Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SYSTEM RETRACTOR TLC 8201175

Facility

$625.00

Hospital Charge Code	270633800
Hospital Revenue Code	272
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

SYSTEM SMALL JOINT REAMING

Facility

$2,775.00

Service Code	HCPCS C1776
Hospital Charge Code	270680731
Hospital Revenue Code	278
Min. Negotiated Rate	$416.25
Max. Negotiated Rate	$671.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$671.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$610.50
Rate for Payer: Qualcare PPO/HMO/WC	$416.25

SYSTEM SMALL JOINT REAMING

Facility

$2,775.00

Service Code	HCPCS C1776
Hospital Charge Code	270680731
Hospital Revenue Code	278
Min. Negotiated Rate	$66.88
Max. Negotiated Rate	$1,387.50
Rate for Payer: Aetna Commercial	$1,054.50
Rate for Payer: Aetna Medicare Advantage	$832.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$707.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$707.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$707.62
Rate for Payer: Cigna Commercial	$1,387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$671.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$610.50
Rate for Payer: Qualcare PPO/HMO/WC	$416.25
Rate for Payer: UnitedHealthcare Community & State	$66.88
Rate for Payer: Wellpoint Medicaid Managed Care	$73.54

SYSTEM SML BON FIX 062 SBFS062

Facility

$1,475.00

Hospital Charge Code	270634780
Hospital Revenue Code	272
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.50
Rate for Payer: Oxford Commercial	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$295.00
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

SYSTEM SML BON FIX 062 SBFS062

Facility

$1,475.00

Hospital Charge Code	270634780
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SYSTEM SOLYX SIS

Facility

$9,501.75

Service Code	HCPCS C1771
Hospital Charge Code	270677084
Hospital Revenue Code	278
Min. Negotiated Rate	$1,425.26
Max. Negotiated Rate	$2,299.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,090.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.26

SYSTEM SOLYX SIS

Facility

$9,501.75

Service Code	HCPCS C1771
Hospital Charge Code	270677084
Hospital Revenue Code	278
Min. Negotiated Rate	$228.99
Max. Negotiated Rate	$4,750.88
Rate for Payer: Aetna Commercial	$3,610.66
Rate for Payer: Aetna Medicare Advantage	$2,850.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.95
Rate for Payer: Cigna Commercial	$4,750.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,090.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.26
Rate for Payer: UnitedHealthcare Community & State	$228.99
Rate for Payer: Wellpoint Medicaid Managed Care	$251.80

SYSTEM SPARC SLING

Facility

$4,625.00

Service Code	HCPCS C1771
Hospital Charge Code	270623602
Hospital Revenue Code	278
Min. Negotiated Rate	$111.46
Max. Negotiated Rate	$2,312.50
Rate for Payer: Aetna Commercial	$1,757.50
Rate for Payer: Aetna Medicare Advantage	$1,387.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,179.38
Rate for Payer: Cigna Commercial	$2,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,017.50
Rate for Payer: Qualcare PPO/HMO/WC	$693.75
Rate for Payer: UnitedHealthcare Community & State	$111.46
Rate for Payer: Wellpoint Medicaid Managed Care	$122.56

SYSTEM SPARC SLING

Facility

$4,625.00

Service Code	HCPCS C1771
Hospital Charge Code	270623602
Hospital Revenue Code	278
Min. Negotiated Rate	$693.75
Max. Negotiated Rate	$1,119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,017.50
Rate for Payer: Qualcare PPO/HMO/WC	$693.75

SYSTEM SURG STEEL CBL F BO

Facility

$1,588.85

Hospital Charge Code	270607201
Hospital Revenue Code	278
Min. Negotiated Rate	$38.29
Max. Negotiated Rate	$794.42
Rate for Payer: Aetna Commercial	$603.76
Rate for Payer: Aetna Medicare Advantage	$476.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$405.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$405.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$317.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$405.16
Rate for Payer: Cigna Commercial	$794.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$349.55
Rate for Payer: Qualcare PPO/HMO/WC	$238.33
Rate for Payer: UnitedHealthcare Community & State	$38.29
Rate for Payer: Wellpoint Medicaid Managed Care	$42.10

SYSTEM SURG STEEL CBL F BO

Facility

$1,588.85

Hospital Charge Code	270607201
Hospital Revenue Code	278
Min. Negotiated Rate	$238.33
Max. Negotiated Rate	$384.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$317.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$349.55
Rate for Payer: Qualcare PPO/HMO/WC	$238.33

SYSTEM SYMPHONY SINGLE PUMP

Facility

$71.04

Hospital Charge Code	270667339
Hospital Revenue Code	270
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$35.52
Rate for Payer: Aetna Commercial	$27.00
Rate for Payer: Aetna Medicare Advantage	$21.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.12
Rate for Payer: Cigna Commercial	$35.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.31
Rate for Payer: Oxford Commercial	$14.21
Rate for Payer: Qualcare PPO/HMO/WC	$10.66
Rate for Payer: UnitedHealthcare Commercial	$14.21
Rate for Payer: UnitedHealthcare Community & State	$1.71
Rate for Payer: Wellpoint Medicaid Managed Care	$1.88

SYSTEM SYMPHONY SINGLE PUMP

Facility

$71.04

Hospital Charge Code	270667339
Hospital Revenue Code	270
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$10.66
Rate for Payer: Qualcare PPO/HMO/WC	$10.66

SYSTEM THERM ROOM TEMP

Facility

$99.25

Hospital Charge Code	270600723
Hospital Revenue Code	270
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$14.89
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

SYSTEM THERM ROOM TEMP

Facility

$99.25

Hospital Charge Code	270600723
Hospital Revenue Code	270
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$49.62
Rate for Payer: Aetna Commercial	$37.72
Rate for Payer: Aetna Medicare Advantage	$29.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.31
Rate for Payer: Cigna Commercial	$49.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.77
Rate for Payer: Oxford Commercial	$19.85
Rate for Payer: Qualcare PPO/HMO/WC	$14.89
Rate for Payer: UnitedHealthcare Commercial	$19.85
Rate for Payer: UnitedHealthcare Community & State	$2.39
Rate for Payer: Wellpoint Medicaid Managed Care	$2.63

SYSTEM THROMBECTOMY PROL 86311

Facility

$2,975.00

Hospital Charge Code	270632896V
Hospital Revenue Code	278
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) NJ Health	$595.00
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	$719.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$654.50
Rate for Payer: Qualcare PPO/HMO/WC	$446.25
Rate for Payer: UnitedHealthcare Community & State	$71.70
Rate for Payer: Wellpoint Medicaid Managed Care	$78.84

SYSTEM THROMBECTOMY PROL 86311

Facility

$2,975.00

Hospital Charge Code	270632896V
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$719.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$654.50
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

SYSTEM THROMBECTOMY PROL 86511

Facility

$2,975.00

Hospital Charge Code	270632896
Hospital Revenue Code	278
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) NJ Health	$595.00
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	$719.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$654.50
Rate for Payer: Qualcare PPO/HMO/WC	$446.25
Rate for Payer: UnitedHealthcare Community & State	$71.70
Rate for Payer: Wellpoint Medicaid Managed Care	$78.84

SYSTEM THROMBECTOMY PROL 86511

Facility

$2,975.00

Hospital Charge Code	270632896
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$719.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$654.50
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

SYSTEM TRACH ADULT W/SWIVEL T

Facility

$29.61

Hospital Charge Code	270622088
Hospital Revenue Code	270
Min. Negotiated Rate	$4.44
Max. Negotiated Rate	$4.44
Rate for Payer: Qualcare PPO/HMO/WC	$4.44

SYSTEM TRACH ADULT W/SWIVEL T

Facility

$29.61

Hospital Charge Code	270622088
Hospital Revenue Code	270
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$14.80
Rate for Payer: Aetna Commercial	$11.25
Rate for Payer: Aetna Medicare Advantage	$8.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.55
Rate for Payer: Cigna Commercial	$14.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: Oxford Commercial	$5.92
Rate for Payer: Qualcare PPO/HMO/WC	$4.44
Rate for Payer: UnitedHealthcare Commercial	$5.92
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.78

SYSTEM TRANSURETHRAL INJECT

Facility

$231.25

Hospital Charge Code	270604621
Hospital Revenue Code	272
Min. Negotiated Rate	$5.57
Max. Negotiated Rate	$115.62
Rate for Payer: Aetna Commercial	$87.88
Rate for Payer: Aetna Medicare Advantage	$69.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.97
Rate for Payer: Cigna Commercial	$115.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.38
Rate for Payer: Oxford Commercial	$46.25
Rate for Payer: Qualcare PPO/HMO/WC	$34.69
Rate for Payer: UnitedHealthcare Commercial	$46.25
Rate for Payer: UnitedHealthcare Community & State	$5.57
Rate for Payer: Wellpoint Medicaid Managed Care	$6.13

SYSTEM TRANSURETHRAL INJECT

Facility

$231.25

Hospital Charge Code	270604621
Hospital Revenue Code	272
Min. Negotiated Rate	$34.69
Max. Negotiated Rate	$34.69
Rate for Payer: Qualcare PPO/HMO/WC	$34.69

SYSTEM UCL INTERNAL BRACE

Facility

$5,895.00

Hospital Charge Code	270680851
Hospital Revenue Code	278
Min. Negotiated Rate	$142.07
Max. Negotiated Rate	$2,947.50
Rate for Payer: Aetna Commercial	$2,240.10
Rate for Payer: Aetna Medicare Advantage	$1,768.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,503.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,503.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,179.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,503.22
Rate for Payer: Cigna Commercial	$2,947.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,426.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,296.90
Rate for Payer: Qualcare PPO/HMO/WC	$884.25
Rate for Payer: UnitedHealthcare Community & State	$142.07
Rate for Payer: Wellpoint Medicaid Managed Care	$156.22

SYSTEM UCL INTERNAL BRACE

Facility

$5,895.00

Hospital Charge Code	270680851
Hospital Revenue Code	278
Min. Negotiated Rate	$884.25
Max. Negotiated Rate	$1,426.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,179.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,426.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,296.90
Rate for Payer: Qualcare PPO/HMO/WC	$884.25

Know your out-of-pocket cost for care.

All Charges