Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BAND LIGATOR-6 SHOOTER SAEED M

Facility

$521.00

Hospital Charge Code	270334801
Hospital Revenue Code	272
Min. Negotiated Rate	$12.56
Max. Negotiated Rate	$260.50
Rate for Payer: Aetna Commercial	$197.98
Rate for Payer: Aetna Medicare Advantage	$156.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.85
Rate for Payer: Cigna Commercial	$260.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.30
Rate for Payer: Oxford Commercial	$104.20
Rate for Payer: Qualcare PPO/HMO/WC	$78.15
Rate for Payer: UnitedHealthcare Commercial	$104.20
Rate for Payer: UnitedHealthcare Community & State	$12.56
Rate for Payer: Wellpoint Medicaid Managed Care	$13.81

BANDNET FULLHEADCAP NON-ST.

Facility

$19.98

Hospital Charge Code	270650505
Hospital Revenue Code	272
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$9.99
Rate for Payer: Aetna Commercial	$7.59
Rate for Payer: Aetna Medicare Advantage	$5.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.09
Rate for Payer: Cigna Commercial	$9.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.99
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$4.00
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

BANDNET FULLHEADCAP NON-ST.

Facility

$19.98

Hospital Charge Code	270650505
Hospital Revenue Code	272
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

BAND SET STRUT MAXFRAME SET

Facility

$2,250.00

Hospital Charge Code	270683952
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

BAND SET STRUT MAXFRAME SET

Facility

$2,250.00

Hospital Charge Code	270683952
Hospital Revenue Code	272
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$675.00
Rate for Payer: Oxford Commercial	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$450.00
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

BANKART ASP, 90

Facility

$1,725.00

Hospital Charge Code	270656493
Hospital Revenue Code	272
Min. Negotiated Rate	$41.57
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$517.50
Rate for Payer: Oxford Commercial	$345.00
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Commercial	$345.00
Rate for Payer: UnitedHealthcare Community & State	$41.57
Rate for Payer: Wellpoint Medicaid Managed Care	$45.71

BANKART ASP, 90

Facility

$1,725.00

Hospital Charge Code	270656493
Hospital Revenue Code	272
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$258.75
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

BANK CRAFTSTICK BARREL CS507J

Facility

$4.80

Hospital Charge Code	270645737
Hospital Revenue Code	272
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.40
Rate for Payer: Aetna Commercial	$1.82
Rate for Payer: Aetna Medicare Advantage	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.22
Rate for Payer: Cigna Commercial	$2.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.44
Rate for Payer: Oxford Commercial	$0.96
Rate for Payer: Qualcare PPO/HMO/WC	$0.72
Rate for Payer: UnitedHealthcare Commercial	$0.96
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

BANK CRAFTSTICK BARREL CS507J

Facility

$4.80

Hospital Charge Code	270645737
Hospital Revenue Code	272
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$0.72
Rate for Payer: Qualcare PPO/HMO/WC	$0.72

BARBITURATE SCREEN AND CONFIRM

Facility

$190.45

Service Code	HCPCS 80345
Hospital Charge Code	3038101
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

BARBITURATE SCREEN AND CONFIRM

Facility

$190.45

Service Code	HCPCS 80345
Hospital Charge Code	3038101
Hospital Revenue Code	301
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$72.37
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$5.05

BARBITURATES ID & QN 1

Facility

$78.70

Service Code	HCPCS 80345
Hospital Charge Code	39900047
Hospital Revenue Code	301
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$29.91
Rate for Payer: Aetna Medicare Advantage	$23.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.07
Rate for Payer: Cigna Commercial	$39.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$2.09

BARBITURATES ID & QN 1

Facility

$78.70

Service Code	HCPCS 80345
Hospital Charge Code	39900047
Hospital Revenue Code	301
Min. Negotiated Rate	$11.80
Max. Negotiated Rate	$11.80
Rate for Payer: Qualcare PPO/HMO/WC	$11.80

BARBITURATES (QUANT URINE)

Facility

$159.25

Service Code	HCPCS 80345
Hospital Charge Code	3000395
Hospital Revenue Code	301
Min. Negotiated Rate	$23.89
Max. Negotiated Rate	$23.89
Rate for Payer: Qualcare PPO/HMO/WC	$23.89

BARBITURATES (QUANT URINE)

Facility

$159.25

Service Code	HCPCS 80345
Hospital Charge Code	3000395
Hospital Revenue Code	301
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$60.52
Rate for Payer: Aetna Medicare Advantage	$47.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.61
Rate for Payer: Cigna Commercial	$79.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.89
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$4.22

BARBITURATES (QUANT) URINE***

Facility

$57.00

Hospital Charge Code	3010394
Hospital Revenue Code	309
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$21.66
Rate for Payer: Aetna Medicare Advantage	$17.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.54
Rate for Payer: Cigna Commercial	$28.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.55
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.37
Rate for Payer: Wellpoint Medicaid Managed Care	$1.51

BARBITURATES (QUANT) URINE***

Facility

$57.00

Hospital Charge Code	3010394
Hospital Revenue Code	309
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$8.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.55

BARBITURATES, URINE

Facility

$298.20

Service Code	HCPCS 80345
Hospital Charge Code	38472131
Hospital Revenue Code	301
Min. Negotiated Rate	$7.90
Max. Negotiated Rate	$149.10
Rate for Payer: Aetna Commercial	$113.32
Rate for Payer: Aetna Medicare Advantage	$89.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.04
Rate for Payer: Cigna Commercial	$149.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.73
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$7.90

BARBITURATES, URINE

Facility

$298.20

Service Code	HCPCS 80345
Hospital Charge Code	38472131
Hospital Revenue Code	301
Min. Negotiated Rate	$44.73
Max. Negotiated Rate	$44.73
Rate for Payer: Qualcare PPO/HMO/WC	$44.73

BAR CONNECT 5.0X300 39394

Facility

$127.75

Hospital Charge Code	270634839
Hospital Revenue Code	278
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$63.88
Rate for Payer: Aetna Commercial	$48.55
Rate for Payer: Aetna Medicare Advantage	$38.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.58
Rate for Payer: Cigna Commercial	$63.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$28.11
Rate for Payer: Qualcare PPO/HMO/WC	$19.16
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

BAR CONNECT 5.0X300 39394

Facility

$127.75

Hospital Charge Code	270634839
Hospital Revenue Code	278
Min. Negotiated Rate	$19.16
Max. Negotiated Rate	$30.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$28.11
Rate for Payer: Qualcare PPO/HMO/WC	$19.16

BAR CONNECTING 4.0 X 220MM

Facility

$225.00

Hospital Charge Code	270661252
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

BAR CONNECTING 4.0 X 220MM

Facility

$225.00

Hospital Charge Code	270661252
Hospital Revenue Code	272
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.50
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$45.00
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

BAR CRBN 11MM X 250MM

Facility

$1,457.50

Service Code	HCPCS C1713
Hospital Charge Code	270704154
Hospital Revenue Code	278
Min. Negotiated Rate	$35.13
Max. Negotiated Rate	$728.75
Rate for Payer: Aetna Commercial	$553.85
Rate for Payer: Aetna Medicare Advantage	$437.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$371.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$371.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$291.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$371.66
Rate for Payer: Cigna Commercial	$728.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$218.62
Rate for Payer: UnitedHealthcare Community & State	$35.13
Rate for Payer: Wellpoint Medicaid Managed Care	$38.62

BAR CRBN 11MM X 250MM

Facility

$1,457.50

Service Code	HCPCS C1713
Hospital Charge Code	270704154
Hospital Revenue Code	278
Min. Negotiated Rate	$218.62
Max. Negotiated Rate	$352.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$291.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$218.62

Know your out-of-pocket cost for care.

All Charges