Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RASP MICRO RCPRCT SML 5053-080

Facility

$360.00

Hospital Charge Code	270643474
Hospital Revenue Code	272
Min. Negotiated Rate	$8.68
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$136.80
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.00
Rate for Payer: Oxford Commercial	$72.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$72.00
Rate for Payer: UnitedHealthcare Community & State	$8.68
Rate for Payer: Wellpoint Medicaid Managed Care	$9.54

RASP SMALL FOR PEN DRIVE

Facility

$616.00

Hospital Charge Code	270674682
Hospital Revenue Code	272
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$92.40

RASP SMALL FOR PEN DRIVE

Facility

$616.00

Hospital Charge Code	270674682
Hospital Revenue Code	272
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$308.00
Rate for Payer: Aetna Commercial	$234.08
Rate for Payer: Aetna Medicare Advantage	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.08
Rate for Payer: Cigna Commercial	$308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.80
Rate for Payer: Oxford Commercial	$123.20
Rate for Payer: Qualcare PPO/HMO/WC	$92.40
Rate for Payer: UnitedHealthcare Commercial	$123.20
Rate for Payer: UnitedHealthcare Community & State	$14.85
Rate for Payer: Wellpoint Medicaid Managed Care	$16.32

RASP SMALL TEAR 5x11

Facility

$280.25

Hospital Charge Code	270673035
Hospital Revenue Code	272
Min. Negotiated Rate	$42.04
Max. Negotiated Rate	$42.04
Rate for Payer: Qualcare PPO/HMO/WC	$42.04

RASP SMALL TEAR 5x11

Facility

$280.25

Hospital Charge Code	270673035
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$140.12
Rate for Payer: Aetna Commercial	$106.50
Rate for Payer: Aetna Medicare Advantage	$84.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.46
Rate for Payer: Cigna Commercial	$140.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.08
Rate for Payer: Oxford Commercial	$56.05
Rate for Payer: Qualcare PPO/HMO/WC	$42.04
Rate for Payer: UnitedHealthcare Commercial	$56.05
Rate for Payer: UnitedHealthcare Community & State	$6.75
Rate for Payer: Wellpoint Medicaid Managed Care	$7.43

RASP SM CROSSCUT F/PEN DRIVE

Facility

$616.00

Hospital Charge Code	270674680
Hospital Revenue Code	272
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$308.00
Rate for Payer: Aetna Commercial	$234.08
Rate for Payer: Aetna Medicare Advantage	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.08
Rate for Payer: Cigna Commercial	$308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.80
Rate for Payer: Oxford Commercial	$123.20
Rate for Payer: Qualcare PPO/HMO/WC	$92.40
Rate for Payer: UnitedHealthcare Commercial	$123.20
Rate for Payer: UnitedHealthcare Community & State	$14.85
Rate for Payer: Wellpoint Medicaid Managed Care	$16.32

RASP SM CROSSCUT F/PEN DRIVE

Facility

$616.00

Hospital Charge Code	270674680
Hospital Revenue Code	272
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$92.40

RASP SML TEAR CROSSCUT 5x11MM

Facility

$280.25

Hospital Charge Code	270674137
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$140.12
Rate for Payer: Aetna Commercial	$106.50
Rate for Payer: Aetna Medicare Advantage	$84.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.46
Rate for Payer: Cigna Commercial	$140.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.08
Rate for Payer: Oxford Commercial	$56.05
Rate for Payer: Qualcare PPO/HMO/WC	$42.04
Rate for Payer: UnitedHealthcare Commercial	$56.05
Rate for Payer: UnitedHealthcare Community & State	$6.75
Rate for Payer: Wellpoint Medicaid Managed Care	$7.43

RASP SML TEAR CROSSCUT 5x11MM

Facility

$280.25

Hospital Charge Code	270674137
Hospital Revenue Code	272
Min. Negotiated Rate	$42.04
Max. Negotiated Rate	$42.04
Rate for Payer: Qualcare PPO/HMO/WC	$42.04

RASP TEAR 13.0 X 7.0MM

Facility

$249.20

Hospital Charge Code	270664104
Hospital Revenue Code	272
Min. Negotiated Rate	$37.38
Max. Negotiated Rate	$37.38
Rate for Payer: Qualcare PPO/HMO/WC	$37.38

RASP TEAR 13.0 X 7.0MM

Facility

$249.20

Hospital Charge Code	270664104
Hospital Revenue Code	272
Min. Negotiated Rate	$6.01
Max. Negotiated Rate	$124.60
Rate for Payer: Aetna Commercial	$94.70
Rate for Payer: Aetna Medicare Advantage	$74.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.55
Rate for Payer: Cigna Commercial	$124.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.76
Rate for Payer: Oxford Commercial	$49.84
Rate for Payer: Qualcare PPO/HMO/WC	$37.38
Rate for Payer: UnitedHealthcare Commercial	$49.84
Rate for Payer: UnitedHealthcare Community & State	$6.01
Rate for Payer: Wellpoint Medicaid Managed Care	$6.60

RAST(2)

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38476783
Hospital Revenue Code	305
Min. Negotiated Rate	$119.40
Max. Negotiated Rate	$119.40
Rate for Payer: Qualcare PPO/HMO/WC	$119.40

RAST(2)

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38476783
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$398.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$398.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$21.09

RAST(3)

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38476784
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$398.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$398.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$21.09

RAST(3)

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38476784
Hospital Revenue Code	305
Min. Negotiated Rate	$119.40
Max. Negotiated Rate	$119.40
Rate for Payer: Qualcare PPO/HMO/WC	$119.40

RAST(4)

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38476785
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$398.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$398.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$21.09

RAST(4)

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38476785
Hospital Revenue Code	305
Min. Negotiated Rate	$119.40
Max. Negotiated Rate	$119.40
Rate for Payer: Qualcare PPO/HMO/WC	$119.40

RAST(5)

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38476786
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$398.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$398.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$21.09

RAST(5)

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38476786
Hospital Revenue Code	305
Min. Negotiated Rate	$119.40
Max. Negotiated Rate	$119.40
Rate for Payer: Qualcare PPO/HMO/WC	$119.40

RAST(6)

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38476787
Hospital Revenue Code	305
Min. Negotiated Rate	$119.40
Max. Negotiated Rate	$119.40
Rate for Payer: Qualcare PPO/HMO/WC	$119.40

RAST(6)

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38476787
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$398.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$398.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$21.09

RAST(7)

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38476788
Hospital Revenue Code	305
Min. Negotiated Rate	$119.40
Max. Negotiated Rate	$119.40
Rate for Payer: Qualcare PPO/HMO/WC	$119.40

RAST(7)

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38476788
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$398.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$398.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$21.09

RAST(8)

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38476789
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$398.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$398.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$21.09

RAST(8)

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38476789
Hospital Revenue Code	305
Min. Negotiated Rate	$119.40
Max. Negotiated Rate	$119.40
Rate for Payer: Qualcare PPO/HMO/WC	$119.40

Know your out-of-pocket cost for care.

All Charges