Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

POWDER MATRISTEM 100mg WP0100

Facility

$1,600.00

Hospital Charge Code	270644126
Hospital Revenue Code	278
Min. Negotiated Rate	$38.56
Max. Negotiated Rate	$800.00
Rate for Payer: Aetna Commercial	$608.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$408.00
Rate for Payer: Cigna Commercial	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$352.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00
Rate for Payer: UnitedHealthcare Community & State	$38.56
Rate for Payer: Wellpoint Medicaid Managed Care	$42.40

POWDER MATRISTEM 100mg WP0100

Facility

$1,600.00

Hospital Charge Code	270644126
Hospital Revenue Code	278
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$387.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$352.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

POWDER STOMAHESIVE

Facility

$37.65

Hospital Charge Code	270303177
Hospital Revenue Code	272
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$5.65
Rate for Payer: Qualcare PPO/HMO/WC	$5.65

POWDER STOMAHESIVE

Facility

$37.65

Hospital Charge Code	270303177
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.82
Rate for Payer: Aetna Commercial	$14.31
Rate for Payer: Aetna Medicare Advantage	$11.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.60
Rate for Payer: Cigna Commercial	$18.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.29
Rate for Payer: Oxford Commercial	$7.53
Rate for Payer: Qualcare PPO/HMO/WC	$5.65
Rate for Payer: UnitedHealthcare Commercial	$7.53
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

POWDER SURGICEL 3.0 GM

Facility

$848.13

Hospital Charge Code	270688736
Hospital Revenue Code	272
Min. Negotiated Rate	$127.22
Max. Negotiated Rate	$127.22
Rate for Payer: Qualcare PPO/HMO/WC	$127.22

POWDER SURGICEL 3.0 GM

Facility

$848.13

Hospital Charge Code	270688736
Hospital Revenue Code	272
Min. Negotiated Rate	$20.44
Max. Negotiated Rate	$424.06
Rate for Payer: Aetna Commercial	$322.29
Rate for Payer: Aetna Medicare Advantage	$254.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.27
Rate for Payer: Cigna Commercial	$424.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.44
Rate for Payer: Oxford Commercial	$169.63
Rate for Payer: Qualcare PPO/HMO/WC	$127.22
Rate for Payer: UnitedHealthcare Commercial	$169.63
Rate for Payer: UnitedHealthcare Community & State	$20.44
Rate for Payer: Wellpoint Medicaid Managed Care	$22.48

POWDER TALCUM 90GM

Facility

$37.80

Hospital Charge Code	6005144
Hospital Revenue Code	251
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$5.67
Rate for Payer: Qualcare PPO/HMO/WC	$5.67

POWDER TALCUM 90GM

Facility

$37.80

Hospital Charge Code	6005144
Hospital Revenue Code	251
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.90
Rate for Payer: Aetna Commercial	$14.36
Rate for Payer: Aetna Medicare Advantage	$11.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.64
Rate for Payer: Cigna Commercial	$18.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.34
Rate for Payer: Oxford Commercial	$7.56
Rate for Payer: Qualcare PPO/HMO/WC	$5.67
Rate for Payer: UnitedHealthcare Commercial	$7.56
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

POWER GLIDE PRO FLEX 20 GX 10

Facility

$5,050.00

Service Code	HCPCS C1751
Hospital Charge Code	270680295
Hospital Revenue Code	278
Min. Negotiated Rate	$121.70
Max. Negotiated Rate	$2,525.00
Rate for Payer: Aetna Commercial	$1,919.00
Rate for Payer: Aetna Medicare Advantage	$1,515.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,287.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,287.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,287.75
Rate for Payer: Cigna Commercial	$2,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,222.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,111.00
Rate for Payer: Qualcare PPO/HMO/WC	$757.50
Rate for Payer: UnitedHealthcare Community & State	$121.70
Rate for Payer: Wellpoint Medicaid Managed Care	$133.82

POWER GLIDE PRO FLEX 20 GX 10

Facility

$5,050.00

Service Code	HCPCS C1751
Hospital Charge Code	270680295
Hospital Revenue Code	278
Min. Negotiated Rate	$757.50
Max. Negotiated Rate	$1,222.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,222.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,111.00
Rate for Payer: Qualcare PPO/HMO/WC	$757.50

POWERGLIDE PROFLEX TEMP20G10CM

Facility

$290.00

Hospital Charge Code	270686348S
Hospital Revenue Code	272
Min. Negotiated Rate	$6.99
Max. Negotiated Rate	$145.00
Rate for Payer: Aetna Commercial	$110.20
Rate for Payer: Aetna Medicare Advantage	$87.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.95
Rate for Payer: Cigna Commercial	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.00
Rate for Payer: Oxford Commercial	$58.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.50
Rate for Payer: UnitedHealthcare Commercial	$58.00
Rate for Payer: UnitedHealthcare Community & State	$6.99
Rate for Payer: Wellpoint Medicaid Managed Care	$7.68

POWERGLIDE PROFLEX TEMP20G10CM

Facility

$290.00

Hospital Charge Code	270686348S
Hospital Revenue Code	272
Min. Negotiated Rate	$43.50
Max. Negotiated Rate	$43.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.50

POWERLINK AORTIC EXTENSION

Facility

$15,475.00

Hospital Charge Code	270645895
Hospital Revenue Code	278
Min. Negotiated Rate	$372.95
Max. Negotiated Rate	$7,737.50
Rate for Payer: Aetna Commercial	$5,880.50
Rate for Payer: Aetna Medicare Advantage	$4,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,946.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,946.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,095.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,946.12
Rate for Payer: Cigna Commercial	$7,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,744.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,404.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.25
Rate for Payer: UnitedHealthcare Community & State	$372.95
Rate for Payer: Wellpoint Medicaid Managed Care	$410.09

POWERLINK AORTIC EXTENSION

Facility

$15,475.00

Hospital Charge Code	270645895
Hospital Revenue Code	278
Min. Negotiated Rate	$2,321.25
Max. Negotiated Rate	$3,744.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,744.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,404.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.25

POWERLINK AORTIC EXTENSION

Facility

$14,975.00

Hospital Charge Code	270645896
Hospital Revenue Code	278
Min. Negotiated Rate	$360.90
Max. Negotiated Rate	$7,487.50
Rate for Payer: Aetna Commercial	$5,690.50
Rate for Payer: Aetna Medicare Advantage	$4,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,818.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,818.62
Rate for Payer: Cigna Commercial	$7,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,294.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25
Rate for Payer: UnitedHealthcare Community & State	$360.90
Rate for Payer: Wellpoint Medicaid Managed Care	$396.84

POWERLINK AORTIC EXTENSION

Facility

$14,975.00

Hospital Charge Code	270645896
Hospital Revenue Code	278
Min. Negotiated Rate	$2,246.25
Max. Negotiated Rate	$3,623.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,623.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,294.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,246.25

POWERLINK BIFURCATED ENDOGRAPH

Facility

$53,975.00

Hospital Charge Code	270645864
Hospital Revenue Code	278
Min. Negotiated Rate	$1,300.80
Max. Negotiated Rate	$26,987.50
Rate for Payer: Aetna Commercial	$20,510.50
Rate for Payer: Aetna Medicare Advantage	$16,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,763.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,763.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,763.62
Rate for Payer: Cigna Commercial	$26,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,061.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11,874.50
Rate for Payer: Qualcare PPO/HMO/WC	$8,096.25
Rate for Payer: UnitedHealthcare Community & State	$1,300.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,430.34

POWERLINK BIFURCATED ENDOGRAPH

Facility

$53,975.00

Hospital Charge Code	270645864
Hospital Revenue Code	278
Min. Negotiated Rate	$8,096.25
Max. Negotiated Rate	$13,061.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,061.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11,874.50
Rate for Payer: Qualcare PPO/HMO/WC	$8,096.25

POWER PICC BARD

Facility

$415.00

Service Code	HCPCS C1751
Hospital Charge Code	270664895
Hospital Revenue Code	278
Min. Negotiated Rate	$62.25
Max. Negotiated Rate	$100.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$91.30
Rate for Payer: Qualcare PPO/HMO/WC	$62.25

POWER PICC BARD

Facility

$3,780.00

Service Code	HCPCS C1751
Hospital Charge Code	270664895O
Hospital Revenue Code	278
Min. Negotiated Rate	$91.10
Max. Negotiated Rate	$1,890.00
Rate for Payer: Aetna Commercial	$1,436.40
Rate for Payer: Aetna Medicare Advantage	$1,134.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$963.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$963.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$756.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$963.90
Rate for Payer: Cigna Commercial	$1,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$914.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$831.60
Rate for Payer: Qualcare PPO/HMO/WC	$567.00
Rate for Payer: UnitedHealthcare Community & State	$91.10
Rate for Payer: Wellpoint Medicaid Managed Care	$100.17

POWER PICC BARD

Facility

$415.00

Service Code	HCPCS C1751
Hospital Charge Code	270664895
Hospital Revenue Code	278
Min. Negotiated Rate	$10.00
Max. Negotiated Rate	$207.50
Rate for Payer: Aetna Commercial	$157.70
Rate for Payer: Aetna Medicare Advantage	$124.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.83
Rate for Payer: Cigna Commercial	$207.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$91.30
Rate for Payer: Qualcare PPO/HMO/WC	$62.25
Rate for Payer: UnitedHealthcare Community & State	$10.00
Rate for Payer: Wellpoint Medicaid Managed Care	$11.00

POWER PICC BARD

Facility

$3,780.00

Service Code	HCPCS C1751
Hospital Charge Code	270664895O
Hospital Revenue Code	278
Min. Negotiated Rate	$567.00
Max. Negotiated Rate	$914.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$756.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$914.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$831.60
Rate for Payer: Qualcare PPO/HMO/WC	$567.00

POWERPICC SV CATHETER 4 FR

Facility

$1,150.00

Service Code	HCPCS C1751
Hospital Charge Code	270686571
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

POWERPICC SV CATHETER 4 FR

Facility

$1,150.00

Service Code	HCPCS C1751
Hospital Charge Code	270686571
Hospital Revenue Code	278
Min. Negotiated Rate	$27.71
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Community & State	$27.71
Rate for Payer: Wellpoint Medicaid Managed Care	$30.48

POWERPICK 45 DEG 6MM

Facility

$505.00

Service Code	HCPCS C1751
Hospital Charge Code	270681576
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

Know your out-of-pocket cost for care.

All Charges