Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SAVE A TOOTH****

Facility

$61.00

Hospital Charge Code	8007392
Hospital Revenue Code	272
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

SAVE A TOOTH****

Facility

$61.00

Hospital Charge Code	8007392
Hospital Revenue Code	272
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$23.18
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.30
Rate for Payer: Oxford Commercial	$12.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$12.20
Rate for Payer: UnitedHealthcare Community & State	$1.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.62

SAVE A TOOTH******

Facility

$61.00

Hospital Charge Code	8004392
Hospital Revenue Code	272
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$23.18
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.30
Rate for Payer: Oxford Commercial	$12.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$12.20
Rate for Payer: UnitedHealthcare Community & State	$1.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.62

SAVE A TOOTH******

Facility

$61.00

Hospital Charge Code	8004392
Hospital Revenue Code	272
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

SAVER CELL AUTOTRAN

Facility

$2,363.25

Hospital Charge Code	270601082
Hospital Revenue Code	272
Min. Negotiated Rate	$354.49
Max. Negotiated Rate	$354.49
Rate for Payer: Qualcare PPO/HMO/WC	$354.49

SAVER CELL AUTOTRAN

Facility

$2,363.25

Hospital Charge Code	270601082
Hospital Revenue Code	272
Min. Negotiated Rate	$56.95
Max. Negotiated Rate	$1,181.62
Rate for Payer: Aetna Commercial	$898.03
Rate for Payer: Aetna Medicare Advantage	$708.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$602.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$602.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$602.63
Rate for Payer: Cigna Commercial	$1,181.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$708.98
Rate for Payer: Oxford Commercial	$472.65
Rate for Payer: Qualcare PPO/HMO/WC	$354.49
Rate for Payer: UnitedHealthcare Commercial	$472.65
Rate for Payer: UnitedHealthcare Community & State	$56.95
Rate for Payer: Wellpoint Medicaid Managed Care	$62.63

SAVER CELL AUTOTRANS

Facility

$2,874.45

Hospital Charge Code	270601081
Hospital Revenue Code	272
Min. Negotiated Rate	$69.27
Max. Negotiated Rate	$1,437.22
Rate for Payer: Aetna Commercial	$1,092.29
Rate for Payer: Aetna Medicare Advantage	$862.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$732.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$732.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$732.98
Rate for Payer: Cigna Commercial	$1,437.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$862.34
Rate for Payer: Oxford Commercial	$574.89
Rate for Payer: Qualcare PPO/HMO/WC	$431.17
Rate for Payer: UnitedHealthcare Commercial	$574.89
Rate for Payer: UnitedHealthcare Community & State	$69.27
Rate for Payer: Wellpoint Medicaid Managed Care	$76.17

SAVER CELL AUTOTRANS

Facility

$2,874.45

Hospital Charge Code	270601081
Hospital Revenue Code	272
Min. Negotiated Rate	$431.17
Max. Negotiated Rate	$431.17
Rate for Payer: Qualcare PPO/HMO/WC	$431.17

SAVORY DILATATION***

Facility

$237.60

Hospital Charge Code	2300614
Hospital Revenue Code	759
Min. Negotiated Rate	$5.73
Max. Negotiated Rate	$118.80
Rate for Payer: Aetna Commercial	$90.29
Rate for Payer: Aetna Medicare Advantage	$71.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.59
Rate for Payer: Cigna Commercial	$118.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.28
Rate for Payer: Qualcare PPO/HMO/WC	$35.64
Rate for Payer: UnitedHealthcare Community & State	$5.73
Rate for Payer: Wellpoint Medicaid Managed Care	$6.30

SAVORY DILATATION***

Facility

$237.60

Hospital Charge Code	2300614
Hospital Revenue Code	759
Min. Negotiated Rate	$35.64
Max. Negotiated Rate	$35.64
Rate for Payer: Qualcare PPO/HMO/WC	$35.64

SAW 105 DEG 12x11.5x0.4MM/70MM

Facility

$430.50

Hospital Charge Code	270674677
Hospital Revenue Code	272
Min. Negotiated Rate	$10.38
Max. Negotiated Rate	$215.25
Rate for Payer: Aetna Commercial	$163.59
Rate for Payer: Aetna Medicare Advantage	$129.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.78
Rate for Payer: Cigna Commercial	$215.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.15
Rate for Payer: Oxford Commercial	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.58
Rate for Payer: UnitedHealthcare Commercial	$86.10
Rate for Payer: UnitedHealthcare Community & State	$10.38
Rate for Payer: Wellpoint Medicaid Managed Care	$11.41

SAW 105 DEG 12x11.5x0.4MM/70MM

Facility

$430.50

Hospital Charge Code	270674677
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

SAW 105 DEG 12x4.5x0.4MM/70MM

Facility

$430.50

Hospital Charge Code	270674679
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

SAW 105 DEG 12x4.5x0.4MM/70MM

Facility

$430.50

Hospital Charge Code	270674679
Hospital Revenue Code	272
Min. Negotiated Rate	$10.38
Max. Negotiated Rate	$215.25
Rate for Payer: Aetna Commercial	$163.59
Rate for Payer: Aetna Medicare Advantage	$129.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.78
Rate for Payer: Cigna Commercial	$215.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.15
Rate for Payer: Oxford Commercial	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.58
Rate for Payer: UnitedHealthcare Commercial	$86.10
Rate for Payer: UnitedHealthcare Community & State	$10.38
Rate for Payer: Wellpoint Medicaid Managed Care	$11.41

SAW 105 DEG 12x9.5x0.4MM/70MM

Facility

$430.50

Hospital Charge Code	270674678
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

SAW 105 DEG 12x9.5x0.4MM/70MM

Facility

$430.50

Hospital Charge Code	270674678
Hospital Revenue Code	272
Min. Negotiated Rate	$10.38
Max. Negotiated Rate	$215.25
Rate for Payer: Aetna Commercial	$163.59
Rate for Payer: Aetna Medicare Advantage	$129.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.78
Rate for Payer: Cigna Commercial	$215.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.15
Rate for Payer: Oxford Commercial	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.58
Rate for Payer: UnitedHealthcare Commercial	$86.10
Rate for Payer: UnitedHealthcare Community & State	$10.38
Rate for Payer: Wellpoint Medicaid Managed Care	$11.41

SAW 105 DEG 7x12x0.4MM/70MM

Facility

$430.50

Hospital Charge Code	270674676
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

SAW 105 DEG 7x12x0.4MM/70MM

Facility

$430.50

Hospital Charge Code	270674676
Hospital Revenue Code	272
Min. Negotiated Rate	$10.38
Max. Negotiated Rate	$215.25
Rate for Payer: Aetna Commercial	$163.59
Rate for Payer: Aetna Medicare Advantage	$129.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.78
Rate for Payer: Cigna Commercial	$215.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.15
Rate for Payer: Oxford Commercial	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.58
Rate for Payer: UnitedHealthcare Commercial	$86.10
Rate for Payer: UnitedHealthcare Community & State	$10.38
Rate for Payer: Wellpoint Medicaid Managed Care	$11.41

SAW 20x6.4/2.9x0.6MM TRAP LONG

Facility

$413.00

Hospital Charge Code	270674670
Hospital Revenue Code	272
Min. Negotiated Rate	$61.95
Max. Negotiated Rate	$61.95
Rate for Payer: Qualcare PPO/HMO/WC	$61.95

SAW 20x6.4/2.9x0.6MM TRAP LONG

Facility

$413.00

Hospital Charge Code	270674670
Hospital Revenue Code	272
Min. Negotiated Rate	$9.95
Max. Negotiated Rate	$206.50
Rate for Payer: Aetna Commercial	$156.94
Rate for Payer: Aetna Medicare Advantage	$123.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.31
Rate for Payer: Cigna Commercial	$206.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.90
Rate for Payer: Oxford Commercial	$82.60
Rate for Payer: Qualcare PPO/HMO/WC	$61.95
Rate for Payer: UnitedHealthcare Commercial	$82.60
Rate for Payer: UnitedHealthcare Community & State	$9.95
Rate for Payer: Wellpoint Medicaid Managed Care	$10.94

SAW 27x6.4/2.9x0.6MM TRAP LONG

Facility

$413.00

Hospital Charge Code	270674671
Hospital Revenue Code	272
Min. Negotiated Rate	$61.95
Max. Negotiated Rate	$61.95
Rate for Payer: Qualcare PPO/HMO/WC	$61.95

SAW 27x6.4/2.9x0.6MM TRAP LONG

Facility

$413.00

Hospital Charge Code	270674671
Hospital Revenue Code	272
Min. Negotiated Rate	$9.95
Max. Negotiated Rate	$206.50
Rate for Payer: Aetna Commercial	$156.94
Rate for Payer: Aetna Medicare Advantage	$123.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.31
Rate for Payer: Cigna Commercial	$206.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.90
Rate for Payer: Oxford Commercial	$82.60
Rate for Payer: Qualcare PPO/HMO/WC	$61.95
Rate for Payer: UnitedHealthcare Commercial	$82.60
Rate for Payer: UnitedHealthcare Community & State	$9.95
Rate for Payer: Wellpoint Medicaid Managed Care	$10.94

SAW 33.5x6.4x0.6MM OFFSET DOWN

Facility

$430.50

Hospital Charge Code	270674667
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

SAW 33.5x6.4x0.6MM OFFSET DOWN

Facility

$430.50

Hospital Charge Code	270674667
Hospital Revenue Code	272
Min. Negotiated Rate	$10.38
Max. Negotiated Rate	$215.25
Rate for Payer: Aetna Commercial	$163.59
Rate for Payer: Aetna Medicare Advantage	$129.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.78
Rate for Payer: Cigna Commercial	$215.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.15
Rate for Payer: Oxford Commercial	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.58
Rate for Payer: UnitedHealthcare Commercial	$86.10
Rate for Payer: UnitedHealthcare Community & State	$10.38
Rate for Payer: Wellpoint Medicaid Managed Care	$11.41

SAW 33.5x6.4x0.6MM OFFSET LEFT

Facility

$430.50

Hospital Charge Code	270674669
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

Know your out-of-pocket cost for care.

All Charges