Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PUSH/INFUSION COMBO LEVEL 5

Facility

$1,345.95

Service Code	HCPCS C8954
Hospital Charge Code	3401024
Hospital Revenue Code	335
Min. Negotiated Rate	$201.89
Max. Negotiated Rate	$201.89
Rate for Payer: Qualcare PPO/HMO/WC	$201.89

PUSH/INFUSION COMBO LEVEL 5

Facility

$1,345.95

Service Code	HCPCS C8954
Hospital Charge Code	3401024
Hospital Revenue Code	335
Min. Negotiated Rate	$32.44
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$511.46
Rate for Payer: Aetna Medicare Advantage	$403.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$343.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$343.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$343.22
Rate for Payer: Cigna Commercial	$672.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.79
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$201.89
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$32.44
Rate for Payer: Wellpoint Medicaid Managed Care	$35.67

PUSH/INFUSION COMBO LEVEL 6

Facility

$1,550.10

Service Code	HCPCS C8954
Hospital Charge Code	3401025
Hospital Revenue Code	335
Min. Negotiated Rate	$232.51
Max. Negotiated Rate	$232.51
Rate for Payer: Qualcare PPO/HMO/WC	$232.51

PUSH/INFUSION COMBO LEVEL 6

Facility

$1,550.10

Service Code	HCPCS C8954
Hospital Charge Code	3401025
Hospital Revenue Code	335
Min. Negotiated Rate	$37.36
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$589.04
Rate for Payer: Aetna Medicare Advantage	$465.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.28
Rate for Payer: Cigna Commercial	$775.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$465.03
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.51
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$37.36
Rate for Payer: Wellpoint Medicaid Managed Care	$41.08

PUSHLOCK 3.5 MM HIP

Facility

$875.00

Hospital Charge Code	270688378
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

PUSHLOCK 3.5 MM HIP

Facility

$875.00

Hospital Charge Code	270688378
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

PUSHLOCK 4.5X18.5MM

Facility

$2,300.00

Hospital Charge Code	270641351
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$506.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00

PUSHLOCK 4.5X18.5MM

Facility

$2,300.00

Hospital Charge Code	270641351
Hospital Revenue Code	278
Min. Negotiated Rate	$55.43
Max. Negotiated Rate	$1,150.00
Rate for Payer: Aetna Commercial	$874.00
Rate for Payer: Aetna Medicare Advantage	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$586.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$586.50
Rate for Payer: Cigna Commercial	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$556.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$506.00
Rate for Payer: Qualcare PPO/HMO/WC	$345.00
Rate for Payer: UnitedHealthcare Community & State	$55.43
Rate for Payer: Wellpoint Medicaid Managed Care	$60.95

PUSHLOCK HIP 2.9MM DISP KIT

Facility

$875.00

Hospital Charge Code	270677471
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

PUSHLOCK HIP 2.9MM DISP KIT

Facility

$875.00

Hospital Charge Code	270677471
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

PUSH TRANSFUSION, BLOOD

Facility

$1,425.45

Service Code	HCPCS 36440
Hospital Charge Code	5780185
Hospital Revenue Code	391
Min. Negotiated Rate	$34.35
Max. Negotiated Rate	$1,891.95
Rate for Payer: Aetna Commercial	$1,425.63
Rate for Payer: Aetna Medicare Advantage	$1,698.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,891.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,891.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$524.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,891.95
Rate for Payer: Cigna Commercial	$1,050.61
Rate for Payer: Cigna Medicare Advantage	$524.13
Rate for Payer: Clover Medicare Advantage	$497.92
Rate for Payer: EmblemHealth Commercial	$1,572.39
Rate for Payer: Humana Medicare Advantage	$539.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$524.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$427.63
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$213.82
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$34.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$524.13
Rate for Payer: Wellcare Medicare Advantage	$524.13
Rate for Payer: Wellpoint Medicaid Managed Care	$37.77

PUSH TRANSFUSION, BLOOD

Facility

$1,425.45

Service Code	HCPCS 36440
Hospital Charge Code	1600000760
Hospital Revenue Code	360
Min. Negotiated Rate	$34.35
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,425.63
Rate for Payer: Aetna Medicare Advantage	$1,698.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,891.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,891.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$524.13
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	$1,891.95
Rate for Payer: Cigna Commercial	$1,050.61
Rate for Payer: Cigna Medicare Advantage	$524.13
Rate for Payer: Clover Medicare Advantage	$497.92
Rate for Payer: EmblemHealth Commercial	$1,572.39
Rate for Payer: Humana Medicare Advantage	$539.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$524.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$427.63
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$213.82
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$34.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$524.13
Rate for Payer: Wellcare Medicare Advantage	$524.13
Rate for Payer: Wellpoint Medicaid Managed Care	$37.77

PUSH TRANSFUSION, BLOOD

Facility

$1,425.45

Service Code	HCPCS 36440
Hospital Charge Code	1600000760
Hospital Revenue Code	360
Min. Negotiated Rate	$213.82
Max. Negotiated Rate	$213.82
Rate for Payer: Qualcare PPO/HMO/WC	$213.82

PUSH TRANSFUSION, BLOOD

Facility

$1,425.45

Service Code	HCPCS 36440
Hospital Charge Code	5780185
Hospital Revenue Code	391
Min. Negotiated Rate	$213.82
Max. Negotiated Rate	$213.82
Rate for Payer: Qualcare PPO/HMO/WC	$213.82

PUTTY 10 CC OSTEOSELECT

Facility

$4,930.00

Hospital Charge Code	270701850
Hospital Revenue Code	278
Min. Negotiated Rate	$739.50
Max. Negotiated Rate	$1,193.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$986.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,193.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,084.60
Rate for Payer: Qualcare PPO/HMO/WC	$739.50

PUTTY 10 CC OSTEOSELECT

Facility

$4,930.00

Hospital Charge Code	270701850
Hospital Revenue Code	278
Min. Negotiated Rate	$118.81
Max. Negotiated Rate	$2,465.00
Rate for Payer: Aetna Commercial	$1,873.40
Rate for Payer: Aetna Medicare Advantage	$1,479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,257.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,257.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$986.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,257.15
Rate for Payer: Cigna Commercial	$2,465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,193.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,084.60
Rate for Payer: Qualcare PPO/HMO/WC	$739.50
Rate for Payer: UnitedHealthcare Community & State	$118.81
Rate for Payer: Wellpoint Medicaid Managed Care	$130.65

PUTTY 1 CC

Facility

$625.00

Service Code	HCPCS C1716
Hospital Charge Code	270701788
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

PUTTY 1 CC

Facility

$625.00

Service Code	HCPCS C1716
Hospital Charge Code	270701788
Hospital Revenue Code	278
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$2,155.71
Rate for Payer: Aetna Commercial	$1,624.38
Rate for Payer: Aetna Medicare Advantage	$1,934.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,155.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,155.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,155.71
Rate for Payer: Cigna Commercial	$1,197.08
Rate for Payer: Cigna Medicare Advantage	$597.20
Rate for Payer: Clover Medicare Advantage	$567.34
Rate for Payer: EmblemHealth Commercial	$1,791.60
Rate for Payer: Humana Medicare Advantage	$615.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$597.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$597.20
Rate for Payer: Wellcare Medicare Advantage	$597.20
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

PUTTY ACCELL DBM 10 023000100

Facility

$7,425.00

Hospital Charge Code	270638640
Hospital Revenue Code	278
Min. Negotiated Rate	$178.94
Max. Negotiated Rate	$3,712.50
Rate for Payer: Aetna Commercial	$2,821.50
Rate for Payer: Aetna Medicare Advantage	$2,227.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,893.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,893.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,893.38
Rate for Payer: Cigna Commercial	$3,712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,796.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,113.75
Rate for Payer: UnitedHealthcare Community & State	$178.94
Rate for Payer: Wellpoint Medicaid Managed Care	$196.76

PUTTY ACCELL DBM 10 023000100

Facility

$7,425.00

Hospital Charge Code	270638640
Hospital Revenue Code	278
Min. Negotiated Rate	$1,113.75
Max. Negotiated Rate	$1,796.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,796.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,113.75

PUTTY ACCELL EVO3 5CC

Facility

$6,106.45

Hospital Charge Code	270668133
Hospital Revenue Code	278
Min. Negotiated Rate	$915.97
Max. Negotiated Rate	$1,477.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,221.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,477.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,343.42
Rate for Payer: Qualcare PPO/HMO/WC	$915.97

PUTTY ACCELL EVO3 5CC

Facility

$6,106.45

Hospital Charge Code	270668133
Hospital Revenue Code	278
Min. Negotiated Rate	$147.17
Max. Negotiated Rate	$3,053.22
Rate for Payer: Aetna Commercial	$2,320.45
Rate for Payer: Aetna Medicare Advantage	$1,831.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,557.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,557.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,221.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,557.14
Rate for Payer: Cigna Commercial	$3,053.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,477.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,343.42
Rate for Payer: Qualcare PPO/HMO/WC	$915.97
Rate for Payer: UnitedHealthcare Community & State	$147.17
Rate for Payer: Wellpoint Medicaid Managed Care	$161.82

PUTTY ACCELL EVO3C 5CC

Facility

$6,834.70

Hospital Charge Code	270668134
Hospital Revenue Code	278
Min. Negotiated Rate	$1,025.20
Max. Negotiated Rate	$1,654.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,366.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,654.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,503.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,025.20

PUTTY ACCELL EVO3C 5CC

Facility

$6,834.70

Hospital Charge Code	270668134
Hospital Revenue Code	278
Min. Negotiated Rate	$164.72
Max. Negotiated Rate	$3,417.35
Rate for Payer: Aetna Commercial	$2,597.19
Rate for Payer: Aetna Medicare Advantage	$2,050.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,742.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,742.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,366.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,742.85
Rate for Payer: Cigna Commercial	$3,417.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,654.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,503.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,025.20
Rate for Payer: UnitedHealthcare Community & State	$164.72
Rate for Payer: Wellpoint Medicaid Managed Care	$181.12

PUTTY ALLOFUSE DBM 10CC

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270681848
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

Know your out-of-pocket cost for care.

All Charges