Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

QUINTANA M

Facility

$88.25

Service Code	HCPCS 86611
Hospital Charge Code	303072D
Hospital Revenue Code	300
Min. Negotiated Rate	$13.24
Max. Negotiated Rate	$13.24
Rate for Payer: Qualcare PPO/HMO/WC	$13.24

QUINTANA M

Facility

$88.25

Service Code	HCPCS 86611
Hospital Charge Code	303072D
Hospital Revenue Code	300
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$27.69
Rate for Payer: Aetna Medicare Advantage	$32.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.75
Rate for Payer: Cigna Commercial	$44.12
Rate for Payer: Cigna Medicare Advantage	$10.18
Rate for Payer: Clover Medicare Advantage	$9.67
Rate for Payer: EmblemHealth Commercial	$30.54
Rate for Payer: Humana Medicare Advantage	$10.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.24
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.18
Rate for Payer: Wellcare Medicare Advantage	$10.18
Rate for Payer: Wellpoint Medicaid Managed Care	$2.34

QUINTANA M

Facility

$70.65

Service Code	HCPCS 86611
Hospital Charge Code	3035072D
Hospital Revenue Code	300
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$27.69
Rate for Payer: Aetna Medicare Advantage	$32.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.75
Rate for Payer: Cigna Commercial	$35.33
Rate for Payer: Cigna Medicare Advantage	$10.18
Rate for Payer: Clover Medicare Advantage	$9.67
Rate for Payer: EmblemHealth Commercial	$30.54
Rate for Payer: Humana Medicare Advantage	$10.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.18
Rate for Payer: Wellcare Medicare Advantage	$10.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.87

QUINTANA M

Facility

$70.65

Service Code	HCPCS 86611
Hospital Charge Code	3035072D
Hospital Revenue Code	300
Min. Negotiated Rate	$10.60
Max. Negotiated Rate	$10.60
Rate for Payer: Qualcare PPO/HMO/WC	$10.60

QUINUPRISTIN/DALFOP INJ 500MG

Facility

$824.85

Hospital Charge Code	60628925
Hospital Revenue Code	250
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.43
Rate for Payer: Aetna Commercial	$313.44
Rate for Payer: Aetna Medicare Advantage	$247.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.34
Rate for Payer: Cigna Commercial	$412.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.46
Rate for Payer: Oxford Commercial	$164.97
Rate for Payer: Qualcare PPO/HMO/WC	$123.73
Rate for Payer: UnitedHealthcare Commercial	$164.97
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

QUINUPRISTIN/DALFOP INJ 500MG

Facility

$824.85

Hospital Charge Code	60628925
Hospital Revenue Code	250
Min. Negotiated Rate	$123.73
Max. Negotiated Rate	$123.73
Rate for Payer: Qualcare PPO/HMO/WC	$123.73

R3ACT SYNDS IMP 4.2X42MM, 14MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270701419
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

R3ACT SYNDS IMP 4.2X42MM, 14MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270701419
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

R3CON LOCKING PLATE SCREW 3.5X

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270701712
Hospital Revenue Code	278
Min. Negotiated Rate	$15.91
Max. Negotiated Rate	$330.00
Rate for Payer: Aetna Commercial	$250.80
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00
Rate for Payer: UnitedHealthcare Community & State	$15.91
Rate for Payer: Wellpoint Medicaid Managed Care	$17.49

R3CON LOCKING PLATE SCREW 3.5X

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270701712
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$159.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

R3CON N-LOCK SCREW 2.7X22MM

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270700333
Hospital Revenue Code	278
Min. Negotiated Rate	$15.91
Max. Negotiated Rate	$330.00
Rate for Payer: Aetna Commercial	$250.80
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00
Rate for Payer: UnitedHealthcare Community & State	$15.91
Rate for Payer: Wellpoint Medicaid Managed Care	$17.49

R3CON N-LOCK SCREW 2.7X22MM

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270700333
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$159.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

R3ECON NLKING SCREW 2.7X24MM

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270701417
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$159.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

R3ECON NLKING SCREW 2.7X24MM

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270701417
Hospital Revenue Code	278
Min. Negotiated Rate	$15.91
Max. Negotiated Rate	$330.00
Rate for Payer: Aetna Commercial	$250.80
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.00
Rate for Payer: UnitedHealthcare Community & State	$15.91
Rate for Payer: Wellpoint Medicaid Managed Care	$17.49

R3FLEX IMPLANT W/INST, SK

Facility

$6,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270701516
Hospital Revenue Code	278
Min. Negotiated Rate	$165.69
Max. Negotiated Rate	$3,437.50
Rate for Payer: Aetna Commercial	$2,612.50
Rate for Payer: Aetna Medicare Advantage	$2,062.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,753.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,753.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,753.12
Rate for Payer: Cigna Commercial	$3,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,663.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.25
Rate for Payer: UnitedHealthcare Community & State	$165.69
Rate for Payer: Wellpoint Medicaid Managed Care	$182.19

R3FLEX IMPLANT W/INST, SK

Facility

$6,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270701516
Hospital Revenue Code	278
Min. Negotiated Rate	$1,031.25
Max. Negotiated Rate	$1,663.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,663.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.25

RAABE GUIDING SHEATH 10FR 80CM

Facility

$530.00

Hospital Charge Code	270658518
Hospital Revenue Code	278
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.60
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

RAABE GUIDING SHEATH 10FR 80CM

Facility

$530.00

Hospital Charge Code	270658518
Hospital Revenue Code	278
Min. Negotiated Rate	$12.77
Max. Negotiated Rate	$265.00
Rate for Payer: Aetna Commercial	$201.40
Rate for Payer: Aetna Medicare Advantage	$159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.15
Rate for Payer: Cigna Commercial	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.60
Rate for Payer: Qualcare PPO/HMO/WC	$79.50
Rate for Payer: UnitedHealthcare Community & State	$12.77
Rate for Payer: Wellpoint Medicaid Managed Care	$14.04

RAABE GUIDING SHEATH 6FR 55cm

Facility

$220.50

Hospital Charge Code	2709003590
Hospital Revenue Code	272
Min. Negotiated Rate	$5.31
Max. Negotiated Rate	$110.25
Rate for Payer: Aetna Commercial	$83.79
Rate for Payer: Aetna Medicare Advantage	$66.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.23
Rate for Payer: Cigna Commercial	$110.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.15
Rate for Payer: Oxford Commercial	$44.10
Rate for Payer: Qualcare PPO/HMO/WC	$33.08
Rate for Payer: UnitedHealthcare Commercial	$44.10
Rate for Payer: UnitedHealthcare Community & State	$5.31
Rate for Payer: Wellpoint Medicaid Managed Care	$5.84

RAABE GUIDING SHEATH 6FR 55cm

Facility

$220.50

Hospital Charge Code	2709003590
Hospital Revenue Code	272
Min. Negotiated Rate	$33.08
Max. Negotiated Rate	$33.08
Rate for Payer: Qualcare PPO/HMO/WC	$33.08

RAABE GUIDING SHEATH 6FR 70MM

Facility

$220.50

Hospital Charge Code	2709003239
Hospital Revenue Code	272
Min. Negotiated Rate	$5.31
Max. Negotiated Rate	$110.25
Rate for Payer: Aetna Commercial	$83.79
Rate for Payer: Aetna Medicare Advantage	$66.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.23
Rate for Payer: Cigna Commercial	$110.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.15
Rate for Payer: Oxford Commercial	$44.10
Rate for Payer: Qualcare PPO/HMO/WC	$33.08
Rate for Payer: UnitedHealthcare Commercial	$44.10
Rate for Payer: UnitedHealthcare Community & State	$5.31
Rate for Payer: Wellpoint Medicaid Managed Care	$5.84

RAABE GUIDING SHEATH 6FR 70MM

Facility

$220.50

Hospital Charge Code	2709003239
Hospital Revenue Code	272
Min. Negotiated Rate	$33.08
Max. Negotiated Rate	$33.08
Rate for Payer: Qualcare PPO/HMO/WC	$33.08

RAABE GUIDING SHEATH 6FR 90MM

Facility

$287.00

Hospital Charge Code	2709003582
Hospital Revenue Code	272
Min. Negotiated Rate	$43.05
Max. Negotiated Rate	$43.05
Rate for Payer: Qualcare PPO/HMO/WC	$43.05

RAABE GUIDING SHEATH 6FR 90MM

Facility

$287.00

Hospital Charge Code	2709003582
Hospital Revenue Code	272
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$143.50
Rate for Payer: Aetna Commercial	$109.06
Rate for Payer: Aetna Medicare Advantage	$86.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.19
Rate for Payer: Cigna Commercial	$143.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.10
Rate for Payer: Oxford Commercial	$57.40
Rate for Payer: Qualcare PPO/HMO/WC	$43.05
Rate for Payer: UnitedHealthcare Commercial	$57.40
Rate for Payer: UnitedHealthcare Community & State	$6.92
Rate for Payer: Wellpoint Medicaid Managed Care	$7.61

RAABE GUIDING SHEATH 7FR 55cm

Facility

$277.50

Hospital Charge Code	2709003589
Hospital Revenue Code	272
Min. Negotiated Rate	$41.62
Max. Negotiated Rate	$41.62
Rate for Payer: Qualcare PPO/HMO/WC	$41.62

Know your out-of-pocket cost for care.

All Charges