Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SHEARS MEDICUT SCISSORS 320-10

Facility

$52.00

Hospital Charge Code	270610065
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

SHEARS MINI 2MM 171305

Facility

$496.85

Hospital Charge Code	270612741
Hospital Revenue Code	272
Min. Negotiated Rate	$11.97
Max. Negotiated Rate	$248.43
Rate for Payer: Aetna Commercial	$188.80
Rate for Payer: Aetna Medicare Advantage	$149.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.70
Rate for Payer: Cigna Commercial	$248.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.06
Rate for Payer: Oxford Commercial	$99.37
Rate for Payer: Qualcare PPO/HMO/WC	$74.53
Rate for Payer: UnitedHealthcare Commercial	$99.37
Rate for Payer: UnitedHealthcare Community & State	$11.97
Rate for Payer: Wellpoint Medicaid Managed Care	$13.17

SHEARS MINI 2MM 171305

Facility

$496.85

Hospital Charge Code	270612741
Hospital Revenue Code	272
Min. Negotiated Rate	$74.53
Max. Negotiated Rate	$74.53
Rate for Payer: Qualcare PPO/HMO/WC	$74.53

SHEARS PISTOL GRIP 5MM LCSK5

Facility

$2,491.25

Hospital Charge Code	270610040
Hospital Revenue Code	272
Min. Negotiated Rate	$373.69
Max. Negotiated Rate	$373.69
Rate for Payer: Qualcare PPO/HMO/WC	$373.69

SHEARS PISTOL GRIP 5MM LCSK5

Facility

$2,491.25

Hospital Charge Code	270610040
Hospital Revenue Code	272
Min. Negotiated Rate	$60.04
Max. Negotiated Rate	$1,245.62
Rate for Payer: Aetna Commercial	$946.67
Rate for Payer: Aetna Medicare Advantage	$747.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$635.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$635.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$635.27
Rate for Payer: Cigna Commercial	$1,245.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$747.38
Rate for Payer: Oxford Commercial	$498.25
Rate for Payer: Qualcare PPO/HMO/WC	$373.69
Rate for Payer: UnitedHealthcare Commercial	$498.25
Rate for Payer: UnitedHealthcare Community & State	$60.04
Rate for Payer: Wellpoint Medicaid Managed Care	$66.02

SHEATH 10FR 30cm

Facility

$380.00

Hospital Charge Code	270634843
Hospital Revenue Code	272
Min. Negotiated Rate	$57.00
Max. Negotiated Rate	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.00

SHEATH 10FR 30cm

Facility

$380.00

Hospital Charge Code	270634843
Hospital Revenue Code	272
Min. Negotiated Rate	$9.16
Max. Negotiated Rate	$190.00
Rate for Payer: Aetna Commercial	$144.40
Rate for Payer: Aetna Medicare Advantage	$114.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.90
Rate for Payer: Cigna Commercial	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.00
Rate for Payer: Oxford Commercial	$76.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.00
Rate for Payer: UnitedHealthcare Commercial	$76.00
Rate for Payer: UnitedHealthcare Community & State	$9.16
Rate for Payer: Wellpoint Medicaid Managed Care	$10.07

SHEATH 12FR PG123000

Facility

$385.00

Hospital Charge Code	270635531
Hospital Revenue Code	272
Min. Negotiated Rate	$57.75
Max. Negotiated Rate	$57.75
Rate for Payer: Qualcare PPO/HMO/WC	$57.75

SHEATH 12FR PG123000

Facility

$385.00

Hospital Charge Code	270635531
Hospital Revenue Code	272
Min. Negotiated Rate	$9.28
Max. Negotiated Rate	$192.50
Rate for Payer: Aetna Commercial	$146.30
Rate for Payer: Aetna Medicare Advantage	$115.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.17
Rate for Payer: Cigna Commercial	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.50
Rate for Payer: Oxford Commercial	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.75
Rate for Payer: UnitedHealthcare Commercial	$77.00
Rate for Payer: UnitedHealthcare Community & State	$9.28
Rate for Payer: Wellpoint Medicaid Managed Care	$10.20

SHEATH 14 FR

Facility

$2,235.00

Service Code	HCPCS C1894
Hospital Charge Code	270681916
Hospital Revenue Code	278
Min. Negotiated Rate	$53.86
Max. Negotiated Rate	$1,117.50
Rate for Payer: Aetna Commercial	$849.30
Rate for Payer: Aetna Medicare Advantage	$670.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$569.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$569.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$447.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$569.92
Rate for Payer: Cigna Commercial	$1,117.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$540.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$491.70
Rate for Payer: Qualcare PPO/HMO/WC	$335.25
Rate for Payer: UnitedHealthcare Community & State	$53.86
Rate for Payer: Wellpoint Medicaid Managed Care	$59.23

SHEATH 14 FR

Facility

$2,235.00

Service Code	HCPCS C1894
Hospital Charge Code	270681916
Hospital Revenue Code	278
Min. Negotiated Rate	$335.25
Max. Negotiated Rate	$540.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$447.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$540.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$491.70
Rate for Payer: Qualcare PPO/HMO/WC	$335.25

SHEATH 18FR ONAL MCVS118 *****

Facility

$360.00

Hospital Charge Code	1608363
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

SHEATH 18FR ONAL MCVS118 *****

Facility

$360.00

Hospital Charge Code	1608363
Hospital Revenue Code	272
Min. Negotiated Rate	$8.68
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$136.80
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.00
Rate for Payer: Oxford Commercial	$72.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$72.00
Rate for Payer: UnitedHealthcare Community & State	$8.68
Rate for Payer: Wellpoint Medicaid Managed Care	$9.54

SHEATH 18FR PG183000

Facility

$615.00

Hospital Charge Code	270635530
Hospital Revenue Code	272
Min. Negotiated Rate	$92.25
Max. Negotiated Rate	$92.25
Rate for Payer: Qualcare PPO/HMO/WC	$92.25

SHEATH 18FR PG183000

Facility

$615.00

Hospital Charge Code	270635530
Hospital Revenue Code	272
Min. Negotiated Rate	$14.82
Max. Negotiated Rate	$307.50
Rate for Payer: Aetna Commercial	$233.70
Rate for Payer: Aetna Medicare Advantage	$184.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.82
Rate for Payer: Cigna Commercial	$307.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.50
Rate for Payer: Oxford Commercial	$123.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.25
Rate for Payer: UnitedHealthcare Commercial	$123.00
Rate for Payer: UnitedHealthcare Community & State	$14.82
Rate for Payer: Wellpoint Medicaid Managed Care	$16.30

SHEATH 21FR SACHSE URETHROTOME

Facility

$5,360.00

Hospital Charge Code	270644827
Hospital Revenue Code	272
Min. Negotiated Rate	$129.18
Max. Negotiated Rate	$2,680.00
Rate for Payer: Aetna Commercial	$2,036.80
Rate for Payer: Aetna Medicare Advantage	$1,608.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,366.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,366.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,366.80
Rate for Payer: Cigna Commercial	$2,680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,608.00
Rate for Payer: Oxford Commercial	$1,072.00
Rate for Payer: Qualcare PPO/HMO/WC	$804.00
Rate for Payer: UnitedHealthcare Commercial	$1,072.00
Rate for Payer: UnitedHealthcare Community & State	$129.18
Rate for Payer: Wellpoint Medicaid Managed Care	$142.04

SHEATH 21FR SACHSE URETHROTOME

Facility

$5,360.00

Hospital Charge Code	270644827
Hospital Revenue Code	272
Min. Negotiated Rate	$804.00
Max. Negotiated Rate	$804.00
Rate for Payer: Qualcare PPO/HMO/WC	$804.00

SHEATH 33mm ENDOSCOPIC STAPLER

Facility

$1,422.65

Hospital Charge Code	270630330
Hospital Revenue Code	272
Min. Negotiated Rate	$34.29
Max. Negotiated Rate	$711.33
Rate for Payer: Aetna Commercial	$540.61
Rate for Payer: Aetna Medicare Advantage	$426.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$362.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$362.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$362.78
Rate for Payer: Cigna Commercial	$711.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$426.80
Rate for Payer: Oxford Commercial	$284.53
Rate for Payer: Qualcare PPO/HMO/WC	$213.40
Rate for Payer: UnitedHealthcare Commercial	$284.53
Rate for Payer: UnitedHealthcare Community & State	$34.29
Rate for Payer: Wellpoint Medicaid Managed Care	$37.70

SHEATH 33mm ENDOSCOPIC STAPLER

Facility

$1,422.65

Hospital Charge Code	270630330
Hospital Revenue Code	272
Min. Negotiated Rate	$213.40
Max. Negotiated Rate	$213.40
Rate for Payer: Qualcare PPO/HMO/WC	$213.40

SHEATH 6.5FR 12CM 0.038 50CM

Facility

$40.00

Hospital Charge Code	270661685
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.00
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

SHEATH 6.5FR 12CM 0.038 50CM

Facility

$40.00

Hospital Charge Code	270661685
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

SHEATH 6F 088 NEURON MAX LONG

Facility

$2,475.00

Hospital Charge Code	270684222
Hospital Revenue Code	272
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$742.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

SHEATH 6F 088 NEURON MAX LONG

Facility

$2,475.00

Hospital Charge Code	270684222
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

SHEATH 6FR 45CM

Facility

$251.50

Hospital Charge Code	270667642
Hospital Revenue Code	272
Min. Negotiated Rate	$37.73
Max. Negotiated Rate	$37.73
Rate for Payer: Qualcare PPO/HMO/WC	$37.73

SHEATH 6FR 45CM

Facility

$350.00

Hospital Charge Code	270667642N
Hospital Revenue Code	272
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

Know your out-of-pocket cost for care.

All Charges