Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STAPLER ENDOPATH ECHELON FX 60

Facility

$859.17

Hospital Charge Code	270669515
Hospital Revenue Code	272
Min. Negotiated Rate	$20.71
Max. Negotiated Rate	$429.58
Rate for Payer: Aetna Commercial	$326.48
Rate for Payer: Aetna Medicare Advantage	$257.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.09
Rate for Payer: Cigna Commercial	$429.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.75
Rate for Payer: Oxford Commercial	$171.83
Rate for Payer: Qualcare PPO/HMO/WC	$128.88
Rate for Payer: UnitedHealthcare Commercial	$171.83
Rate for Payer: UnitedHealthcare Community & State	$20.71
Rate for Payer: Wellpoint Medicaid Managed Care	$22.77

STAPLER ENDO ROTIC MINI 174309

Facility

$746.45

Hospital Charge Code	270600109
Hospital Revenue Code	272
Min. Negotiated Rate	$17.99
Max. Negotiated Rate	$373.23
Rate for Payer: Aetna Commercial	$283.65
Rate for Payer: Aetna Medicare Advantage	$223.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$190.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$190.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$190.34
Rate for Payer: Cigna Commercial	$373.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.94
Rate for Payer: Oxford Commercial	$149.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.97
Rate for Payer: UnitedHealthcare Commercial	$149.29
Rate for Payer: UnitedHealthcare Community & State	$17.99
Rate for Payer: Wellpoint Medicaid Managed Care	$19.78

STAPLER ENDO ROTIC MINI 174309

Facility

$746.45

Hospital Charge Code	270600109
Hospital Revenue Code	272
Min. Negotiated Rate	$111.97
Max. Negotiated Rate	$111.97
Rate for Payer: Qualcare PPO/HMO/WC	$111.97

STAPLER ENDO TA ********

Facility

$12.00

Hospital Charge Code	1605856
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

STAPLER ENDO TA ********

Facility

$12.00

Hospital Charge Code	1605856
Hospital Revenue Code	272
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

STAPLER ENDO TA 30 2.5 010901

Facility

$2,323.25

Hospital Charge Code	270600126
Hospital Revenue Code	272
Min. Negotiated Rate	$55.99
Max. Negotiated Rate	$1,161.62
Rate for Payer: Aetna Commercial	$882.84
Rate for Payer: Aetna Medicare Advantage	$696.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.43
Rate for Payer: Cigna Commercial	$1,161.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$696.98
Rate for Payer: Oxford Commercial	$464.65
Rate for Payer: Qualcare PPO/HMO/WC	$348.49
Rate for Payer: UnitedHealthcare Commercial	$464.65
Rate for Payer: UnitedHealthcare Community & State	$55.99
Rate for Payer: Wellpoint Medicaid Managed Care	$61.57

STAPLER ENDO TA 30 2.5 010901

Facility

$2,323.25

Hospital Charge Code	270600126
Hospital Revenue Code	272
Min. Negotiated Rate	$348.49
Max. Negotiated Rate	$348.49
Rate for Payer: Qualcare PPO/HMO/WC	$348.49

STAPLER ENDO TA-30 2.5 MF WHT

Facility

$425.87

Hospital Charge Code	270658617
Hospital Revenue Code	272
Min. Negotiated Rate	$10.26
Max. Negotiated Rate	$212.94
Rate for Payer: Aetna Commercial	$161.83
Rate for Payer: Aetna Medicare Advantage	$127.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.60
Rate for Payer: Cigna Commercial	$212.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.76
Rate for Payer: Oxford Commercial	$85.17
Rate for Payer: Qualcare PPO/HMO/WC	$63.88
Rate for Payer: UnitedHealthcare Commercial	$85.17
Rate for Payer: UnitedHealthcare Community & State	$10.26
Rate for Payer: Wellpoint Medicaid Managed Care	$11.29

STAPLER ENDO TA-30 2.5 MF WHT

Facility

$425.87

Hospital Charge Code	270658617
Hospital Revenue Code	272
Min. Negotiated Rate	$63.88
Max. Negotiated Rate	$63.88
Rate for Payer: Qualcare PPO/HMO/WC	$63.88

STAPLER ENDO TA 30 3.5 010903

Facility

$2,323.25

Hospital Charge Code	270600128
Hospital Revenue Code	272
Min. Negotiated Rate	$55.99
Max. Negotiated Rate	$1,161.62
Rate for Payer: Aetna Commercial	$882.84
Rate for Payer: Aetna Medicare Advantage	$696.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.43
Rate for Payer: Cigna Commercial	$1,161.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$696.98
Rate for Payer: Oxford Commercial	$464.65
Rate for Payer: Qualcare PPO/HMO/WC	$348.49
Rate for Payer: UnitedHealthcare Commercial	$464.65
Rate for Payer: UnitedHealthcare Community & State	$55.99
Rate for Payer: Wellpoint Medicaid Managed Care	$61.57

STAPLER ENDO TA 30 3.5 010903

Facility

$2,323.25

Hospital Charge Code	270600128
Hospital Revenue Code	272
Min. Negotiated Rate	$348.49
Max. Negotiated Rate	$348.49
Rate for Payer: Qualcare PPO/HMO/WC	$348.49

STAPLER ENDO UNI 65 4.8 173052

Facility

$940.40

Hospital Charge Code	270600084
Hospital Revenue Code	272
Min. Negotiated Rate	$141.06
Max. Negotiated Rate	$141.06
Rate for Payer: Qualcare PPO/HMO/WC	$141.06

STAPLER ENDO UNI 65 4.8 173052

Facility

$940.40

Hospital Charge Code	270600084
Hospital Revenue Code	272
Min. Negotiated Rate	$22.66
Max. Negotiated Rate	$470.20
Rate for Payer: Aetna Commercial	$357.35
Rate for Payer: Aetna Medicare Advantage	$282.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.80
Rate for Payer: Cigna Commercial	$470.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$282.12
Rate for Payer: Oxford Commercial	$188.08
Rate for Payer: Qualcare PPO/HMO/WC	$141.06
Rate for Payer: UnitedHealthcare Commercial	$188.08
Rate for Payer: UnitedHealthcare Community & State	$22.66
Rate for Payer: Wellpoint Medicaid Managed Care	$24.92

STAPLER ENDO UNIVERSAL 65 DEG

Facility

$774.59

Hospital Charge Code	270655604
Hospital Revenue Code	272
Min. Negotiated Rate	$18.67
Max. Negotiated Rate	$387.30
Rate for Payer: Aetna Commercial	$294.34
Rate for Payer: Aetna Medicare Advantage	$232.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.52
Rate for Payer: Cigna Commercial	$387.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.38
Rate for Payer: Oxford Commercial	$154.92
Rate for Payer: Qualcare PPO/HMO/WC	$116.19
Rate for Payer: UnitedHealthcare Commercial	$154.92
Rate for Payer: UnitedHealthcare Community & State	$18.67
Rate for Payer: Wellpoint Medicaid Managed Care	$20.53

STAPLER ENDO UNIVERSAL 65 DEG

Facility

$774.59

Hospital Charge Code	270655604
Hospital Revenue Code	272
Min. Negotiated Rate	$116.19
Max. Negotiated Rate	$116.19
Rate for Payer: Qualcare PPO/HMO/WC	$116.19

STAPLER ENDOWRIST 12 MM

Facility

$3,900.00

Hospital Charge Code	270677733
Hospital Revenue Code	278
Min. Negotiated Rate	$585.00
Max. Negotiated Rate	$943.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$943.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$858.00
Rate for Payer: Qualcare PPO/HMO/WC	$585.00

STAPLER ENDOWRIST 12 MM

Facility

$3,900.00

Hospital Charge Code	270677733
Hospital Revenue Code	278
Min. Negotiated Rate	$93.99
Max. Negotiated Rate	$1,950.00
Rate for Payer: Aetna Commercial	$1,482.00
Rate for Payer: Aetna Medicare Advantage	$1,170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$994.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$994.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$994.50
Rate for Payer: Cigna Commercial	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$943.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$858.00
Rate for Payer: Qualcare PPO/HMO/WC	$585.00
Rate for Payer: UnitedHealthcare Community & State	$93.99
Rate for Payer: Wellpoint Medicaid Managed Care	$103.35

STAPLER ENDOWRIST XI 45 KIT

Facility

$89,975.00

Hospital Charge Code	270678164
Hospital Revenue Code	272
Min. Negotiated Rate	$13,496.25
Max. Negotiated Rate	$13,496.25
Rate for Payer: Qualcare PPO/HMO/WC	$13,496.25

STAPLER ENDOWRIST XI 45 KIT

Facility

$89,975.00

Hospital Charge Code	270678164
Hospital Revenue Code	272
Min. Negotiated Rate	$2,168.40
Max. Negotiated Rate	$44,987.50
Rate for Payer: Aetna Commercial	$34,190.50
Rate for Payer: Aetna Medicare Advantage	$26,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,943.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,943.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,943.62
Rate for Payer: Cigna Commercial	$44,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26,992.50
Rate for Payer: Oxford Commercial	$17,995.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,496.25
Rate for Payer: UnitedHealthcare Commercial	$17,995.00
Rate for Payer: UnitedHealthcare Community & State	$2,168.40
Rate for Payer: Wellpoint Medicaid Managed Care	$2,384.34

STAPLER GIA 60 3.8 MLTF ******

Facility

$538.66

Hospital Charge Code	27060046
Hospital Revenue Code	272
Min. Negotiated Rate	$12.98
Max. Negotiated Rate	$269.33
Rate for Payer: Aetna Commercial	$204.69
Rate for Payer: Aetna Medicare Advantage	$161.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.36
Rate for Payer: Cigna Commercial	$269.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.60
Rate for Payer: Oxford Commercial	$107.73
Rate for Payer: Qualcare PPO/HMO/WC	$80.80
Rate for Payer: UnitedHealthcare Commercial	$107.73
Rate for Payer: UnitedHealthcare Community & State	$12.98
Rate for Payer: Wellpoint Medicaid Managed Care	$14.27

STAPLER GIA 60 3.8 MLTF ******

Facility

$538.66

Hospital Charge Code	27060046
Hospital Revenue Code	272
Min. Negotiated Rate	$80.80
Max. Negotiated Rate	$80.80
Rate for Payer: Qualcare PPO/HMO/WC	$80.80

STAPLER GIA 60-3.8 SINGLE RELO

Facility

$450.02

Hospital Charge Code	270600046
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

STAPLER GIA 60-3.8 SINGLE RELO

Facility

$450.02

Hospital Charge Code	270600046
Hospital Revenue Code	272
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$225.01
Rate for Payer: Aetna Commercial	$171.01
Rate for Payer: Aetna Medicare Advantage	$135.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.76
Rate for Payer: Cigna Commercial	$225.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.01
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$90.00
Rate for Payer: UnitedHealthcare Community & State	$10.85
Rate for Payer: Wellpoint Medicaid Managed Care	$11.93

STAPLER GIA 60-4.8 SINGLE

Facility

$450.02

Hospital Charge Code	270676236
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

STAPLER GIA 60-4.8 SINGLE

Facility

$450.02

Hospital Charge Code	270676236
Hospital Revenue Code	272
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$225.01
Rate for Payer: Aetna Commercial	$171.01
Rate for Payer: Aetna Medicare Advantage	$135.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.76
Rate for Payer: Cigna Commercial	$225.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.01
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$90.00
Rate for Payer: UnitedHealthcare Community & State	$10.85
Rate for Payer: Wellpoint Medicaid Managed Care	$11.93

Know your out-of-pocket cost for care.

All Charges