Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ONLAY TIB INSRT SZ6 9MM THICK

Facility

$5,435.00

Hospital Charge Code	270668836
Hospital Revenue Code	278
Min. Negotiated Rate	$130.98
Max. Negotiated Rate	$2,717.50
Rate for Payer: Aetna Commercial	$2,065.30
Rate for Payer: Aetna Medicare Advantage	$1,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,385.92
Rate for Payer: Cigna Commercial	$2,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,195.70
Rate for Payer: Qualcare PPO/HMO/WC	$815.25
Rate for Payer: UnitedHealthcare Community & State	$130.98
Rate for Payer: Wellpoint Medicaid Managed Care	$144.03

ONLAY TIB INSRT SZ7 10MM THICK

Facility

$5,435.00

Hospital Charge Code	270668841
Hospital Revenue Code	278
Min. Negotiated Rate	$130.98
Max. Negotiated Rate	$2,717.50
Rate for Payer: Aetna Commercial	$2,065.30
Rate for Payer: Aetna Medicare Advantage	$1,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,385.92
Rate for Payer: Cigna Commercial	$2,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,195.70
Rate for Payer: Qualcare PPO/HMO/WC	$815.25
Rate for Payer: UnitedHealthcare Community & State	$130.98
Rate for Payer: Wellpoint Medicaid Managed Care	$144.03

ONLAY TIB INSRT SZ7 10MM THICK

Facility

$5,435.00

Hospital Charge Code	270668841
Hospital Revenue Code	278
Min. Negotiated Rate	$815.25
Max. Negotiated Rate	$1,315.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,195.70
Rate for Payer: Qualcare PPO/HMO/WC	$815.25

ONLAY TIB INSRT SZ7 12MM THICK

Facility

$5,435.00

Hospital Charge Code	270668842
Hospital Revenue Code	278
Min. Negotiated Rate	$815.25
Max. Negotiated Rate	$1,315.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,195.70
Rate for Payer: Qualcare PPO/HMO/WC	$815.25

ONLAY TIB INSRT SZ7 12MM THICK

Facility

$5,435.00

Hospital Charge Code	270668842
Hospital Revenue Code	278
Min. Negotiated Rate	$130.98
Max. Negotiated Rate	$2,717.50
Rate for Payer: Aetna Commercial	$2,065.30
Rate for Payer: Aetna Medicare Advantage	$1,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,385.92
Rate for Payer: Cigna Commercial	$2,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,195.70
Rate for Payer: Qualcare PPO/HMO/WC	$815.25
Rate for Payer: UnitedHealthcare Community & State	$130.98
Rate for Payer: Wellpoint Medicaid Managed Care	$144.03

ONLAY TIB INSRT SZ7 8MM THICK

Facility

$5,435.00

Hospital Charge Code	270668839
Hospital Revenue Code	278
Min. Negotiated Rate	$815.25
Max. Negotiated Rate	$1,315.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,195.70
Rate for Payer: Qualcare PPO/HMO/WC	$815.25

ONLAY TIB INSRT SZ7 8MM THICK

Facility

$5,435.00

Hospital Charge Code	270668839
Hospital Revenue Code	278
Min. Negotiated Rate	$130.98
Max. Negotiated Rate	$2,717.50
Rate for Payer: Aetna Commercial	$2,065.30
Rate for Payer: Aetna Medicare Advantage	$1,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,385.92
Rate for Payer: Cigna Commercial	$2,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,195.70
Rate for Payer: Qualcare PPO/HMO/WC	$815.25
Rate for Payer: UnitedHealthcare Community & State	$130.98
Rate for Payer: Wellpoint Medicaid Managed Care	$144.03

ONLAY TIB INSRT SZ7 9MM THICK

Facility

$5,435.00

Hospital Charge Code	270668840
Hospital Revenue Code	278
Min. Negotiated Rate	$815.25
Max. Negotiated Rate	$1,315.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,195.70
Rate for Payer: Qualcare PPO/HMO/WC	$815.25

ONLAY TIB INSRT SZ7 9MM THICK

Facility

$5,435.00

Hospital Charge Code	270668840
Hospital Revenue Code	278
Min. Negotiated Rate	$130.98
Max. Negotiated Rate	$2,717.50
Rate for Payer: Aetna Commercial	$2,065.30
Rate for Payer: Aetna Medicare Advantage	$1,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,385.92
Rate for Payer: Cigna Commercial	$2,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,195.70
Rate for Payer: Qualcare PPO/HMO/WC	$815.25
Rate for Payer: UnitedHealthcare Community & State	$130.98
Rate for Payer: Wellpoint Medicaid Managed Care	$144.03

ONLAY TIB INSRT SZ8 10MM THICK

Facility

$5,435.00

Hospital Charge Code	270668845
Hospital Revenue Code	278
Min. Negotiated Rate	$815.25
Max. Negotiated Rate	$1,315.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,195.70
Rate for Payer: Qualcare PPO/HMO/WC	$815.25

ONLAY TIB INSRT SZ8 10MM THICK

Facility

$5,435.00

Hospital Charge Code	270668845
Hospital Revenue Code	278
Min. Negotiated Rate	$130.98
Max. Negotiated Rate	$2,717.50
Rate for Payer: Aetna Commercial	$2,065.30
Rate for Payer: Aetna Medicare Advantage	$1,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,385.92
Rate for Payer: Cigna Commercial	$2,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,195.70
Rate for Payer: Qualcare PPO/HMO/WC	$815.25
Rate for Payer: UnitedHealthcare Community & State	$130.98
Rate for Payer: Wellpoint Medicaid Managed Care	$144.03

ONLAY TIB INSRT SZ8 12MM THICK

Facility

$5,435.00

Hospital Charge Code	270668846
Hospital Revenue Code	278
Min. Negotiated Rate	$130.98
Max. Negotiated Rate	$2,717.50
Rate for Payer: Aetna Commercial	$2,065.30
Rate for Payer: Aetna Medicare Advantage	$1,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,385.92
Rate for Payer: Cigna Commercial	$2,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,195.70
Rate for Payer: Qualcare PPO/HMO/WC	$815.25
Rate for Payer: UnitedHealthcare Community & State	$130.98
Rate for Payer: Wellpoint Medicaid Managed Care	$144.03

ONLAY TIB INSRT SZ8 12MM THICK

Facility

$5,435.00

Hospital Charge Code	270668846
Hospital Revenue Code	278
Min. Negotiated Rate	$815.25
Max. Negotiated Rate	$1,315.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,195.70
Rate for Payer: Qualcare PPO/HMO/WC	$815.25

ONLAY TIB INSRT SZ8 8MM THICK

Facility

$5,435.00

Hospital Charge Code	270668843
Hospital Revenue Code	278
Min. Negotiated Rate	$130.98
Max. Negotiated Rate	$2,717.50
Rate for Payer: Aetna Commercial	$2,065.30
Rate for Payer: Aetna Medicare Advantage	$1,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,385.92
Rate for Payer: Cigna Commercial	$2,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,195.70
Rate for Payer: Qualcare PPO/HMO/WC	$815.25
Rate for Payer: UnitedHealthcare Community & State	$130.98
Rate for Payer: Wellpoint Medicaid Managed Care	$144.03

ONLAY TIB INSRT SZ8 8MM THICK

Facility

$5,435.00

Hospital Charge Code	270668843
Hospital Revenue Code	278
Min. Negotiated Rate	$815.25
Max. Negotiated Rate	$1,315.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,195.70
Rate for Payer: Qualcare PPO/HMO/WC	$815.25

ONLAY TIB INSRT SZ8 9MM THICK

Facility

$5,435.00

Hospital Charge Code	270668844
Hospital Revenue Code	278
Min. Negotiated Rate	$815.25
Max. Negotiated Rate	$1,315.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,195.70
Rate for Payer: Qualcare PPO/HMO/WC	$815.25

ONLAY TIB INSRT SZ8 9MM THICK

Facility

$5,435.00

Hospital Charge Code	270668844
Hospital Revenue Code	278
Min. Negotiated Rate	$130.98
Max. Negotiated Rate	$2,717.50
Rate for Payer: Aetna Commercial	$2,065.30
Rate for Payer: Aetna Medicare Advantage	$1,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,385.92
Rate for Payer: Cigna Commercial	$2,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,195.70
Rate for Payer: Qualcare PPO/HMO/WC	$815.25
Rate for Payer: UnitedHealthcare Community & State	$130.98
Rate for Payer: Wellpoint Medicaid Managed Care	$144.03

ON-Q PAIN PUMP W/ BUPIVACAINE

Facility

$4,281.30

Service Code	NDC 61553032160
Hospital Charge Code	606390094
Hospital Revenue Code	250
Min. Negotiated Rate	$642.20
Max. Negotiated Rate	$642.20
Rate for Payer: Qualcare PPO/HMO/WC	$642.20

ON-Q PAIN PUMP W/ BUPIVACAINE

Facility

$4,281.30

Service Code	NDC 61553032160
Hospital Charge Code	606390094
Hospital Revenue Code	250
Min. Negotiated Rate	$103.18
Max. Negotiated Rate	$2,140.65
Rate for Payer: Aetna Commercial	$1,626.89
Rate for Payer: Aetna Medicare Advantage	$1,284.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,091.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,091.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,091.73
Rate for Payer: Cigna Commercial	$2,140.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,284.39
Rate for Payer: Oxford Commercial	$856.26
Rate for Payer: Qualcare PPO/HMO/WC	$642.20
Rate for Payer: UnitedHealthcare Commercial	$856.26
Rate for Payer: UnitedHealthcare Community & State	$103.18
Rate for Payer: Wellpoint Medicaid Managed Care	$113.45

ON-Q SOAKER 6.5

Facility

$280.00

Hospital Charge Code	270335662
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$106.40
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.00
Rate for Payer: Oxford Commercial	$56.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Commercial	$56.00
Rate for Payer: UnitedHealthcare Community & State	$6.75
Rate for Payer: Wellpoint Medicaid Managed Care	$7.42

ON-Q SOAKER 6.5

Facility

$280.00

Hospital Charge Code	270335662
Hospital Revenue Code	272
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

OOPHORECTMY PARTIAL OR TTAL UL

Facility

$6,544.55

Service Code	HCPCS 58940
Hospital Charge Code	1600000827
Hospital Revenue Code	360
Min. Negotiated Rate	$981.68
Max. Negotiated Rate	$981.68
Rate for Payer: Qualcare PPO/HMO/WC	$981.68

OOPHORECTMY PARTIAL OR TTAL UL

Facility

$6,544.55

Service Code	HCPCS 58940
Hospital Charge Code	1600000827
Hospital Revenue Code	360
Min. Negotiated Rate	$157.72
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$2,486.93
Rate for Payer: Aetna Medicare Advantage	$1,963.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,668.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,668.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,668.86
Rate for Payer: Cigna Commercial	$3,272.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,963.37
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$981.68
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$157.72
Rate for Payer: Wellpoint Medicaid Managed Care	$173.43

OPAL SPACER 10MMX24MM 12MM HIG

Facility

$27,565.00

Hospital Charge Code	270656691
Hospital Revenue Code	278
Min. Negotiated Rate	$664.32
Max. Negotiated Rate	$13,782.50
Rate for Payer: Aetna Commercial	$10,474.70
Rate for Payer: Aetna Medicare Advantage	$8,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,029.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,029.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,513.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,029.07
Rate for Payer: Cigna Commercial	$13,782.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,670.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,064.30
Rate for Payer: Qualcare PPO/HMO/WC	$4,134.75
Rate for Payer: UnitedHealthcare Community & State	$664.32
Rate for Payer: Wellpoint Medicaid Managed Care	$730.47

OPAL SPACER 10MMX24MM 12MM HIG

Facility

$27,565.00

Hospital Charge Code	270656691
Hospital Revenue Code	278
Min. Negotiated Rate	$4,134.75
Max. Negotiated Rate	$6,670.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,513.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,670.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,064.30
Rate for Payer: Qualcare PPO/HMO/WC	$4,134.75

Know your out-of-pocket cost for care.

All Charges