Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SAWBLADE STR UNIV WIDE .315

Facility

$915.00

Hospital Charge Code	270677042
Hospital Revenue Code	270
Min. Negotiated Rate	$137.25
Max. Negotiated Rate	$137.25
Rate for Payer: Qualcare PPO/HMO/WC	$137.25

SAWBLADE STR UNIV WIDE .315

Facility

$915.00

Hospital Charge Code	270677042
Hospital Revenue Code	270
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$457.50
Rate for Payer: Aetna Commercial	$347.70
Rate for Payer: Aetna Medicare Advantage	$274.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$233.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$233.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$233.32
Rate for Payer: Cigna Commercial	$457.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.50
Rate for Payer: Oxford Commercial	$183.00
Rate for Payer: Qualcare PPO/HMO/WC	$137.25
Rate for Payer: UnitedHealthcare Commercial	$183.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$24.25

SAW CARTILAG DBLE SIDE CONN

Facility

$640.00

Hospital Charge Code	270698543
Hospital Revenue Code	272
Min. Negotiated Rate	$15.42
Max. Negotiated Rate	$320.00
Rate for Payer: Aetna Commercial	$243.20
Rate for Payer: Aetna Medicare Advantage	$192.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.20
Rate for Payer: Cigna Commercial	$320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.00
Rate for Payer: Oxford Commercial	$128.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.00
Rate for Payer: UnitedHealthcare Commercial	$128.00
Rate for Payer: UnitedHealthcare Community & State	$15.42
Rate for Payer: Wellpoint Medicaid Managed Care	$16.96

SAW CARTILAG DBLE SIDE CONN

Facility

$640.00

Hospital Charge Code	270698543
Hospital Revenue Code	272
Min. Negotiated Rate	$96.00
Max. Negotiated Rate	$96.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.00

SAW GIGLI DISP 12

Facility

$87.31

Hospital Charge Code	270601045
Hospital Revenue Code	272
Min. Negotiated Rate	$13.10
Max. Negotiated Rate	$13.10
Rate for Payer: Qualcare PPO/HMO/WC	$13.10

SAW GIGLI DISP 12

Facility

$87.31

Hospital Charge Code	270601045
Hospital Revenue Code	272
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$43.66
Rate for Payer: Aetna Commercial	$33.18
Rate for Payer: Aetna Medicare Advantage	$26.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.26
Rate for Payer: Cigna Commercial	$43.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.19
Rate for Payer: Oxford Commercial	$17.46
Rate for Payer: Qualcare PPO/HMO/WC	$13.10
Rate for Payer: UnitedHealthcare Commercial	$17.46
Rate for Payer: UnitedHealthcare Community & State	$2.10
Rate for Payer: Wellpoint Medicaid Managed Care	$2.31

SAW GIGLI DISP 20

Facility

$98.39

Hospital Charge Code	270601046
Hospital Revenue Code	272
Min. Negotiated Rate	$14.76
Max. Negotiated Rate	$14.76
Rate for Payer: Qualcare PPO/HMO/WC	$14.76

SAW GIGLI DISP 20

Facility

$98.39

Hospital Charge Code	270601046
Hospital Revenue Code	272
Min. Negotiated Rate	$2.37
Max. Negotiated Rate	$49.20
Rate for Payer: Aetna Commercial	$37.39
Rate for Payer: Aetna Medicare Advantage	$29.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.09
Rate for Payer: Cigna Commercial	$49.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.52
Rate for Payer: Oxford Commercial	$19.68
Rate for Payer: Qualcare PPO/HMO/WC	$14.76
Rate for Payer: UnitedHealthcare Commercial	$19.68
Rate for Payer: UnitedHealthcare Community & State	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$2.61

SBCL PHLEBOTOMY SERVICE

Facility

$25.00

Hospital Charge Code	38474114
Hospital Revenue Code	301
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

SBCL PHLEBOTOMY SERVICE

Facility

$25.00

Hospital Charge Code	38474114
Hospital Revenue Code	301
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

S/B LESION

Facility

$1,083.25

Service Code	HCPCS 11057
Hospital Charge Code	87502565
Hospital Revenue Code	761
Min. Negotiated Rate	$162.49
Max. Negotiated Rate	$162.49
Rate for Payer: Qualcare PPO/HMO/WC	$162.49

S/B LESION

Facility

$1,083.25

Service Code	HCPCS 11057
Hospital Charge Code	87502565
Hospital Revenue Code	761
Min. Negotiated Rate	$26.11
Max. Negotiated Rate	$860.41
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.41
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.98
Rate for Payer: Oxford Commercial	$216.65
Rate for Payer: Qualcare PPO/HMO/WC	$162.49
Rate for Payer: UnitedHealthcare Commercial	$216.65
Rate for Payer: UnitedHealthcare Community & State	$26.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$28.71

SBRT DELIVERY

Facility

$9,462.75

Service Code	HCPCS 77373
Hospital Charge Code	85000675
Hospital Revenue Code	333
Min. Negotiated Rate	$1,419.41
Max. Negotiated Rate	$1,419.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,419.41

SBRT DELIVERY

Facility

$9,462.75

Service Code	HCPCS 77373
Hospital Charge Code	85000675
Hospital Revenue Code	333
Min. Negotiated Rate	$228.05
Max. Negotiated Rate	$7,667.91
Rate for Payer: Aetna Commercial	$5,777.96
Rate for Payer: Aetna Medicare Advantage	$6,882.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,667.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,667.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,124.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,667.91
Rate for Payer: Cigna Commercial	$4,258.06
Rate for Payer: Cigna Medicare Advantage	$1,486.97
Rate for Payer: Clover Medicare Advantage	$2,018.04
Rate for Payer: EmblemHealth Commercial	$6,372.75
Rate for Payer: Humana Medicare Advantage	$2,187.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,124.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,838.82
Rate for Payer: Oxford Commercial	$1,009.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,419.41
Rate for Payer: UnitedHealthcare Commercial	$1,770.00
Rate for Payer: UnitedHealthcare Community & State	$228.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,124.25
Rate for Payer: Wellcare Medicare Advantage	$2,124.25
Rate for Payer: Wellpoint Medicaid Managed Care	$250.76

SBRT MANAGEMENT

Facility

$3,300.35

Service Code	HCPCS 77435
Hospital Charge Code	85000795
Hospital Revenue Code	333
Min. Negotiated Rate	$495.05
Max. Negotiated Rate	$495.05
Rate for Payer: Qualcare PPO/HMO/WC	$495.05

SBRT MANAGEMENT

Facility

$3,300.35

Service Code	HCPCS 77435
Hospital Charge Code	85000795
Hospital Revenue Code	333
Min. Negotiated Rate	$79.54
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$1,254.13
Rate for Payer: Aetna Medicare Advantage	$990.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$841.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$841.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$841.59
Rate for Payer: Cigna Commercial	$1,650.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$990.11
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$495.05
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$79.54
Rate for Payer: Wellpoint Medicaid Managed Care	$87.46

SCAFFOLD CELL BN MATRIX 1CC

Facility

$7,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270692355
Hospital Revenue Code	278
Min. Negotiated Rate	$1,155.00
Max. Negotiated Rate	$1,863.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,863.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,155.00

SCAFFOLD CELL BN MATRIX 1CC

Facility

$7,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270692355
Hospital Revenue Code	278
Min. Negotiated Rate	$185.57
Max. Negotiated Rate	$3,850.00
Rate for Payer: Aetna Commercial	$2,926.00
Rate for Payer: Aetna Medicare Advantage	$2,310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,963.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,963.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,963.50
Rate for Payer: Cigna Commercial	$3,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,863.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,155.00
Rate for Payer: UnitedHealthcare Community & State	$185.57
Rate for Payer: Wellpoint Medicaid Managed Care	$204.05

SCALE PEDIATRIC/INFANT 1G

Facility

$9,975.00

Hospital Charge Code	270658989
Hospital Revenue Code	278
Min. Negotiated Rate	$240.40
Max. Negotiated Rate	$4,987.50
Rate for Payer: Aetna Commercial	$3,790.50
Rate for Payer: Aetna Medicare Advantage	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,194.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25
Rate for Payer: UnitedHealthcare Community & State	$240.40
Rate for Payer: Wellpoint Medicaid Managed Care	$264.34

SCALE PEDIATRIC/INFANT 1G

Facility

$9,975.00

Hospital Charge Code	270658989
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$2,413.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,194.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

SCALLOP IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	401186003A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SCALLOP IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	401186003A
Hospital Revenue Code	302
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
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	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

SCALP DISPOSABLE CLIP APPLIER

Facility

$2,750.00

Hospital Charge Code	270665367
Hospital Revenue Code	270
Min. Negotiated Rate	$66.28
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.00
Rate for Payer: Oxford Commercial	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Commercial	$550.00
Rate for Payer: UnitedHealthcare Community & State	$66.28
Rate for Payer: Wellpoint Medicaid Managed Care	$72.88

SCALP DISPOSABLE CLIP APPLIER

Facility

$2,750.00

Hospital Charge Code	270665367
Hospital Revenue Code	270
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

SCALPEL BLADE #10 STER DISP

Facility

$5.86

Hospital Charge Code	270650075
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.93
Rate for Payer: Aetna Commercial	$2.23
Rate for Payer: Aetna Medicare Advantage	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.49
Rate for Payer: Cigna Commercial	$2.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.76
Rate for Payer: Oxford Commercial	$1.17
Rate for Payer: Qualcare PPO/HMO/WC	$0.88
Rate for Payer: UnitedHealthcare Commercial	$1.17
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

Know your out-of-pocket cost for care.

All Charges