Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SYSTEM FIXATION MENISCAL ULTRA

Facility

$1,595.00

Hospital Charge Code	270656316
Hospital Revenue Code	272
Min. Negotiated Rate	$38.44
Max. Negotiated Rate	$797.50
Rate for Payer: Aetna Commercial	$606.10
Rate for Payer: Aetna Medicare Advantage	$478.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$406.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$406.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$406.73
Rate for Payer: Cigna Commercial	$797.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$478.50
Rate for Payer: Oxford Commercial	$319.00
Rate for Payer: Qualcare PPO/HMO/WC	$239.25
Rate for Payer: UnitedHealthcare Commercial	$319.00
Rate for Payer: UnitedHealthcare Community & State	$38.44
Rate for Payer: Wellpoint Medicaid Managed Care	$42.27

SYSTEM FIXATION MENISCAL ULTRA

Facility

$1,595.00

Hospital Charge Code	270656316
Hospital Revenue Code	272
Min. Negotiated Rate	$239.25
Max. Negotiated Rate	$239.25
Rate for Payer: Qualcare PPO/HMO/WC	$239.25

SYSTEM FLUID MGMT 16001302

Facility

$2,618.95

Hospital Charge Code	270630299
Hospital Revenue Code	272
Min. Negotiated Rate	$63.12
Max. Negotiated Rate	$1,309.47
Rate for Payer: Aetna Commercial	$995.20
Rate for Payer: Aetna Medicare Advantage	$785.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$667.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$667.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$667.83
Rate for Payer: Cigna Commercial	$1,309.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$785.68
Rate for Payer: Oxford Commercial	$523.79
Rate for Payer: Qualcare PPO/HMO/WC	$392.84
Rate for Payer: UnitedHealthcare Commercial	$523.79
Rate for Payer: UnitedHealthcare Community & State	$63.12
Rate for Payer: Wellpoint Medicaid Managed Care	$69.40

SYSTEM FLUID MGMT 16001302

Facility

$2,618.95

Hospital Charge Code	270630299
Hospital Revenue Code	272
Min. Negotiated Rate	$392.84
Max. Negotiated Rate	$392.84
Rate for Payer: Qualcare PPO/HMO/WC	$392.84

SYSTEM FORCE TRIAD RENTAL FEE

Facility

$2,975.00

Hospital Charge Code	270643234
Hospital Revenue Code	272
Min. Negotiated Rate	$71.70
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$1,130.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$892.50
Rate for Payer: Oxford Commercial	$595.00
Rate for Payer: Qualcare PPO/HMO/WC	$446.25
Rate for Payer: UnitedHealthcare Commercial	$595.00
Rate for Payer: UnitedHealthcare Community & State	$71.70
Rate for Payer: Wellpoint Medicaid Managed Care	$78.84

SYSTEM FORCE TRIAD RENTAL FEE

Facility

$2,975.00

Hospital Charge Code	270643234
Hospital Revenue Code	272
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$446.25
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

SYSTEM GELPORT HAND ACCESS

Facility

$2,875.00

Hospital Charge Code	270639482
Hospital Revenue Code	272
Min. Negotiated Rate	$69.29
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$1,092.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$862.50
Rate for Payer: Oxford Commercial	$575.00
Rate for Payer: Qualcare PPO/HMO/WC	$431.25
Rate for Payer: UnitedHealthcare Commercial	$575.00
Rate for Payer: UnitedHealthcare Community & State	$69.29
Rate for Payer: Wellpoint Medicaid Managed Care	$76.19

SYSTEM GELPORT HAND ACCESS

Facility

$2,875.00

Hospital Charge Code	270639482
Hospital Revenue Code	272
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$431.25
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

SYSTEM IMPLANT LNT 4.75 BC

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692479
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

SYSTEM IMPLANT LNT 4.75 BC

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692479
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

SYSTEM INDIGO 12 LIGHTING ASPI

Facility

$34,050.00

Hospital Charge Code	270689719
Hospital Revenue Code	272
Min. Negotiated Rate	$820.61
Max. Negotiated Rate	$17,025.00
Rate for Payer: Aetna Commercial	$12,939.00
Rate for Payer: Aetna Medicare Advantage	$10,215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,682.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,682.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,682.75
Rate for Payer: Cigna Commercial	$17,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,215.00
Rate for Payer: Oxford Commercial	$6,810.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,107.50
Rate for Payer: UnitedHealthcare Commercial	$6,810.00
Rate for Payer: UnitedHealthcare Community & State	$820.61
Rate for Payer: Wellpoint Medicaid Managed Care	$902.33

SYSTEM INDIGO 12 LIGHTING ASPI

Facility

$34,050.00

Hospital Charge Code	270689719
Hospital Revenue Code	272
Min. Negotiated Rate	$5,107.50
Max. Negotiated Rate	$5,107.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,107.50

SYSTEM INTRASCAN ULTRSND

Facility

$5,376.00

Hospital Charge Code	270607646
Hospital Revenue Code	270
Min. Negotiated Rate	$806.40
Max. Negotiated Rate	$806.40
Rate for Payer: Qualcare PPO/HMO/WC	$806.40

SYSTEM INTRASCAN ULTRSND

Facility

$5,376.00

Hospital Charge Code	270607646
Hospital Revenue Code	270
Min. Negotiated Rate	$129.56
Max. Negotiated Rate	$2,688.00
Rate for Payer: Aetna Commercial	$2,042.88
Rate for Payer: Aetna Medicare Advantage	$1,612.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.88
Rate for Payer: Cigna Commercial	$2,688.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,612.80
Rate for Payer: Oxford Commercial	$1,075.20
Rate for Payer: Qualcare PPO/HMO/WC	$806.40
Rate for Payer: UnitedHealthcare Commercial	$1,075.20
Rate for Payer: UnitedHealthcare Community & State	$129.56
Rate for Payer: Wellpoint Medicaid Managed Care	$142.46

SYSTEM INZONE DETACHMENT

Facility

$1,068.75

Hospital Charge Code	270689820S
Hospital Revenue Code	272
Min. Negotiated Rate	$160.31
Max. Negotiated Rate	$160.31
Rate for Payer: Qualcare PPO/HMO/WC	$160.31

SYSTEM INZONE DETACHMENT

Facility

$1,068.75

Hospital Charge Code	270689820S
Hospital Revenue Code	272
Min. Negotiated Rate	$25.76
Max. Negotiated Rate	$534.38
Rate for Payer: Aetna Commercial	$406.12
Rate for Payer: Aetna Medicare Advantage	$320.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.53
Rate for Payer: Cigna Commercial	$534.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.62
Rate for Payer: Oxford Commercial	$213.75
Rate for Payer: Qualcare PPO/HMO/WC	$160.31
Rate for Payer: UnitedHealthcare Commercial	$213.75
Rate for Payer: UnitedHealthcare Community & State	$25.76
Rate for Payer: Wellpoint Medicaid Managed Care	$28.32

SYSTEM INZONE DETACHMENT

Facility

$1,068.75

Hospital Charge Code	270689820
Hospital Revenue Code	272
Min. Negotiated Rate	$25.76
Max. Negotiated Rate	$534.38
Rate for Payer: Aetna Commercial	$406.12
Rate for Payer: Aetna Medicare Advantage	$320.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.53
Rate for Payer: Cigna Commercial	$534.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.62
Rate for Payer: Oxford Commercial	$213.75
Rate for Payer: Qualcare PPO/HMO/WC	$160.31
Rate for Payer: UnitedHealthcare Commercial	$213.75
Rate for Payer: UnitedHealthcare Community & State	$25.76
Rate for Payer: Wellpoint Medicaid Managed Care	$28.32

SYSTEM INZONE DETACHMENT

Facility

$1,068.75

Hospital Charge Code	270689820
Hospital Revenue Code	272
Min. Negotiated Rate	$160.31
Max. Negotiated Rate	$160.31
Rate for Payer: Qualcare PPO/HMO/WC	$160.31

SYSTEM JETSTREAM 1.6mm

Facility

$16,125.00

Service Code	HCPCS C1724
Hospital Charge Code	270646322
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,547.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

SYSTEM JETSTREAM 1.6mm

Facility

$16,125.00

Service Code	HCPCS C1724
Hospital Charge Code	270646322S
Hospital Revenue Code	278
Min. Negotiated Rate	$388.61
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,547.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$388.61
Rate for Payer: Wellpoint Medicaid Managed Care	$427.31

SYSTEM JETSTREAM 1.6mm

Facility

$16,125.00

Service Code	HCPCS C1724
Hospital Charge Code	270646322
Hospital Revenue Code	278
Min. Negotiated Rate	$388.61
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,547.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$388.61
Rate for Payer: Wellpoint Medicaid Managed Care	$427.31

SYSTEM JETSTREAM 1.6mm

Facility

$16,125.00

Service Code	HCPCS C1724
Hospital Charge Code	270646322S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,547.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

SYSTEM JETSTREAM 1.6MM PV3116F

Facility

$16,125.00

Service Code	HCPCS C1724
Hospital Charge Code	270646322N
Hospital Revenue Code	278
Min. Negotiated Rate	$388.61
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,547.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$388.61
Rate for Payer: Wellpoint Medicaid Managed Care	$427.31

SYSTEM JETSTREAM 1.6MM PV3116F

Facility

$16,125.00

Service Code	HCPCS C1724
Hospital Charge Code	270646322C
Hospital Revenue Code	278
Min. Negotiated Rate	$388.61
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,547.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$388.61
Rate for Payer: Wellpoint Medicaid Managed Care	$427.31

SYSTEM JETSTREAM 1.6MM PV3116F

Facility

$16,125.00

Service Code	HCPCS C1724
Hospital Charge Code	270646322N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,547.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

Know your out-of-pocket cost for care.

All Charges