Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STAPLER UNT RELOAD 60MM PROXIM

Facility

$226.15

Hospital Charge Code	270671552
Hospital Revenue Code	272
Min. Negotiated Rate	$5.45
Max. Negotiated Rate	$113.08
Rate for Payer: Aetna Commercial	$85.94
Rate for Payer: Aetna Medicare Advantage	$67.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.67
Rate for Payer: Cigna Commercial	$113.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.84
Rate for Payer: Oxford Commercial	$45.23
Rate for Payer: Qualcare PPO/HMO/WC	$33.92
Rate for Payer: UnitedHealthcare Commercial	$45.23
Rate for Payer: UnitedHealthcare Community & State	$5.45
Rate for Payer: Wellpoint Medicaid Managed Care	$5.99

STAPLER VERSATACK MF 4.8MM

Facility

$394.45

Hospital Charge Code	270658742
Hospital Revenue Code	270
Min. Negotiated Rate	$9.51
Max. Negotiated Rate	$197.22
Rate for Payer: Aetna Commercial	$149.89
Rate for Payer: Aetna Medicare Advantage	$118.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.58
Rate for Payer: Cigna Commercial	$197.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.33
Rate for Payer: Oxford Commercial	$78.89
Rate for Payer: Qualcare PPO/HMO/WC	$59.17
Rate for Payer: UnitedHealthcare Commercial	$78.89
Rate for Payer: UnitedHealthcare Community & State	$9.51
Rate for Payer: Wellpoint Medicaid Managed Care	$10.45

STAPLER VERSATACK MF 4.8MM

Facility

$394.45

Hospital Charge Code	270658742
Hospital Revenue Code	270
Min. Negotiated Rate	$59.17
Max. Negotiated Rate	$59.17
Rate for Payer: Qualcare PPO/HMO/WC	$59.17

STAPLER WHITE RELOAD ECHE 60

Facility

$696.95

Hospital Charge Code	270661392
Hospital Revenue Code	272
Min. Negotiated Rate	$104.54
Max. Negotiated Rate	$104.54
Rate for Payer: Qualcare PPO/HMO/WC	$104.54

STAPLER WHITE RELOAD ECHE 60

Facility

$696.95

Hospital Charge Code	270661392
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 Z 8MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696297
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

STAPLER Z 8MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696297
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

STAPLES 8X8 ARCUS

Facility

$4,840.00

Hospital Charge Code	270691322
Hospital Revenue Code	272
Min. Negotiated Rate	$726.00
Max. Negotiated Rate	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$726.00

STAPLES 8X8 ARCUS

Facility

$4,840.00

Hospital Charge Code	270691322
Hospital Revenue Code	272
Min. Negotiated Rate	$116.64
Max. Negotiated Rate	$2,420.00
Rate for Payer: Aetna Commercial	$1,839.20
Rate for Payer: Aetna Medicare Advantage	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,234.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,234.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,234.20
Rate for Payer: Cigna Commercial	$2,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Oxford Commercial	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$726.00
Rate for Payer: UnitedHealthcare Commercial	$968.00
Rate for Payer: UnitedHealthcare Community & State	$116.64
Rate for Payer: Wellpoint Medicaid Managed Care	$128.26

STAPLES FX

Facility

$171.00

Hospital Charge Code	270335162
Hospital Revenue Code	272
Min. Negotiated Rate	$4.12
Max. Negotiated Rate	$85.50
Rate for Payer: Aetna Commercial	$64.98
Rate for Payer: Aetna Medicare Advantage	$51.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.60
Rate for Payer: Cigna Commercial	$85.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.30
Rate for Payer: Oxford Commercial	$34.20
Rate for Payer: Qualcare PPO/HMO/WC	$25.65
Rate for Payer: UnitedHealthcare Commercial	$34.20
Rate for Payer: UnitedHealthcare Community & State	$4.12
Rate for Payer: Wellpoint Medicaid Managed Care	$4.53

STAPLES FX

Facility

$171.00

Hospital Charge Code	270335162
Hospital Revenue Code	272
Min. Negotiated Rate	$25.65
Max. Negotiated Rate	$25.65
Rate for Payer: Qualcare PPO/HMO/WC	$25.65

STAPLE SKIN EXTRACTOR

Facility

$8.66

Hospital Charge Code	270649984
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$1.30
Rate for Payer: Qualcare PPO/HMO/WC	$1.30

STAPLE SKIN EXTRACTOR

Facility

$8.66

Hospital Charge Code	270649984
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.33
Rate for Payer: Aetna Commercial	$3.29
Rate for Payer: Aetna Medicare Advantage	$2.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.21
Rate for Payer: Cigna Commercial	$4.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$1.73
Rate for Payer: Qualcare PPO/HMO/WC	$1.30
Rate for Payer: UnitedHealthcare Commercial	$1.73
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

STAPLES SINGLE N

Facility

$1,647.85

Hospital Charge Code	270670928
Hospital Revenue Code	272
Min. Negotiated Rate	$247.18
Max. Negotiated Rate	$247.18
Rate for Payer: Qualcare PPO/HMO/WC	$247.18

STAPLES SINGLE N

Facility

$1,647.85

Hospital Charge Code	270670928
Hospital Revenue Code	272
Min. Negotiated Rate	$39.71
Max. Negotiated Rate	$823.92
Rate for Payer: Aetna Commercial	$626.18
Rate for Payer: Aetna Medicare Advantage	$494.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.20
Rate for Payer: Cigna Commercial	$823.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$494.36
Rate for Payer: Oxford Commercial	$329.57
Rate for Payer: Qualcare PPO/HMO/WC	$247.18
Rate for Payer: UnitedHealthcare Commercial	$329.57
Rate for Payer: UnitedHealthcare Community & State	$39.71
Rate for Payer: Wellpoint Medicaid Managed Care	$43.67

STAPLE STR NITINOL 8X8MM

Facility

$6,036.25

Service Code	HCPCS C1713
Hospital Charge Code	270700181
Hospital Revenue Code	278
Min. Negotiated Rate	$145.47
Max. Negotiated Rate	$3,018.12
Rate for Payer: Aetna Commercial	$2,293.78
Rate for Payer: Aetna Medicare Advantage	$1,810.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,539.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,539.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,207.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,539.24
Rate for Payer: Cigna Commercial	$3,018.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,460.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,327.97
Rate for Payer: Qualcare PPO/HMO/WC	$905.44
Rate for Payer: UnitedHealthcare Community & State	$145.47
Rate for Payer: Wellpoint Medicaid Managed Care	$159.96

STAPLE STR NITINOL 8X8MM

Facility

$6,036.25

Service Code	HCPCS C1713
Hospital Charge Code	270700181
Hospital Revenue Code	278
Min. Negotiated Rate	$905.44
Max. Negotiated Rate	$1,460.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,207.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,460.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,327.97
Rate for Payer: Qualcare PPO/HMO/WC	$905.44

STAPLE SUPER MX NITI 20WX15L

Facility

$17,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270693215
Hospital Revenue Code	278
Min. Negotiated Rate	$429.58
Max. Negotiated Rate	$8,912.50
Rate for Payer: Aetna Commercial	$6,773.50
Rate for Payer: Aetna Medicare Advantage	$5,347.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,545.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,545.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,565.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,545.38
Rate for Payer: Cigna Commercial	$8,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,313.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,921.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,673.75
Rate for Payer: UnitedHealthcare Community & State	$429.58
Rate for Payer: Wellpoint Medicaid Managed Care	$472.36

STAPLE SUPER MX NITI 20WX15L

Facility

$17,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270693215
Hospital Revenue Code	278
Min. Negotiated Rate	$2,673.75
Max. Negotiated Rate	$4,313.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,565.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,313.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,921.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,673.75

STAPLE SYSTEM 10X10X10MM

Facility

$6,270.00

Service Code	HCPCS C1713
Hospital Charge Code	270690538
Hospital Revenue Code	278
Min. Negotiated Rate	$940.50
Max. Negotiated Rate	$1,517.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,254.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,517.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,379.40
Rate for Payer: Qualcare PPO/HMO/WC	$940.50

STAPLE SYSTEM 10X10X10MM

Facility

$6,270.00

Service Code	HCPCS C1713
Hospital Charge Code	270690538
Hospital Revenue Code	278
Min. Negotiated Rate	$151.11
Max. Negotiated Rate	$3,135.00
Rate for Payer: Aetna Commercial	$2,382.60
Rate for Payer: Aetna Medicare Advantage	$1,881.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,598.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,598.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,254.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,598.85
Rate for Payer: Cigna Commercial	$3,135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,517.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,379.40
Rate for Payer: Qualcare PPO/HMO/WC	$940.50
Rate for Payer: UnitedHealthcare Community & State	$151.11
Rate for Payer: Wellpoint Medicaid Managed Care	$166.16

STAPLE UNI-CLIP NTCH 15x12MM L

Facility

$3,868.55

Hospital Charge Code	270668132
Hospital Revenue Code	272
Min. Negotiated Rate	$93.23
Max. Negotiated Rate	$1,934.28
Rate for Payer: Aetna Commercial	$1,470.05
Rate for Payer: Aetna Medicare Advantage	$1,160.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$986.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$986.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$986.48
Rate for Payer: Cigna Commercial	$1,934.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,160.57
Rate for Payer: Oxford Commercial	$773.71
Rate for Payer: Qualcare PPO/HMO/WC	$580.28
Rate for Payer: UnitedHealthcare Commercial	$773.71
Rate for Payer: UnitedHealthcare Community & State	$93.23
Rate for Payer: Wellpoint Medicaid Managed Care	$102.52

STAPLE UNI-CLIP NTCH 15x12MM L

Facility

$3,868.55

Hospital Charge Code	270668132
Hospital Revenue Code	272
Min. Negotiated Rate	$580.28
Max. Negotiated Rate	$580.28
Rate for Payer: Qualcare PPO/HMO/WC	$580.28

STAPLE Z 10/11MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270695607
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

STAPLE Z 10/11MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270695607
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

Know your out-of-pocket cost for care.

All Charges