Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NERVE PROTECTOR 7X40MM

Facility

$14,175.00

Service Code	HCPCS C1763
Hospital Charge Code	270696287
Hospital Revenue Code	278
Min. Negotiated Rate	$2,126.25
Max. Negotiated Rate	$3,430.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,430.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,118.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,126.25

NERVE PROTECTOR/WRAP

Facility

$9,875.00

Hospital Charge Code	270664248
Hospital Revenue Code	270
Min. Negotiated Rate	$237.99
Max. Negotiated Rate	$4,937.50
Rate for Payer: Aetna Commercial	$3,752.50
Rate for Payer: Aetna Medicare Advantage	$2,962.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,518.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,518.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,518.12
Rate for Payer: Cigna Commercial	$4,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,962.50
Rate for Payer: Oxford Commercial	$1,975.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,481.25
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$237.99
Rate for Payer: Wellpoint Medicaid Managed Care	$261.69

NERVE PROTECTOR/WRAP

Facility

$9,875.00

Hospital Charge Code	270664248
Hospital Revenue Code	270
Min. Negotiated Rate	$1,481.25
Max. Negotiated Rate	$1,481.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,481.25

NERVE SET STIMUPLEX 21GAx4

Facility

$67.17

Hospital Charge Code	270656035
Hospital Revenue Code	272
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$33.59
Rate for Payer: Aetna Commercial	$25.52
Rate for Payer: Aetna Medicare Advantage	$20.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.13
Rate for Payer: Cigna Commercial	$33.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.15
Rate for Payer: Oxford Commercial	$13.43
Rate for Payer: Qualcare PPO/HMO/WC	$10.08
Rate for Payer: UnitedHealthcare Commercial	$13.43
Rate for Payer: UnitedHealthcare Community & State	$1.62
Rate for Payer: Wellpoint Medicaid Managed Care	$1.78

NERVE SET STIMUPLEX 21GAx4

Facility

$67.17

Hospital Charge Code	270656035
Hospital Revenue Code	272
Min. Negotiated Rate	$10.08
Max. Negotiated Rate	$10.08
Rate for Payer: Qualcare PPO/HMO/WC	$10.08

NERVO PROTECTOR

Facility

$9,400.00

Hospital Charge Code	270661463
Hospital Revenue Code	278
Min. Negotiated Rate	$1,410.00
Max. Negotiated Rate	$2,274.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,274.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,068.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,410.00

NERVO PROTECTOR

Facility

$9,400.00

Hospital Charge Code	270661463
Hospital Revenue Code	278
Min. Negotiated Rate	$226.54
Max. Negotiated Rate	$4,700.00
Rate for Payer: Aetna Commercial	$3,572.00
Rate for Payer: Aetna Medicare Advantage	$2,820.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,880.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,397.00
Rate for Payer: Cigna Commercial	$4,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,274.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,068.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,410.00
Rate for Payer: UnitedHealthcare Community & State	$226.54
Rate for Payer: Wellpoint Medicaid Managed Care	$249.10

NERVOUS SYSTEM MALIGNANCY

Facility

$9,874.05

Service Code	APR-DRG 0412
Min. Negotiated Rate	$9,680.44
Max. Negotiated Rate	$9,874.05
Rate for Payer: UnitedHealthcare Community & State	$9,680.44
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,874.05
Rate for Payer: Wellpoint Medicaid Managed Care	$9,680.44

NERVOUS SYSTEM MALIGNANCY

Facility

$13,061.98

Service Code	APR-DRG 0413
Min. Negotiated Rate	$12,805.86
Max. Negotiated Rate	$13,061.98
Rate for Payer: UnitedHealthcare Community & State	$12,805.86
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,061.98
Rate for Payer: Wellpoint Medicaid Managed Care	$12,805.86

NERVOUS SYSTEM MALIGNANCY

Facility

$9,484.65

Service Code	APR-DRG 0411
Min. Negotiated Rate	$9,298.68
Max. Negotiated Rate	$9,484.65
Rate for Payer: UnitedHealthcare Community & State	$9,298.68
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,484.65
Rate for Payer: Wellpoint Medicaid Managed Care	$9,298.68

NERVOUS SYSTEM MALIGNANCY

Facility

$19,079.17

Service Code	APR-DRG 0414
Min. Negotiated Rate	$18,705.07
Max. Negotiated Rate	$19,079.17
Rate for Payer: UnitedHealthcare Community & State	$18,705.07
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,079.17
Rate for Payer: Wellpoint Medicaid Managed Care	$18,705.07

NERVOUS SYSTEM NEOPLASMS WITH MCC

Facility

$51,486.05

Service Code	MSDRG 054
Min. Negotiated Rate	$15,676.84
Max. Negotiated Rate	$51,486.05
Rate for Payer: Aetna Medicare Advantage	$51,486.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34,193.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34,193.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,501.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34,193.67
Rate for Payer: Cigna Commercial	$28,574.41
Rate for Payer: Cigna Medicare Advantage	$16,501.94
Rate for Payer: Clover Medicare Advantage	$15,676.84
Rate for Payer: EmblemHealth Commercial	$49,505.82
Rate for Payer: Humana Medicare Advantage	$16,997.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,501.94
Rate for Payer: Oxford Commercial	$20,536.81
Rate for Payer: UnitedHealthcare Commercial	$36,011.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,501.94
Rate for Payer: Wellcare Medicare Advantage	$16,501.94

NERVOUS SYSTEM NEOPLASMS WITHOUT MCC

Facility

$35,089.27

Service Code	MSDRG 055
Min. Negotiated Rate	$10,684.23
Max. Negotiated Rate	$35,089.27
Rate for Payer: Aetna Medicare Advantage	$35,089.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,889.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,889.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,246.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,889.27
Rate for Payer: Cigna Commercial	$19,080.79
Rate for Payer: Cigna Medicare Advantage	$11,246.56
Rate for Payer: Clover Medicare Advantage	$10,684.23
Rate for Payer: EmblemHealth Commercial	$33,739.68
Rate for Payer: Humana Medicare Advantage	$11,583.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11,246.56
Rate for Payer: Oxford Commercial	$13,713.62
Rate for Payer: UnitedHealthcare Commercial	$24,047.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,246.56
Rate for Payer: Wellcare Medicare Advantage	$11,246.56

NET RETRIEVAL***

Facility

$57.00

Hospital Charge Code	2300846
Hospital Revenue Code	279
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$8.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.55

NET RETRIEVAL***

Facility

$57.00

Hospital Charge Code	2300846
Hospital Revenue Code	279
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$28.50
Rate for Payer: Aetna Commercial	$21.66
Rate for Payer: Aetna Medicare Advantage	$17.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.54
Rate for Payer: Cigna Commercial	$28.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.10
Rate for Payer: Oxford Commercial	$11.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.55
Rate for Payer: UnitedHealthcare Commercial	$11.40
Rate for Payer: UnitedHealthcare Community & State	$1.37
Rate for Payer: Wellpoint Medicaid Managed Care	$1.51

NET RETRIEVAL ROTH DISP 2.5mm

Facility

$392.65

Hospital Charge Code	270650906
Hospital Revenue Code	272
Min. Negotiated Rate	$58.90
Max. Negotiated Rate	$58.90
Rate for Payer: Qualcare PPO/HMO/WC	$58.90

NET RETRIEVAL ROTH DISP 2.5mm

Facility

$392.65

Hospital Charge Code	270650906
Hospital Revenue Code	272
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$196.32
Rate for Payer: Aetna Commercial	$149.21
Rate for Payer: Aetna Medicare Advantage	$117.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.13
Rate for Payer: Cigna Commercial	$196.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.80
Rate for Payer: Oxford Commercial	$78.53
Rate for Payer: Qualcare PPO/HMO/WC	$58.90
Rate for Payer: UnitedHealthcare Commercial	$78.53
Rate for Payer: UnitedHealthcare Community & State	$9.46
Rate for Payer: Wellpoint Medicaid Managed Care	$10.41

NET ROTH RETRIEVAL 2.5MM

Facility

$525.00

Hospital Charge Code	270658147
Hospital Revenue Code	272
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.50
Rate for Payer: Oxford Commercial	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Commercial	$105.00
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

NET ROTH RETRIEVAL 2.5MM

Facility

$525.00

Hospital Charge Code	270658147
Hospital Revenue Code	272
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

NET ROTH RETRIEVAL 2.5mm 230cm

Facility

$470.00

Hospital Charge Code	270600968
Hospital Revenue Code	272
Min. Negotiated Rate	$11.33
Max. Negotiated Rate	$235.00
Rate for Payer: Aetna Commercial	$178.60
Rate for Payer: Aetna Medicare Advantage	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.85
Rate for Payer: Cigna Commercial	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.00
Rate for Payer: Oxford Commercial	$94.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.50
Rate for Payer: UnitedHealthcare Commercial	$94.00
Rate for Payer: UnitedHealthcare Community & State	$11.33
Rate for Payer: Wellpoint Medicaid Managed Care	$12.46

NET ROTH RETRIEVAL 2.5mm 230cm

Facility

$470.00

Hospital Charge Code	270600968
Hospital Revenue Code	272
Min. Negotiated Rate	$70.50
Max. Negotiated Rate	$70.50
Rate for Payer: Qualcare PPO/HMO/WC	$70.50

NEURO DRILL AGGRESSIVE 3X3.8MM

Facility

$866.15

Hospital Charge Code	270673698
Hospital Revenue Code	272
Min. Negotiated Rate	$20.87
Max. Negotiated Rate	$433.07
Rate for Payer: Aetna Commercial	$329.14
Rate for Payer: Aetna Medicare Advantage	$259.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$220.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$220.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$220.87
Rate for Payer: Cigna Commercial	$433.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.85
Rate for Payer: Oxford Commercial	$173.23
Rate for Payer: Qualcare PPO/HMO/WC	$129.92
Rate for Payer: UnitedHealthcare Commercial	$173.23
Rate for Payer: UnitedHealthcare Community & State	$20.87
Rate for Payer: Wellpoint Medicaid Managed Care	$22.95

NEURO DRILL AGGRESSIVE 3X3.8MM

Facility

$866.15

Hospital Charge Code	270673698
Hospital Revenue Code	272
Min. Negotiated Rate	$129.92
Max. Negotiated Rate	$129.92
Rate for Payer: Qualcare PPO/HMO/WC	$129.92

NEURO FLUID MANAGEMENT KIT

Facility

$205.00

Hospital Charge Code	270682762S
Hospital Revenue Code	272
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$102.50
Rate for Payer: Aetna Commercial	$77.90
Rate for Payer: Aetna Medicare Advantage	$61.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.27
Rate for Payer: Cigna Commercial	$102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.50
Rate for Payer: Oxford Commercial	$41.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.75
Rate for Payer: UnitedHealthcare Commercial	$41.00
Rate for Payer: UnitedHealthcare Community & State	$4.94
Rate for Payer: Wellpoint Medicaid Managed Care	$5.43

NEURO FLUID MANAGEMENT KIT

Facility

$205.00

Hospital Charge Code	270682762
Hospital Revenue Code	272
Min. Negotiated Rate	$30.75
Max. Negotiated Rate	$30.75
Rate for Payer: Qualcare PPO/HMO/WC	$30.75

Know your out-of-pocket cost for care.

All Charges