Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCALPEL STER DISP #15

Facility

$7.85

Hospital Charge Code	270301920W
Hospital Revenue Code	272
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$1.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.18

SCALPEL STER DISP #15

Facility

$7.85

Hospital Charge Code	270301920
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.92
Rate for Payer: Aetna Commercial	$2.98
Rate for Payer: Aetna Medicare Advantage	$2.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.00
Rate for Payer: Cigna Commercial	$3.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.35
Rate for Payer: Oxford Commercial	$1.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.18
Rate for Payer: UnitedHealthcare Commercial	$1.57
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SCALPEL STER DISP #15

Facility

$7.85

Hospital Charge Code	270301920S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.92
Rate for Payer: Aetna Commercial	$2.98
Rate for Payer: Aetna Medicare Advantage	$2.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.00
Rate for Payer: Cigna Commercial	$3.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.35
Rate for Payer: Oxford Commercial	$1.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.18
Rate for Payer: UnitedHealthcare Commercial	$1.57
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SCALPEL STER DISP #15

Facility

$7.85

Hospital Charge Code	270301920
Hospital Revenue Code	272
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$1.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.18

SCALPEL STER DISP #15

Facility

$10.00

Hospital Charge Code	270301920N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$3.80
Rate for Payer: Aetna Medicare Advantage	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.55
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.00
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$2.00
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

SCALPEL STER DISP #15

Facility

$7.85

Hospital Charge Code	270301920S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$1.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.18

SCALPEL STER DISP #15

Facility

$7.85

Hospital Charge Code	270301920W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.92
Rate for Payer: Aetna Commercial	$2.98
Rate for Payer: Aetna Medicare Advantage	$2.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.00
Rate for Payer: Cigna Commercial	$3.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.35
Rate for Payer: Oxford Commercial	$1.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.18
Rate for Payer: UnitedHealthcare Commercial	$1.57
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SCALPEL STER DISP #15

Facility

$10.00

Hospital Charge Code	270301920N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

SCALPEL STER DISP #20

Facility

$7.25

Hospital Charge Code	270301925
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

SCALPEL STER DISP #20

Facility

$7.25

Hospital Charge Code	270301925
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.75
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.17
Rate for Payer: Oxford Commercial	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$1.45
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SCALP VEINS****

Facility

$25.00

Hospital Charge Code	7000524
Hospital Revenue Code	279
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

SCALP VEINS****

Facility

$25.00

Hospital Charge Code	7000524
Hospital Revenue Code	279
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.50
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	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

SCAN PROC CRANIAL EXTRA

Facility

$2,905.13

Service Code	HCPCS 61782
Hospital Charge Code	1600000615
Hospital Revenue Code	360
Min. Negotiated Rate	$70.01
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,103.95
Rate for Payer: Aetna Medicare Advantage	$871.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$740.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$740.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$740.81
Rate for Payer: Cigna Commercial	$1,452.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.54
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$435.77
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$70.01
Rate for Payer: Wellpoint Medicaid Managed Care	$76.99

SCAN PROC CRANIAL EXTRA

Facility

$2,905.13

Service Code	HCPCS 61782
Hospital Charge Code	1600000615
Hospital Revenue Code	360
Min. Negotiated Rate	$435.77
Max. Negotiated Rate	$435.77
Rate for Payer: Qualcare PPO/HMO/WC	$435.77

SCAN PROC SPINAL

Facility

$7,221.00

Service Code	HCPCS 61783
Hospital Charge Code	24001192
Hospital Revenue Code	360
Min. Negotiated Rate	$1,083.15
Max. Negotiated Rate	$1,083.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.15

SCAN PROC SPINAL

Facility

$7,221.00

Service Code	HCPCS 61783
Hospital Charge Code	24001192
Hospital Revenue Code	360
Min. Negotiated Rate	$174.03
Max. Negotiated Rate	$3,610.50
Rate for Payer: Aetna Commercial	$2,743.98
Rate for Payer: Aetna Medicare Advantage	$2,166.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,841.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,841.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,841.36
Rate for Payer: Cigna Commercial	$3,610.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,166.30
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.15
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$174.03
Rate for Payer: Wellpoint Medicaid Managed Care	$191.36

SCAN PROC SPINAL

Facility

$2,265.10

Service Code	HCPCS 61783
Hospital Charge Code	1600000623
Hospital Revenue Code	360
Min. Negotiated Rate	$339.76
Max. Negotiated Rate	$339.76
Rate for Payer: Qualcare PPO/HMO/WC	$339.76

SCAN PROC SPINAL

Facility

$2,265.10

Service Code	HCPCS 61783
Hospital Charge Code	1600000623
Hospital Revenue Code	360
Min. Negotiated Rate	$54.59
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$860.74
Rate for Payer: Aetna Medicare Advantage	$679.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$577.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$577.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$577.60
Rate for Payer: Cigna Commercial	$1,132.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$679.53
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$339.76
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$54.59
Rate for Payer: Wellpoint Medicaid Managed Care	$60.03

SCAPHOID STAPLE MED.LONG

Facility

$278.00

Hospital Charge Code	270331202
Hospital Revenue Code	278
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$139.00
Rate for Payer: Aetna Commercial	$105.64
Rate for Payer: Aetna Medicare Advantage	$83.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.89
Rate for Payer: Cigna Commercial	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.16
Rate for Payer: Qualcare PPO/HMO/WC	$41.70
Rate for Payer: UnitedHealthcare Community & State	$6.70
Rate for Payer: Wellpoint Medicaid Managed Care	$7.37

SCAPHOID STAPLE MED.LONG

Facility

$278.00

Hospital Charge Code	270331202
Hospital Revenue Code	278
Min. Negotiated Rate	$41.70
Max. Negotiated Rate	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.16
Rate for Payer: Qualcare PPO/HMO/WC	$41.70

SCAPULA COMPL-BILAT

Facility

$5,100.00

Service Code	HCPCS 7301050
Hospital Charge Code	94061211
Hospital Revenue Code	320
Min. Negotiated Rate	$122.91
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

SCAPULA COMPL-BILAT

Facility

$5,100.00

Service Code	HCPCS 7301050
Hospital Charge Code	94061211
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

SCAPULA COMPL-LT

Facility

$5,100.00

Service Code	HCPCS 73010LT
Hospital Charge Code	94061281
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

SCAPULA COMPL-LT

Facility

$5,100.00

Service Code	HCPCS 73010LT
Hospital Charge Code	94061281
Hospital Revenue Code	320
Min. Negotiated Rate	$122.91
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

SCAPULA COMPL-RT

Facility

$294.00

Service Code	HCPCS 73010RT
Hospital Charge Code	94061283
Hospital Revenue Code	320
Min. Negotiated Rate	$44.10
Max. Negotiated Rate	$44.10
Rate for Payer: Qualcare PPO/HMO/WC	$44.10

Know your out-of-pocket cost for care.

All Charges