Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STAPLER SURG TA LONG 30-3.5

Facility

$407.00

Hospital Charge Code	270334717
Hospital Revenue Code	272
Min. Negotiated Rate	$61.05
Max. Negotiated Rate	$61.05
Rate for Payer: Qualcare PPO/HMO/WC	$61.05

STAPLER SURG TA LONG 30-3.5

Facility

$407.00

Hospital Charge Code	270334717
Hospital Revenue Code	272
Min. Negotiated Rate	$9.81
Max. Negotiated Rate	$203.50
Rate for Payer: Aetna Commercial	$154.66
Rate for Payer: Aetna Medicare Advantage	$122.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.78
Rate for Payer: Cigna Commercial	$203.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.10
Rate for Payer: Oxford Commercial	$81.40
Rate for Payer: Qualcare PPO/HMO/WC	$61.05
Rate for Payer: UnitedHealthcare Commercial	$81.40
Rate for Payer: UnitedHealthcare Community & State	$9.81
Rate for Payer: Wellpoint Medicaid Managed Care	$10.79

STAPLER SYSTEM KIT

Facility

$29,175.00

Hospital Charge Code	270666134
Hospital Revenue Code	270
Min. Negotiated Rate	$4,376.25
Max. Negotiated Rate	$4,376.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,376.25

STAPLER SYSTEM KIT

Facility

$29,175.00

Hospital Charge Code	270666134
Hospital Revenue Code	270
Min. Negotiated Rate	$703.12
Max. Negotiated Rate	$14,587.50
Rate for Payer: Aetna Commercial	$11,086.50
Rate for Payer: Aetna Medicare Advantage	$8,752.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,439.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,439.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,439.62
Rate for Payer: Cigna Commercial	$14,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,752.50
Rate for Payer: Oxford Commercial	$5,835.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,376.25
Rate for Payer: UnitedHealthcare Commercial	$5,835.00
Rate for Payer: UnitedHealthcare Community & State	$703.12
Rate for Payer: Wellpoint Medicaid Managed Care	$773.14

STAPLER TA 30 2.5 010315

Facility

$1,220.00

Hospital Charge Code	270605720
Hospital Revenue Code	272
Min. Negotiated Rate	$29.40
Max. Negotiated Rate	$610.00
Rate for Payer: Aetna Commercial	$463.60
Rate for Payer: Aetna Medicare Advantage	$366.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.10
Rate for Payer: Cigna Commercial	$610.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.00
Rate for Payer: Oxford Commercial	$244.00
Rate for Payer: Qualcare PPO/HMO/WC	$183.00
Rate for Payer: UnitedHealthcare Commercial	$244.00
Rate for Payer: UnitedHealthcare Community & State	$29.40
Rate for Payer: Wellpoint Medicaid Managed Care	$32.33

STAPLER TA 30 2.5 010315

Facility

$1,220.00

Hospital Charge Code	270605720
Hospital Revenue Code	272
Min. Negotiated Rate	$183.00
Max. Negotiated Rate	$183.00
Rate for Payer: Qualcare PPO/HMO/WC	$183.00

STAPLER TA 30-3.5

Facility

$413.92

Hospital Charge Code	270600141
Hospital Revenue Code	272
Min. Negotiated Rate	$9.98
Max. Negotiated Rate	$206.96
Rate for Payer: Aetna Commercial	$157.29
Rate for Payer: Aetna Medicare Advantage	$124.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.55
Rate for Payer: Cigna Commercial	$206.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.18
Rate for Payer: Oxford Commercial	$82.78
Rate for Payer: Qualcare PPO/HMO/WC	$62.09
Rate for Payer: UnitedHealthcare Commercial	$82.78
Rate for Payer: UnitedHealthcare Community & State	$9.98
Rate for Payer: Wellpoint Medicaid Managed Care	$10.97

STAPLER TA 30-3.5

Facility

$413.92

Hospital Charge Code	270600141
Hospital Revenue Code	272
Min. Negotiated Rate	$62.09
Max. Negotiated Rate	$62.09
Rate for Payer: Qualcare PPO/HMO/WC	$62.09

STAPLER TA 30 4.8 015703

Facility

$1,232.00

Hospital Charge Code	270600044
Hospital Revenue Code	272
Min. Negotiated Rate	$29.69
Max. Negotiated Rate	$616.00
Rate for Payer: Aetna Commercial	$468.16
Rate for Payer: Aetna Medicare Advantage	$369.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$314.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$314.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$314.16
Rate for Payer: Cigna Commercial	$616.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.60
Rate for Payer: Oxford Commercial	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$184.80
Rate for Payer: UnitedHealthcare Commercial	$246.40
Rate for Payer: UnitedHealthcare Community & State	$29.69
Rate for Payer: Wellpoint Medicaid Managed Care	$32.65

STAPLER TA 30 4.8 015703

Facility

$1,232.00

Hospital Charge Code	270600044
Hospital Revenue Code	272
Min. Negotiated Rate	$184.80
Max. Negotiated Rate	$184.80
Rate for Payer: Qualcare PPO/HMO/WC	$184.80

STAPLER TA 60 3.5 010317

Facility

$1,242.45

Hospital Charge Code	270600038
Hospital Revenue Code	272
Min. Negotiated Rate	$29.94
Max. Negotiated Rate	$621.23
Rate for Payer: Aetna Commercial	$472.13
Rate for Payer: Aetna Medicare Advantage	$372.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.82
Rate for Payer: Cigna Commercial	$621.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.74
Rate for Payer: Oxford Commercial	$248.49
Rate for Payer: Qualcare PPO/HMO/WC	$186.37
Rate for Payer: UnitedHealthcare Commercial	$248.49
Rate for Payer: UnitedHealthcare Community & State	$29.94
Rate for Payer: Wellpoint Medicaid Managed Care	$32.92

STAPLER TA 60 3.5 010317

Facility

$1,242.45

Hospital Charge Code	270600038
Hospital Revenue Code	272
Min. Negotiated Rate	$186.37
Max. Negotiated Rate	$186.37
Rate for Payer: Qualcare PPO/HMO/WC	$186.37

STAPLER TA 90 3.5 LONG 015082

Facility

$1,272.85

Hospital Charge Code	270600041
Hospital Revenue Code	272
Min. Negotiated Rate	$30.68
Max. Negotiated Rate	$636.42
Rate for Payer: Aetna Commercial	$483.68
Rate for Payer: Aetna Medicare Advantage	$381.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$324.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$324.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$324.58
Rate for Payer: Cigna Commercial	$636.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.86
Rate for Payer: Oxford Commercial	$254.57
Rate for Payer: Qualcare PPO/HMO/WC	$190.93
Rate for Payer: UnitedHealthcare Commercial	$254.57
Rate for Payer: UnitedHealthcare Community & State	$30.68
Rate for Payer: Wellpoint Medicaid Managed Care	$33.73

STAPLER TA 90 3.5 LONG 015082

Facility

$1,272.85

Hospital Charge Code	270600041
Hospital Revenue Code	272
Min. Negotiated Rate	$190.93
Max. Negotiated Rate	$190.93
Rate for Payer: Qualcare PPO/HMO/WC	$190.93

STAPLER TA 90 4.8 LONG 015084

Facility

$1,454.45

Hospital Charge Code	270600043
Hospital Revenue Code	272
Min. Negotiated Rate	$35.05
Max. Negotiated Rate	$727.23
Rate for Payer: Aetna Commercial	$552.69
Rate for Payer: Aetna Medicare Advantage	$436.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$370.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$370.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$370.88
Rate for Payer: Cigna Commercial	$727.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$436.33
Rate for Payer: Oxford Commercial	$290.89
Rate for Payer: Qualcare PPO/HMO/WC	$218.17
Rate for Payer: UnitedHealthcare Commercial	$290.89
Rate for Payer: UnitedHealthcare Community & State	$35.05
Rate for Payer: Wellpoint Medicaid Managed Care	$38.54

STAPLER TA 90 4.8 LONG 015084

Facility

$1,454.45

Hospital Charge Code	270600043
Hospital Revenue Code	272
Min. Negotiated Rate	$218.17
Max. Negotiated Rate	$218.17
Rate for Payer: Qualcare PPO/HMO/WC	$218.17

STAPLER UNIT MULTIFIRE 35W

Facility

$466.96

Hospital Charge Code	270014016
Hospital Revenue Code	272
Min. Negotiated Rate	$70.04
Max. Negotiated Rate	$70.04
Rate for Payer: Qualcare PPO/HMO/WC	$70.04

STAPLER UNIT MULTIFIRE 35W

Facility

$538.85

Hospital Charge Code	270014016N
Hospital Revenue Code	272
Min. Negotiated Rate	$12.99
Max. Negotiated Rate	$269.43
Rate for Payer: Aetna Commercial	$204.76
Rate for Payer: Aetna Medicare Advantage	$161.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.41
Rate for Payer: Cigna Commercial	$269.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.66
Rate for Payer: Oxford Commercial	$107.77
Rate for Payer: Qualcare PPO/HMO/WC	$80.83
Rate for Payer: UnitedHealthcare Commercial	$107.77
Rate for Payer: UnitedHealthcare Community & State	$12.99
Rate for Payer: Wellpoint Medicaid Managed Care	$14.28

STAPLER UNIT MULTIFIRE 35W

Facility

$466.96

Hospital Charge Code	270014016
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$233.48
Rate for Payer: Aetna Commercial	$177.44
Rate for Payer: Aetna Medicare Advantage	$140.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.07
Rate for Payer: Cigna Commercial	$233.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.09
Rate for Payer: Oxford Commercial	$93.39
Rate for Payer: Qualcare PPO/HMO/WC	$70.04
Rate for Payer: UnitedHealthcare Commercial	$93.39
Rate for Payer: UnitedHealthcare Community & State	$11.25
Rate for Payer: Wellpoint Medicaid Managed Care	$12.37

STAPLER UNIT MULTIFIRE 35W

Facility

$538.85

Hospital Charge Code	270014016N
Hospital Revenue Code	272
Min. Negotiated Rate	$80.83
Max. Negotiated Rate	$80.83
Rate for Payer: Qualcare PPO/HMO/WC	$80.83

STAPLER UNIVERSAL ENDO GIA XL

Facility

$2,189.48

Hospital Charge Code	270691810
Hospital Revenue Code	272
Min. Negotiated Rate	$328.42
Max. Negotiated Rate	$328.42
Rate for Payer: Qualcare PPO/HMO/WC	$328.42

STAPLER UNIVERSAL ENDO GIA XL

Facility

$2,189.48

Hospital Charge Code	270691810
Hospital Revenue Code	272
Min. Negotiated Rate	$52.77
Max. Negotiated Rate	$1,094.74
Rate for Payer: Aetna Commercial	$832.00
Rate for Payer: Aetna Medicare Advantage	$656.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$558.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$558.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$558.32
Rate for Payer: Cigna Commercial	$1,094.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$656.84
Rate for Payer: Oxford Commercial	$437.90
Rate for Payer: Qualcare PPO/HMO/WC	$328.42
Rate for Payer: UnitedHealthcare Commercial	$437.90
Rate for Payer: UnitedHealthcare Community & State	$52.77
Rate for Payer: Wellpoint Medicaid Managed Care	$58.02

STAPLER UNIVERS GIA SHORT 12MM

Facility

$1,880.13

Hospital Charge Code	270687314
Hospital Revenue Code	272
Min. Negotiated Rate	$45.31
Max. Negotiated Rate	$940.07
Rate for Payer: Aetna Commercial	$714.45
Rate for Payer: Aetna Medicare Advantage	$564.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$479.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$479.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$479.43
Rate for Payer: Cigna Commercial	$940.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$564.04
Rate for Payer: Oxford Commercial	$376.03
Rate for Payer: Qualcare PPO/HMO/WC	$282.02
Rate for Payer: UnitedHealthcare Commercial	$376.03
Rate for Payer: UnitedHealthcare Community & State	$45.31
Rate for Payer: Wellpoint Medicaid Managed Care	$49.82

STAPLER UNIVERS GIA SHORT 12MM

Facility

$1,880.13

Hospital Charge Code	270687314
Hospital Revenue Code	272
Min. Negotiated Rate	$282.02
Max. Negotiated Rate	$282.02
Rate for Payer: Qualcare PPO/HMO/WC	$282.02

STAPLER UNT RELOAD 60MM PROXIM

Facility

$226.15

Hospital Charge Code	270671552
Hospital Revenue Code	272
Min. Negotiated Rate	$33.92
Max. Negotiated Rate	$33.92
Rate for Payer: Qualcare PPO/HMO/WC	$33.92

Know your out-of-pocket cost for care.

All Charges