Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STRESS VIEWS ANY JOINT

Facility

$196.00

Service Code	HCPCS 77071
Hospital Charge Code	94061191
Hospital Revenue Code	320
Min. Negotiated Rate	$29.40
Max. Negotiated Rate	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$29.40

STRESS VIEWS ANY JOINT

Facility

$196.00

Service Code	HCPCS 77071
Hospital Charge Code	94061191
Hospital Revenue Code	320
Min. Negotiated Rate	$4.72
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$281.22
Rate for Payer: Aetna Medicare Advantage	$334.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$103.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.21
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: Cigna Medicare Advantage	$72.37
Rate for Payer: Clover Medicare Advantage	$98.22
Rate for Payer: EmblemHealth Commercial	$310.17
Rate for Payer: Humana Medicare Advantage	$106.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$103.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.80
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.40
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$4.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$103.39
Rate for Payer: Wellcare Medicare Advantage	$103.39
Rate for Payer: Wellpoint Medicaid Managed Care	$5.19

STRIATED MUSCLE AB W/RFX

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900206
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

STRIATED MUSCLE AB W/RFX

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900206
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

STRIATED MUSCLE ANTIBODY

Facility

$407.00

Service Code	HCPCS 86255
Hospital Charge Code	38472925
Hospital Revenue Code	302
Min. Negotiated Rate	$61.05
Max. Negotiated Rate	$61.05
Rate for Payer: Qualcare PPO/HMO/WC	$61.05

STRIATED MUSCLE ANTIBODY

Facility

$407.00

Service Code	HCPCS 86255
Hospital Charge Code	38472925
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$203.50
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$203.50
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$10.79

STRINGE FASTURN 150ML W/QUICK

Facility

$22.25

Hospital Charge Code	2706000595
Hospital Revenue Code	272
Min. Negotiated Rate	$3.34
Max. Negotiated Rate	$3.34
Rate for Payer: Qualcare PPO/HMO/WC	$3.34

STRINGE FASTURN 150ML W/QUICK

Facility

$22.25

Hospital Charge Code	2706000595
Hospital Revenue Code	272
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.12
Rate for Payer: Aetna Commercial	$8.46
Rate for Payer: Aetna Medicare Advantage	$6.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.67
Rate for Payer: Cigna Commercial	$11.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.67
Rate for Payer: Oxford Commercial	$4.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.34
Rate for Payer: UnitedHealthcare Commercial	$4.45
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

STRIP BIO-OSTETIC

Facility

$5,000.00

Hospital Charge Code	270656124
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

STRIP BIO-OSTETIC

Facility

$5,000.00

Hospital Charge Code	270656124
Hospital Revenue Code	278
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

STRIP BONE LAMINAR 20X40 82C

Facility

$2,759.25

Hospital Charge Code	270615463
Hospital Revenue Code	272
Min. Negotiated Rate	$413.89
Max. Negotiated Rate	$413.89
Rate for Payer: Qualcare PPO/HMO/WC	$413.89

STRIP BONE LAMINAR 20X40 82C

Facility

$2,759.25

Hospital Charge Code	270615463
Hospital Revenue Code	272
Min. Negotiated Rate	$66.50
Max. Negotiated Rate	$1,379.62
Rate for Payer: Aetna Commercial	$1,048.52
Rate for Payer: Aetna Medicare Advantage	$827.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$703.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$703.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$703.61
Rate for Payer: Cigna Commercial	$1,379.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$827.77
Rate for Payer: Oxford Commercial	$551.85
Rate for Payer: Qualcare PPO/HMO/WC	$413.89
Rate for Payer: UnitedHealthcare Commercial	$551.85
Rate for Payer: UnitedHealthcare Community & State	$66.50
Rate for Payer: Wellpoint Medicaid Managed Care	$73.12

STRIP CODMAN SURGICAL 1/4X

Facility

$1,290.00

Hospital Charge Code	270660810
Hospital Revenue Code	272
Min. Negotiated Rate	$31.09
Max. Negotiated Rate	$645.00
Rate for Payer: Aetna Commercial	$490.20
Rate for Payer: Aetna Medicare Advantage	$387.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.95
Rate for Payer: Cigna Commercial	$645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.00
Rate for Payer: Oxford Commercial	$258.00
Rate for Payer: Qualcare PPO/HMO/WC	$193.50
Rate for Payer: UnitedHealthcare Commercial	$258.00
Rate for Payer: UnitedHealthcare Community & State	$31.09
Rate for Payer: Wellpoint Medicaid Managed Care	$34.19

STRIP CODMAN SURGICAL 1/4X

Facility

$1,290.00

Hospital Charge Code	270660810
Hospital Revenue Code	272
Min. Negotiated Rate	$193.50
Max. Negotiated Rate	$193.50
Rate for Payer: Qualcare PPO/HMO/WC	$193.50

STRIP ETHCN PROXI .5 X 4 104K

Facility

$12.38

Hospital Charge Code	270624929
Hospital Revenue Code	272
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$1.86
Rate for Payer: Qualcare PPO/HMO/WC	$1.86

STRIP ETHCN PROXI .5 X 4 104K

Facility

$12.38

Hospital Charge Code	270624929
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$6.19
Rate for Payer: Aetna Commercial	$4.70
Rate for Payer: Aetna Medicare Advantage	$3.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.16
Rate for Payer: Cigna Commercial	$6.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.71
Rate for Payer: Oxford Commercial	$2.48
Rate for Payer: Qualcare PPO/HMO/WC	$1.86
Rate for Payer: UnitedHealthcare Commercial	$2.48
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

STRIP FIBER FUSE 1X10CM

Facility

$10,318.75

Service Code	HCPCS C1713
Hospital Charge Code	270694063
Hospital Revenue Code	278
Min. Negotiated Rate	$248.68
Max. Negotiated Rate	$5,159.38
Rate for Payer: Aetna Commercial	$3,921.12
Rate for Payer: Aetna Medicare Advantage	$3,095.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,631.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,631.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,063.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,631.28
Rate for Payer: Cigna Commercial	$5,159.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,497.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,270.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,547.81
Rate for Payer: UnitedHealthcare Community & State	$248.68
Rate for Payer: Wellpoint Medicaid Managed Care	$273.45

STRIP FIBER FUSE 1X10CM

Facility

$10,318.75

Service Code	HCPCS C1713
Hospital Charge Code	270694063
Hospital Revenue Code	278
Min. Negotiated Rate	$1,547.81
Max. Negotiated Rate	$2,497.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,063.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,497.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,270.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,547.81

STRIP GRAFT BI-OSTETIC

Facility

$5,000.00

Hospital Charge Code	270656126
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

STRIP GRAFT BI-OSTETIC

Facility

$5,000.00

Hospital Charge Code	270656126
Hospital Revenue Code	278
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

STRIP ILIUM TRCORT 45MM 100500

Facility

$4,316.85

Hospital Charge Code	270609381
Hospital Revenue Code	278
Min. Negotiated Rate	$647.53
Max. Negotiated Rate	$1,044.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$863.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,044.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$949.71
Rate for Payer: Qualcare PPO/HMO/WC	$647.53

STRIP ILIUM TRCORT 45MM 100500

Facility

$4,316.85

Hospital Charge Code	270609381
Hospital Revenue Code	278
Min. Negotiated Rate	$104.04
Max. Negotiated Rate	$2,158.43
Rate for Payer: Aetna Commercial	$1,640.40
Rate for Payer: Aetna Medicare Advantage	$1,295.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,100.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,100.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$863.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,100.80
Rate for Payer: Cigna Commercial	$2,158.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,044.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$949.71
Rate for Payer: Qualcare PPO/HMO/WC	$647.53
Rate for Payer: UnitedHealthcare Community & State	$104.04
Rate for Payer: Wellpoint Medicaid Managed Care	$114.40

STRIP ILIUM TRCORT 45MM 500500

Facility

$3,407.25

Hospital Charge Code	270609329
Hospital Revenue Code	278
Min. Negotiated Rate	$82.11
Max. Negotiated Rate	$1,703.62
Rate for Payer: Aetna Commercial	$1,294.76
Rate for Payer: Aetna Medicare Advantage	$1,022.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$868.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$868.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$681.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$868.85
Rate for Payer: Cigna Commercial	$1,703.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$824.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$749.60
Rate for Payer: Qualcare PPO/HMO/WC	$511.09
Rate for Payer: UnitedHealthcare Community & State	$82.11
Rate for Payer: Wellpoint Medicaid Managed Care	$90.29

STRIP ILIUM TRCORT 45MM 500500

Facility

$3,407.25

Hospital Charge Code	270609329
Hospital Revenue Code	278
Min. Negotiated Rate	$511.09
Max. Negotiated Rate	$824.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$681.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$824.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$749.60
Rate for Payer: Qualcare PPO/HMO/WC	$511.09

STRIP ILIUM TRCORT 60MM 100530

Facility

$3,414.45

Hospital Charge Code	270609382
Hospital Revenue Code	278
Min. Negotiated Rate	$512.17
Max. Negotiated Rate	$826.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$682.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$826.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$751.18
Rate for Payer: Qualcare PPO/HMO/WC	$512.17

Know your out-of-pocket cost for care.

All Charges