Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STAPLER JAW 20X20X20 MM

Facility

$8,235.00

Service Code	HCPCS C1713
Hospital Charge Code	270701397
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 LINEAR 30 4.5 GN TX30G

Facility

$1,932.00

Hospital Charge Code	270608649
Hospital Revenue Code	272
Min. Negotiated Rate	$289.80
Max. Negotiated Rate	$289.80
Rate for Payer: Qualcare PPO/HMO/WC	$289.80

STAPLER LINEAR 30 4.5 GN TX30G

Facility

$1,932.00

Hospital Charge Code	270608649
Hospital Revenue Code	272
Min. Negotiated Rate	$46.56
Max. Negotiated Rate	$966.00
Rate for Payer: Aetna Commercial	$734.16
Rate for Payer: Aetna Medicare Advantage	$579.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.66
Rate for Payer: Cigna Commercial	$966.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$579.60
Rate for Payer: Oxford Commercial	$386.40
Rate for Payer: Qualcare PPO/HMO/WC	$289.80
Rate for Payer: UnitedHealthcare Commercial	$386.40
Rate for Payer: UnitedHealthcare Community & State	$46.56
Rate for Payer: Wellpoint Medicaid Managed Care	$51.20

STAPLER LINEAR 3.5X30MM BLUE

Facility

$407.22

Hospital Charge Code	270658413
Hospital Revenue Code	272
Min. Negotiated Rate	$61.08
Max. Negotiated Rate	$61.08
Rate for Payer: Qualcare PPO/HMO/WC	$61.08

STAPLER LINEAR 3.5X30MM BLUE

Facility

$407.22

Hospital Charge Code	270658413
Hospital Revenue Code	272
Min. Negotiated Rate	$9.81
Max. Negotiated Rate	$203.61
Rate for Payer: Aetna Commercial	$154.74
Rate for Payer: Aetna Medicare Advantage	$122.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.84
Rate for Payer: Cigna Commercial	$203.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.17
Rate for Payer: Oxford Commercial	$81.44
Rate for Payer: Qualcare PPO/HMO/WC	$61.08
Rate for Payer: UnitedHealthcare Commercial	$81.44
Rate for Payer: UnitedHealthcare Community & State	$9.81
Rate for Payer: Wellpoint Medicaid Managed Care	$10.79

STAPLER LINEAR 3.8X60MM BLUE

Facility

$1,206.90

Hospital Charge Code	270608737
Hospital Revenue Code	272
Min. Negotiated Rate	$181.03
Max. Negotiated Rate	$181.03
Rate for Payer: Qualcare PPO/HMO/WC	$181.03

STAPLER LINEAR 3.8X60MM BLUE

Facility

$1,206.90

Hospital Charge Code	270608737
Hospital Revenue Code	272
Min. Negotiated Rate	$29.09
Max. Negotiated Rate	$603.45
Rate for Payer: Aetna Commercial	$458.62
Rate for Payer: Aetna Medicare Advantage	$362.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.76
Rate for Payer: Cigna Commercial	$603.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$362.07
Rate for Payer: Oxford Commercial	$241.38
Rate for Payer: Qualcare PPO/HMO/WC	$181.03
Rate for Payer: UnitedHealthcare Commercial	$241.38
Rate for Payer: UnitedHealthcare Community & State	$29.09
Rate for Payer: Wellpoint Medicaid Managed Care	$31.98

STAPLER LINEAR 4.8X30MM GRN

Facility

$421.13

Hospital Charge Code	270608641
Hospital Revenue Code	272
Min. Negotiated Rate	$63.17
Max. Negotiated Rate	$63.17
Rate for Payer: Qualcare PPO/HMO/WC	$63.17

STAPLER LINEAR 4.8X30MM GRN

Facility

$421.13

Hospital Charge Code	270608641
Hospital Revenue Code	272
Min. Negotiated Rate	$10.15
Max. Negotiated Rate	$210.56
Rate for Payer: Aetna Commercial	$160.03
Rate for Payer: Aetna Medicare Advantage	$126.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.39
Rate for Payer: Cigna Commercial	$210.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.34
Rate for Payer: Oxford Commercial	$84.23
Rate for Payer: Qualcare PPO/HMO/WC	$63.17
Rate for Payer: UnitedHealthcare Commercial	$84.23
Rate for Payer: UnitedHealthcare Community & State	$10.15
Rate for Payer: Wellpoint Medicaid Managed Care	$11.16

STAPLER LINEAR 90 HVY TLH90

Facility

$2,068.00

Hospital Charge Code	270608645
Hospital Revenue Code	272
Min. Negotiated Rate	$310.20
Max. Negotiated Rate	$310.20
Rate for Payer: Qualcare PPO/HMO/WC	$310.20

STAPLER LINEAR 90 HVY TLH90

Facility

$2,068.00

Hospital Charge Code	270608645
Hospital Revenue Code	272
Min. Negotiated Rate	$49.84
Max. Negotiated Rate	$1,034.00
Rate for Payer: Aetna Commercial	$785.84
Rate for Payer: Aetna Medicare Advantage	$620.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$527.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$527.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$527.34
Rate for Payer: Cigna Commercial	$1,034.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$620.40
Rate for Payer: Oxford Commercial	$413.60
Rate for Payer: Qualcare PPO/HMO/WC	$310.20
Rate for Payer: UnitedHealthcare Commercial	$413.60
Rate for Payer: UnitedHealthcare Community & State	$49.84
Rate for Payer: Wellpoint Medicaid Managed Care	$54.80

STAPLER LINEAR 90MM DAIL DOWN

Facility

$2,310.77

Hospital Charge Code	270608643
Hospital Revenue Code	272
Min. Negotiated Rate	$55.69
Max. Negotiated Rate	$1,155.38
Rate for Payer: Aetna Commercial	$878.09
Rate for Payer: Aetna Medicare Advantage	$693.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$589.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$589.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$589.25
Rate for Payer: Cigna Commercial	$1,155.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$693.23
Rate for Payer: Oxford Commercial	$462.15
Rate for Payer: Qualcare PPO/HMO/WC	$346.62
Rate for Payer: UnitedHealthcare Commercial	$462.15
Rate for Payer: UnitedHealthcare Community & State	$55.69
Rate for Payer: Wellpoint Medicaid Managed Care	$61.24

STAPLER LINEAR 90MM DAIL DOWN

Facility

$2,310.77

Hospital Charge Code	270608643
Hospital Revenue Code	272
Min. Negotiated Rate	$346.62
Max. Negotiated Rate	$346.62
Rate for Payer: Qualcare PPO/HMO/WC	$346.62

STAPLER LINEAR 90mm DIAL DOWN

Facility

$460.87

Hospital Charge Code	270608731
Hospital Revenue Code	272
Min. Negotiated Rate	$11.11
Max. Negotiated Rate	$230.44
Rate for Payer: Aetna Commercial	$175.13
Rate for Payer: Aetna Medicare Advantage	$138.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.52
Rate for Payer: Cigna Commercial	$230.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.26
Rate for Payer: Oxford Commercial	$92.17
Rate for Payer: Qualcare PPO/HMO/WC	$69.13
Rate for Payer: UnitedHealthcare Commercial	$92.17
Rate for Payer: UnitedHealthcare Community & State	$11.11
Rate for Payer: Wellpoint Medicaid Managed Care	$12.21

STAPLER LINEAR 90mm DIAL DOWN

Facility

$460.87

Hospital Charge Code	270608731
Hospital Revenue Code	272
Min. Negotiated Rate	$69.13
Max. Negotiated Rate	$69.13
Rate for Payer: Qualcare PPO/HMO/WC	$69.13

STAPLER LINEAR GREEN 60MM

Facility

$225.47

Hospital Charge Code	270671555
Hospital Revenue Code	272
Min. Negotiated Rate	$33.82
Max. Negotiated Rate	$33.82
Rate for Payer: Qualcare PPO/HMO/WC	$33.82

STAPLER LINEAR GREEN 60MM

Facility

$225.47

Hospital Charge Code	270671555
Hospital Revenue Code	272
Min. Negotiated Rate	$5.43
Max. Negotiated Rate	$112.73
Rate for Payer: Aetna Commercial	$85.68
Rate for Payer: Aetna Medicare Advantage	$67.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.49
Rate for Payer: Cigna Commercial	$112.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.64
Rate for Payer: Oxford Commercial	$45.09
Rate for Payer: Qualcare PPO/HMO/WC	$33.82
Rate for Payer: UnitedHealthcare Commercial	$45.09
Rate for Payer: UnitedHealthcare Community & State	$5.43
Rate for Payer: Wellpoint Medicaid Managed Care	$5.97

STAPLER LINEAR RELOAD 60MM 4.8

Facility

$441.60

Hospital Charge Code	270671554
Hospital Revenue Code	272
Min. Negotiated Rate	$10.64
Max. Negotiated Rate	$220.80
Rate for Payer: Aetna Commercial	$167.81
Rate for Payer: Aetna Medicare Advantage	$132.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.61
Rate for Payer: Cigna Commercial	$220.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.48
Rate for Payer: Oxford Commercial	$88.32
Rate for Payer: Qualcare PPO/HMO/WC	$66.24
Rate for Payer: UnitedHealthcare Commercial	$88.32
Rate for Payer: UnitedHealthcare Community & State	$10.64
Rate for Payer: Wellpoint Medicaid Managed Care	$11.70

STAPLER LINEAR RELOAD 60MM 4.8

Facility

$441.60

Hospital Charge Code	270671554
Hospital Revenue Code	272
Min. Negotiated Rate	$66.24
Max. Negotiated Rate	$66.24
Rate for Payer: Qualcare PPO/HMO/WC	$66.24

STAPLER LINER RELOAD VASC 30MM

Facility

$397.10

Hospital Charge Code	270671553
Hospital Revenue Code	272
Min. Negotiated Rate	$9.57
Max. Negotiated Rate	$198.55
Rate for Payer: Aetna Commercial	$150.90
Rate for Payer: Aetna Medicare Advantage	$119.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.26
Rate for Payer: Cigna Commercial	$198.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.13
Rate for Payer: Oxford Commercial	$79.42
Rate for Payer: Qualcare PPO/HMO/WC	$59.56
Rate for Payer: UnitedHealthcare Commercial	$79.42
Rate for Payer: UnitedHealthcare Community & State	$9.57
Rate for Payer: Wellpoint Medicaid Managed Care	$10.52

STAPLER LINER RELOAD VASC 30MM

Facility

$397.10

Hospital Charge Code	270671553
Hospital Revenue Code	272
Min. Negotiated Rate	$59.56
Max. Negotiated Rate	$59.56
Rate for Payer: Qualcare PPO/HMO/WC	$59.56

STAPLER MF GIA 80 3 8 GIA8038S

Facility

$781.90

Hospital Charge Code	270630396
Hospital Revenue Code	272
Min. Negotiated Rate	$117.28
Max. Negotiated Rate	$117.28
Rate for Payer: Qualcare PPO/HMO/WC	$117.28

STAPLER MF GIA 80 3 8 GIA8038S

Facility

$781.90

Hospital Charge Code	270630396
Hospital Revenue Code	272
Min. Negotiated Rate	$18.84
Max. Negotiated Rate	$390.95
Rate for Payer: Aetna Commercial	$297.12
Rate for Payer: Aetna Medicare Advantage	$234.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.38
Rate for Payer: Cigna Commercial	$390.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.57
Rate for Payer: Oxford Commercial	$156.38
Rate for Payer: Qualcare PPO/HMO/WC	$117.28
Rate for Payer: UnitedHealthcare Commercial	$156.38
Rate for Payer: UnitedHealthcare Community & State	$18.84
Rate for Payer: Wellpoint Medicaid Managed Care	$20.72

STAPLER M/F TA 30-V3

Facility

$573.50

Hospital Charge Code	270658645
Hospital Revenue Code	272
Min. Negotiated Rate	$86.03
Max. Negotiated Rate	$86.03
Rate for Payer: Qualcare PPO/HMO/WC	$86.03

STAPLER M/F TA 30-V3

Facility

$573.50

Hospital Charge Code	270658645
Hospital Revenue Code	272
Min. Negotiated Rate	$13.82
Max. Negotiated Rate	$286.75
Rate for Payer: Aetna Commercial	$217.93
Rate for Payer: Aetna Medicare Advantage	$172.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.24
Rate for Payer: Cigna Commercial	$286.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.05
Rate for Payer: Oxford Commercial	$114.70
Rate for Payer: Qualcare PPO/HMO/WC	$86.03
Rate for Payer: UnitedHealthcare Commercial	$114.70
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: Wellpoint Medicaid Managed Care	$15.20

Know your out-of-pocket cost for care.

All Charges