Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RACK JURGN PIN BALL .028 W28**

Facility

$125.00

Hospital Charge Code	1604776
Hospital Revenue Code	272
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

RACK LID F/7.3MM CANN SCREW

Facility

$398.60

Hospital Charge Code	270677619
Hospital Revenue Code	272
Min. Negotiated Rate	$9.61
Max. Negotiated Rate	$199.30
Rate for Payer: Aetna Commercial	$151.47
Rate for Payer: Aetna Medicare Advantage	$119.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.64
Rate for Payer: Cigna Commercial	$199.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.58
Rate for Payer: Oxford Commercial	$79.72
Rate for Payer: Qualcare PPO/HMO/WC	$59.79
Rate for Payer: UnitedHealthcare Commercial	$79.72
Rate for Payer: UnitedHealthcare Community & State	$9.61
Rate for Payer: Wellpoint Medicaid Managed Care	$10.56

RACK LID F/7.3MM CANN SCREW

Facility

$398.60

Hospital Charge Code	270677619
Hospital Revenue Code	272
Min. Negotiated Rate	$59.79
Max. Negotiated Rate	$59.79
Rate for Payer: Qualcare PPO/HMO/WC	$59.79

RACK WECK 15.0

Facility

$684.35

Hospital Charge Code	270666117
Hospital Revenue Code	270
Min. Negotiated Rate	$102.65
Max. Negotiated Rate	$102.65
Rate for Payer: Qualcare PPO/HMO/WC	$102.65

RACK WECK 15.0

Facility

$684.35

Hospital Charge Code	270666117
Hospital Revenue Code	270
Min. Negotiated Rate	$16.49
Max. Negotiated Rate	$342.18
Rate for Payer: Aetna Commercial	$260.05
Rate for Payer: Aetna Medicare Advantage	$205.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.51
Rate for Payer: Cigna Commercial	$342.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.31
Rate for Payer: Oxford Commercial	$136.87
Rate for Payer: Qualcare PPO/HMO/WC	$102.65
Rate for Payer: UnitedHealthcare Commercial	$136.87
Rate for Payer: UnitedHealthcare Community & State	$16.49
Rate for Payer: Wellpoint Medicaid Managed Care	$18.14

RACK WECK 18.0

Facility

$588.55

Hospital Charge Code	270666098
Hospital Revenue Code	270
Min. Negotiated Rate	$14.18
Max. Negotiated Rate	$294.27
Rate for Payer: Aetna Commercial	$223.65
Rate for Payer: Aetna Medicare Advantage	$176.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.08
Rate for Payer: Cigna Commercial	$294.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.56
Rate for Payer: Oxford Commercial	$117.71
Rate for Payer: Qualcare PPO/HMO/WC	$88.28
Rate for Payer: UnitedHealthcare Commercial	$117.71
Rate for Payer: UnitedHealthcare Community & State	$14.18
Rate for Payer: Wellpoint Medicaid Managed Care	$15.60

RACK WECK 18.0

Facility

$588.55

Hospital Charge Code	270666098
Hospital Revenue Code	270
Min. Negotiated Rate	$88.28
Max. Negotiated Rate	$88.28
Rate for Payer: Qualcare PPO/HMO/WC	$88.28

RADENOID BLADE

Facility

$220.00

Hospital Charge Code	270337857
Hospital Revenue Code	272
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$83.60
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.00
Rate for Payer: Oxford Commercial	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Commercial	$44.00
Rate for Payer: UnitedHealthcare Community & State	$5.30
Rate for Payer: Wellpoint Medicaid Managed Care	$5.83

RADENOID BLADE

Facility

$220.00

Hospital Charge Code	270337857
Hospital Revenue Code	272
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

RAD EXC WRIST BURSA/FARM TEND

Facility

$6,353.84

Service Code	HCPCS 25115
Hospital Charge Code	16000422
Hospital Revenue Code	360
Min. Negotiated Rate	$153.13
Max. Negotiated Rate	$8,157.00
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
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	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,906.15
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$953.08
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$153.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$168.38

RAD EXC WRIST BURSA/FARM TEND

Facility

$6,353.84

Service Code	HCPCS 25115
Hospital Charge Code	16000422
Hospital Revenue Code	360
Min. Negotiated Rate	$953.08
Max. Negotiated Rate	$953.08
Rate for Payer: Qualcare PPO/HMO/WC	$953.08

RADIAL COMPRESSOR

Facility

$135.00

Hospital Charge Code	2709002916
Hospital Revenue Code	272
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.50
Rate for Payer: Oxford Commercial	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Commercial	$27.00
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

RADIAL COMPRESSOR

Facility

$135.00

Hospital Charge Code	2709002916
Hospital Revenue Code	272
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$20.25
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

RADIAL HEAD 19X5.5MM STM .9

Facility

$17,703.15

Service Code	HCPCS C1776
Hospital Charge Code	270696904
Hospital Revenue Code	278
Min. Negotiated Rate	$2,655.47
Max. Negotiated Rate	$4,284.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,540.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,284.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,894.69
Rate for Payer: Qualcare PPO/HMO/WC	$2,655.47

RADIAL HEAD 19X5.5MM STM .9

Facility

$17,703.15

Service Code	HCPCS C1776
Hospital Charge Code	270696904
Hospital Revenue Code	278
Min. Negotiated Rate	$426.65
Max. Negotiated Rate	$8,851.58
Rate for Payer: Aetna Commercial	$6,727.20
Rate for Payer: Aetna Medicare Advantage	$5,310.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,514.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,514.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,540.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,514.30
Rate for Payer: Cigna Commercial	$8,851.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,284.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,894.69
Rate for Payer: Qualcare PPO/HMO/WC	$2,655.47
Rate for Payer: UnitedHealthcare Community & State	$426.65
Rate for Payer: Wellpoint Medicaid Managed Care	$469.13

RADIAL HEAD LOCK SCREW 20MM

Facility

$11,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270680785
Hospital Revenue Code	278
Min. Negotiated Rate	$277.15
Max. Negotiated Rate	$5,750.00
Rate for Payer: Aetna Commercial	$4,370.00
Rate for Payer: Aetna Medicare Advantage	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,932.50
Rate for Payer: Cigna Commercial	$5,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,530.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00
Rate for Payer: UnitedHealthcare Community & State	$277.15
Rate for Payer: Wellpoint Medicaid Managed Care	$304.75

RADIAL HEAD LOCK SCREW 20MM

Facility

$11,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270680785
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$2,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,530.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00

RADIAL HEAD POLYMER 24MM

Facility

$12,045.00

Service Code	HCPCS C1776
Hospital Charge Code	270695661
Hospital Revenue Code	278
Min. Negotiated Rate	$290.28
Max. Negotiated Rate	$6,022.50
Rate for Payer: Aetna Commercial	$4,577.10
Rate for Payer: Aetna Medicare Advantage	$3,613.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,071.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,071.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,409.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,071.47
Rate for Payer: Cigna Commercial	$6,022.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,914.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,649.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,806.75
Rate for Payer: UnitedHealthcare Community & State	$290.28
Rate for Payer: Wellpoint Medicaid Managed Care	$319.19

RADIAL HEAD POLYMER 24MM

Facility

$12,045.00

Service Code	HCPCS C1776
Hospital Charge Code	270695661
Hospital Revenue Code	278
Min. Negotiated Rate	$1,806.75
Max. Negotiated Rate	$2,914.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,409.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,914.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,649.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,806.75

RADIAL HEAD PROSTHESIS

Facility

$20,750.00

Hospital Charge Code	270663135
Hospital Revenue Code	278
Min. Negotiated Rate	$3,112.50
Max. Negotiated Rate	$5,021.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,021.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,565.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,112.50

RADIAL HEAD PROSTHESIS

Facility

$20,750.00

Hospital Charge Code	270663135
Hospital Revenue Code	278
Min. Negotiated Rate	$500.07
Max. Negotiated Rate	$10,375.00
Rate for Payer: Aetna Commercial	$7,885.00
Rate for Payer: Aetna Medicare Advantage	$6,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,291.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,291.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,291.25
Rate for Payer: Cigna Commercial	$10,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,021.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,565.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,112.50
Rate for Payer: UnitedHealthcare Community & State	$500.07
Rate for Payer: Wellpoint Medicaid Managed Care	$549.88

RADIAL JAW 160CM FORCEP

Facility

$46.25

Hospital Charge Code	270653857
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$23.12
Rate for Payer: Aetna Commercial	$17.57
Rate for Payer: Aetna Medicare Advantage	$13.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.79
Rate for Payer: Cigna Commercial	$23.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.88
Rate for Payer: Oxford Commercial	$9.25
Rate for Payer: Qualcare PPO/HMO/WC	$6.94
Rate for Payer: UnitedHealthcare Commercial	$9.25
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$1.23

RADIAL JAW 160CM FORCEP

Facility

$46.25

Hospital Charge Code	270653857
Hospital Revenue Code	272
Min. Negotiated Rate	$6.94
Max. Negotiated Rate	$6.94
Rate for Payer: Qualcare PPO/HMO/WC	$6.94

RADIAL JAW HOT BIOPSY

Facility

$140.00

Hospital Charge Code	270654280
Hospital Revenue Code	270
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

RADIAL JAW HOT BIOPSY

Facility

$140.00

Hospital Charge Code	270654280
Hospital Revenue Code	270
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$70.00
Rate for Payer: Aetna Commercial	$53.20
Rate for Payer: Aetna Medicare Advantage	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.70
Rate for Payer: Cigna Commercial	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.00
Rate for Payer: Oxford Commercial	$28.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00
Rate for Payer: UnitedHealthcare Commercial	$28.00
Rate for Payer: UnitedHealthcare Community & State	$3.37
Rate for Payer: Wellpoint Medicaid Managed Care	$3.71

Know your out-of-pocket cost for care.

All Charges