Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RESECT PHALANGL BS SGL TOE BL

Facility

$21,065.30

Service Code	HCPCS 28126
Hospital Charge Code	16000720
Hospital Revenue Code	360
Min. Negotiated Rate	$3,159.80
Max. Negotiated Rate	$3,159.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.80

RESECT PHALANGL BS SGL TOE BL

Facility

$21,065.30

Service Code	HCPCS 28126
Hospital Charge Code	16000720
Hospital Revenue Code	360
Min. Negotiated Rate	$507.67
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,319.59
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.80
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$507.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$558.23

RESECT SM INTEST,SGL RESECT&AN

Facility

$14,675.36

Service Code	HCPCS 44120
Hospital Charge Code	16000969
Hospital Revenue Code	360
Min. Negotiated Rate	$2,201.30
Max. Negotiated Rate	$2,201.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,201.30

RESECT SM INTEST,SGL RESECT&AN

Facility

$14,675.36

Service Code	HCPCS 44120
Hospital Charge Code	16000969
Hospital Revenue Code	360
Min. Negotiated Rate	$353.68
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,576.64
Rate for Payer: Aetna Medicare Advantage	$4,402.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,742.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,742.22
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	$3,742.22
Rate for Payer: Cigna Commercial	$7,337.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,402.61
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,201.30
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$353.68
Rate for Payer: Wellpoint Medicaid Managed Care	$388.90

RESECT THIGH/KNEE TUM 5 CM/>

Facility

$16,680.90

Service Code	HCPCS 27364
Hospital Charge Code	16000882
Hospital Revenue Code	360
Min. Negotiated Rate	$2,502.14
Max. Negotiated Rate	$2,502.14
Rate for Payer: Qualcare PPO/HMO/WC	$2,502.14

RESECT THIGH/KNEE TUM 5 CM/>

Facility

$16,680.90

Service Code	HCPCS 27364
Hospital Charge Code	16000882
Hospital Revenue Code	360
Min. Negotiated Rate	$402.01
Max. Negotiated Rate	$12,456.64
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,456.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,456.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,742.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,456.64
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,004.27
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,502.14
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$402.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$442.04

RESERPINE 0.1 MG TAB

Facility

$4.15

Hospital Charge Code	60627643
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.08
Rate for Payer: Aetna Commercial	$1.58
Rate for Payer: Aetna Medicare Advantage	$1.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.06
Rate for Payer: Cigna Commercial	$2.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.25
Rate for Payer: Oxford Commercial	$0.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.62
Rate for Payer: UnitedHealthcare Commercial	$0.83
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

RESERPINE 0.1 MG TAB

Facility

$4.15

Hospital Charge Code	60627643
Hospital Revenue Code	250
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$0.62
Rate for Payer: Qualcare PPO/HMO/WC	$0.62

RESERPINE TAB 0.25MG

Facility

$1.95

Hospital Charge Code	60628697
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.98
Rate for Payer: Aetna Commercial	$0.74
Rate for Payer: Aetna Medicare Advantage	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.50
Rate for Payer: Cigna Commercial	$0.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.59
Rate for Payer: Oxford Commercial	$0.39
Rate for Payer: Qualcare PPO/HMO/WC	$0.29
Rate for Payer: UnitedHealthcare Commercial	$0.39
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

RESERPINE TAB 0.25MG

Facility

$1.95

Hospital Charge Code	60628697
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

RESERV COLL COBE ELE ESOR300

Facility

$322.50

Hospital Charge Code	270637901
Hospital Revenue Code	272
Min. Negotiated Rate	$7.77
Max. Negotiated Rate	$161.25
Rate for Payer: Aetna Commercial	$122.55
Rate for Payer: Aetna Medicare Advantage	$96.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.24
Rate for Payer: Cigna Commercial	$161.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.75
Rate for Payer: Oxford Commercial	$64.50
Rate for Payer: Qualcare PPO/HMO/WC	$48.38
Rate for Payer: UnitedHealthcare Commercial	$64.50
Rate for Payer: UnitedHealthcare Community & State	$7.77
Rate for Payer: Wellpoint Medicaid Managed Care	$8.55

RESERV COLL COBE ELE ESOR300

Facility

$322.50

Hospital Charge Code	270637901
Hospital Revenue Code	272
Min. Negotiated Rate	$48.38
Max. Negotiated Rate	$48.38
Rate for Payer: Qualcare PPO/HMO/WC	$48.38

RESERVIOR 100C

Facility

$18.05

Hospital Charge Code	270656215
Hospital Revenue Code	270
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$9.03
Rate for Payer: Aetna Commercial	$6.86
Rate for Payer: Aetna Medicare Advantage	$5.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.60
Rate for Payer: Cigna Commercial	$9.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.42
Rate for Payer: Oxford Commercial	$3.61
Rate for Payer: Qualcare PPO/HMO/WC	$2.71
Rate for Payer: UnitedHealthcare Commercial	$3.61
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

RESERVIOR 100C

Facility

$18.05

Hospital Charge Code	270656215
Hospital Revenue Code	270
Min. Negotiated Rate	$2.71
Max. Negotiated Rate	$2.71
Rate for Payer: Qualcare PPO/HMO/WC	$2.71

RESERVIOR KIT 3 SPRING 400cc

Facility

$36.73

Hospital Charge Code	270655680
Hospital Revenue Code	271
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$18.36
Rate for Payer: Aetna Commercial	$13.96
Rate for Payer: Aetna Medicare Advantage	$11.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.37
Rate for Payer: Cigna Commercial	$18.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.02
Rate for Payer: Oxford Commercial	$7.35
Rate for Payer: Qualcare PPO/HMO/WC	$5.51
Rate for Payer: UnitedHealthcare Commercial	$7.35
Rate for Payer: UnitedHealthcare Community & State	$0.89
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

RESERVIOR KIT 3 SPRING 400cc

Facility

$36.73

Hospital Charge Code	270655680
Hospital Revenue Code	271
Min. Negotiated Rate	$5.51
Max. Negotiated Rate	$5.51
Rate for Payer: Qualcare PPO/HMO/WC	$5.51

RESERV J P LG HEYER ********

Facility

$34.00

Hospital Charge Code	8002461
Hospital Revenue Code	279
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.10
Rate for Payer: Qualcare PPO/HMO/WC	$5.10

RESERV J P LG HEYER ********

Facility

$34.00

Hospital Charge Code	8002461
Hospital Revenue Code	279
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$17.00
Rate for Payer: Aetna Commercial	$12.92
Rate for Payer: Aetna Medicare Advantage	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.67
Rate for Payer: Cigna Commercial	$17.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.20
Rate for Payer: Oxford Commercial	$6.80
Rate for Payer: Qualcare PPO/HMO/WC	$5.10
Rate for Payer: UnitedHealthcare Commercial	$6.80
Rate for Payer: UnitedHealthcare Community & State	$0.82
Rate for Payer: Wellpoint Medicaid Managed Care	$0.90

RESERVOIR

Facility

$11,205.00

Hospital Charge Code	270687911
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.75
Max. Negotiated Rate	$2,711.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,465.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.75

RESERVOIR

Facility

$11,205.00

Hospital Charge Code	270687911
Hospital Revenue Code	278
Min. Negotiated Rate	$270.04
Max. Negotiated Rate	$5,602.50
Rate for Payer: Aetna Commercial	$4,257.90
Rate for Payer: Aetna Medicare Advantage	$3,361.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,857.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,857.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,857.28
Rate for Payer: Cigna Commercial	$5,602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,465.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.75
Rate for Payer: UnitedHealthcare Community & State	$270.04
Rate for Payer: Wellpoint Medicaid Managed Care	$296.93

RESERVOIR 150U HAE#205

Facility

$21.40

Hospital Charge Code	270659792
Hospital Revenue Code	272
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$3.21
Rate for Payer: Qualcare PPO/HMO/WC	$3.21

RESERVOIR 150U HAE#205

Facility

$21.40

Hospital Charge Code	270659792
Hospital Revenue Code	272
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$10.70
Rate for Payer: Aetna Commercial	$8.13
Rate for Payer: Aetna Medicare Advantage	$6.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.46
Rate for Payer: Cigna Commercial	$10.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.42
Rate for Payer: Oxford Commercial	$4.28
Rate for Payer: Qualcare PPO/HMO/WC	$3.21
Rate for Payer: UnitedHealthcare Commercial	$4.28
Rate for Payer: UnitedHealthcare Community & State	$0.52
Rate for Payer: Wellpoint Medicaid Managed Care	$0.57

RESERVOIR 75cc 90-9075K-LOC

Facility

$7,375.00

Hospital Charge Code	270640426
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$1,784.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,622.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

RESERVOIR 75cc 90-9075K-LOC

Facility

$7,375.00

Hospital Charge Code	270640426
Hospital Revenue Code	278
Min. Negotiated Rate	$177.74
Max. Negotiated Rate	$3,687.50
Rate for Payer: Aetna Commercial	$2,802.50
Rate for Payer: Aetna Medicare Advantage	$2,212.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,880.62
Rate for Payer: Cigna Commercial	$3,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,622.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25
Rate for Payer: UnitedHealthcare Community & State	$177.74
Rate for Payer: Wellpoint Medicaid Managed Care	$195.44

RESERVOIR BIOFLEX 9060KLC

Facility

$6,150.45

Hospital Charge Code	270633691
Hospital Revenue Code	272
Min. Negotiated Rate	$922.57
Max. Negotiated Rate	$922.57
Rate for Payer: Qualcare PPO/HMO/WC	$922.57

Know your out-of-pocket cost for care.

All Charges