Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SHELL MALLORY RADIAL 12104160

Facility

$6,477.85

Hospital Charge Code	270631108
Hospital Revenue Code	278
Min. Negotiated Rate	$156.12
Max. Negotiated Rate	$3,238.93
Rate for Payer: Aetna Commercial	$2,461.58
Rate for Payer: Aetna Medicare Advantage	$1,943.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.85
Rate for Payer: Cigna Commercial	$3,238.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,567.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,425.13
Rate for Payer: Qualcare PPO/HMO/WC	$971.68
Rate for Payer: UnitedHealthcare Community & State	$156.12
Rate for Payer: Wellpoint Medicaid Managed Care	$171.66

SHELL MALLORY RADIAL 12104160

Facility

$6,477.85

Hospital Charge Code	270631108
Hospital Revenue Code	278
Min. Negotiated Rate	$971.68
Max. Negotiated Rate	$1,567.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,567.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,425.13
Rate for Payer: Qualcare PPO/HMO/WC	$971.68

SHELL MALLORY RADIAL 3HOL 50mm

Facility

$6,530.00

Hospital Charge Code	270638890
Hospital Revenue Code	278
Min. Negotiated Rate	$157.37
Max. Negotiated Rate	$3,265.00
Rate for Payer: Aetna Commercial	$2,481.40
Rate for Payer: Aetna Medicare Advantage	$1,959.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,665.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,665.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,665.15
Rate for Payer: Cigna Commercial	$3,265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,580.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,436.60
Rate for Payer: Qualcare PPO/HMO/WC	$979.50
Rate for Payer: UnitedHealthcare Community & State	$157.37
Rate for Payer: Wellpoint Medicaid Managed Care	$173.04

SHELL MALLORY RADIAL 3HOL 50mm

Facility

$6,530.00

Hospital Charge Code	270638890
Hospital Revenue Code	278
Min. Negotiated Rate	$979.50
Max. Negotiated Rate	$1,580.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,580.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,436.60
Rate for Payer: Qualcare PPO/HMO/WC	$979.50

SHELL MALLORY RADIAL 3HOL 52mm

Facility

$6,530.00

Hospital Charge Code	270633517
Hospital Revenue Code	278
Min. Negotiated Rate	$157.37
Max. Negotiated Rate	$3,265.00
Rate for Payer: Aetna Commercial	$2,481.40
Rate for Payer: Aetna Medicare Advantage	$1,959.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,665.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,665.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,665.15
Rate for Payer: Cigna Commercial	$3,265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,580.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,436.60
Rate for Payer: Qualcare PPO/HMO/WC	$979.50
Rate for Payer: UnitedHealthcare Community & State	$157.37
Rate for Payer: Wellpoint Medicaid Managed Care	$173.04

SHELL MALLORY RADIAL 3HOL 52mm

Facility

$6,530.00

Hospital Charge Code	270633517
Hospital Revenue Code	278
Min. Negotiated Rate	$979.50
Max. Negotiated Rate	$1,580.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,580.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,436.60
Rate for Payer: Qualcare PPO/HMO/WC	$979.50

SHELL MALLORY RADIAL 3HOL 58mm

Facility

$6,477.85

Hospital Charge Code	270633497
Hospital Revenue Code	278
Min. Negotiated Rate	$971.68
Max. Negotiated Rate	$1,567.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,567.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,425.13
Rate for Payer: Qualcare PPO/HMO/WC	$971.68

SHELL MALLORY RADIAL 3HOL 58mm

Facility

$6,477.85

Hospital Charge Code	270633497
Hospital Revenue Code	278
Min. Negotiated Rate	$156.12
Max. Negotiated Rate	$3,238.93
Rate for Payer: Aetna Commercial	$2,461.58
Rate for Payer: Aetna Medicare Advantage	$1,943.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.85
Rate for Payer: Cigna Commercial	$3,238.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,567.64
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,425.13
Rate for Payer: Qualcare PPO/HMO/WC	$971.68
Rate for Payer: UnitedHealthcare Community & State	$156.12
Rate for Payer: Wellpoint Medicaid Managed Care	$171.66

SHELL MALY RADL 3H 54 12104154

Facility

$6,530.00

Hospital Charge Code	270632929
Hospital Revenue Code	278
Min. Negotiated Rate	$979.50
Max. Negotiated Rate	$1,580.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,580.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,436.60
Rate for Payer: Qualcare PPO/HMO/WC	$979.50

SHELL MALY RADL 3H 54 12104154

Facility

$6,530.00

Hospital Charge Code	270632929
Hospital Revenue Code	278
Min. Negotiated Rate	$157.37
Max. Negotiated Rate	$3,265.00
Rate for Payer: Aetna Commercial	$2,481.40
Rate for Payer: Aetna Medicare Advantage	$1,959.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,665.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,665.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,665.15
Rate for Payer: Cigna Commercial	$3,265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,580.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,436.60
Rate for Payer: Qualcare PPO/HMO/WC	$979.50
Rate for Payer: UnitedHealthcare Community & State	$157.37
Rate for Payer: Wellpoint Medicaid Managed Care	$173.04

SHELL MET DUR 0100214158

Facility

$15,476.00

Hospital Charge Code	270638549
Hospital Revenue Code	278
Min. Negotiated Rate	$372.97
Max. Negotiated Rate	$7,738.00
Rate for Payer: Aetna Commercial	$5,880.88
Rate for Payer: Aetna Medicare Advantage	$4,642.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,946.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,946.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,095.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,946.38
Rate for Payer: Cigna Commercial	$7,738.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,745.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,404.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.40
Rate for Payer: UnitedHealthcare Community & State	$372.97
Rate for Payer: Wellpoint Medicaid Managed Care	$410.11

SHELL MET DUR 0100214158

Facility

$15,476.00

Hospital Charge Code	270638549
Hospital Revenue Code	278
Min. Negotiated Rate	$2,321.40
Max. Negotiated Rate	$3,745.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,095.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,745.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,404.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.40

SHELL MPACT DM ACETABULAR 056

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270694236
Hospital Revenue Code	278
Min. Negotiated Rate	$241.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$241.00
Rate for Payer: Wellpoint Medicaid Managed Care	$265.00

SHELL MPACT DM ACETABULAR 056

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270694236
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

SHELL MULTIPOLAR BIPOLAR

Facility

$2,255.00

Hospital Charge Code	270658834
Hospital Revenue Code	278
Min. Negotiated Rate	$54.35
Max. Negotiated Rate	$1,127.50
Rate for Payer: Aetna Commercial	$856.90
Rate for Payer: Aetna Medicare Advantage	$676.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$575.02
Rate for Payer: Cigna Commercial	$1,127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25
Rate for Payer: UnitedHealthcare Community & State	$54.35
Rate for Payer: Wellpoint Medicaid Managed Care	$59.76

SHELL MULTIPOLAR BIPOLAR

Facility

$2,255.00

Hospital Charge Code	270658834
Hospital Revenue Code	278
Min. Negotiated Rate	$338.25
Max. Negotiated Rate	$545.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$338.25

SHELL OSSEOTI MUTLI HOLE 60

Facility

$18,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270686593
Hospital Revenue Code	278
Min. Negotiated Rate	$2,848.50
Max. Negotiated Rate	$4,595.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,798.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,595.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,177.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,848.50

SHELL OSSEOTI MUTLI HOLE 60

Facility

$18,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270686593
Hospital Revenue Code	278
Min. Negotiated Rate	$457.66
Max. Negotiated Rate	$9,495.00
Rate for Payer: Aetna Commercial	$7,216.20
Rate for Payer: Aetna Medicare Advantage	$5,697.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,842.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,842.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,842.45
Rate for Payer: Cigna Commercial	$9,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,595.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,177.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,848.50
Rate for Payer: UnitedHealthcare Community & State	$457.66
Rate for Payer: Wellpoint Medicaid Managed Care	$503.24

SHELL OSSEOT MULT HOLE 48MMSZC

Facility

$18,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270695251
Hospital Revenue Code	278
Min. Negotiated Rate	$2,848.50
Max. Negotiated Rate	$4,595.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,798.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,595.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,177.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,848.50

SHELL OSSEOT MULT HOLE 48MMSZC

Facility

$18,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270695251
Hospital Revenue Code	278
Min. Negotiated Rate	$457.66
Max. Negotiated Rate	$9,495.00
Rate for Payer: Aetna Commercial	$7,216.20
Rate for Payer: Aetna Medicare Advantage	$5,697.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,842.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,842.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,842.45
Rate for Payer: Cigna Commercial	$9,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,595.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,177.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,848.50
Rate for Payer: UnitedHealthcare Community & State	$457.66
Rate for Payer: Wellpoint Medicaid Managed Care	$503.24

SHELL PPS LTD ACET 52 E

Facility

$6,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690468
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,430.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

SHELL PPS LTD ACET 52 E

Facility

$6,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690468
Hospital Revenue Code	278
Min. Negotiated Rate	$156.65
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$2,470.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,430.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Community & State	$156.65
Rate for Payer: Wellpoint Medicaid Managed Care	$172.25

SHELLQUADPRIMEBFPROCOTYL50MM

Facility

$14,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270697653
Hospital Revenue Code	278
Min. Negotiated Rate	$2,160.00
Max. Negotiated Rate	$3,484.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,484.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,168.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,160.00

SHELLQUADPRIMEBFPROCOTYL50MM

Facility

$14,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270697653
Hospital Revenue Code	278
Min. Negotiated Rate	$347.04
Max. Negotiated Rate	$7,200.00
Rate for Payer: Aetna Commercial	$5,472.00
Rate for Payer: Aetna Medicare Advantage	$4,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,672.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,672.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,880.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,672.00
Rate for Payer: Cigna Commercial	$7,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,484.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,168.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,160.00
Rate for Payer: UnitedHealthcare Community & State	$347.04
Rate for Payer: Wellpoint Medicaid Managed Care	$381.60

SHELL RAD 3HOL 56mm 12-104156

Facility

$6,477.65

Hospital Charge Code	270630536
Hospital Revenue Code	278
Min. Negotiated Rate	$156.11
Max. Negotiated Rate	$3,238.82
Rate for Payer: Aetna Commercial	$2,461.51
Rate for Payer: Aetna Medicare Advantage	$1,943.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.80
Rate for Payer: Cigna Commercial	$3,238.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,567.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,425.08
Rate for Payer: Qualcare PPO/HMO/WC	$971.65
Rate for Payer: UnitedHealthcare Community & State	$156.11
Rate for Payer: Wellpoint Medicaid Managed Care	$171.66

Know your out-of-pocket cost for care.

All Charges