	$10.12

ASSY ASPIRATION MED A&A

Facility

$67.50

Hospital Charge Code	270612026
Hospital Revenue Code	270
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$33.75
Rate for Payer: Aetna Commercial	$25.65
Rate for Payer: Aetna Medicare Advantage	$20.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.21
Rate for Payer: Cigna Commercial	$33.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.25
Rate for Payer: Oxford Commercial	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.12
Rate for Payer: UnitedHealthcare Commercial	$13.50
Rate for Payer: UnitedHealthcare Community & State	$1.63
Rate for Payer: Wellpoint Medicaid Managed Care	$1.79

ASSY CABLE 23X 52MM

Facility

$1,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270690627
Hospital Revenue Code	278
Min. Negotiated Rate	$38.80
Max. Negotiated Rate	$805.00
Rate for Payer: Aetna Commercial	$611.80
Rate for Payer: Aetna Medicare Advantage	$483.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.55
Rate for Payer: Cigna Commercial	$805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$354.20
Rate for Payer: Qualcare PPO/HMO/WC	$241.50
Rate for Payer: UnitedHealthcare Community & State	$38.80
Rate for Payer: Wellpoint Medicaid Managed Care	$42.66

ASSY CABLE 23X 52MM

Facility

$1,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270690627
Hospital Revenue Code	278
Min. Negotiated Rate	$241.50
Max. Negotiated Rate	$389.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$354.20
Rate for Payer: Qualcare PPO/HMO/WC	$241.50

ASSY DELTA SHUNT REG LEV 1.5

Facility

$10,828.80

Service Code	HCPCS C1889
Hospital Charge Code	270691051
Hospital Revenue Code	278
Min. Negotiated Rate	$1,624.32
Max. Negotiated Rate	$2,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,165.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,620.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,382.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,624.32

ASSY DELTA SHUNT REG LEV 1.5

Facility

$10,828.80

Service Code	HCPCS C1889
Hospital Charge Code	270691051
Hospital Revenue Code	278
Min. Negotiated Rate	$260.97
Max. Negotiated Rate	$5,414.40
Rate for Payer: Aetna Commercial	$4,114.94
Rate for Payer: Aetna Medicare Advantage	$3,248.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,761.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,761.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,165.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,761.34
Rate for Payer: Cigna Commercial	$5,414.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,620.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,382.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,624.32
Rate for Payer: UnitedHealthcare Community & State	$260.97
Rate for Payer: Wellpoint Medicaid Managed Care	$286.96

ASSY DELTA SHUNT REG P/L1

Facility

$8,155.20

Service Code	HCPCS C1729
Hospital Charge Code	270647134
Hospital Revenue Code	278
Min. Negotiated Rate	$1,223.28
Max. Negotiated Rate	$1,973.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,631.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,973.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,794.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,223.28

ASSY DELTA SHUNT REG P/L1

Facility

$8,155.20

Service Code	HCPCS C1729
Hospital Charge Code	270647134
Hospital Revenue Code	278
Min. Negotiated Rate	$196.54
Max. Negotiated Rate	$4,077.60
Rate for Payer: Aetna Commercial	$3,098.98
Rate for Payer: Aetna Medicare Advantage	$2,446.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,079.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,079.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,631.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,079.58
Rate for Payer: Cigna Commercial	$4,077.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,973.56
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,794.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,223.28
Rate for Payer: UnitedHealthcare Community & State	$196.54
Rate for Payer: Wellpoint Medicaid Managed Care	$216.11

ASSY, HOOK-UP OLYMPUS 2K

Facility

$2,426.50

Hospital Charge Code	270678492
Hospital Revenue Code	272
Min. Negotiated Rate	$58.48
Max. Negotiated Rate	$1,213.25
Rate for Payer: Aetna Commercial	$922.07
Rate for Payer: Aetna Medicare Advantage	$727.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.76
Rate for Payer: Cigna Commercial	$1,213.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$727.95
Rate for Payer: Oxford Commercial	$485.30
Rate for Payer: Qualcare PPO/HMO/WC	$363.98
Rate for Payer: UnitedHealthcare Commercial	$485.30
Rate for Payer: UnitedHealthcare Community & State	$58.48
Rate for Payer: Wellpoint Medicaid Managed Care	$64.30

ASSY, HOOK-UP OLYMPUS 2K

Facility

$2,426.50

Hospital Charge Code	270678492
Hospital Revenue Code	272
Min. Negotiated Rate	$363.98
Max. Negotiated Rate	$363.98
Rate for Payer: Qualcare PPO/HMO/WC	$363.98

ASSY HOSE AIR 33FT

Facility

$833.50

Hospital Charge Code	270634529
Hospital Revenue Code	270
Min. Negotiated Rate	$125.03
Max. Negotiated Rate	$125.03
Rate for Payer: Qualcare PPO/HMO/WC	$125.03

ASSY HOSE AIR 33FT

Facility

$833.50

Hospital Charge Code	270634529
Hospital Revenue Code	270
Min. Negotiated Rate	$20.09
Max. Negotiated Rate	$416.75
Rate for Payer: Aetna Commercial	$316.73
Rate for Payer: Aetna Medicare Advantage	$250.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.54
Rate for Payer: Cigna Commercial	$416.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.05
Rate for Payer: Oxford Commercial	$166.70
Rate for Payer: Qualcare PPO/HMO/WC	$125.03
Rate for Payer: UnitedHealthcare Commercial	$166.70
Rate for Payer: UnitedHealthcare Community & State	$20.09
Rate for Payer: Wellpoint Medicaid Managed Care	$22.09

ASSY HOSE NITROUS OXIDE 33FT

Facility

$833.50

Hospital Charge Code	270634530
Hospital Revenue Code	270
Min. Negotiated Rate	$20.09
Max. Negotiated Rate	$416.75
Rate for Payer: Aetna Commercial	$316.73
Rate for Payer: Aetna Medicare Advantage	$250.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.54
Rate for Payer: Cigna Commercial	$416.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.05
Rate for Payer: Oxford Commercial	$166.70
Rate for Payer: Qualcare PPO/HMO/WC	$125.03
Rate for Payer: UnitedHealthcare Commercial	$166.70
Rate for Payer: UnitedHealthcare Community & State	$20.09
Rate for Payer: Wellpoint Medicaid Managed Care	$22.09

ASSY HOSE NITROUS OXIDE 33FT

Facility

$833.50

Hospital Charge Code	270634530
Hospital Revenue Code	270
Min. Negotiated Rate	$125.03
Max. Negotiated Rate	$125.03
Rate for Payer: Qualcare PPO/HMO/WC	$125.03

Know your out-of-pocket cost for care.

All Charges