Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ROTATOR CUFF GRASPER

Facility

$4,975.00

Hospital Charge Code	270656555
Hospital Revenue Code	272
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$746.25
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

ROTATOR CUFF,REP ARTHROSCOPY

Facility

$50,586.00

Service Code	HCPCS 29827
Hospital Charge Code	16000197
Hospital Revenue Code	360
Min. Negotiated Rate	$1,219.12
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,175.80
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,587.90
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,219.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,340.53

ROTATOR CUFF,REP ARTHROSCOPY

Facility

$50,586.00

Service Code	HCPCS 29827
Hospital Charge Code	16000197
Hospital Revenue Code	360
Min. Negotiated Rate	$7,587.90
Max. Negotiated Rate	$7,587.90
Rate for Payer: Qualcare PPO/HMO/WC	$7,587.90

ROTAVIRUS AG

Facility

$103.25

Service Code	HCPCS 87425
Hospital Charge Code	3006709
Hospital Revenue Code	306
Min. Negotiated Rate	$15.49
Max. Negotiated Rate	$15.49
Rate for Payer: Qualcare PPO/HMO/WC	$15.49

ROTAVIRUS AG

Facility

$390.00

Service Code	HCPCS 87425
Hospital Charge Code	39900289
Hospital Revenue Code	306
Min. Negotiated Rate	$9.58
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.59
Rate for Payer: Aetna Medicare Advantage	$38.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.24
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.98
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Medicare Advantage	$11.98
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ROTAVIRUS AG

Facility

$390.00

Service Code	HCPCS 87425
Hospital Charge Code	39900289
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ROTAVIRUS AG

Facility

$103.25

Service Code	HCPCS 87425
Hospital Charge Code	3006709
Hospital Revenue Code	306
Min. Negotiated Rate	$2.74
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.59
Rate for Payer: Aetna Medicare Advantage	$38.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.24
Rate for Payer: Cigna Commercial	$51.62
Rate for Payer: Cigna Medicare Advantage	$11.98
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Medicare Advantage	$11.98
Rate for Payer: Wellpoint Medicaid Managed Care	$2.74

ROTAVIRUS ANTIGEN

Facility

$329.00

Service Code	HCPCS 86759
Hospital Charge Code	38476036
Hospital Revenue Code	302
Min. Negotiated Rate	$49.35
Max. Negotiated Rate	$49.35
Rate for Payer: Qualcare PPO/HMO/WC	$49.35

ROTAVIRUS ANTIGEN

Facility

$329.00

Service Code	HCPCS 86759
Hospital Charge Code	38476036
Hospital Revenue Code	302
Min. Negotiated Rate	$8.72
Max. Negotiated Rate	$164.50
Rate for Payer: Aetna Commercial	$49.59
Rate for Payer: Aetna Medicare Advantage	$59.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.80
Rate for Payer: Cigna Commercial	$164.50
Rate for Payer: Cigna Medicare Advantage	$18.23
Rate for Payer: Clover Medicare Advantage	$17.32
Rate for Payer: EmblemHealth Commercial	$54.69
Rate for Payer: Humana Medicare Advantage	$18.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.23
Rate for Payer: Wellcare Medicare Advantage	$18.23
Rate for Payer: Wellpoint Medicaid Managed Care	$8.72

ROTAVIRUS VACCINE, LIVE ORAL

Facility

$855.79

Service Code	HCPCS 90680
Hospital Charge Code	606350976
Hospital Revenue Code	636
Min. Negotiated Rate	$128.37
Max. Negotiated Rate	$207.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.10
Rate for Payer: Qualcare PPO/HMO/WC	$128.37

ROTAVIRUS VACCINE, LIVE ORAL

Facility

$855.79

Service Code	HCPCS 90680
Hospital Charge Code	606350976
Hospital Revenue Code	636
Min. Negotiated Rate	$20.62
Max. Negotiated Rate	$427.89
Rate for Payer: Aetna Commercial	$325.20
Rate for Payer: Aetna Medicare Advantage	$256.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.23
Rate for Payer: Cigna Commercial	$427.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.10
Rate for Payer: Qualcare PPO/HMO/WC	$128.37
Rate for Payer: UnitedHealthcare Community & State	$20.62
Rate for Payer: Wellpoint Medicaid Managed Care	$22.68

ROTH NET

Facility

$94.00

Hospital Charge Code	270325612
Hospital Revenue Code	272
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$47.00
Rate for Payer: Aetna Commercial	$35.72
Rate for Payer: Aetna Medicare Advantage	$28.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.97
Rate for Payer: Cigna Commercial	$47.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.20
Rate for Payer: Oxford Commercial	$18.80
Rate for Payer: Qualcare PPO/HMO/WC	$14.10
Rate for Payer: UnitedHealthcare Commercial	$18.80
Rate for Payer: UnitedHealthcare Community & State	$2.27
Rate for Payer: Wellpoint Medicaid Managed Care	$2.49

ROTH NET

Facility

$94.00

Hospital Charge Code	270325612
Hospital Revenue Code	272
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$14.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.10

ROTH NET RETRIEVER UNIV

Facility

$525.00

Hospital Charge Code	270658151
Hospital Revenue Code	272
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.50
Rate for Payer: Oxford Commercial	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Commercial	$105.00
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

ROTH NET RETRIEVER UNIV

Facility

$525.00

Hospital Charge Code	270658151
Hospital Revenue Code	272
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

ROTH NET RETRIEVER UNIV

Facility

$525.00

Hospital Charge Code	270670091
Hospital Revenue Code	272
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

ROTH NET RETRIEVER UNIV

Facility

$525.00

Hospital Charge Code	270670091
Hospital Revenue Code	272
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.50
Rate for Payer: Oxford Commercial	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Commercial	$105.00
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

ROTICULATOR 55 3.5 4.8 POLY***

Facility

$546.00

Hospital Charge Code	1600964
Hospital Revenue Code	272
Min. Negotiated Rate	$13.16
Max. Negotiated Rate	$273.00
Rate for Payer: Aetna Commercial	$207.48
Rate for Payer: Aetna Medicare Advantage	$163.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.23
Rate for Payer: Cigna Commercial	$273.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.80
Rate for Payer: Oxford Commercial	$109.20
Rate for Payer: Qualcare PPO/HMO/WC	$81.90
Rate for Payer: UnitedHealthcare Commercial	$109.20
Rate for Payer: UnitedHealthcare Community & State	$13.16
Rate for Payer: Wellpoint Medicaid Managed Care	$14.47

ROTICULATOR 55 3.5 4.8 POLY***

Facility

$546.00

Hospital Charge Code	1600964
Hospital Revenue Code	272
Min. Negotiated Rate	$81.90
Max. Negotiated Rate	$81.90
Rate for Payer: Qualcare PPO/HMO/WC	$81.90

ROTICULATOR 55-3.5 STAPLER

Facility

$948.00

Hospital Charge Code	270334752
Hospital Revenue Code	272
Min. Negotiated Rate	$142.20
Max. Negotiated Rate	$142.20
Rate for Payer: Qualcare PPO/HMO/WC	$142.20

ROTICULATOR 55-3.5 STAPLER

Facility

$948.00

Hospital Charge Code	270334752
Hospital Revenue Code	272
Min. Negotiated Rate	$22.85
Max. Negotiated Rate	$474.00
Rate for Payer: Aetna Commercial	$360.24
Rate for Payer: Aetna Medicare Advantage	$284.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.74
Rate for Payer: Cigna Commercial	$474.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.40
Rate for Payer: Oxford Commercial	$189.60
Rate for Payer: Qualcare PPO/HMO/WC	$142.20
Rate for Payer: UnitedHealthcare Commercial	$189.60
Rate for Payer: UnitedHealthcare Community & State	$22.85
Rate for Payer: Wellpoint Medicaid Managed Care	$25.12

ROTICULATOR ENDO GIA 60-2.5

Facility

$973.03

Hospital Charge Code	270660574
Hospital Revenue Code	272
Min. Negotiated Rate	$23.45
Max. Negotiated Rate	$486.51
Rate for Payer: Aetna Commercial	$369.75
Rate for Payer: Aetna Medicare Advantage	$291.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.12
Rate for Payer: Cigna Commercial	$486.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.91
Rate for Payer: Oxford Commercial	$194.61
Rate for Payer: Qualcare PPO/HMO/WC	$145.95
Rate for Payer: UnitedHealthcare Commercial	$194.61
Rate for Payer: UnitedHealthcare Community & State	$23.45
Rate for Payer: Wellpoint Medicaid Managed Care	$25.79

ROTICULATOR ENDO GIA 60-2.5

Facility

$973.03

Hospital Charge Code	270660574
Hospital Revenue Code	272
Min. Negotiated Rate	$145.95
Max. Negotiated Rate	$145.95
Rate for Payer: Qualcare PPO/HMO/WC	$145.95

ROTICULATOR GIA 60mm 4.5 SULU

Facility

$1,021.63

Hospital Charge Code	270655597
Hospital Revenue Code	271
Min. Negotiated Rate	$24.62
Max. Negotiated Rate	$510.81
Rate for Payer: Aetna Commercial	$388.22
Rate for Payer: Aetna Medicare Advantage	$306.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.52
Rate for Payer: Cigna Commercial	$510.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$306.49
Rate for Payer: Oxford Commercial	$204.33
Rate for Payer: Qualcare PPO/HMO/WC	$153.24
Rate for Payer: UnitedHealthcare Commercial	$204.33
Rate for Payer: UnitedHealthcare Community & State	$24.62
Rate for Payer: Wellpoint Medicaid Managed Care	$27.07

ROTICULATOR GIA 60mm 4.5 SULU

Facility

$1,021.63

Hospital Charge Code	270655597
Hospital Revenue Code	271
Min. Negotiated Rate	$153.24
Max. Negotiated Rate	$153.24
Rate for Payer: Qualcare PPO/HMO/WC	$153.24

Know your out-of-pocket cost for care.

All Charges