Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PORT SINGLE SITE 8.5

Facility

$750.00

Hospital Charge Code	270664270
Hospital Revenue Code	272
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

PORT VORTEX P12155K

Facility

$1,750.00

Hospital Charge Code	270639110V
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$385.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

PORT VORTEX P12155K

Facility

$1,750.00

Hospital Charge Code	270639110V
Hospital Revenue Code	278
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$385.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

POSITIONER HEAD ADULT

Facility

$10.14

Hospital Charge Code	270665497
Hospital Revenue Code	270
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$1.52
Rate for Payer: Qualcare PPO/HMO/WC	$1.52

POSITIONER HEAD ADULT

Facility

$10.14

Hospital Charge Code	270665497
Hospital Revenue Code	270
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$5.07
Rate for Payer: Aetna Commercial	$3.85
Rate for Payer: Aetna Medicare Advantage	$3.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.59
Rate for Payer: Cigna Commercial	$5.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.04
Rate for Payer: Oxford Commercial	$2.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.52
Rate for Payer: UnitedHealthcare Commercial	$2.03
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

POSITIONER HIP LONG PEG

Facility

$2,740.00

Hospital Charge Code	270677974
Hospital Revenue Code	272
Min. Negotiated Rate	$66.03
Max. Negotiated Rate	$1,370.00
Rate for Payer: Aetna Commercial	$1,041.20
Rate for Payer: Aetna Medicare Advantage	$822.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$698.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$698.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$698.70
Rate for Payer: Cigna Commercial	$1,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$822.00
Rate for Payer: Oxford Commercial	$548.00
Rate for Payer: Qualcare PPO/HMO/WC	$411.00
Rate for Payer: UnitedHealthcare Commercial	$548.00
Rate for Payer: UnitedHealthcare Community & State	$66.03
Rate for Payer: Wellpoint Medicaid Managed Care	$72.61

POSITIONER HIP LONG PEG

Facility

$2,740.00

Hospital Charge Code	270677974
Hospital Revenue Code	272
Min. Negotiated Rate	$411.00
Max. Negotiated Rate	$411.00
Rate for Payer: Qualcare PPO/HMO/WC	$411.00

POSITIONER HIP SHORT PEG

Facility

$2,740.00

Hospital Charge Code	270677975
Hospital Revenue Code	272
Min. Negotiated Rate	$66.03
Max. Negotiated Rate	$1,370.00
Rate for Payer: Aetna Commercial	$1,041.20
Rate for Payer: Aetna Medicare Advantage	$822.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$698.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$698.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$698.70
Rate for Payer: Cigna Commercial	$1,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$822.00
Rate for Payer: Oxford Commercial	$548.00
Rate for Payer: Qualcare PPO/HMO/WC	$411.00
Rate for Payer: UnitedHealthcare Commercial	$548.00
Rate for Payer: UnitedHealthcare Community & State	$66.03
Rate for Payer: Wellpoint Medicaid Managed Care	$72.61

POSITIONER HIP SHORT PEG

Facility

$2,740.00

Hospital Charge Code	270677975
Hospital Revenue Code	272
Min. Negotiated Rate	$411.00
Max. Negotiated Rate	$411.00
Rate for Payer: Qualcare PPO/HMO/WC	$411.00

POSITIONER LATERAL IMP *****

Facility

$66.00

Hospital Charge Code	1606516
Hospital Revenue Code	272
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$25.08
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.80
Rate for Payer: Oxford Commercial	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$13.20
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

POSITIONER LATERAL IMP *****

Facility

$66.00

Hospital Charge Code	1606516
Hospital Revenue Code	272
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

POSITIONER LG RECTANGLE 25

Facility

$497.50

Hospital Charge Code	270646189
Hospital Revenue Code	271
Min. Negotiated Rate	$11.99
Max. Negotiated Rate	$248.75
Rate for Payer: Aetna Commercial	$189.05
Rate for Payer: Aetna Medicare Advantage	$149.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.86
Rate for Payer: Cigna Commercial	$248.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.25
Rate for Payer: Oxford Commercial	$99.50
Rate for Payer: Qualcare PPO/HMO/WC	$74.62
Rate for Payer: UnitedHealthcare Commercial	$99.50
Rate for Payer: UnitedHealthcare Community & State	$11.99
Rate for Payer: Wellpoint Medicaid Managed Care	$13.18

POSITIONER LG RECTANGLE 25

Facility

$497.50

Hospital Charge Code	270646189
Hospital Revenue Code	271
Min. Negotiated Rate	$74.62
Max. Negotiated Rate	$74.62
Rate for Payer: Qualcare PPO/HMO/WC	$74.62

POSITIONER MMD KNEE 193

Facility

$1,237.65

Hospital Charge Code	270623919
Hospital Revenue Code	272
Min. Negotiated Rate	$185.65
Max. Negotiated Rate	$185.65
Rate for Payer: Qualcare PPO/HMO/WC	$185.65

POSITIONER MMD KNEE 193

Facility

$1,237.65

Hospital Charge Code	270623919
Hospital Revenue Code	272
Min. Negotiated Rate	$29.83
Max. Negotiated Rate	$618.83
Rate for Payer: Aetna Commercial	$470.31
Rate for Payer: Aetna Medicare Advantage	$371.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.60
Rate for Payer: Cigna Commercial	$618.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$371.30
Rate for Payer: Oxford Commercial	$247.53
Rate for Payer: Qualcare PPO/HMO/WC	$185.65
Rate for Payer: UnitedHealthcare Commercial	$247.53
Rate for Payer: UnitedHealthcare Community & State	$29.83
Rate for Payer: Wellpoint Medicaid Managed Care	$32.80

POSITIONER PIGAZZI KIT

Facility

$727.40

Hospital Charge Code	270677558
Hospital Revenue Code	272
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$363.70
Rate for Payer: Aetna Commercial	$276.41
Rate for Payer: Aetna Medicare Advantage	$218.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.49
Rate for Payer: Cigna Commercial	$363.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.22
Rate for Payer: Oxford Commercial	$145.48
Rate for Payer: Qualcare PPO/HMO/WC	$109.11
Rate for Payer: UnitedHealthcare Commercial	$145.48
Rate for Payer: UnitedHealthcare Community & State	$17.53
Rate for Payer: Wellpoint Medicaid Managed Care	$19.28

POSITIONER PIGAZZI KIT

Facility

$727.40

Hospital Charge Code	270677558
Hospital Revenue Code	272
Min. Negotiated Rate	$109.11
Max. Negotiated Rate	$109.11
Rate for Payer: Qualcare PPO/HMO/WC	$109.11

POSITIONER SALVATION LEG

Facility

$1,280.00

Hospital Charge Code	270684462
Hospital Revenue Code	272
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$640.00
Rate for Payer: Aetna Commercial	$486.40
Rate for Payer: Aetna Medicare Advantage	$384.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$326.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$326.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$326.40
Rate for Payer: Cigna Commercial	$640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.00
Rate for Payer: Oxford Commercial	$256.00
Rate for Payer: Qualcare PPO/HMO/WC	$192.00
Rate for Payer: UnitedHealthcare Commercial	$256.00
Rate for Payer: UnitedHealthcare Community & State	$30.85
Rate for Payer: Wellpoint Medicaid Managed Care	$33.92

POSITIONER SALVATION LEG

Facility

$1,280.00

Hospital Charge Code	270684462
Hospital Revenue Code	272
Min. Negotiated Rate	$192.00
Max. Negotiated Rate	$192.00
Rate for Payer: Qualcare PPO/HMO/WC	$192.00

POSITIONER SLT KIT

Facility

$358.75

Hospital Charge Code	270675045
Hospital Revenue Code	272
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$179.38
Rate for Payer: Aetna Commercial	$136.32
Rate for Payer: Aetna Medicare Advantage	$107.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.48
Rate for Payer: Cigna Commercial	$179.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.62
Rate for Payer: Oxford Commercial	$71.75
Rate for Payer: Qualcare PPO/HMO/WC	$53.81
Rate for Payer: UnitedHealthcare Commercial	$71.75
Rate for Payer: UnitedHealthcare Community & State	$8.65
Rate for Payer: Wellpoint Medicaid Managed Care	$9.51

POSITIONER SLT KIT

Facility

$358.75

Hospital Charge Code	270675045
Hospital Revenue Code	272
Min. Negotiated Rate	$53.81
Max. Negotiated Rate	$53.81
Rate for Payer: Qualcare PPO/HMO/WC	$53.81

POSITIONER SPIDER LIMB KIT

Facility

$466.80

Hospital Charge Code	270678171
Hospital Revenue Code	272
Min. Negotiated Rate	$70.02
Max. Negotiated Rate	$70.02
Rate for Payer: Qualcare PPO/HMO/WC	$70.02

POSITIONER SPIDER LIMB KIT

Facility

$466.80

Hospital Charge Code	270678171
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$233.40
Rate for Payer: Aetna Commercial	$177.38
Rate for Payer: Aetna Medicare Advantage	$140.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.03
Rate for Payer: Cigna Commercial	$233.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.04
Rate for Payer: Oxford Commercial	$93.36
Rate for Payer: Qualcare PPO/HMO/WC	$70.02
Rate for Payer: UnitedHealthcare Commercial	$93.36
Rate for Payer: UnitedHealthcare Community & State	$11.25
Rate for Payer: Wellpoint Medicaid Managed Care	$12.37

POSITIONER WELL LEG HOLDER

Facility

$63.00

Hospital Charge Code	270665635
Hospital Revenue Code	270
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna Commercial	$23.94
Rate for Payer: Aetna Medicare Advantage	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.07
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.90
Rate for Payer: Oxford Commercial	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$12.60
Rate for Payer: UnitedHealthcare Community & State	$1.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1.67

POSITIONER WELL LEG HOLDER

Facility

$63.00

Hospital Charge Code	270665635
Hospital Revenue Code	270
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

Know your out-of-pocket cost for care.

All Charges