Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STAPLER GIA 80-3.8 SINGLE RELO

Facility

$663.15

Hospital Charge Code	270651817
Hospital Revenue Code	272
Min. Negotiated Rate	$15.98
Max. Negotiated Rate	$331.57
Rate for Payer: Aetna Commercial	$252.00
Rate for Payer: Aetna Medicare Advantage	$198.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.10
Rate for Payer: Cigna Commercial	$331.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.94
Rate for Payer: Oxford Commercial	$132.63
Rate for Payer: Qualcare PPO/HMO/WC	$99.47
Rate for Payer: UnitedHealthcare Commercial	$132.63
Rate for Payer: UnitedHealthcare Community & State	$15.98
Rate for Payer: Wellpoint Medicaid Managed Care	$17.57

STAPLER GIA 80-3.8 SINGLE RELO

Facility

$663.15

Hospital Charge Code	270651817
Hospital Revenue Code	272
Min. Negotiated Rate	$99.47
Max. Negotiated Rate	$99.47
Rate for Payer: Qualcare PPO/HMO/WC	$99.47

STAPLER GIA 80 SINGLE RELOAD

Facility

$663.15

Hospital Charge Code	270630397
Hospital Revenue Code	272
Min. Negotiated Rate	$99.47
Max. Negotiated Rate	$99.47
Rate for Payer: Qualcare PPO/HMO/WC	$99.47

STAPLER GIA 80 SINGLE RELOAD

Facility

$663.15

Hospital Charge Code	270630397
Hospital Revenue Code	272
Min. Negotiated Rate	$15.98
Max. Negotiated Rate	$331.57
Rate for Payer: Aetna Commercial	$252.00
Rate for Payer: Aetna Medicare Advantage	$198.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.10
Rate for Payer: Cigna Commercial	$331.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.94
Rate for Payer: Oxford Commercial	$132.63
Rate for Payer: Qualcare PPO/HMO/WC	$99.47
Rate for Payer: UnitedHealthcare Commercial	$132.63
Rate for Payer: UnitedHealthcare Community & State	$15.98
Rate for Payer: Wellpoint Medicaid Managed Care	$17.57

STAPLER GIA ENDO 12MM

Facility

$439.47

Hospital Charge Code	270661153
Hospital Revenue Code	272
Min. Negotiated Rate	$65.92
Max. Negotiated Rate	$65.92
Rate for Payer: Qualcare PPO/HMO/WC	$65.92

STAPLER GIA ENDO 12MM

Facility

$439.47

Hospital Charge Code	270661153
Hospital Revenue Code	272
Min. Negotiated Rate	$10.59
Max. Negotiated Rate	$219.74
Rate for Payer: Aetna Commercial	$167.00
Rate for Payer: Aetna Medicare Advantage	$131.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.06
Rate for Payer: Cigna Commercial	$219.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.84
Rate for Payer: Oxford Commercial	$87.89
Rate for Payer: Qualcare PPO/HMO/WC	$65.92
Rate for Payer: UnitedHealthcare Commercial	$87.89
Rate for Payer: UnitedHealthcare Community & State	$10.59
Rate for Payer: Wellpoint Medicaid Managed Care	$11.65

STAPLER GIA UNIVERSAL 12MM

Facility

$478.93

Hospital Charge Code	270619586
Hospital Revenue Code	272
Min. Negotiated Rate	$11.54
Max. Negotiated Rate	$239.47
Rate for Payer: Aetna Commercial	$181.99
Rate for Payer: Aetna Medicare Advantage	$143.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.13
Rate for Payer: Cigna Commercial	$239.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.68
Rate for Payer: Oxford Commercial	$95.79
Rate for Payer: Qualcare PPO/HMO/WC	$71.84
Rate for Payer: UnitedHealthcare Commercial	$95.79
Rate for Payer: UnitedHealthcare Community & State	$11.54
Rate for Payer: Wellpoint Medicaid Managed Care	$12.69

STAPLER GIA UNIVERSAL 12MM

Facility

$478.93

Hospital Charge Code	270619586
Hospital Revenue Code	272
Min. Negotiated Rate	$71.84
Max. Negotiated Rate	$71.84
Rate for Payer: Qualcare PPO/HMO/WC	$71.84

STAPLER GOLD RELOAD FOR ECH 60

Facility

$732.86

Hospital Charge Code	270661384
Hospital Revenue Code	272
Min. Negotiated Rate	$109.93
Max. Negotiated Rate	$109.93
Rate for Payer: Qualcare PPO/HMO/WC	$109.93

STAPLER GOLD RELOAD FOR ECH 60

Facility

$732.86

Hospital Charge Code	270661384
Hospital Revenue Code	272
Min. Negotiated Rate	$17.66
Max. Negotiated Rate	$366.43
Rate for Payer: Aetna Commercial	$278.49
Rate for Payer: Aetna Medicare Advantage	$219.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.88
Rate for Payer: Cigna Commercial	$366.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.86
Rate for Payer: Oxford Commercial	$146.57
Rate for Payer: Qualcare PPO/HMO/WC	$109.93
Rate for Payer: UnitedHealthcare Commercial	$146.57
Rate for Payer: UnitedHealthcare Community & State	$17.66
Rate for Payer: Wellpoint Medicaid Managed Care	$19.42

STAPLER GRAY RELOAD FOR ECH 60

Facility

$696.95

Hospital Charge Code	270661390
Hospital Revenue Code	272
Min. Negotiated Rate	$104.54
Max. Negotiated Rate	$104.54
Rate for Payer: Qualcare PPO/HMO/WC	$104.54

STAPLER GRAY RELOAD FOR ECH 60

Facility

$696.95

Hospital Charge Code	270661390
Hospital Revenue Code	272
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$348.48
Rate for Payer: Aetna Commercial	$264.84
Rate for Payer: Aetna Medicare Advantage	$209.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.72
Rate for Payer: Cigna Commercial	$348.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.09
Rate for Payer: Oxford Commercial	$139.39
Rate for Payer: Qualcare PPO/HMO/WC	$104.54
Rate for Payer: UnitedHealthcare Commercial	$139.39
Rate for Payer: UnitedHealthcare Community & State	$16.80
Rate for Payer: Wellpoint Medicaid Managed Care	$18.47

STAPLER GREEN RELOAD ECH 60

Facility

$696.95

Hospital Charge Code	270661388
Hospital Revenue Code	272
Min. Negotiated Rate	$104.54
Max. Negotiated Rate	$104.54
Rate for Payer: Qualcare PPO/HMO/WC	$104.54

STAPLER GREEN RELOAD ECH 60

Facility

$696.95

Hospital Charge Code	270661388
Hospital Revenue Code	272
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$348.48
Rate for Payer: Aetna Commercial	$264.84
Rate for Payer: Aetna Medicare Advantage	$209.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.72
Rate for Payer: Cigna Commercial	$348.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.09
Rate for Payer: Oxford Commercial	$139.39
Rate for Payer: Qualcare PPO/HMO/WC	$104.54
Rate for Payer: UnitedHealthcare Commercial	$139.39
Rate for Payer: UnitedHealthcare Community & State	$16.80
Rate for Payer: Wellpoint Medicaid Managed Care	$18.47

STAPLER HEMORRHOID EEA 33MM

Facility

$1,833.75

Hospital Charge Code	270648448
Hospital Revenue Code	272
Min. Negotiated Rate	$275.06
Max. Negotiated Rate	$275.06
Rate for Payer: Qualcare PPO/HMO/WC	$275.06

STAPLER HEMORRHOID EEA 33MM

Facility

$1,833.75

Hospital Charge Code	270648448
Hospital Revenue Code	272
Min. Negotiated Rate	$44.19
Max. Negotiated Rate	$916.88
Rate for Payer: Aetna Commercial	$696.83
Rate for Payer: Aetna Medicare Advantage	$550.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$467.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$467.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$467.61
Rate for Payer: Cigna Commercial	$916.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.12
Rate for Payer: Oxford Commercial	$366.75
Rate for Payer: Qualcare PPO/HMO/WC	$275.06
Rate for Payer: UnitedHealthcare Commercial	$366.75
Rate for Payer: UnitedHealthcare Community & State	$44.19
Rate for Payer: Wellpoint Medicaid Managed Care	$48.59

STAPLER ILS 21MM INTALUMINAL

Facility

$1,535.80

Hospital Charge Code	270671544
Hospital Revenue Code	272
Min. Negotiated Rate	$230.37
Max. Negotiated Rate	$230.37
Rate for Payer: Qualcare PPO/HMO/WC	$230.37

STAPLER ILS 21MM INTALUMINAL

Facility

$1,535.80

Hospital Charge Code	270671544
Hospital Revenue Code	272
Min. Negotiated Rate	$37.01
Max. Negotiated Rate	$767.90
Rate for Payer: Aetna Commercial	$583.60
Rate for Payer: Aetna Medicare Advantage	$460.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$391.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$391.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$391.63
Rate for Payer: Cigna Commercial	$767.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$460.74
Rate for Payer: Oxford Commercial	$307.16
Rate for Payer: Qualcare PPO/HMO/WC	$230.37
Rate for Payer: UnitedHealthcare Commercial	$307.16
Rate for Payer: UnitedHealthcare Community & State	$37.01
Rate for Payer: Wellpoint Medicaid Managed Care	$40.70

STAPLER INSORB 30 SKIN

Facility

$500.25

Hospital Charge Code	270662528
Hospital Revenue Code	272
Min. Negotiated Rate	$12.06
Max. Negotiated Rate	$250.12
Rate for Payer: Aetna Commercial	$190.09
Rate for Payer: Aetna Medicare Advantage	$150.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.56
Rate for Payer: Cigna Commercial	$250.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.07
Rate for Payer: Oxford Commercial	$100.05
Rate for Payer: Qualcare PPO/HMO/WC	$75.04
Rate for Payer: UnitedHealthcare Commercial	$100.05
Rate for Payer: UnitedHealthcare Community & State	$12.06
Rate for Payer: Wellpoint Medicaid Managed Care	$13.26

STAPLER INSORB 30 SKIN

Facility

$500.25

Hospital Charge Code	270662528
Hospital Revenue Code	272
Min. Negotiated Rate	$75.04
Max. Negotiated Rate	$75.04
Rate for Payer: Qualcare PPO/HMO/WC	$75.04

STAPLER INSORB SUBCUTICUL 1020

Facility

$210.00

Hospital Charge Code	270639060
Hospital Revenue Code	272
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$79.80
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.00
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$42.00
Rate for Payer: UnitedHealthcare Community & State	$5.06
Rate for Payer: Wellpoint Medicaid Managed Care	$5.57

STAPLER INSORB SUBCUTICUL 1020

Facility

$210.00

Hospital Charge Code	270639060
Hospital Revenue Code	272
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

STAPLER JAW 18X18X18 MM

Facility

$8,235.00

Service Code	HCPCS C1713
Hospital Charge Code	270701398
Hospital Revenue Code	278
Min. Negotiated Rate	$1,235.25
Max. Negotiated Rate	$1,992.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,647.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,992.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,811.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,235.25

STAPLER JAW 18X18X18 MM

Facility

$8,235.00

Service Code	HCPCS C1713
Hospital Charge Code	270701398
Hospital Revenue Code	278
Min. Negotiated Rate	$198.46
Max. Negotiated Rate	$4,117.50
Rate for Payer: Aetna Commercial	$3,129.30
Rate for Payer: Aetna Medicare Advantage	$2,470.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,099.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,099.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,647.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,099.93
Rate for Payer: Cigna Commercial	$4,117.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,992.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,811.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,235.25
Rate for Payer: UnitedHealthcare Community & State	$198.46
Rate for Payer: Wellpoint Medicaid Managed Care	$218.23

STAPLER JAW 20X20X20 MM

Facility

$8,235.00

Service Code	HCPCS C1713
Hospital Charge Code	270701397
Hospital Revenue Code	278
Min. Negotiated Rate	$198.46
Max. Negotiated Rate	$4,117.50
Rate for Payer: Aetna Commercial	$3,129.30
Rate for Payer: Aetna Medicare Advantage	$2,470.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,099.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,099.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,647.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,099.93
Rate for Payer: Cigna Commercial	$4,117.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,992.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,811.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,235.25
Rate for Payer: UnitedHealthcare Community & State	$198.46
Rate for Payer: Wellpoint Medicaid Managed Care	$218.23

Know your out-of-pocket cost for care.

All Charges