Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STAPLER RELOADABLE TA 90-4.8

Facility

$519.73

Hospital Charge Code	270630413
Hospital Revenue Code	272
Min. Negotiated Rate	$77.96
Max. Negotiated Rate	$77.96
Rate for Payer: Qualcare PPO/HMO/WC	$77.96

STAPLER RELOADABLE TA 90-4.8

Facility

$495.05

Hospital Charge Code	270631413
Hospital Revenue Code	272
Min. Negotiated Rate	$74.26
Max. Negotiated Rate	$74.26
Rate for Payer: Qualcare PPO/HMO/WC	$74.26

STAPLER RELOADABLE TA 90-4.8

Facility

$495.05

Hospital Charge Code	270631413
Hospital Revenue Code	272
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$247.53
Rate for Payer: Aetna Commercial	$188.12
Rate for Payer: Aetna Medicare Advantage	$148.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.24
Rate for Payer: Cigna Commercial	$247.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.51
Rate for Payer: Oxford Commercial	$99.01
Rate for Payer: Qualcare PPO/HMO/WC	$74.26
Rate for Payer: UnitedHealthcare Commercial	$99.01
Rate for Payer: UnitedHealthcare Community & State	$11.93
Rate for Payer: Wellpoint Medicaid Managed Care	$13.12

STAPLER RELOADABLE TA 90-4.8

Facility

$519.73

Hospital Charge Code	270630413
Hospital Revenue Code	272
Min. Negotiated Rate	$12.53
Max. Negotiated Rate	$259.87
Rate for Payer: Aetna Commercial	$197.50
Rate for Payer: Aetna Medicare Advantage	$155.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.53
Rate for Payer: Cigna Commercial	$259.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.92
Rate for Payer: Oxford Commercial	$103.95
Rate for Payer: Qualcare PPO/HMO/WC	$77.96
Rate for Payer: UnitedHealthcare Commercial	$103.95
Rate for Payer: UnitedHealthcare Community & State	$12.53
Rate for Payer: Wellpoint Medicaid Managed Care	$13.77

STAPLER RELOAD CUTTER BLUE

Facility

$1,265.50

Hospital Charge Code	270672160
Hospital Revenue Code	272
Min. Negotiated Rate	$189.82
Max. Negotiated Rate	$189.82
Rate for Payer: Qualcare PPO/HMO/WC	$189.82

STAPLER RELOAD CUTTER BLUE

Facility

$1,265.50

Hospital Charge Code	270672160
Hospital Revenue Code	272
Min. Negotiated Rate	$30.50
Max. Negotiated Rate	$632.75
Rate for Payer: Aetna Commercial	$480.89
Rate for Payer: Aetna Medicare Advantage	$379.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.70
Rate for Payer: Cigna Commercial	$632.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.65
Rate for Payer: Oxford Commercial	$253.10
Rate for Payer: Qualcare PPO/HMO/WC	$189.82
Rate for Payer: UnitedHealthcare Commercial	$253.10
Rate for Payer: UnitedHealthcare Community & State	$30.50
Rate for Payer: Wellpoint Medicaid Managed Care	$33.54

STAPLER RELOAD CUTTER GREEN

Facility

$1,265.50

Hospital Charge Code	270672161
Hospital Revenue Code	272
Min. Negotiated Rate	$189.82
Max. Negotiated Rate	$189.82
Rate for Payer: Qualcare PPO/HMO/WC	$189.82

STAPLER RELOAD CUTTER GREEN

Facility

$1,265.50

Hospital Charge Code	270672161
Hospital Revenue Code	272
Min. Negotiated Rate	$30.50
Max. Negotiated Rate	$632.75
Rate for Payer: Aetna Commercial	$480.89
Rate for Payer: Aetna Medicare Advantage	$379.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.70
Rate for Payer: Cigna Commercial	$632.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.65
Rate for Payer: Oxford Commercial	$253.10
Rate for Payer: Qualcare PPO/HMO/WC	$189.82
Rate for Payer: UnitedHealthcare Commercial	$253.10
Rate for Payer: UnitedHealthcare Community & State	$30.50
Rate for Payer: Wellpoint Medicaid Managed Care	$33.54

STAPLER RELOAD FOR ECH 60

Facility

$696.95

Hospital Charge Code	270662819
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 RELOAD FOR ECH 60

Facility

$696.95

Hospital Charge Code	270662819
Hospital Revenue Code	272
Min. Negotiated Rate	$104.54
Max. Negotiated Rate	$104.54
Rate for Payer: Qualcare PPO/HMO/WC	$104.54

STAPLER RELOAD SGL USE TA3048S

Facility

$444.25

Hospital Charge Code	270630403
Hospital Revenue Code	272
Min. Negotiated Rate	$10.71
Max. Negotiated Rate	$222.12
Rate for Payer: Aetna Commercial	$168.81
Rate for Payer: Aetna Medicare Advantage	$133.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.28
Rate for Payer: Cigna Commercial	$222.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.28
Rate for Payer: Oxford Commercial	$88.85
Rate for Payer: Qualcare PPO/HMO/WC	$66.64
Rate for Payer: UnitedHealthcare Commercial	$88.85
Rate for Payer: UnitedHealthcare Community & State	$10.71
Rate for Payer: Wellpoint Medicaid Managed Care	$11.77

STAPLER RELOAD SGL USE TA3048S

Facility

$444.25

Hospital Charge Code	270630403
Hospital Revenue Code	272
Min. Negotiated Rate	$66.64
Max. Negotiated Rate	$66.64
Rate for Payer: Qualcare PPO/HMO/WC	$66.64

STAPLER RELOAD TA6048S

Facility

$428.10

Hospital Charge Code	270666221
Hospital Revenue Code	272
Min. Negotiated Rate	$10.32
Max. Negotiated Rate	$214.05
Rate for Payer: Aetna Commercial	$162.68
Rate for Payer: Aetna Medicare Advantage	$128.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.17
Rate for Payer: Cigna Commercial	$214.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.43
Rate for Payer: Oxford Commercial	$85.62
Rate for Payer: Qualcare PPO/HMO/WC	$64.22
Rate for Payer: UnitedHealthcare Commercial	$85.62
Rate for Payer: UnitedHealthcare Community & State	$10.32
Rate for Payer: Wellpoint Medicaid Managed Care	$11.34

STAPLER RELOAD TA6048S

Facility

$428.10

Hospital Charge Code	270666221
Hospital Revenue Code	272
Min. Negotiated Rate	$64.22
Max. Negotiated Rate	$64.22
Rate for Payer: Qualcare PPO/HMO/WC	$64.22

STAPLER ROTIC 55 3.8 BL AX55B

Facility

$3,165.65

Hospital Charge Code	270608651
Hospital Revenue Code	272
Min. Negotiated Rate	$76.29
Max. Negotiated Rate	$1,582.83
Rate for Payer: Aetna Commercial	$1,202.95
Rate for Payer: Aetna Medicare Advantage	$949.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$807.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$807.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$807.24
Rate for Payer: Cigna Commercial	$1,582.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$949.70
Rate for Payer: Oxford Commercial	$633.13
Rate for Payer: Qualcare PPO/HMO/WC	$474.85
Rate for Payer: UnitedHealthcare Commercial	$633.13
Rate for Payer: UnitedHealthcare Community & State	$76.29
Rate for Payer: Wellpoint Medicaid Managed Care	$83.89

STAPLER ROTIC 55 3.8 BL AX55B

Facility

$3,165.65

Hospital Charge Code	270608651
Hospital Revenue Code	272
Min. Negotiated Rate	$474.85
Max. Negotiated Rate	$474.85
Rate for Payer: Qualcare PPO/HMO/WC	$474.85

STAPLER ROTIC 55 4.5 GN AX55G

Facility

$3,165.65

Hospital Charge Code	270608652
Hospital Revenue Code	272
Min. Negotiated Rate	$76.29
Max. Negotiated Rate	$1,582.83
Rate for Payer: Aetna Commercial	$1,202.95
Rate for Payer: Aetna Medicare Advantage	$949.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$807.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$807.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$807.24
Rate for Payer: Cigna Commercial	$1,582.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$949.70
Rate for Payer: Oxford Commercial	$633.13
Rate for Payer: Qualcare PPO/HMO/WC	$474.85
Rate for Payer: UnitedHealthcare Commercial	$633.13
Rate for Payer: UnitedHealthcare Community & State	$76.29
Rate for Payer: Wellpoint Medicaid Managed Care	$83.89

STAPLER ROTIC 55 4.5 GN AX55G

Facility

$3,165.65

Hospital Charge Code	270608652
Hospital Revenue Code	272
Min. Negotiated Rate	$474.85
Max. Negotiated Rate	$474.85
Rate for Payer: Qualcare PPO/HMO/WC	$474.85

STAPLER ROTICULATOR 30-3.5 BLU

Facility

$1,057.78

Hospital Charge Code	270652232
Hospital Revenue Code	272
Min. Negotiated Rate	$158.67
Max. Negotiated Rate	$158.67
Rate for Payer: Qualcare PPO/HMO/WC	$158.67

STAPLER ROTICULATOR 30-3.5 BLU

Facility

$1,057.78

Hospital Charge Code	270652232
Hospital Revenue Code	272
Min. Negotiated Rate	$25.49
Max. Negotiated Rate	$528.89
Rate for Payer: Aetna Commercial	$401.96
Rate for Payer: Aetna Medicare Advantage	$317.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.73
Rate for Payer: Cigna Commercial	$528.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$317.33
Rate for Payer: Oxford Commercial	$211.56
Rate for Payer: Qualcare PPO/HMO/WC	$158.67
Rate for Payer: UnitedHealthcare Commercial	$211.56
Rate for Payer: UnitedHealthcare Community & State	$25.49
Rate for Payer: Wellpoint Medicaid Managed Care	$28.03

STAPLER ROTICULATOR 30-V3 WHI

Facility

$1,138.22

Hospital Charge Code	270600138
Hospital Revenue Code	272
Min. Negotiated Rate	$170.73
Max. Negotiated Rate	$170.73
Rate for Payer: Qualcare PPO/HMO/WC	$170.73

STAPLER ROTICULATOR 30-V3 WHI

Facility

$1,138.22

Hospital Charge Code	270600138
Hospital Revenue Code	272
Min. Negotiated Rate	$27.43
Max. Negotiated Rate	$569.11
Rate for Payer: Aetna Commercial	$432.52
Rate for Payer: Aetna Medicare Advantage	$341.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.25
Rate for Payer: Cigna Commercial	$569.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.47
Rate for Payer: Oxford Commercial	$227.64
Rate for Payer: Qualcare PPO/HMO/WC	$170.73
Rate for Payer: UnitedHealthcare Commercial	$227.64
Rate for Payer: UnitedHealthcare Community & State	$27.43
Rate for Payer: Wellpoint Medicaid Managed Care	$30.16

STAPLER ROTICULATOR 55-3.5 BLU

Facility

$1,010.37

Hospital Charge Code	270600115
Hospital Revenue Code	272
Min. Negotiated Rate	$24.35
Max. Negotiated Rate	$505.19
Rate for Payer: Aetna Commercial	$383.94
Rate for Payer: Aetna Medicare Advantage	$303.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$257.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$257.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$257.64
Rate for Payer: Cigna Commercial	$505.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.11
Rate for Payer: Oxford Commercial	$202.07
Rate for Payer: Qualcare PPO/HMO/WC	$151.56
Rate for Payer: UnitedHealthcare Commercial	$202.07
Rate for Payer: UnitedHealthcare Community & State	$24.35
Rate for Payer: Wellpoint Medicaid Managed Care	$26.77

STAPLER ROTICULATOR 55-3.5 BLU

Facility

$1,010.37

Hospital Charge Code	270600115
Hospital Revenue Code	272
Min. Negotiated Rate	$151.56
Max. Negotiated Rate	$151.56
Rate for Payer: Qualcare PPO/HMO/WC	$151.56

STAPLER ROTICULATOR 55-4.8 GRN

Facility

$6,219.40

Hospital Charge Code	270600116
Hospital Revenue Code	272
Min. Negotiated Rate	$932.91
Max. Negotiated Rate	$932.91
Rate for Payer: Qualcare PPO/HMO/WC	$932.91

Know your out-of-pocket cost for care.

All Charges