Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RETRACT ALEXIS 2.5 6CM LAP SYS

Facility

$1,000.00

Hospital Charge Code	270683713
Hospital Revenue Code	272
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

RETRACT ALEXIS 5-9 LAP SYSTEM

Facility

$1,000.00

Hospital Charge Code	270683714
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

RETRACT ALEXIS 5-9 LAP SYSTEM

Facility

$1,000.00

Hospital Charge Code	270683714
Hospital Revenue Code	272
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

RETRACT KELLY BLADE180MM 76*51

Facility

$1,725.00

Hospital Charge Code	270665984
Hospital Revenue Code	270
Min. Negotiated Rate	$41.57
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$517.50
Rate for Payer: Oxford Commercial	$345.00
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Commercial	$345.00
Rate for Payer: UnitedHealthcare Community & State	$41.57
Rate for Payer: Wellpoint Medicaid Managed Care	$45.71

RETRACT KELLY BLADE180MM 76*51

Facility

$1,725.00

Hospital Charge Code	270665984
Hospital Revenue Code	270
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$258.75
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

RETRACTOR ALEXIS 5-9CM

Facility

$375.00

Hospital Charge Code	270687087
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

RETRACTOR ALEXIS 5-9CM

Facility

$375.00

Hospital Charge Code	270687087
Hospital Revenue Code	272
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

RETRACTOR ALEXIX WOUND MEDIUM

Facility

$270.00

Hospital Charge Code	270688644
Hospital Revenue Code	272
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

RETRACTOR ALEXIX WOUND MEDIUM

Facility

$270.00

Hospital Charge Code	270688644
Hospital Revenue Code	272
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.00
Rate for Payer: Oxford Commercial	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Commercial	$54.00
Rate for Payer: UnitedHealthcare Community & State	$6.51
Rate for Payer: Wellpoint Medicaid Managed Care	$7.16

RETRACTOR APP MOBIUS 900500

Facility

$495.25

Hospital Charge Code	270625163
Hospital Revenue Code	272
Min. Negotiated Rate	$74.29
Max. Negotiated Rate	$74.29
Rate for Payer: Qualcare PPO/HMO/WC	$74.29

RETRACTOR APP MOBIUS 900500

Facility

$495.25

Hospital Charge Code	270625163
Hospital Revenue Code	272
Min. Negotiated Rate	$11.94
Max. Negotiated Rate	$247.62
Rate for Payer: Aetna Commercial	$188.19
Rate for Payer: Aetna Medicare Advantage	$148.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.29
Rate for Payer: Cigna Commercial	$247.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.57
Rate for Payer: Oxford Commercial	$99.05
Rate for Payer: Qualcare PPO/HMO/WC	$74.29
Rate for Payer: UnitedHealthcare Commercial	$99.05
Rate for Payer: UnitedHealthcare Community & State	$11.94
Rate for Payer: Wellpoint Medicaid Managed Care	$13.12

RETRACTOR BLADE BLUNT 35MM

Facility

$358.60

Hospital Charge Code	270653461
Hospital Revenue Code	272
Min. Negotiated Rate	$53.79
Max. Negotiated Rate	$53.79
Rate for Payer: Qualcare PPO/HMO/WC	$53.79

RETRACTOR BLADE BLUNT 35MM

Facility

$358.60

Hospital Charge Code	270653461
Hospital Revenue Code	272
Min. Negotiated Rate	$8.64
Max. Negotiated Rate	$179.30
Rate for Payer: Aetna Commercial	$136.27
Rate for Payer: Aetna Medicare Advantage	$107.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.44
Rate for Payer: Cigna Commercial	$179.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.58
Rate for Payer: Oxford Commercial	$71.72
Rate for Payer: Qualcare PPO/HMO/WC	$53.79
Rate for Payer: UnitedHealthcare Commercial	$71.72
Rate for Payer: UnitedHealthcare Community & State	$8.64
Rate for Payer: Wellpoint Medicaid Managed Care	$9.50

RETRACTOR BLADE BLUNT 40MM

Facility

$358.60

Hospital Charge Code	270653462
Hospital Revenue Code	272
Min. Negotiated Rate	$8.64
Max. Negotiated Rate	$179.30
Rate for Payer: Aetna Commercial	$136.27
Rate for Payer: Aetna Medicare Advantage	$107.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.44
Rate for Payer: Cigna Commercial	$179.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.58
Rate for Payer: Oxford Commercial	$71.72
Rate for Payer: Qualcare PPO/HMO/WC	$53.79
Rate for Payer: UnitedHealthcare Commercial	$71.72
Rate for Payer: UnitedHealthcare Community & State	$8.64
Rate for Payer: Wellpoint Medicaid Managed Care	$9.50

RETRACTOR BLADE BLUNT 40MM

Facility

$358.60

Hospital Charge Code	270653462
Hospital Revenue Code	272
Min. Negotiated Rate	$53.79
Max. Negotiated Rate	$53.79
Rate for Payer: Qualcare PPO/HMO/WC	$53.79

RETRACTOR BLADE BLUNT 45MM

Facility

$358.60

Hospital Charge Code	270653463
Hospital Revenue Code	272
Min. Negotiated Rate	$53.79
Max. Negotiated Rate	$53.79
Rate for Payer: Qualcare PPO/HMO/WC	$53.79

RETRACTOR BLADE BLUNT 45MM

Facility

$358.60

Hospital Charge Code	270653463
Hospital Revenue Code	272
Min. Negotiated Rate	$8.64
Max. Negotiated Rate	$179.30
Rate for Payer: Aetna Commercial	$136.27
Rate for Payer: Aetna Medicare Advantage	$107.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.44
Rate for Payer: Cigna Commercial	$179.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.58
Rate for Payer: Oxford Commercial	$71.72
Rate for Payer: Qualcare PPO/HMO/WC	$53.79
Rate for Payer: UnitedHealthcare Commercial	$71.72
Rate for Payer: UnitedHealthcare Community & State	$8.64
Rate for Payer: Wellpoint Medicaid Managed Care	$9.50

RETRACTOR BLADE BLUNT 50MM

Facility

$358.60

Hospital Charge Code	270653464
Hospital Revenue Code	272
Min. Negotiated Rate	$53.79
Max. Negotiated Rate	$53.79
Rate for Payer: Qualcare PPO/HMO/WC	$53.79

RETRACTOR BLADE BLUNT 50MM

Facility

$358.60

Hospital Charge Code	270653464
Hospital Revenue Code	272
Min. Negotiated Rate	$8.64
Max. Negotiated Rate	$179.30
Rate for Payer: Aetna Commercial	$136.27
Rate for Payer: Aetna Medicare Advantage	$107.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.44
Rate for Payer: Cigna Commercial	$179.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.58
Rate for Payer: Oxford Commercial	$71.72
Rate for Payer: Qualcare PPO/HMO/WC	$53.79
Rate for Payer: UnitedHealthcare Commercial	$71.72
Rate for Payer: UnitedHealthcare Community & State	$8.64
Rate for Payer: Wellpoint Medicaid Managed Care	$9.50

RETRACTOR BLADE BLUNT 55MM

Facility

$358.60

Hospital Charge Code	270653465
Hospital Revenue Code	272
Min. Negotiated Rate	$8.64
Max. Negotiated Rate	$179.30
Rate for Payer: Aetna Commercial	$136.27
Rate for Payer: Aetna Medicare Advantage	$107.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.44
Rate for Payer: Cigna Commercial	$179.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.58
Rate for Payer: Oxford Commercial	$71.72
Rate for Payer: Qualcare PPO/HMO/WC	$53.79
Rate for Payer: UnitedHealthcare Commercial	$71.72
Rate for Payer: UnitedHealthcare Community & State	$8.64
Rate for Payer: Wellpoint Medicaid Managed Care	$9.50

RETRACTOR BLADE BLUNT 55MM

Facility

$358.60

Hospital Charge Code	270653465
Hospital Revenue Code	272
Min. Negotiated Rate	$53.79
Max. Negotiated Rate	$53.79
Rate for Payer: Qualcare PPO/HMO/WC	$53.79

RETRACTOR BLADE SHARP 35MM

Facility

$362.50

Hospital Charge Code	270653455
Hospital Revenue Code	272
Min. Negotiated Rate	$54.38
Max. Negotiated Rate	$54.38
Rate for Payer: Qualcare PPO/HMO/WC	$54.38

RETRACTOR BLADE SHARP 35MM

Facility

$362.50

Hospital Charge Code	270653455
Hospital Revenue Code	272
Min. Negotiated Rate	$8.74
Max. Negotiated Rate	$181.25
Rate for Payer: Aetna Commercial	$137.75
Rate for Payer: Aetna Medicare Advantage	$108.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.44
Rate for Payer: Cigna Commercial	$181.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.75
Rate for Payer: Oxford Commercial	$72.50
Rate for Payer: Qualcare PPO/HMO/WC	$54.38
Rate for Payer: UnitedHealthcare Commercial	$72.50
Rate for Payer: UnitedHealthcare Community & State	$8.74
Rate for Payer: Wellpoint Medicaid Managed Care	$9.61

RETRACTOR BLADE SHARP 40MM

Facility

$362.50

Hospital Charge Code	270653456
Hospital Revenue Code	272
Min. Negotiated Rate	$54.38
Max. Negotiated Rate	$54.38
Rate for Payer: Qualcare PPO/HMO/WC	$54.38

RETRACTOR BLADE SHARP 40MM

Facility

$362.50

Hospital Charge Code	270653456
Hospital Revenue Code	272
Min. Negotiated Rate	$8.74
Max. Negotiated Rate	$181.25
Rate for Payer: Aetna Commercial	$137.75
Rate for Payer: Aetna Medicare Advantage	$108.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.44
Rate for Payer: Cigna Commercial	$181.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.75
Rate for Payer: Oxford Commercial	$72.50
Rate for Payer: Qualcare PPO/HMO/WC	$54.38
Rate for Payer: UnitedHealthcare Commercial	$72.50
Rate for Payer: UnitedHealthcare Community & State	$8.74
Rate for Payer: Wellpoint Medicaid Managed Care	$9.61

Know your out-of-pocket cost for care.

All Charges