Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SOLCOTRANS ACD-A 18258516

Facility

$119.25

Hospital Charge Code	270605239
Hospital Revenue Code	272
Min. Negotiated Rate	$17.89
Max. Negotiated Rate	$17.89
Rate for Payer: Qualcare PPO/HMO/WC	$17.89

SOLCOTRANS ACD-A 18258516

Facility

$119.25

Hospital Charge Code	270605239
Hospital Revenue Code	272
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$59.62
Rate for Payer: Aetna Commercial	$45.31
Rate for Payer: Aetna Medicare Advantage	$35.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.41
Rate for Payer: Cigna Commercial	$59.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.77
Rate for Payer: Oxford Commercial	$23.85
Rate for Payer: Qualcare PPO/HMO/WC	$17.89
Rate for Payer: UnitedHealthcare Commercial	$23.85
Rate for Payer: UnitedHealthcare Community & State	$2.87
Rate for Payer: Wellpoint Medicaid Managed Care	$3.16

SOLCOTRANS ACD-A ST 1600******

Facility

$18.30

Hospital Charge Code	1603166
Hospital Revenue Code	272
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$9.15
Rate for Payer: Aetna Commercial	$6.95
Rate for Payer: Aetna Medicare Advantage	$5.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.67
Rate for Payer: Cigna Commercial	$9.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.49
Rate for Payer: Oxford Commercial	$3.66
Rate for Payer: Qualcare PPO/HMO/WC	$2.75
Rate for Payer: UnitedHealthcare Commercial	$3.66
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

SOLCOTRANS ACD-A ST 1600******

Facility

$18.30

Hospital Charge Code	1603166
Hospital Revenue Code	272
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$2.75
Rate for Payer: Qualcare PPO/HMO/WC	$2.75

SOLCOTRANS PRE-FILTER ST1250**

Facility

$11.20

Hospital Charge Code	1603174
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.60
Rate for Payer: Aetna Commercial	$4.26
Rate for Payer: Aetna Medicare Advantage	$3.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.86
Rate for Payer: Cigna Commercial	$5.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.36
Rate for Payer: Oxford Commercial	$2.24
Rate for Payer: Qualcare PPO/HMO/WC	$1.68
Rate for Payer: UnitedHealthcare Commercial	$2.24
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

SOLCOTRANS PRE-FILTER ST1250**

Facility

$11.20

Hospital Charge Code	1603174
Hospital Revenue Code	272
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$1.68
Rate for Payer: Qualcare PPO/HMO/WC	$1.68

SOLCOTRANS ST 1000 **********

Facility

$240.50

Hospital Charge Code	1603158
Hospital Revenue Code	272
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$120.25
Rate for Payer: Aetna Commercial	$91.39
Rate for Payer: Aetna Medicare Advantage	$72.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.33
Rate for Payer: Cigna Commercial	$120.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.15
Rate for Payer: Oxford Commercial	$48.10
Rate for Payer: Qualcare PPO/HMO/WC	$36.08
Rate for Payer: UnitedHealthcare Commercial	$48.10
Rate for Payer: UnitedHealthcare Community & State	$5.80
Rate for Payer: Wellpoint Medicaid Managed Care	$6.37

SOLCOTRANS ST 1000 **********

Facility

$240.50

Hospital Charge Code	1603158
Hospital Revenue Code	272
Min. Negotiated Rate	$36.08
Max. Negotiated Rate	$36.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.08

SOLENT OMNI THROMBECTOMY SET

Facility

$8,450.00

Service Code	HCPCS C1757
Hospital Charge Code	270648590C
Hospital Revenue Code	278
Min. Negotiated Rate	$203.65
Max. Negotiated Rate	$4,225.00
Rate for Payer: Aetna Commercial	$3,211.00
Rate for Payer: Aetna Medicare Advantage	$2,535.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,154.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,154.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,154.75
Rate for Payer: Cigna Commercial	$4,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,044.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,859.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,267.50
Rate for Payer: UnitedHealthcare Community & State	$203.65
Rate for Payer: Wellpoint Medicaid Managed Care	$223.93

SOLENT OMNI THROMBECTOMY SET

Facility

$8,450.00

Service Code	HCPCS C1757
Hospital Charge Code	270648590C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,267.50
Max. Negotiated Rate	$2,044.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,044.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,859.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,267.50

SOL FL THD SCR BLNT HD 2.7X18

Facility

$783.75

Service Code	HCPCS C1713
Hospital Charge Code	270701335
Hospital Revenue Code	278
Min. Negotiated Rate	$117.56
Max. Negotiated Rate	$189.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$172.43
Rate for Payer: Qualcare PPO/HMO/WC	$117.56

SOL FL THD SCR BLNT HD 2.7X18

Facility

$783.75

Service Code	HCPCS C1713
Hospital Charge Code	270701335
Hospital Revenue Code	278
Min. Negotiated Rate	$18.89
Max. Negotiated Rate	$391.88
Rate for Payer: Aetna Commercial	$297.82
Rate for Payer: Aetna Medicare Advantage	$235.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.86
Rate for Payer: Cigna Commercial	$391.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$172.43
Rate for Payer: Qualcare PPO/HMO/WC	$117.56
Rate for Payer: UnitedHealthcare Community & State	$18.89
Rate for Payer: Wellpoint Medicaid Managed Care	$20.77

SOLID JOUST 7.2X135

Facility

$5,458.75

Service Code	HCPCS C1713
Hospital Charge Code	270701937
Hospital Revenue Code	278
Min. Negotiated Rate	$818.81
Max. Negotiated Rate	$1,321.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,091.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,321.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,200.92
Rate for Payer: Qualcare PPO/HMO/WC	$818.81

SOLID JOUST 7.2X135

Facility

$5,458.75

Service Code	HCPCS C1713
Hospital Charge Code	270701937
Hospital Revenue Code	278
Min. Negotiated Rate	$131.56
Max. Negotiated Rate	$2,729.38
Rate for Payer: Aetna Commercial	$2,074.32
Rate for Payer: Aetna Medicare Advantage	$1,637.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,391.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,391.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,091.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,391.98
Rate for Payer: Cigna Commercial	$2,729.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,321.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,200.92
Rate for Payer: Qualcare PPO/HMO/WC	$818.81
Rate for Payer: UnitedHealthcare Community & State	$131.56
Rate for Payer: Wellpoint Medicaid Managed Care	$144.66

SOLIDLOK HEX TIP 3.5MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270689271
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SOLIDLOK HEX TIP 3.5MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270689271
Hospital Revenue Code	278
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

SOLID SCREWDRIVER SHANK S-CP

Facility

$605.00

Hospital Charge Code	270686086
Hospital Revenue Code	272
Min. Negotiated Rate	$14.58
Max. Negotiated Rate	$302.50
Rate for Payer: Aetna Commercial	$229.90
Rate for Payer: Aetna Medicare Advantage	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.28
Rate for Payer: Cigna Commercial	$302.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Oxford Commercial	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.75
Rate for Payer: UnitedHealthcare Commercial	$121.00
Rate for Payer: UnitedHealthcare Community & State	$14.58
Rate for Payer: Wellpoint Medicaid Managed Care	$16.03

SOLID SCREWDRIVER SHANK S-CP

Facility

$605.00

Hospital Charge Code	270686086
Hospital Revenue Code	272
Min. Negotiated Rate	$90.75
Max. Negotiated Rate	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$90.75

SOLIUM CHLOR 0.9% IRRIG 3000ml

Facility

$35.00

Hospital Charge Code	270649754
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$17.50
Rate for Payer: Aetna Commercial	$13.30
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.50
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$7.00
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

SOLIUM CHLOR 0.9% IRRIG 3000ml

Facility

$35.00

Hospital Charge Code	270649754
Hospital Revenue Code	272
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

SOLUABLE TRANSFERRING RECEPTOR

Facility

$667.59

Service Code	HCPCS 84238
Hospital Charge Code	39900451
Hospital Revenue Code	301
Min. Negotiated Rate	$17.69
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$99.47
Rate for Payer: Aetna Medicare Advantage	$118.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$36.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.01
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$36.57
Rate for Payer: Clover Medicare Advantage	$34.74
Rate for Payer: EmblemHealth Commercial	$109.71
Rate for Payer: Humana Medicare Advantage	$37.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$36.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$29.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$36.57
Rate for Payer: Wellcare Medicare Advantage	$36.57
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

SOLUABLE TRANSFERRING RECEPTOR

Facility

$667.59

Service Code	HCPCS 84238
Hospital Charge Code	39900451
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

SOLUABLE TRANSFERRIN RECEPTOR

Facility

$253.45

Service Code	HCPCS 84238
Hospital Charge Code	3009165
Hospital Revenue Code	301
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$132.01
Rate for Payer: Aetna Commercial	$99.47
Rate for Payer: Aetna Medicare Advantage	$118.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$36.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.01
Rate for Payer: Cigna Commercial	$126.72
Rate for Payer: Cigna Medicare Advantage	$36.57
Rate for Payer: Clover Medicare Advantage	$34.74
Rate for Payer: EmblemHealth Commercial	$109.71
Rate for Payer: Humana Medicare Advantage	$37.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$36.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.02
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$29.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$36.57
Rate for Payer: Wellcare Medicare Advantage	$36.57
Rate for Payer: Wellpoint Medicaid Managed Care	$6.72

SOLUABLE TRANSFERRIN RECEPTOR

Facility

$253.45

Service Code	HCPCS 84238
Hospital Charge Code	3009165
Hospital Revenue Code	301
Min. Negotiated Rate	$38.02
Max. Negotiated Rate	$38.02
Rate for Payer: Qualcare PPO/HMO/WC	$38.02

SOLUBLE TRANSFERRIN RECEPTOR

Facility

$290.00

Service Code	HCPCS 84238
Hospital Charge Code	38472301
Hospital Revenue Code	301
Min. Negotiated Rate	$7.68
Max. Negotiated Rate	$145.00
Rate for Payer: Aetna Commercial	$99.47
Rate for Payer: Aetna Medicare Advantage	$118.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$36.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.01
Rate for Payer: Cigna Commercial	$145.00
Rate for Payer: Cigna Medicare Advantage	$36.57
Rate for Payer: Clover Medicare Advantage	$34.74
Rate for Payer: EmblemHealth Commercial	$109.71
Rate for Payer: Humana Medicare Advantage	$37.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$36.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$29.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$36.57
Rate for Payer: Wellcare Medicare Advantage	$36.57
Rate for Payer: Wellpoint Medicaid Managed Care	$7.68

Know your out-of-pocket cost for care.

All Charges