Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RETRACTOR RING 14.1 CM X 14.1C

Facility

$376.52

Hospital Charge Code	270679363
Hospital Revenue Code	272
Min. Negotiated Rate	$56.48
Max. Negotiated Rate	$56.48
Rate for Payer: Qualcare PPO/HMO/WC	$56.48

RETRACTOR RING 14.1 CM X 14.1C

Facility

$376.52

Hospital Charge Code	270679363
Hospital Revenue Code	272
Min. Negotiated Rate	$9.07
Max. Negotiated Rate	$188.26
Rate for Payer: Aetna Commercial	$143.08
Rate for Payer: Aetna Medicare Advantage	$112.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.01
Rate for Payer: Cigna Commercial	$188.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.96
Rate for Payer: Oxford Commercial	$75.30
Rate for Payer: Qualcare PPO/HMO/WC	$56.48
Rate for Payer: UnitedHealthcare Commercial	$75.30
Rate for Payer: UnitedHealthcare Community & State	$9.07
Rate for Payer: Wellpoint Medicaid Managed Care	$9.98

RETRACTOR SHARP PRONG ROLLET 4

Facility

$155.95

Hospital Charge Code	270688725
Hospital Revenue Code	272
Min. Negotiated Rate	$23.39
Max. Negotiated Rate	$23.39
Rate for Payer: Qualcare PPO/HMO/WC	$23.39

RETRACTOR SHARP PRONG ROLLET 4

Facility

$155.95

Hospital Charge Code	270688725
Hospital Revenue Code	272
Min. Negotiated Rate	$3.76
Max. Negotiated Rate	$77.97
Rate for Payer: Aetna Commercial	$59.26
Rate for Payer: Aetna Medicare Advantage	$46.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.77
Rate for Payer: Cigna Commercial	$77.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.78
Rate for Payer: Oxford Commercial	$31.19
Rate for Payer: Qualcare PPO/HMO/WC	$23.39
Rate for Payer: UnitedHealthcare Commercial	$31.19
Rate for Payer: UnitedHealthcare Community & State	$3.76
Rate for Payer: Wellpoint Medicaid Managed Care	$4.13

RETRACTOR SQUARE COLON 14.CMX

Facility

$331.65

Hospital Charge Code	270679384
Hospital Revenue Code	272
Min. Negotiated Rate	$7.99
Max. Negotiated Rate	$165.82
Rate for Payer: Aetna Commercial	$126.03
Rate for Payer: Aetna Medicare Advantage	$99.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.57
Rate for Payer: Cigna Commercial	$165.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.50
Rate for Payer: Oxford Commercial	$66.33
Rate for Payer: Qualcare PPO/HMO/WC	$49.75
Rate for Payer: UnitedHealthcare Commercial	$66.33
Rate for Payer: UnitedHealthcare Community & State	$7.99
Rate for Payer: Wellpoint Medicaid Managed Care	$8.79

RETRACTOR SQUARE COLON 14.CMX

Facility

$331.65

Hospital Charge Code	270679384
Hospital Revenue Code	272
Min. Negotiated Rate	$49.75
Max. Negotiated Rate	$49.75
Rate for Payer: Qualcare PPO/HMO/WC	$49.75

RETRACTOR SURGICAL 3308G

Facility

$323.25

Hospital Charge Code	270608600
Hospital Revenue Code	272
Min. Negotiated Rate	$48.49
Max. Negotiated Rate	$48.49
Rate for Payer: Qualcare PPO/HMO/WC	$48.49

RETRACTOR SURGICAL 3308G

Facility

$323.25

Hospital Charge Code	270608600
Hospital Revenue Code	272
Min. Negotiated Rate	$7.79
Max. Negotiated Rate	$161.62
Rate for Payer: Aetna Commercial	$122.83
Rate for Payer: Aetna Medicare Advantage	$96.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.43
Rate for Payer: Cigna Commercial	$161.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.97
Rate for Payer: Oxford Commercial	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.49
Rate for Payer: UnitedHealthcare Commercial	$64.65
Rate for Payer: UnitedHealthcare Community & State	$7.79
Rate for Payer: Wellpoint Medicaid Managed Care	$8.57

RETRACTOR SURGICAL 3308G******

Facility

$168.00

Hospital Charge Code	608600
Hospital Revenue Code	272
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$84.00
Rate for Payer: Aetna Commercial	$63.84
Rate for Payer: Aetna Medicare Advantage	$50.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.84
Rate for Payer: Cigna Commercial	$84.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.40
Rate for Payer: Oxford Commercial	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$25.20
Rate for Payer: UnitedHealthcare Commercial	$33.60
Rate for Payer: UnitedHealthcare Community & State	$4.05
Rate for Payer: Wellpoint Medicaid Managed Care	$4.45

RETRACTOR SURGICAL 3308G******

Facility

$168.00

Hospital Charge Code	608600
Hospital Revenue Code	272
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$25.20
Rate for Payer: Qualcare PPO/HMO/WC	$25.20

RETRACTOR TRACHEA LUER

Facility

$124.85

Hospital Charge Code	270688724
Hospital Revenue Code	272
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.42
Rate for Payer: Aetna Commercial	$47.44
Rate for Payer: Aetna Medicare Advantage	$37.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.84
Rate for Payer: Cigna Commercial	$62.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.45
Rate for Payer: Oxford Commercial	$24.97
Rate for Payer: Qualcare PPO/HMO/WC	$18.73
Rate for Payer: UnitedHealthcare Commercial	$24.97
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

RETRACTOR TRACHEA LUER

Facility

$124.85

Hospital Charge Code	270688724
Hospital Revenue Code	272
Min. Negotiated Rate	$18.73
Max. Negotiated Rate	$18.73
Rate for Payer: Qualcare PPO/HMO/WC	$18.73

RETRACTOR VAGINAL V-CARE LG

Facility

$940.19

Hospital Charge Code	270664721
Hospital Revenue Code	270
Min. Negotiated Rate	$141.03
Max. Negotiated Rate	$141.03
Rate for Payer: Qualcare PPO/HMO/WC	$141.03

RETRACTOR VAGINAL V-CARE LG

Facility

$940.19

Hospital Charge Code	270664721
Hospital Revenue Code	270
Min. Negotiated Rate	$22.66
Max. Negotiated Rate	$470.10
Rate for Payer: Aetna Commercial	$357.27
Rate for Payer: Aetna Medicare Advantage	$282.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.75
Rate for Payer: Cigna Commercial	$470.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$282.06
Rate for Payer: Oxford Commercial	$188.04
Rate for Payer: Qualcare PPO/HMO/WC	$141.03
Rate for Payer: UnitedHealthcare Commercial	$188.04
Rate for Payer: UnitedHealthcare Community & State	$22.66
Rate for Payer: Wellpoint Medicaid Managed Care	$24.92

RETRACTOR VAGINAL V-CARE MED

Facility

$386.28

Hospital Charge Code	270662541
Hospital Revenue Code	272
Min. Negotiated Rate	$57.94
Max. Negotiated Rate	$57.94
Rate for Payer: Qualcare PPO/HMO/WC	$57.94

RETRACTOR VAGINAL V-CARE MED

Facility

$386.28

Hospital Charge Code	270662541
Hospital Revenue Code	272
Min. Negotiated Rate	$9.31
Max. Negotiated Rate	$193.14
Rate for Payer: Aetna Commercial	$146.79
Rate for Payer: Aetna Medicare Advantage	$115.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.50
Rate for Payer: Cigna Commercial	$193.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.88
Rate for Payer: Oxford Commercial	$77.26
Rate for Payer: Qualcare PPO/HMO/WC	$57.94
Rate for Payer: UnitedHealthcare Commercial	$77.26
Rate for Payer: UnitedHealthcare Community & State	$9.31
Rate for Payer: Wellpoint Medicaid Managed Care	$10.24

RETRACTOR VAGINAL V-CARE SM

Facility

$478.47

Hospital Charge Code	270662543
Hospital Revenue Code	272
Min. Negotiated Rate	$11.53
Max. Negotiated Rate	$239.24
Rate for Payer: Aetna Commercial	$181.82
Rate for Payer: Aetna Medicare Advantage	$143.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.01
Rate for Payer: Cigna Commercial	$239.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.54
Rate for Payer: Oxford Commercial	$95.69
Rate for Payer: Qualcare PPO/HMO/WC	$71.77
Rate for Payer: UnitedHealthcare Commercial	$95.69
Rate for Payer: UnitedHealthcare Community & State	$11.53
Rate for Payer: Wellpoint Medicaid Managed Care	$12.68

RETRACTOR VAGINAL V-CARE SM

Facility

$478.47

Hospital Charge Code	270662543
Hospital Revenue Code	272
Min. Negotiated Rate	$71.77
Max. Negotiated Rate	$71.77
Rate for Payer: Qualcare PPO/HMO/WC	$71.77

RETRACTOR VAGITRAC VAGINAL

Facility

$576.00

Hospital Charge Code	270602692
Hospital Revenue Code	272
Min. Negotiated Rate	$13.88
Max. Negotiated Rate	$288.00
Rate for Payer: Aetna Commercial	$218.88
Rate for Payer: Aetna Medicare Advantage	$172.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.88
Rate for Payer: Cigna Commercial	$288.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.80
Rate for Payer: Oxford Commercial	$115.20
Rate for Payer: Qualcare PPO/HMO/WC	$86.40
Rate for Payer: UnitedHealthcare Commercial	$115.20
Rate for Payer: UnitedHealthcare Community & State	$13.88
Rate for Payer: Wellpoint Medicaid Managed Care	$15.26

RETRACTOR VAGITRAC VAGINAL

Facility

$576.00

Hospital Charge Code	270602692
Hospital Revenue Code	272
Min. Negotiated Rate	$86.40
Max. Negotiated Rate	$86.40
Rate for Payer: Qualcare PPO/HMO/WC	$86.40

RETRACTOR Z KNEE

Facility

$820.50

Hospital Charge Code	270692075
Hospital Revenue Code	272
Min. Negotiated Rate	$123.08
Max. Negotiated Rate	$123.08
Rate for Payer: Qualcare PPO/HMO/WC	$123.08

RETRACTOR Z KNEE

Facility

$820.50

Hospital Charge Code	270692075
Hospital Revenue Code	272
Min. Negotiated Rate	$19.77
Max. Negotiated Rate	$410.25
Rate for Payer: Aetna Commercial	$311.79
Rate for Payer: Aetna Medicare Advantage	$246.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.23
Rate for Payer: Cigna Commercial	$410.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.15
Rate for Payer: Oxford Commercial	$164.10
Rate for Payer: Qualcare PPO/HMO/WC	$123.08
Rate for Payer: UnitedHealthcare Commercial	$164.10
Rate for Payer: UnitedHealthcare Community & State	$19.77
Rate for Payer: Wellpoint Medicaid Managed Care	$21.74

RETRCT DEXTR SM ACCESS FLR01

Facility

$1,350.00

Hospital Charge Code	270640478
Hospital Revenue Code	272
Min. Negotiated Rate	$32.53
Max. Negotiated Rate	$675.00
Rate for Payer: Aetna Commercial	$513.00
Rate for Payer: Aetna Medicare Advantage	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$344.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$344.25
Rate for Payer: Cigna Commercial	$675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.00
Rate for Payer: Oxford Commercial	$270.00
Rate for Payer: Qualcare PPO/HMO/WC	$202.50
Rate for Payer: UnitedHealthcare Commercial	$270.00
Rate for Payer: UnitedHealthcare Community & State	$32.53
Rate for Payer: Wellpoint Medicaid Managed Care	$35.77

RETRCT DEXTR SM ACCESS FLR01

Facility

$1,350.00

Hospital Charge Code	270640478
Hospital Revenue Code	272
Min. Negotiated Rate	$202.50
Max. Negotiated Rate	$202.50
Rate for Payer: Qualcare PPO/HMO/WC	$202.50

RETRIEVAL BALLON

Facility

$172.00

Hospital Charge Code	270325610
Hospital Revenue Code	272
Min. Negotiated Rate	$4.15
Max. Negotiated Rate	$86.00
Rate for Payer: Aetna Commercial	$65.36
Rate for Payer: Aetna Medicare Advantage	$51.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.60
Rate for Payer: Oxford Commercial	$34.40
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Commercial	$34.40
Rate for Payer: UnitedHealthcare Community & State	$4.15
Rate for Payer: Wellpoint Medicaid Managed Care	$4.56

Know your out-of-pocket cost for care.

All Charges