Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RING HEEL PROTECTOR

Facility

$131.25

Hospital Charge Code	270605946
Hospital Revenue Code	270
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$65.62
Rate for Payer: Aetna Commercial	$49.88
Rate for Payer: Aetna Medicare Advantage	$39.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.47
Rate for Payer: Cigna Commercial	$65.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.38
Rate for Payer: Oxford Commercial	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$19.69
Rate for Payer: UnitedHealthcare Commercial	$26.25
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$3.48

RING HEEL PROTECTOR

Facility

$131.25

Hospital Charge Code	270605946
Hospital Revenue Code	270
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$19.69
Rate for Payer: Qualcare PPO/HMO/WC	$19.69

RINGLOC 62MM SZ 25

Facility

$16,375.00

Service Code	HCPCS C1776
Hospital Charge Code	270673644
Hospital Revenue Code	278
Min. Negotiated Rate	$2,456.25
Max. Negotiated Rate	$3,962.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,962.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,602.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,456.25

RINGLOC 62MM SZ 25

Facility

$16,375.00

Service Code	HCPCS C1776
Hospital Charge Code	270673644
Hospital Revenue Code	278
Min. Negotiated Rate	$394.64
Max. Negotiated Rate	$8,187.50
Rate for Payer: Aetna Commercial	$6,222.50
Rate for Payer: Aetna Medicare Advantage	$4,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,175.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,175.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,175.62
Rate for Payer: Cigna Commercial	$8,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,962.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,602.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,456.25
Rate for Payer: UnitedHealthcare Community & State	$394.64
Rate for Payer: Wellpoint Medicaid Managed Care	$433.94

RINGLOC 64MM SZ 26

Facility

$16,375.00

Service Code	HCPCS C1776
Hospital Charge Code	270673599
Hospital Revenue Code	278
Min. Negotiated Rate	$2,456.25
Max. Negotiated Rate	$3,962.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,962.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,602.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,456.25

RINGLOC 64MM SZ 26

Facility

$16,375.00

Service Code	HCPCS C1776
Hospital Charge Code	270673599
Hospital Revenue Code	278
Min. Negotiated Rate	$394.64
Max. Negotiated Rate	$8,187.50
Rate for Payer: Aetna Commercial	$6,222.50
Rate for Payer: Aetna Medicare Advantage	$4,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,175.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,175.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,175.62
Rate for Payer: Cigna Commercial	$8,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,962.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,602.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,456.25
Rate for Payer: UnitedHealthcare Community & State	$394.64
Rate for Payer: Wellpoint Medicaid Managed Care	$433.94

RINGLOC BI-POLAR 28X51MM

Facility

$5,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270608175
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

RINGLOC BI-POLAR 28X51MM

Facility

$5,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270608175
Hospital Revenue Code	278
Min. Negotiated Rate	$126.53
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,155.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$126.53
Rate for Payer: Wellpoint Medicaid Managed Care	$139.12

RING MALYUGIN

Facility

$625.00

Hospital Charge Code	270660095
Hospital Revenue Code	270
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

RING MALYUGIN

Facility

$625.00

Hospital Charge Code	270660095
Hospital Revenue Code	270
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

RING MAXFR 180MM 5/8

Facility

$5,691.80

Hospital Charge Code	270693739
Hospital Revenue Code	272
Min. Negotiated Rate	$853.77
Max. Negotiated Rate	$853.77
Rate for Payer: Qualcare PPO/HMO/WC	$853.77

RING MAXFR 180MM 5/8

Facility

$5,691.80

Hospital Charge Code	270693739
Hospital Revenue Code	272
Min. Negotiated Rate	$137.17
Max. Negotiated Rate	$2,845.90
Rate for Payer: Aetna Commercial	$2,162.88
Rate for Payer: Aetna Medicare Advantage	$1,707.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,451.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,451.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,451.41
Rate for Payer: Cigna Commercial	$2,845.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,707.54
Rate for Payer: Oxford Commercial	$1,138.36
Rate for Payer: Qualcare PPO/HMO/WC	$853.77
Rate for Payer: UnitedHealthcare Commercial	$1,138.36
Rate for Payer: UnitedHealthcare Community & State	$137.17
Rate for Payer: Wellpoint Medicaid Managed Care	$150.83

RING MEDIUM 1/3 FC10030

Facility

$1,463.25

Hospital Charge Code	270632399
Hospital Revenue Code	272
Min. Negotiated Rate	$219.49
Max. Negotiated Rate	$219.49
Rate for Payer: Qualcare PPO/HMO/WC	$219.49

RING MEDIUM 1/3 FC10030

Facility

$1,463.25

Hospital Charge Code	270632399
Hospital Revenue Code	272
Min. Negotiated Rate	$35.26
Max. Negotiated Rate	$731.62
Rate for Payer: Aetna Commercial	$556.03
Rate for Payer: Aetna Medicare Advantage	$438.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.13
Rate for Payer: Cigna Commercial	$731.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.98
Rate for Payer: Oxford Commercial	$292.65
Rate for Payer: Qualcare PPO/HMO/WC	$219.49
Rate for Payer: UnitedHealthcare Commercial	$292.65
Rate for Payer: UnitedHealthcare Community & State	$35.26
Rate for Payer: Wellpoint Medicaid Managed Care	$38.78

RING OPEN 180mm 4936-0-018

Facility

$2,824.00

Hospital Charge Code	270643403
Hospital Revenue Code	272
Min. Negotiated Rate	$423.60
Max. Negotiated Rate	$423.60
Rate for Payer: Qualcare PPO/HMO/WC	$423.60

RING OPEN 180mm 4936-0-018

Facility

$2,824.00

Hospital Charge Code	270643403
Hospital Revenue Code	272
Min. Negotiated Rate	$68.06
Max. Negotiated Rate	$1,412.00
Rate for Payer: Aetna Commercial	$1,073.12
Rate for Payer: Aetna Medicare Advantage	$847.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$720.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$720.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$720.12
Rate for Payer: Cigna Commercial	$1,412.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.20
Rate for Payer: Oxford Commercial	$564.80
Rate for Payer: Qualcare PPO/HMO/WC	$423.60
Rate for Payer: UnitedHealthcare Commercial	$564.80
Rate for Payer: UnitedHealthcare Community & State	$68.06
Rate for Payer: Wellpoint Medicaid Managed Care	$74.84

RING PESSARY 9 W/SUPPORT PRSO9

Facility

$248.00

Hospital Charge Code	270632416
Hospital Revenue Code	272
Min. Negotiated Rate	$5.98
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$94.24
Rate for Payer: Aetna Medicare Advantage	$74.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.24
Rate for Payer: Cigna Commercial	$124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.40
Rate for Payer: Oxford Commercial	$49.60
Rate for Payer: Qualcare PPO/HMO/WC	$37.20
Rate for Payer: UnitedHealthcare Commercial	$49.60
Rate for Payer: UnitedHealthcare Community & State	$5.98
Rate for Payer: Wellpoint Medicaid Managed Care	$6.57

RING PESSARY 9 W/SUPPORT PRSO9

Facility

$248.00

Hospital Charge Code	270632416
Hospital Revenue Code	272
Min. Negotiated Rate	$37.20
Max. Negotiated Rate	$37.20
Rate for Payer: Qualcare PPO/HMO/WC	$37.20

RING TI HALF 150MM

Facility

$2,286.20

Hospital Charge Code	270693740
Hospital Revenue Code	272
Min. Negotiated Rate	$55.10
Max. Negotiated Rate	$1,143.10
Rate for Payer: Aetna Commercial	$868.76
Rate for Payer: Aetna Medicare Advantage	$685.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$582.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$582.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$582.98
Rate for Payer: Cigna Commercial	$1,143.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$685.86
Rate for Payer: Oxford Commercial	$457.24
Rate for Payer: Qualcare PPO/HMO/WC	$342.93
Rate for Payer: UnitedHealthcare Commercial	$457.24
Rate for Payer: UnitedHealthcare Community & State	$55.10
Rate for Payer: Wellpoint Medicaid Managed Care	$60.58

RING TI HALF 150MM

Facility

$2,286.20

Hospital Charge Code	270693740
Hospital Revenue Code	272
Min. Negotiated Rate	$342.93
Max. Negotiated Rate	$342.93
Rate for Payer: Qualcare PPO/HMO/WC	$342.93

RING TOSS

Facility

$119.95

Hospital Charge Code	270663158
Hospital Revenue Code	270
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$59.98
Rate for Payer: Aetna Commercial	$45.58
Rate for Payer: Aetna Medicare Advantage	$35.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.59
Rate for Payer: Cigna Commercial	$59.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.98
Rate for Payer: Oxford Commercial	$23.99
Rate for Payer: Qualcare PPO/HMO/WC	$17.99
Rate for Payer: UnitedHealthcare Commercial	$23.99
Rate for Payer: UnitedHealthcare Community & State	$2.89
Rate for Payer: Wellpoint Medicaid Managed Care	$3.18

RING TOSS

Facility

$119.95

Hospital Charge Code	270663158
Hospital Revenue Code	270
Min. Negotiated Rate	$17.99
Max. Negotiated Rate	$17.99
Rate for Payer: Qualcare PPO/HMO/WC	$17.99

RING TUB SALVATION 160

Facility

$5,630.00

Hospital Charge Code	270684448
Hospital Revenue Code	272
Min. Negotiated Rate	$844.50
Max. Negotiated Rate	$844.50
Rate for Payer: Qualcare PPO/HMO/WC	$844.50

RING TUB SALVATION 160

Facility

$5,630.00

Hospital Charge Code	270684448
Hospital Revenue Code	272
Min. Negotiated Rate	$135.68
Max. Negotiated Rate	$2,815.00
Rate for Payer: Aetna Commercial	$2,139.40
Rate for Payer: Aetna Medicare Advantage	$1,689.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,435.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,435.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,435.65
Rate for Payer: Cigna Commercial	$2,815.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.00
Rate for Payer: Oxford Commercial	$1,126.00
Rate for Payer: Qualcare PPO/HMO/WC	$844.50
Rate for Payer: UnitedHealthcare Commercial	$1,126.00
Rate for Payer: UnitedHealthcare Community & State	$135.68
Rate for Payer: Wellpoint Medicaid Managed Care	$149.19

RING VALTRAC 25X1.5 8082-00**

Facility

$897.00

Hospital Charge Code	1604818
Hospital Revenue Code	272
Min. Negotiated Rate	$134.55
Max. Negotiated Rate	$134.55
Rate for Payer: Qualcare PPO/HMO/WC	$134.55

Know your out-of-pocket cost for care.

All Charges