Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PATCH GTX SFT TISS1320030020**

Facility

$2,283.00

Hospital Charge Code	1604040
Hospital Revenue Code	278
Min. Negotiated Rate	$55.02
Max. Negotiated Rate	$1,141.50
Rate for Payer: Aetna Commercial	$867.54
Rate for Payer: Aetna Medicare Advantage	$684.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$582.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$582.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$582.16
Rate for Payer: Cigna Commercial	$1,141.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$502.26
Rate for Payer: Qualcare PPO/HMO/WC	$342.45
Rate for Payer: UnitedHealthcare Community & State	$55.02
Rate for Payer: Wellpoint Medicaid Managed Care	$60.50

PATCH GTX SOFT TISSUE 5X20CM**

Facility

$1,156.00

Hospital Charge Code	1604032
Hospital Revenue Code	278
Min. Negotiated Rate	$173.40
Max. Negotiated Rate	$279.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$231.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$254.32
Rate for Payer: Qualcare PPO/HMO/WC	$173.40

PATCH GTX SOFT TISSUE 5X20CM**

Facility

$1,156.00

Hospital Charge Code	1604032
Hospital Revenue Code	278
Min. Negotiated Rate	$27.86
Max. Negotiated Rate	$578.00
Rate for Payer: Aetna Commercial	$439.28
Rate for Payer: Aetna Medicare Advantage	$346.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$294.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$294.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$231.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$294.78
Rate for Payer: Cigna Commercial	$578.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$254.32
Rate for Payer: Qualcare PPO/HMO/WC	$173.40
Rate for Payer: UnitedHealthcare Community & State	$27.86
Rate for Payer: Wellpoint Medicaid Managed Care	$30.63

PATCH HEMASHLD FINESSE 8x75mm

Facility

$500.30

Service Code	HCPCS C1768
Hospital Charge Code	270630314
Hospital Revenue Code	272
Min. Negotiated Rate	$12.06
Max. Negotiated Rate	$250.15
Rate for Payer: Aetna Commercial	$190.11
Rate for Payer: Aetna Medicare Advantage	$150.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.58
Rate for Payer: Cigna Commercial	$250.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.09
Rate for Payer: Oxford Commercial	$100.06
Rate for Payer: Qualcare PPO/HMO/WC	$75.05
Rate for Payer: UnitedHealthcare Commercial	$100.06
Rate for Payer: UnitedHealthcare Community & State	$12.06
Rate for Payer: Wellpoint Medicaid Managed Care	$13.26

PATCH HEMASHLD FINESSE 8x75mm

Facility

$500.30

Service Code	HCPCS C1768
Hospital Charge Code	270630314
Hospital Revenue Code	272
Min. Negotiated Rate	$75.05
Max. Negotiated Rate	$75.05
Rate for Payer: Qualcare PPO/HMO/WC	$75.05

PATCH HFIN 1X3/2.5X7.6 019530

Facility

$722.25

Hospital Charge Code	270630289
Hospital Revenue Code	272
Min. Negotiated Rate	$108.34
Max. Negotiated Rate	$108.34
Rate for Payer: Qualcare PPO/HMO/WC	$108.34

PATCH HFIN 1X3/2.5X7.6 019530

Facility

$722.25

Hospital Charge Code	270630289
Hospital Revenue Code	272
Min. Negotiated Rate	$17.41
Max. Negotiated Rate	$361.12
Rate for Payer: Aetna Commercial	$274.45
Rate for Payer: Aetna Medicare Advantage	$216.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.17
Rate for Payer: Cigna Commercial	$361.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.68
Rate for Payer: Oxford Commercial	$144.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.34
Rate for Payer: UnitedHealthcare Commercial	$144.45
Rate for Payer: UnitedHealthcare Community & State	$17.41
Rate for Payer: Wellpoint Medicaid Managed Care	$19.14

PATCH PERCARDIAL 6X10 555-610

Facility

$2,667.25

Hospital Charge Code	270615779
Hospital Revenue Code	272
Min. Negotiated Rate	$400.09
Max. Negotiated Rate	$400.09
Rate for Payer: Qualcare PPO/HMO/WC	$400.09

PATCH PERCARDIAL 6X10 555-610

Facility

$2,667.25

Hospital Charge Code	270615779
Hospital Revenue Code	272
Min. Negotiated Rate	$64.28
Max. Negotiated Rate	$1,333.62
Rate for Payer: Aetna Commercial	$1,013.55
Rate for Payer: Aetna Medicare Advantage	$800.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$680.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$680.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$680.15
Rate for Payer: Cigna Commercial	$1,333.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$800.17
Rate for Payer: Oxford Commercial	$533.45
Rate for Payer: Qualcare PPO/HMO/WC	$400.09
Rate for Payer: UnitedHealthcare Commercial	$533.45
Rate for Payer: UnitedHealthcare Community & State	$64.28
Rate for Payer: Wellpoint Medicaid Managed Care	$70.68

PATCH PERICARD 12 CIRC 555-12C

Facility

$3,448.00

Hospital Charge Code	270619075
Hospital Revenue Code	272
Min. Negotiated Rate	$83.10
Max. Negotiated Rate	$1,724.00
Rate for Payer: Aetna Commercial	$1,310.24
Rate for Payer: Aetna Medicare Advantage	$1,034.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$879.24
Rate for Payer: Cigna Commercial	$1,724.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,034.40
Rate for Payer: Oxford Commercial	$689.60
Rate for Payer: Qualcare PPO/HMO/WC	$517.20
Rate for Payer: UnitedHealthcare Commercial	$689.60
Rate for Payer: UnitedHealthcare Community & State	$83.10
Rate for Payer: Wellpoint Medicaid Managed Care	$91.37

PATCH PERICARD 12 CIRC 555-12C

Facility

$3,448.00

Hospital Charge Code	270619075
Hospital Revenue Code	272
Min. Negotiated Rate	$517.20
Max. Negotiated Rate	$517.20
Rate for Payer: Qualcare PPO/HMO/WC	$517.20

PATCH PLUG MARLEX BARD

Facility

$1,362.50

Service Code	HCPCS C1781
Hospital Charge Code	270601199
Hospital Revenue Code	278
Min. Negotiated Rate	$204.38
Max. Negotiated Rate	$329.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$299.75
Rate for Payer: Qualcare PPO/HMO/WC	$204.38

PATCH PLUG MARLEX BARD

Facility

$1,362.50

Service Code	HCPCS C1781
Hospital Charge Code	270601199
Hospital Revenue Code	278
Min. Negotiated Rate	$32.84
Max. Negotiated Rate	$681.25
Rate for Payer: Aetna Commercial	$517.75
Rate for Payer: Aetna Medicare Advantage	$408.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$347.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$347.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$347.44
Rate for Payer: Cigna Commercial	$681.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$299.75
Rate for Payer: Qualcare PPO/HMO/WC	$204.38
Rate for Payer: UnitedHealthcare Community & State	$32.84
Rate for Payer: Wellpoint Medicaid Managed Care	$36.11

PATCH PLUG MARLEX MEDIUM

Facility

$1,213.50

Hospital Charge Code	270621075
Hospital Revenue Code	272
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$606.75
Rate for Payer: Aetna Commercial	$461.13
Rate for Payer: Aetna Medicare Advantage	$364.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.44
Rate for Payer: Cigna Commercial	$606.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.05
Rate for Payer: Oxford Commercial	$242.70
Rate for Payer: Qualcare PPO/HMO/WC	$182.03
Rate for Payer: UnitedHealthcare Commercial	$242.70
Rate for Payer: UnitedHealthcare Community & State	$29.25
Rate for Payer: Wellpoint Medicaid Managed Care	$32.16

PATCH PLUG MARLEX MEDIUM

Facility

$1,213.50

Hospital Charge Code	270621075
Hospital Revenue Code	272
Min. Negotiated Rate	$182.03
Max. Negotiated Rate	$182.03
Rate for Payer: Qualcare PPO/HMO/WC	$182.03

PATCH TISSUE 10.CM X 15.0CM

Facility

$2,060.00

Hospital Charge Code	270650766
Hospital Revenue Code	272
Min. Negotiated Rate	$49.65
Max. Negotiated Rate	$1,030.00
Rate for Payer: Aetna Commercial	$782.80
Rate for Payer: Aetna Medicare Advantage	$618.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$525.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$525.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$525.30
Rate for Payer: Cigna Commercial	$1,030.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$618.00
Rate for Payer: Oxford Commercial	$412.00
Rate for Payer: Qualcare PPO/HMO/WC	$309.00
Rate for Payer: UnitedHealthcare Commercial	$412.00
Rate for Payer: UnitedHealthcare Community & State	$49.65
Rate for Payer: Wellpoint Medicaid Managed Care	$54.59

PATCH TISSUE 10.CM X 15.0CM

Facility

$2,060.00

Hospital Charge Code	270650766
Hospital Revenue Code	272
Min. Negotiated Rate	$309.00
Max. Negotiated Rate	$309.00
Rate for Payer: Qualcare PPO/HMO/WC	$309.00

PATCH VASC COLLAGN 8x75 CP0875

Facility

$615.10

Hospital Charge Code	270634353
Hospital Revenue Code	272
Min. Negotiated Rate	$14.82
Max. Negotiated Rate	$307.55
Rate for Payer: Aetna Commercial	$233.74
Rate for Payer: Aetna Medicare Advantage	$184.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.85
Rate for Payer: Cigna Commercial	$307.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.53
Rate for Payer: Oxford Commercial	$123.02
Rate for Payer: Qualcare PPO/HMO/WC	$92.27
Rate for Payer: UnitedHealthcare Commercial	$123.02
Rate for Payer: UnitedHealthcare Community & State	$14.82
Rate for Payer: Wellpoint Medicaid Managed Care	$16.30

PATCH VASC COLLAGN 8x75 CP0875

Facility

$615.10

Hospital Charge Code	270634353
Hospital Revenue Code	272
Min. Negotiated Rate	$92.27
Max. Negotiated Rate	$92.27
Rate for Payer: Qualcare PPO/HMO/WC	$92.27

PATCH VASCGARD 0.8 8CM VG0108N

Facility

$915.65

Service Code	HCPCS C1768
Hospital Charge Code	270619788
Hospital Revenue Code	278
Min. Negotiated Rate	$137.35
Max. Negotiated Rate	$221.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$183.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$201.44
Rate for Payer: Qualcare PPO/HMO/WC	$137.35

PATCH VASCGARD 0.8 8CM VG0108N

Facility

$915.65

Service Code	HCPCS C1768
Hospital Charge Code	270619788
Hospital Revenue Code	278
Min. Negotiated Rate	$22.07
Max. Negotiated Rate	$457.82
Rate for Payer: Aetna Commercial	$347.95
Rate for Payer: Aetna Medicare Advantage	$274.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$233.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$233.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$183.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$233.49
Rate for Payer: Cigna Commercial	$457.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$201.44
Rate for Payer: Qualcare PPO/HMO/WC	$137.35
Rate for Payer: UnitedHealthcare Community & State	$22.07
Rate for Payer: Wellpoint Medicaid Managed Care	$24.26

PATCH VASCU 2X9 NR-555-CRT29

Facility

$971.25

Hospital Charge Code	270615141
Hospital Revenue Code	278
Min. Negotiated Rate	$145.69
Max. Negotiated Rate	$235.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$213.68
Rate for Payer: Qualcare PPO/HMO/WC	$145.69

PATCH VASCU 2X9 NR-555-CRT29

Facility

$971.25

Hospital Charge Code	270615141
Hospital Revenue Code	278
Min. Negotiated Rate	$23.41
Max. Negotiated Rate	$485.62
Rate for Payer: Aetna Commercial	$369.07
Rate for Payer: Aetna Medicare Advantage	$291.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.67
Rate for Payer: Cigna Commercial	$485.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$213.68
Rate for Payer: Qualcare PPO/HMO/WC	$145.69
Rate for Payer: UnitedHealthcare Community & State	$23.41
Rate for Payer: Wellpoint Medicaid Managed Care	$25.74

PATCH VASCUGUARD 1x10cm

Facility

$855.00

Hospital Charge Code	270642471
Hospital Revenue Code	272
Min. Negotiated Rate	$128.25
Max. Negotiated Rate	$128.25
Rate for Payer: Qualcare PPO/HMO/WC	$128.25

PATCH VASCUGUARD 1x10cm

Facility

$855.00

Hospital Charge Code	270642471
Hospital Revenue Code	272
Min. Negotiated Rate	$20.61
Max. Negotiated Rate	$427.50
Rate for Payer: Aetna Commercial	$324.90
Rate for Payer: Aetna Medicare Advantage	$256.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.03
Rate for Payer: Cigna Commercial	$427.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.50
Rate for Payer: Oxford Commercial	$171.00
Rate for Payer: Qualcare PPO/HMO/WC	$128.25
Rate for Payer: UnitedHealthcare Commercial	$171.00
Rate for Payer: UnitedHealthcare Community & State	$20.61
Rate for Payer: Wellpoint Medicaid Managed Care	$22.66

Know your out-of-pocket cost for care.

All Charges