Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

OPTEFIL 1CC SYRINGE

Facility

$624.00

Hospital Charge Code	270332652
Hospital Revenue Code	278
Min. Negotiated Rate	$15.04
Max. Negotiated Rate	$312.00
Rate for Payer: Aetna Commercial	$237.12
Rate for Payer: Aetna Medicare Advantage	$187.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.12
Rate for Payer: Cigna Commercial	$312.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.28
Rate for Payer: Qualcare PPO/HMO/WC	$93.60
Rate for Payer: UnitedHealthcare Community & State	$15.04
Rate for Payer: Wellpoint Medicaid Managed Care	$16.54

OPTEFIL 1CC SYRINGE

Facility

$624.00

Hospital Charge Code	270332652
Hospital Revenue Code	278
Min. Negotiated Rate	$93.60
Max. Negotiated Rate	$151.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.28
Rate for Payer: Qualcare PPO/HMO/WC	$93.60

OPTEFORM ALLOGRAFT 3x20MM

Facility

$1,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270681387
Hospital Revenue Code	278
Min. Negotiated Rate	$39.77
Max. Negotiated Rate	$825.00
Rate for Payer: Aetna Commercial	$627.00
Rate for Payer: Aetna Medicare Advantage	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.75
Rate for Payer: Cigna Commercial	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.50
Rate for Payer: UnitedHealthcare Community & State	$39.77
Rate for Payer: Wellpoint Medicaid Managed Care	$43.73

OPTEFORM ALLOGRAFT 3x20MM

Facility

$1,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270681387
Hospital Revenue Code	278
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$399.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.50

OPTEFORM ALLOGRAFT 3x20MM

Facility

$1,650.00

Service Code	HCPCS C1762
Hospital Charge Code	270674250
Hospital Revenue Code	278
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$399.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.50

OPTEFORM ALLOGRAFT 3x20MM

Facility

$1,650.00

Service Code	HCPCS C1762
Hospital Charge Code	270674250
Hospital Revenue Code	278
Min. Negotiated Rate	$39.77
Max. Negotiated Rate	$825.00
Rate for Payer: Aetna Commercial	$627.00
Rate for Payer: Aetna Medicare Advantage	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.75
Rate for Payer: Cigna Commercial	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.50
Rate for Payer: UnitedHealthcare Community & State	$39.77
Rate for Payer: Wellpoint Medicaid Managed Care	$43.73

OPTEFORM DISC 45MM

Facility

$8,437.50

Hospital Charge Code	270674125
Hospital Revenue Code	278
Min. Negotiated Rate	$1,265.62
Max. Negotiated Rate	$2,041.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,041.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,856.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,265.62

OPTEFORM DISC 45MM

Facility

$8,437.50

Hospital Charge Code	270674125
Hospital Revenue Code	278
Min. Negotiated Rate	$203.34
Max. Negotiated Rate	$4,218.75
Rate for Payer: Aetna Commercial	$3,206.25
Rate for Payer: Aetna Medicare Advantage	$2,531.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,151.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,151.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,151.56
Rate for Payer: Cigna Commercial	$4,218.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,041.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,856.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,265.62
Rate for Payer: UnitedHealthcare Community & State	$203.34
Rate for Payer: Wellpoint Medicaid Managed Care	$223.59

OPTEMP CAUTERY

Facility

$255.00

Hospital Charge Code	270332557
Hospital Revenue Code	272
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$38.25
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

OPTEMP CAUTERY

Facility

$255.00

Hospital Charge Code	270332557
Hospital Revenue Code	272
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$96.90
Rate for Payer: Aetna Medicare Advantage	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.03
Rate for Payer: Cigna Commercial	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.50
Rate for Payer: Oxford Commercial	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.25
Rate for Payer: UnitedHealthcare Commercial	$51.00
Rate for Payer: UnitedHealthcare Community & State	$6.15
Rate for Payer: Wellpoint Medicaid Managed Care	$6.76

OPTICHAMBER

Facility

$45.22

Hospital Charge Code	270651553
Hospital Revenue Code	270
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$22.61
Rate for Payer: Aetna Commercial	$17.18
Rate for Payer: Aetna Medicare Advantage	$13.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.53
Rate for Payer: Cigna Commercial	$22.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.57
Rate for Payer: Oxford Commercial	$9.04
Rate for Payer: Qualcare PPO/HMO/WC	$6.78
Rate for Payer: UnitedHealthcare Commercial	$9.04
Rate for Payer: UnitedHealthcare Community & State	$1.09
Rate for Payer: Wellpoint Medicaid Managed Care	$1.20

OPTICHAMBER

Facility

$45.22

Hospital Charge Code	270651553
Hospital Revenue Code	270
Min. Negotiated Rate	$6.78
Max. Negotiated Rate	$6.78
Rate for Payer: Qualcare PPO/HMO/WC	$6.78

OPTICHAMBER HS80010

Facility

$26.35

Hospital Charge Code	270635276
Hospital Revenue Code	272
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$13.18
Rate for Payer: Aetna Commercial	$10.01
Rate for Payer: Aetna Medicare Advantage	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.72
Rate for Payer: Cigna Commercial	$13.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.91
Rate for Payer: Oxford Commercial	$5.27
Rate for Payer: Qualcare PPO/HMO/WC	$3.95
Rate for Payer: UnitedHealthcare Commercial	$5.27
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

OPTICHAMBER HS80010

Facility

$26.35

Hospital Charge Code	270635276
Hospital Revenue Code	272
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$3.95
Rate for Payer: Qualcare PPO/HMO/WC	$3.95

OPTICROSS HD 5FR

Facility

$5,625.00

Hospital Charge Code	270703405
Hospital Revenue Code	278
Min. Negotiated Rate	$135.56
Max. Negotiated Rate	$2,812.50
Rate for Payer: Aetna Commercial	$2,137.50
Rate for Payer: Aetna Medicare Advantage	$1,687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,434.38
Rate for Payer: Cigna Commercial	$2,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,361.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,237.50
Rate for Payer: Qualcare PPO/HMO/WC	$843.75
Rate for Payer: UnitedHealthcare Community & State	$135.56
Rate for Payer: Wellpoint Medicaid Managed Care	$149.06

OPTICROSS HD 5FR

Facility

$5,625.00

Hospital Charge Code	270703405
Hospital Revenue Code	278
Min. Negotiated Rate	$843.75
Max. Negotiated Rate	$1,361.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,361.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,237.50
Rate for Payer: Qualcare PPO/HMO/WC	$843.75

OPTICROSS HD 6 FR

Facility

$5,625.00

Hospital Charge Code	270703406
Hospital Revenue Code	278
Min. Negotiated Rate	$843.75
Max. Negotiated Rate	$1,361.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,361.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,237.50
Rate for Payer: Qualcare PPO/HMO/WC	$843.75

OPTICROSS HD 6 FR

Facility

$5,625.00

Hospital Charge Code	270703406
Hospital Revenue Code	278
Min. Negotiated Rate	$135.56
Max. Negotiated Rate	$2,812.50
Rate for Payer: Aetna Commercial	$2,137.50
Rate for Payer: Aetna Medicare Advantage	$1,687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,434.38
Rate for Payer: Cigna Commercial	$2,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,361.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,237.50
Rate for Payer: Qualcare PPO/HMO/WC	$843.75
Rate for Payer: UnitedHealthcare Community & State	$135.56
Rate for Payer: Wellpoint Medicaid Managed Care	$149.06

OPTIFIX

Facility

$3,400.00

Hospital Charge Code	270685689
Hospital Revenue Code	272
Min. Negotiated Rate	$510.00
Max. Negotiated Rate	$510.00
Rate for Payer: Qualcare PPO/HMO/WC	$510.00

OPTIFIX

Facility

$3,400.00

Hospital Charge Code	270685689
Hospital Revenue Code	272
Min. Negotiated Rate	$81.94
Max. Negotiated Rate	$1,700.00
Rate for Payer: Aetna Commercial	$1,292.00
Rate for Payer: Aetna Medicare Advantage	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$867.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$867.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$867.00
Rate for Payer: Cigna Commercial	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,020.00
Rate for Payer: Oxford Commercial	$680.00
Rate for Payer: Qualcare PPO/HMO/WC	$510.00
Rate for Payer: UnitedHealthcare Commercial	$680.00
Rate for Payer: UnitedHealthcare Community & State	$81.94
Rate for Payer: Wellpoint Medicaid Managed Care	$90.10

OPTILETS-500/TAB

Facility

$3.00

Hospital Charge Code	60633579
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

OPTILETS-500/TAB

Facility

$3.00

Hospital Charge Code	60633579
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

OPTIMUS X FIBER PLUS

Facility

$6,750.00

Service Code	HCPCS C1765
Hospital Charge Code	270703776
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

OPTIMUS X FIBER PLUS

Facility

$6,750.00

Service Code	HCPCS C1765
Hospital Charge Code	270703776
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

OPTIMUS X FIBER PLUS 10CC

Facility

$11,625.00

Hospital Charge Code	270703477
Hospital Revenue Code	278
Min. Negotiated Rate	$1,743.75
Max. Negotiated Rate	$2,813.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,813.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,557.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,743.75

Know your out-of-pocket cost for care.

All Charges