Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

2CC INFLUX SPARC

Facility

$4,675.00

Service Code	HCPCS C1765
Hospital Charge Code	270705824
Hospital Revenue Code	278
Min. Negotiated Rate	$701.25
Max. Negotiated Rate	$1,131.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,131.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$701.25

2CC INFLUX SPARC

Facility

$4,675.00

Service Code	HCPCS C1765
Hospital Charge Code	270705824
Hospital Revenue Code	278
Min. Negotiated Rate	$112.67
Max. Negotiated Rate	$2,337.50
Rate for Payer: Aetna Commercial	$1,776.50
Rate for Payer: Aetna Medicare Advantage	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,192.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,192.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,192.12
Rate for Payer: Cigna Commercial	$2,337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,131.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$701.25
Rate for Payer: UnitedHealthcare Community & State	$112.67
Rate for Payer: Wellpoint Medicaid Managed Care	$123.89

2 DOSE SM-153 QUADRAMED

Facility

$14,130.00

Hospital Charge Code	270619807
Hospital Revenue Code	250
Min. Negotiated Rate	$340.53
Max. Negotiated Rate	$7,065.00
Rate for Payer: Aetna Commercial	$5,369.40
Rate for Payer: Aetna Medicare Advantage	$4,239.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,603.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,603.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,603.15
Rate for Payer: Cigna Commercial	$7,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,239.00
Rate for Payer: Oxford Commercial	$2,826.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,119.50
Rate for Payer: UnitedHealthcare Commercial	$2,826.00
Rate for Payer: UnitedHealthcare Community & State	$340.53
Rate for Payer: Wellpoint Medicaid Managed Care	$374.44

2 DOSE SM-153 QUADRAMED

Facility

$14,130.00

Hospital Charge Code	270619807
Hospital Revenue Code	250
Min. Negotiated Rate	$2,119.50
Max. Negotiated Rate	$2,119.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,119.50

2D TTE W OR W/O FOL W/CON,FU

Facility

$6,070.00

Service Code	HCPCS C8924
Hospital Charge Code	365438924
Hospital Revenue Code	480
Min. Negotiated Rate	$910.50
Max. Negotiated Rate	$910.50
Rate for Payer: Qualcare PPO/HMO/WC	$910.50

2D TTE W OR W/O FOL W/CON,FU

Facility

$6,070.00

Service Code	HCPCS C8924
Hospital Charge Code	365438924
Hospital Revenue Code	480
Min. Negotiated Rate	$146.29
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$1,127.36
Rate for Payer: Aetna Medicare Advantage	$1,342.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,496.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$414.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,496.11
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: Cigna Medicare Advantage	$414.47
Rate for Payer: Clover Medicare Advantage	$393.75
Rate for Payer: EmblemHealth Commercial	$1,243.41
Rate for Payer: Humana Medicare Advantage	$426.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$414.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,821.00
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$910.50
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$146.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$414.47
Rate for Payer: Wellcare Medicare Advantage	$414.47
Rate for Payer: Wellpoint Medicaid Managed Care	$160.85

2IN THICK ARMBOARDS PADS

Facility

$313.75

Hospital Charge Code	270656093
Hospital Revenue Code	271
Min. Negotiated Rate	$47.06
Max. Negotiated Rate	$47.06
Rate for Payer: Qualcare PPO/HMO/WC	$47.06

2IN THICK ARMBOARDS PADS

Facility

$313.75

Hospital Charge Code	270656093
Hospital Revenue Code	271
Min. Negotiated Rate	$7.56
Max. Negotiated Rate	$156.88
Rate for Payer: Aetna Commercial	$119.22
Rate for Payer: Aetna Medicare Advantage	$94.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.01
Rate for Payer: Cigna Commercial	$156.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.12
Rate for Payer: Oxford Commercial	$62.75
Rate for Payer: Qualcare PPO/HMO/WC	$47.06
Rate for Payer: UnitedHealthcare Commercial	$62.75
Rate for Payer: UnitedHealthcare Community & State	$7.56
Rate for Payer: Wellpoint Medicaid Managed Care	$8.31

2MM POST

Facility

$195.00

Hospital Charge Code	270339446
Hospital Revenue Code	278
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.90
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

2MM POST

Facility

$195.00

Hospital Charge Code	270339446
Hospital Revenue Code	278
Min. Negotiated Rate	$4.70
Max. Negotiated Rate	$97.50
Rate for Payer: Aetna Commercial	$74.10
Rate for Payer: Aetna Medicare Advantage	$58.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.73
Rate for Payer: Cigna Commercial	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.90
Rate for Payer: Qualcare PPO/HMO/WC	$29.25
Rate for Payer: UnitedHealthcare Community & State	$4.70
Rate for Payer: Wellpoint Medicaid Managed Care	$5.17

2MM REAMER

Facility

$370.00

Hospital Charge Code	270339444
Hospital Revenue Code	272
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$55.50
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

2MM REAMER

Facility

$370.00

Hospital Charge Code	270339444
Hospital Revenue Code	272
Min. Negotiated Rate	$8.92
Max. Negotiated Rate	$185.00
Rate for Payer: Aetna Commercial	$140.60
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.00
Rate for Payer: Oxford Commercial	$74.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.50
Rate for Payer: UnitedHealthcare Commercial	$74.00
Rate for Payer: UnitedHealthcare Community & State	$8.92
Rate for Payer: Wellpoint Medicaid Managed Care	$9.80

2MM STRAIGHT PLATE 8 HOLE REIN

Facility

$4,094.25

Service Code	HCPCS C1713
Hospital Charge Code	270703767
Hospital Revenue Code	278
Min. Negotiated Rate	$98.67
Max. Negotiated Rate	$2,047.12
Rate for Payer: Aetna Commercial	$1,555.82
Rate for Payer: Aetna Medicare Advantage	$1,228.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,044.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,044.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$818.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,044.03
Rate for Payer: Cigna Commercial	$2,047.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$990.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$900.74
Rate for Payer: Qualcare PPO/HMO/WC	$614.14
Rate for Payer: UnitedHealthcare Community & State	$98.67
Rate for Payer: Wellpoint Medicaid Managed Care	$108.50

2MM STRAIGHT PLATE 8 HOLE REIN

Facility

$4,094.25

Service Code	HCPCS C1713
Hospital Charge Code	270703767
Hospital Revenue Code	278
Min. Negotiated Rate	$614.14
Max. Negotiated Rate	$990.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$818.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$990.81
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$900.74
Rate for Payer: Qualcare PPO/HMO/WC	$614.14

2MMX4 KWIRE STERILE

Facility

$440.00

Service Code	HCPCS C1713
Hospital Charge Code	270694260
Hospital Revenue Code	278
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$106.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

2MMX4 KWIRE STERILE

Facility

$440.00

Service Code	HCPCS C1713
Hospital Charge Code	270694260
Hospital Revenue Code	278
Min. Negotiated Rate	$10.60
Max. Negotiated Rate	$220.00
Rate for Payer: Aetna Commercial	$167.20
Rate for Payer: Aetna Medicare Advantage	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.20
Rate for Payer: Cigna Commercial	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$66.00
Rate for Payer: UnitedHealthcare Community & State	$10.60
Rate for Payer: Wellpoint Medicaid Managed Care	$11.66

2ND AMPL PT NUCL ACID MULT

Facility

$47.00

Service Code	HCPCS 83900
Hospital Charge Code	3035161
Hospital Revenue Code	301
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$7.05
Rate for Payer: Qualcare PPO/HMO/WC	$7.05

2ND AMPL PT NUCL ACID MULT

Facility

$47.00

Service Code	HCPCS 83900
Hospital Charge Code	3035161
Hospital Revenue Code	301
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$17.86
Rate for Payer: Aetna Medicare Advantage	$14.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.98
Rate for Payer: Cigna Commercial	$23.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.13
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

2'REPR FT FLEXOR TEND W FR GRF

Facility

$21,066.25

Service Code	HCPCS 28202
Hospital Charge Code	16000633
Hospital Revenue Code	360
Min. Negotiated Rate	$3,159.94
Max. Negotiated Rate	$3,159.94
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.94

2'REPR FT FLEXOR TEND W FR GRF

Facility

$21,066.25

Service Code	HCPCS 28202
Hospital Charge Code	16000633
Hospital Revenue Code	360
Min. Negotiated Rate	$507.70
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,319.88
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.94
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$507.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$558.26

2' REPR/SUTR LEG FLEXOR TENDON

Facility

$19,467.90

Service Code	HCPCS 27659
Hospital Charge Code	16000894
Hospital Revenue Code	360
Min. Negotiated Rate	$469.18
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,840.37
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,920.18
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$469.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$515.90

2' REPR/SUTR LEG FLEXOR TENDON

Facility

$19,467.90

Service Code	HCPCS 27659
Hospital Charge Code	16000894
Hospital Revenue Code	360
Min. Negotiated Rate	$2,920.18
Max. Negotiated Rate	$2,920.18
Rate for Payer: Qualcare PPO/HMO/WC	$2,920.18

2' REPR TORN COLLAT ANKL LIGAM

Facility

$30,595.00

Service Code	HCPCS 27698
Hospital Charge Code	16000316
Hospital Revenue Code	360
Min. Negotiated Rate	$4,589.25
Max. Negotiated Rate	$4,589.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25

2' REPR TORN COLLAT ANKL LIGAM

Facility

$30,595.00

Service Code	HCPCS 27698
Hospital Charge Code	16000316
Hospital Revenue Code	360
Min. Negotiated Rate	$737.34
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,178.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$737.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,880.57
Rate for Payer: Wellpoint Medicaid Managed Care	$15,569.19

2'SUTURE ABD WALL FR EVISCRATN

Facility

$9,107.40

Service Code	HCPCS 49900
Hospital Charge Code	16000755
Hospital Revenue Code	360
Min. Negotiated Rate	$1,366.11
Max. Negotiated Rate	$1,366.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,366.11

Know your out-of-pocket cost for care.

All Charges