Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SLIM TIP DRG LEAD TRIAL KIT

Facility

$35,500.00

Service Code	HCPCS C1897
Hospital Charge Code	270697674
Hospital Revenue Code	278
Min. Negotiated Rate	$855.55
Max. Negotiated Rate	$17,750.00
Rate for Payer: Aetna Commercial	$13,490.00
Rate for Payer: Aetna Medicare Advantage	$10,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,052.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,052.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,052.50
Rate for Payer: Cigna Commercial	$17,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,591.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,810.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,325.00
Rate for Payer: UnitedHealthcare Community & State	$855.55
Rate for Payer: Wellpoint Medicaid Managed Care	$940.75

SLIM TIP DRG LEAD TRIAL KIT

Facility

$35,500.00

Service Code	HCPCS C1897
Hospital Charge Code	270697674
Hospital Revenue Code	278
Min. Negotiated Rate	$5,325.00
Max. Negotiated Rate	$8,591.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,591.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,810.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,325.00

SLING ALTIS SNGL INCISION SYST

Facility

$6,975.00

Service Code	HCPCS C1771
Hospital Charge Code	270676744
Hospital Revenue Code	278
Min. Negotiated Rate	$168.10
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,650.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,534.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Community & State	$168.10
Rate for Payer: Wellpoint Medicaid Managed Care	$184.84

SLING ALTIS SNGL INCISION SYST

Facility

$6,975.00

Service Code	HCPCS C1771
Hospital Charge Code	270676744
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,534.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

SLING ARM LARGE

Facility

$7.55

Hospital Charge Code	270649357
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$1.13

SLING ARM LARGE

Facility

$7.55

Hospital Charge Code	270649357
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.77
Rate for Payer: Aetna Commercial	$2.87
Rate for Payer: Aetna Medicare Advantage	$2.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.93
Rate for Payer: Cigna Commercial	$3.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.27
Rate for Payer: Oxford Commercial	$1.51
Rate for Payer: Qualcare PPO/HMO/WC	$1.13
Rate for Payer: UnitedHealthcare Commercial	$1.51
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

SLING ARM MEDIUM

Facility

$7.55

Hospital Charge Code	270649358
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$1.13

SLING ARM MEDIUM

Facility

$7.55

Hospital Charge Code	270649358
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.77
Rate for Payer: Aetna Commercial	$2.87
Rate for Payer: Aetna Medicare Advantage	$2.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.93
Rate for Payer: Cigna Commercial	$3.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.27
Rate for Payer: Oxford Commercial	$1.51
Rate for Payer: Qualcare PPO/HMO/WC	$1.13
Rate for Payer: UnitedHealthcare Commercial	$1.51
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

SLING ARM SMALL

Facility

$7.55

Hospital Charge Code	270649359
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$1.13

SLING ARM SMALL

Facility

$7.55

Hospital Charge Code	270649359
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.77
Rate for Payer: Aetna Commercial	$2.87
Rate for Payer: Aetna Medicare Advantage	$2.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.93
Rate for Payer: Cigna Commercial	$3.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.27
Rate for Payer: Oxford Commercial	$1.51
Rate for Payer: Qualcare PPO/HMO/WC	$1.13
Rate for Payer: UnitedHealthcare Commercial	$1.51
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

SLING ARM X-LARGE

Facility

$7.55

Hospital Charge Code	270649360
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.77
Rate for Payer: Aetna Commercial	$2.87
Rate for Payer: Aetna Medicare Advantage	$2.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.93
Rate for Payer: Cigna Commercial	$3.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.27
Rate for Payer: Oxford Commercial	$1.51
Rate for Payer: Qualcare PPO/HMO/WC	$1.13
Rate for Payer: UnitedHealthcare Commercial	$1.51
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

SLING ARM X-LARGE

Facility

$7.55

Hospital Charge Code	270649360
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$1.13

SLING COMFORT ******

Facility

$11.00

Hospital Charge Code	8001570
Hospital Revenue Code	279
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.50
Rate for Payer: Aetna Commercial	$4.18
Rate for Payer: Aetna Medicare Advantage	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.81
Rate for Payer: Cigna Commercial	$5.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.30
Rate for Payer: Oxford Commercial	$2.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.65
Rate for Payer: UnitedHealthcare Commercial	$2.20
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

SLING COMFORT ******

Facility

$11.00

Hospital Charge Code	8001570
Hospital Revenue Code	279
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

SLING ELEVATE ANTERIOR

Facility

$12,620.00

Hospital Charge Code	270676778
Hospital Revenue Code	278
Min. Negotiated Rate	$304.14
Max. Negotiated Rate	$6,310.00
Rate for Payer: Aetna Commercial	$4,795.60
Rate for Payer: Aetna Medicare Advantage	$3,786.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,218.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,218.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,524.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,218.10
Rate for Payer: Cigna Commercial	$6,310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,054.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,776.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,893.00
Rate for Payer: UnitedHealthcare Community & State	$304.14
Rate for Payer: Wellpoint Medicaid Managed Care	$334.43

SLING ELEVATE ANTERIOR

Facility

$12,620.00

Hospital Charge Code	270676778
Hospital Revenue Code	278
Min. Negotiated Rate	$1,893.00
Max. Negotiated Rate	$3,054.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,524.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,054.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,776.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,893.00

SLING HEMI SHOULDR LT LG C6152

Facility

$198.45

Hospital Charge Code	270629657
Hospital Revenue Code	270
Min. Negotiated Rate	$29.77
Max. Negotiated Rate	$29.77
Rate for Payer: Qualcare PPO/HMO/WC	$29.77

SLING HEMI SHOULDR LT LG C6152

Facility

$198.45

Hospital Charge Code	270629657
Hospital Revenue Code	270
Min. Negotiated Rate	$4.78
Max. Negotiated Rate	$99.22
Rate for Payer: Aetna Commercial	$75.41
Rate for Payer: Aetna Medicare Advantage	$59.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.60
Rate for Payer: Cigna Commercial	$99.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.53
Rate for Payer: Oxford Commercial	$39.69
Rate for Payer: Qualcare PPO/HMO/WC	$29.77
Rate for Payer: UnitedHealthcare Commercial	$39.69
Rate for Payer: UnitedHealthcare Community & State	$4.78
Rate for Payer: Wellpoint Medicaid Managed Care	$5.26

SLING INFL INFAST 788530

Facility

$1,484.00

Hospital Charge Code	270611027
Hospital Revenue Code	270
Min. Negotiated Rate	$222.60
Max. Negotiated Rate	$222.60
Rate for Payer: Qualcare PPO/HMO/WC	$222.60

SLING INFL INFAST 788530

Facility

$1,484.00

Hospital Charge Code	270611027
Hospital Revenue Code	270
Min. Negotiated Rate	$35.76
Max. Negotiated Rate	$742.00
Rate for Payer: Aetna Commercial	$563.92
Rate for Payer: Aetna Medicare Advantage	$445.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$378.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$378.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$378.42
Rate for Payer: Cigna Commercial	$742.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$445.20
Rate for Payer: Oxford Commercial	$296.80
Rate for Payer: Qualcare PPO/HMO/WC	$222.60
Rate for Payer: UnitedHealthcare Commercial	$296.80
Rate for Payer: UnitedHealthcare Community & State	$35.76
Rate for Payer: Wellpoint Medicaid Managed Care	$39.33

SLING LARGE

Facility

$10.28

Hospital Charge Code	270302915
Hospital Revenue Code	271
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.14
Rate for Payer: Aetna Commercial	$3.91
Rate for Payer: Aetna Medicare Advantage	$3.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.62
Rate for Payer: Cigna Commercial	$5.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.08
Rate for Payer: Oxford Commercial	$2.06
Rate for Payer: Qualcare PPO/HMO/WC	$1.54
Rate for Payer: UnitedHealthcare Commercial	$2.06
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

SLING LARGE

Facility

$10.28

Hospital Charge Code	270302915
Hospital Revenue Code	271
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.54

SLING MALE XP SYS

Facility

$35,975.00

Service Code	HCPCS C1771
Hospital Charge Code	270690092
Hospital Revenue Code	278
Min. Negotiated Rate	$867.00
Max. Negotiated Rate	$17,987.50
Rate for Payer: Aetna Commercial	$13,670.50
Rate for Payer: Aetna Medicare Advantage	$10,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,173.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,173.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,173.62
Rate for Payer: Cigna Commercial	$17,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,705.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,914.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,396.25
Rate for Payer: UnitedHealthcare Community & State	$867.00
Rate for Payer: Wellpoint Medicaid Managed Care	$953.34

SLING MALE XP SYS

Facility

$35,975.00

Service Code	HCPCS C1771
Hospital Charge Code	270690092
Hospital Revenue Code	278
Min. Negotiated Rate	$5,396.25
Max. Negotiated Rate	$8,705.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,705.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,914.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,396.25

SLING MCV TISSUE 2X4 820240

Facility

$2,681.65

Hospital Charge Code	270618554
Hospital Revenue Code	278
Min. Negotiated Rate	$64.63
Max. Negotiated Rate	$1,340.83
Rate for Payer: Aetna Commercial	$1,019.03
Rate for Payer: Aetna Medicare Advantage	$804.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$683.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$683.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$536.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$683.82
Rate for Payer: Cigna Commercial	$1,340.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$589.96
Rate for Payer: Qualcare PPO/HMO/WC	$402.25
Rate for Payer: UnitedHealthcare Community & State	$64.63
Rate for Payer: Wellpoint Medicaid Managed Care	$71.06

Know your out-of-pocket cost for care.

All Charges