Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SNARE SENSATION MICRO OVAL

Facility

$72.50

Hospital Charge Code	270654281
Hospital Revenue Code	272
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$10.88
Rate for Payer: Qualcare PPO/HMO/WC	$10.88

SNARE SENSATION OVAL LRG

Facility

$83.68

Hospital Charge Code	270676243
Hospital Revenue Code	272
Min. Negotiated Rate	$12.55
Max. Negotiated Rate	$12.55
Rate for Payer: Qualcare PPO/HMO/WC	$12.55

SNARE SENSATION OVAL LRG

Facility

$83.68

Hospital Charge Code	270676243
Hospital Revenue Code	272
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$41.84
Rate for Payer: Aetna Commercial	$31.80
Rate for Payer: Aetna Medicare Advantage	$25.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.34
Rate for Payer: Cigna Commercial	$41.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.10
Rate for Payer: Oxford Commercial	$16.74
Rate for Payer: Qualcare PPO/HMO/WC	$12.55
Rate for Payer: UnitedHealthcare Commercial	$16.74
Rate for Payer: UnitedHealthcare Community & State	$2.02
Rate for Payer: Wellpoint Medicaid Managed Care	$2.22

SNARE SENSATION STANDARD OVAL

Facility

$72.50

Service Code	HCPCS C1773
Hospital Charge Code	270603903
Hospital Revenue Code	278
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$17.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.95
Rate for Payer: Qualcare PPO/HMO/WC	$10.88

SNARE SENSATION STANDARD OVAL

Facility

$72.50

Service Code	HCPCS C1773
Hospital Charge Code	270603903
Hospital Revenue Code	278
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$36.25
Rate for Payer: Aetna Commercial	$27.55
Rate for Payer: Aetna Medicare Advantage	$21.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.49
Rate for Payer: Cigna Commercial	$36.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.95
Rate for Payer: Qualcare PPO/HMO/WC	$10.88
Rate for Payer: UnitedHealthcare Community & State	$1.75
Rate for Payer: Wellpoint Medicaid Managed Care	$1.92

SNARE WC 3.0 X 6.0 AS-1-MA

Facility

$112.00

Hospital Charge Code	270624934
Hospital Revenue Code	272
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$16.80

SNARE WC 3.0 X 6.0 AS-1-MA

Facility

$112.00

Hospital Charge Code	270624934
Hospital Revenue Code	272
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$56.00
Rate for Payer: Aetna Commercial	$42.56
Rate for Payer: Aetna Medicare Advantage	$33.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.56
Rate for Payer: Cigna Commercial	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.60
Rate for Payer: Oxford Commercial	$22.40
Rate for Payer: Qualcare PPO/HMO/WC	$16.80
Rate for Payer: UnitedHealthcare Commercial	$22.40
Rate for Payer: UnitedHealthcare Community & State	$2.70
Rate for Payer: Wellpoint Medicaid Managed Care	$2.97

SNARE WC MINI OVAL ASM-1

Facility

$72.00

Hospital Charge Code	270623498
Hospital Revenue Code	272
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

SNARE WC MINI OVAL ASM-1

Facility

$72.00

Hospital Charge Code	270623498
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$36.00
Rate for Payer: Aetna Commercial	$27.36
Rate for Payer: Aetna Medicare Advantage	$21.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.36
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.60
Rate for Payer: Oxford Commercial	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$14.40
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

SNARE WC STD OVAL AS-1

Facility

$86.00

Hospital Charge Code	270623499
Hospital Revenue Code	272
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$43.00
Rate for Payer: Aetna Commercial	$32.68
Rate for Payer: Aetna Medicare Advantage	$25.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.93
Rate for Payer: Cigna Commercial	$43.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.80
Rate for Payer: Oxford Commercial	$17.20
Rate for Payer: Qualcare PPO/HMO/WC	$12.90
Rate for Payer: UnitedHealthcare Commercial	$17.20
Rate for Payer: UnitedHealthcare Community & State	$2.07
Rate for Payer: Wellpoint Medicaid Managed Care	$2.28

SNARE WC STD OVAL AS-1

Facility

$86.00

Hospital Charge Code	270623499
Hospital Revenue Code	272
Min. Negotiated Rate	$12.90
Max. Negotiated Rate	$12.90
Rate for Payer: Qualcare PPO/HMO/WC	$12.90

S&N CAP-FI

Facility

$2,749.95

Hospital Charge Code	270704951
Hospital Revenue Code	279
Min. Negotiated Rate	$66.27
Max. Negotiated Rate	$1,374.97
Rate for Payer: Aetna Commercial	$1,044.98
Rate for Payer: Aetna Medicare Advantage	$824.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.24
Rate for Payer: Cigna Commercial	$1,374.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$824.99
Rate for Payer: Oxford Commercial	$549.99
Rate for Payer: Qualcare PPO/HMO/WC	$412.49
Rate for Payer: UnitedHealthcare Commercial	$549.99
Rate for Payer: UnitedHealthcare Community & State	$66.27
Rate for Payer: Wellpoint Medicaid Managed Care	$72.87

S&N CAP-FI

Facility

$2,749.95

Hospital Charge Code	270704951
Hospital Revenue Code	279
Min. Negotiated Rate	$412.49
Max. Negotiated Rate	$412.49
Rate for Payer: Qualcare PPO/HMO/WC	$412.49

SNT PRTG EFLX PRB35-07-030-120

Facility

$4,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270644086N
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$1,179.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

SNT PRTG EFLX PRB35-07-030-120

Facility

$4,500.00

Service Code	HCPCS C1876
Hospital Charge Code	270644086C
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

SNT PRTG EFLX PRB35-07-030-120

Facility

$4,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270644086N
Hospital Revenue Code	278
Min. Negotiated Rate	$117.49
Max. Negotiated Rate	$2,437.50
Rate for Payer: Aetna Commercial	$1,852.50
Rate for Payer: Aetna Medicare Advantage	$1,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,243.12
Rate for Payer: Cigna Commercial	$2,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25
Rate for Payer: UnitedHealthcare Community & State	$117.49
Rate for Payer: Wellpoint Medicaid Managed Care	$129.19

SNT PRTG EFLX PRB35-07-030-120

Facility

$4,500.00

Service Code	HCPCS C1876
Hospital Charge Code	270644086C
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

SNT PRTG EFLX PRB35-08-030-120

Facility

$4,500.00

Service Code	HCPCS C1876
Hospital Charge Code	270644087C
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

SNT PRTG EFLX PRB35-08-030-120

Facility

$4,500.00

Service Code	HCPCS C1876
Hospital Charge Code	270644087C
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

SNT PRTG EFLX PRB35-08-030-120

Facility

$4,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270644087N
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$1,179.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

SNT PRTG EFLX PRB35-08-030-120

Facility

$4,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270644087N
Hospital Revenue Code	278
Min. Negotiated Rate	$117.49
Max. Negotiated Rate	$2,437.50
Rate for Payer: Aetna Commercial	$1,852.50
Rate for Payer: Aetna Medicare Advantage	$1,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,243.12
Rate for Payer: Cigna Commercial	$2,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25
Rate for Payer: UnitedHealthcare Community & State	$117.49
Rate for Payer: Wellpoint Medicaid Managed Care	$129.19

SOAP CASTILE ENE 2/3 OZ

Facility

$2.45

Hospital Charge Code	270302000
Hospital Revenue Code	270
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$0.93
Rate for Payer: Aetna Medicare Advantage	$0.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.62
Rate for Payer: Cigna Commercial	$1.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.74
Rate for Payer: Oxford Commercial	$0.49
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$0.49
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

SOAP CASTILE ENE 2/3 OZ

Facility

$2.45

Hospital Charge Code	270302000
Hospital Revenue Code	270
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

SOCK ARTHROSCOPY SPEC

Facility

$4.27

Hospital Charge Code	2707601227
Hospital Revenue Code	272
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.13
Rate for Payer: Aetna Commercial	$1.62
Rate for Payer: Aetna Medicare Advantage	$1.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.09
Rate for Payer: Cigna Commercial	$2.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.28
Rate for Payer: Oxford Commercial	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.64
Rate for Payer: UnitedHealthcare Commercial	$0.85
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

SOCK ARTHROSCOPY SPEC

Facility

$4.27

Hospital Charge Code	2707601227
Hospital Revenue Code	272
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$0.64
Rate for Payer: Qualcare PPO/HMO/WC	$0.64

Know your out-of-pocket cost for care.

All Charges