Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SEAL EAKIN COHESIVE 4

Facility

$12.03

Hospital Charge Code	270631879
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

SEAL EAKIN COHESIVE 4

Facility

$12.03

Hospital Charge Code	270631879
Hospital Revenue Code	272
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.01
Rate for Payer: Aetna Commercial	$4.57
Rate for Payer: Aetna Medicare Advantage	$3.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.07
Rate for Payer: Cigna Commercial	$6.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.61
Rate for Payer: Oxford Commercial	$2.41
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.41
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

SEALED CONTAINER W/LID LONG SI

Facility

$3,405.00

Hospital Charge Code	270665558
Hospital Revenue Code	270
Min. Negotiated Rate	$82.06
Max. Negotiated Rate	$1,702.50
Rate for Payer: Aetna Commercial	$1,293.90
Rate for Payer: Aetna Medicare Advantage	$1,021.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$868.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$868.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$868.27
Rate for Payer: Cigna Commercial	$1,702.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,021.50
Rate for Payer: Oxford Commercial	$681.00
Rate for Payer: Qualcare PPO/HMO/WC	$510.75
Rate for Payer: UnitedHealthcare Commercial	$681.00
Rate for Payer: UnitedHealthcare Community & State	$82.06
Rate for Payer: Wellpoint Medicaid Managed Care	$90.23

SEALED CONTAINER W/LID LONG SI

Facility

$3,405.00

Hospital Charge Code	270665558
Hospital Revenue Code	270
Min. Negotiated Rate	$510.75
Max. Negotiated Rate	$510.75
Rate for Payer: Qualcare PPO/HMO/WC	$510.75

SEALED LEAD ACID BATTERY

Facility

$345.60

Hospital Charge Code	27065603
Hospital Revenue Code	271
Min. Negotiated Rate	$51.84
Max. Negotiated Rate	$51.84
Rate for Payer: Qualcare PPO/HMO/WC	$51.84

SEALED LEAD ACID BATTERY

Facility

$345.60

Hospital Charge Code	27065603
Hospital Revenue Code	271
Min. Negotiated Rate	$8.33
Max. Negotiated Rate	$172.80
Rate for Payer: Aetna Commercial	$131.33
Rate for Payer: Aetna Medicare Advantage	$103.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.13
Rate for Payer: Cigna Commercial	$172.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.68
Rate for Payer: Oxford Commercial	$69.12
Rate for Payer: Qualcare PPO/HMO/WC	$51.84
Rate for Payer: UnitedHealthcare Commercial	$69.12
Rate for Payer: UnitedHealthcare Community & State	$8.33
Rate for Payer: Wellpoint Medicaid Managed Care	$9.16

SEALER BIPOLAR AQUAMANTYS 6.0M

Facility

$2,625.00

Hospital Charge Code	270660020
Hospital Revenue Code	272
Min. Negotiated Rate	$63.26
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$787.50
Rate for Payer: Oxford Commercial	$525.00
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Commercial	$525.00
Rate for Payer: UnitedHealthcare Community & State	$63.26
Rate for Payer: Wellpoint Medicaid Managed Care	$69.56

SEALER BIPOLAR AQUAMANTYS 6.0M

Facility

$2,625.00

Hospital Charge Code	270660020
Hospital Revenue Code	272
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$393.75
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

SEALING DUETT 624227

Facility

$1,000.00

Service Code	HCPCS C1760
Hospital Charge Code	270624227
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

SEALING DUETT 624227

Facility

$1,000.00

Service Code	HCPCS C1760
Hospital Charge Code	270624227
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SEAL MYSURE

Facility

$51.50

Hospital Charge Code	270664203
Hospital Revenue Code	270
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$25.75
Rate for Payer: Aetna Commercial	$19.57
Rate for Payer: Aetna Medicare Advantage	$15.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.13
Rate for Payer: Cigna Commercial	$25.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.45
Rate for Payer: Oxford Commercial	$10.30
Rate for Payer: Qualcare PPO/HMO/WC	$7.72
Rate for Payer: UnitedHealthcare Commercial	$10.30
Rate for Payer: UnitedHealthcare Community & State	$1.24
Rate for Payer: Wellpoint Medicaid Managed Care	$1.36

SEAL MYSURE

Facility

$51.50

Hospital Charge Code	270664203
Hospital Revenue Code	270
Min. Negotiated Rate	$7.72
Max. Negotiated Rate	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$7.72

SEALS DISP F/SCOPE WARM C3101

Facility

$19.00

Hospital Charge Code	270641091
Hospital Revenue Code	272
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$2.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.85

SEALS DISP F/SCOPE WARM C3101

Facility

$19.00

Hospital Charge Code	270641091
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.50
Rate for Payer: Aetna Commercial	$7.22
Rate for Payer: Aetna Medicare Advantage	$5.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.84
Rate for Payer: Cigna Commercial	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.70
Rate for Payer: Oxford Commercial	$3.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.85
Rate for Payer: UnitedHealthcare Commercial	$3.80
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

SEAL SINGLE SITE UNIV

Facility

$75.00

Hospital Charge Code	270677940
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

SEAL SINGLE SITE UNIV

Facility

$75.00

Hospital Charge Code	270677940
Hospital Revenue Code	272
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

SEAL UNIVERSAL XI 5-8MM

Facility

$90.00

Hospital Charge Code	270668651
Hospital Revenue Code	272
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.00
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

SEAL UNIVERSAL XI 5-8MM

Facility

$90.00

Hospital Charge Code	270668651
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

SEAL UP II 175070 *********

Facility

$19.00

Hospital Charge Code	1608173
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.50
Rate for Payer: Aetna Commercial	$7.22
Rate for Payer: Aetna Medicare Advantage	$5.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.84
Rate for Payer: Cigna Commercial	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.70
Rate for Payer: Oxford Commercial	$3.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.85
Rate for Payer: UnitedHealthcare Commercial	$3.80
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

SEAL UP II 175070 *********

Facility

$19.00

Hospital Charge Code	1608173
Hospital Revenue Code	272
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$2.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.85

SEAMGARD

Facility

$354.00

Hospital Charge Code	270335728
Hospital Revenue Code	278
Min. Negotiated Rate	$8.53
Max. Negotiated Rate	$177.00
Rate for Payer: Aetna Commercial	$134.52
Rate for Payer: Aetna Medicare Advantage	$106.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.27
Rate for Payer: Cigna Commercial	$177.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.88
Rate for Payer: Qualcare PPO/HMO/WC	$53.10
Rate for Payer: UnitedHealthcare Community & State	$8.53
Rate for Payer: Wellpoint Medicaid Managed Care	$9.38

SEAMGARD

Facility

$354.00

Hospital Charge Code	270335728
Hospital Revenue Code	278
Min. Negotiated Rate	$53.10
Max. Negotiated Rate	$85.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$77.88
Rate for Payer: Qualcare PPO/HMO/WC	$53.10

SEAMGUARD

Facility

$600.00

Hospital Charge Code	270605795
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SEAMGUARD

Facility

$600.00

Hospital Charge Code	270605795
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SEAMGUARD 45MM

Facility

$975.00

Hospital Charge Code	270672594
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

Know your out-of-pocket cost for care.

All Charges