Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SYSTEM UROST 45MM 3/4FL

Facility

$92.00

Hospital Charge Code	270600410
Hospital Revenue Code	272
Min. Negotiated Rate	$2.22
Max. Negotiated Rate	$46.00
Rate for Payer: Aetna Commercial	$34.96
Rate for Payer: Aetna Medicare Advantage	$27.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.46
Rate for Payer: Cigna Commercial	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.60
Rate for Payer: Oxford Commercial	$18.40
Rate for Payer: Qualcare PPO/HMO/WC	$13.80
Rate for Payer: UnitedHealthcare Commercial	$18.40
Rate for Payer: UnitedHealthcare Community & State	$2.22
Rate for Payer: Wellpoint Medicaid Managed Care	$2.44

SYSTEM UROST 45MM 3/4FL

Facility

$92.00

Hospital Charge Code	270600410
Hospital Revenue Code	272
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.80

SYSTEM UROST 70MM 2 3/4F

Facility

$92.00

Hospital Charge Code	270600411
Hospital Revenue Code	272
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.80

SYSTEM UROST 70MM 2 3/4F

Facility

$92.00

Hospital Charge Code	270600411
Hospital Revenue Code	272
Min. Negotiated Rate	$2.22
Max. Negotiated Rate	$46.00
Rate for Payer: Aetna Commercial	$34.96
Rate for Payer: Aetna Medicare Advantage	$27.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.46
Rate for Payer: Cigna Commercial	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.60
Rate for Payer: Oxford Commercial	$18.40
Rate for Payer: Qualcare PPO/HMO/WC	$13.80
Rate for Payer: UnitedHealthcare Commercial	$18.40
Rate for Payer: UnitedHealthcare Community & State	$2.22
Rate for Payer: Wellpoint Medicaid Managed Care	$2.44

SYSTEM UROST GNTLE TCH 020929*

Facility

$51.00

Hospital Charge Code	1606037
Hospital Revenue Code	272
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

SYSTEM UROST GNTLE TCH 020929*

Facility

$51.00

Hospital Charge Code	1606037
Hospital Revenue Code	272
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$25.50
Rate for Payer: Aetna Commercial	$19.38
Rate for Payer: Aetna Medicare Advantage	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.01
Rate for Payer: Cigna Commercial	$25.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.30
Rate for Payer: Oxford Commercial	$10.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$10.20
Rate for Payer: UnitedHealthcare Community & State	$1.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1.35

SYSTEM UROST GNTLE TCH 020930*

Facility

$51.00

Hospital Charge Code	1606045
Hospital Revenue Code	272
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$25.50
Rate for Payer: Aetna Commercial	$19.38
Rate for Payer: Aetna Medicare Advantage	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.01
Rate for Payer: Cigna Commercial	$25.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.30
Rate for Payer: Oxford Commercial	$10.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$10.20
Rate for Payer: UnitedHealthcare Community & State	$1.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1.35

SYSTEM UROST GNTLE TCH 020930*

Facility

$51.00

Hospital Charge Code	1606045
Hospital Revenue Code	272
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

SYSTEM UTERINE BALLOON UMBILIC

Facility

$2,844.35

Hospital Charge Code	270657586
Hospital Revenue Code	278
Min. Negotiated Rate	$68.55
Max. Negotiated Rate	$1,422.17
Rate for Payer: Aetna Commercial	$1,080.85
Rate for Payer: Aetna Medicare Advantage	$853.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$725.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$725.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$568.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$725.31
Rate for Payer: Cigna Commercial	$1,422.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$625.76
Rate for Payer: Qualcare PPO/HMO/WC	$426.65
Rate for Payer: UnitedHealthcare Community & State	$68.55
Rate for Payer: Wellpoint Medicaid Managed Care	$75.38

SYSTEM UTERINE BALLOON UMBILIC

Facility

$2,844.35

Hospital Charge Code	270657586
Hospital Revenue Code	278
Min. Negotiated Rate	$426.65
Max. Negotiated Rate	$688.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$568.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$625.76
Rate for Payer: Qualcare PPO/HMO/WC	$426.65

SYSTEM VAC BONE GRAFT 480580VP

Facility

$1,483.10

Hospital Charge Code	270633821
Hospital Revenue Code	272
Min. Negotiated Rate	$222.47
Max. Negotiated Rate	$222.47
Rate for Payer: Qualcare PPO/HMO/WC	$222.47

SYSTEM VAC BONE GRAFT 480580VP

Facility

$1,483.10

Hospital Charge Code	270633821
Hospital Revenue Code	272
Min. Negotiated Rate	$35.74
Max. Negotiated Rate	$741.55
Rate for Payer: Aetna Commercial	$563.58
Rate for Payer: Aetna Medicare Advantage	$444.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$378.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$378.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$378.19
Rate for Payer: Cigna Commercial	$741.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$444.93
Rate for Payer: Oxford Commercial	$296.62
Rate for Payer: Qualcare PPO/HMO/WC	$222.47
Rate for Payer: UnitedHealthcare Commercial	$296.62
Rate for Payer: UnitedHealthcare Community & State	$35.74
Rate for Payer: Wellpoint Medicaid Managed Care	$39.30

SYSTEM VAS ENTRY 5f MINI 45994

Facility

$217.25

Hospital Charge Code	270628619
Hospital Revenue Code	272
Min. Negotiated Rate	$32.59
Max. Negotiated Rate	$32.59
Rate for Payer: Qualcare PPO/HMO/WC	$32.59

SYSTEM VAS ENTRY 5f MINI 45994

Facility

$217.25

Hospital Charge Code	270628619
Hospital Revenue Code	272
Min. Negotiated Rate	$5.24
Max. Negotiated Rate	$108.62
Rate for Payer: Aetna Commercial	$82.56
Rate for Payer: Aetna Medicare Advantage	$65.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.40
Rate for Payer: Cigna Commercial	$108.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.17
Rate for Payer: Oxford Commercial	$43.45
Rate for Payer: Qualcare PPO/HMO/WC	$32.59
Rate for Payer: UnitedHealthcare Commercial	$43.45
Rate for Payer: UnitedHealthcare Community & State	$5.24
Rate for Payer: Wellpoint Medicaid Managed Care	$5.76

SYSTEM VERSA-DAIL 42x18x46mmSH

Facility

$9,550.00

Service Code	HCPCS C1776
Hospital Charge Code	270665691
Hospital Revenue Code	278
Min. Negotiated Rate	$230.16
Max. Negotiated Rate	$4,775.00
Rate for Payer: Aetna Commercial	$3,629.00
Rate for Payer: Aetna Medicare Advantage	$2,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,435.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,435.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,910.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,435.25
Rate for Payer: Cigna Commercial	$4,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,311.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,101.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,432.50
Rate for Payer: UnitedHealthcare Community & State	$230.16
Rate for Payer: Wellpoint Medicaid Managed Care	$253.07

SYSTEM VERSA-DAIL 42x18x46mmSH

Facility

$9,550.00

Service Code	HCPCS C1776
Hospital Charge Code	270665691
Hospital Revenue Code	278
Min. Negotiated Rate	$1,432.50
Max. Negotiated Rate	$2,311.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,910.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,311.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,101.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,432.50

SYSTEM WMT HEAD REPAIR SJOEV01

Facility

$11,780.00

Hospital Charge Code	270628375
Hospital Revenue Code	272
Min. Negotiated Rate	$283.90
Max. Negotiated Rate	$5,890.00
Rate for Payer: Aetna Commercial	$4,476.40
Rate for Payer: Aetna Medicare Advantage	$3,534.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,003.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,003.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,003.90
Rate for Payer: Cigna Commercial	$5,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,534.00
Rate for Payer: Oxford Commercial	$2,356.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,767.00
Rate for Payer: UnitedHealthcare Commercial	$2,356.00
Rate for Payer: UnitedHealthcare Community & State	$283.90
Rate for Payer: Wellpoint Medicaid Managed Care	$312.17

SYSTEM WMT HEAD REPAIR SJOEV01

Facility

$11,780.00

Hospital Charge Code	270628375
Hospital Revenue Code	272
Min. Negotiated Rate	$1,767.00
Max. Negotiated Rate	$1,767.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,767.00

SYSTEM WMT RAD HEAD 2496KITXL

Facility

$11,780.00

Hospital Charge Code	270628230
Hospital Revenue Code	272
Min. Negotiated Rate	$1,767.00
Max. Negotiated Rate	$1,767.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,767.00

SYSTEM WMT RAD HEAD 2496KITXL

Facility

$11,780.00

Hospital Charge Code	270628230
Hospital Revenue Code	272
Min. Negotiated Rate	$283.90
Max. Negotiated Rate	$5,890.00
Rate for Payer: Aetna Commercial	$4,476.40
Rate for Payer: Aetna Medicare Advantage	$3,534.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,003.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,003.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,003.90
Rate for Payer: Cigna Commercial	$5,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,534.00
Rate for Payer: Oxford Commercial	$2,356.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,767.00
Rate for Payer: UnitedHealthcare Commercial	$2,356.00
Rate for Payer: UnitedHealthcare Community & State	$283.90
Rate for Payer: Wellpoint Medicaid Managed Care	$312.17

SYSTEM ZIM CBL GRIP 2232-50-19

Facility

$2,905.65

Hospital Charge Code	270616630
Hospital Revenue Code	278
Min. Negotiated Rate	$435.85
Max. Negotiated Rate	$703.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$581.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$703.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$639.24
Rate for Payer: Qualcare PPO/HMO/WC	$435.85

SYSTEM ZIM CBL GRIP 2232-50-19

Facility

$2,905.65

Hospital Charge Code	270616630
Hospital Revenue Code	278
Min. Negotiated Rate	$70.03
Max. Negotiated Rate	$1,452.83
Rate for Payer: Aetna Commercial	$1,104.15
Rate for Payer: Aetna Medicare Advantage	$871.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$740.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$740.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$581.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$740.94
Rate for Payer: Cigna Commercial	$1,452.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$703.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$639.24
Rate for Payer: Qualcare PPO/HMO/WC	$435.85
Rate for Payer: UnitedHealthcare Community & State	$70.03
Rate for Payer: Wellpoint Medicaid Managed Care	$77.00

SYST FIXAT LAP W/FASTNERS

Facility

$1,975.00

Hospital Charge Code	270644630
Hospital Revenue Code	272
Min. Negotiated Rate	$47.60
Max. Negotiated Rate	$987.50
Rate for Payer: Aetna Commercial	$750.50
Rate for Payer: Aetna Medicare Advantage	$592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.62
Rate for Payer: Cigna Commercial	$987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.50
Rate for Payer: Oxford Commercial	$395.00
Rate for Payer: Qualcare PPO/HMO/WC	$296.25
Rate for Payer: UnitedHealthcare Commercial	$395.00
Rate for Payer: UnitedHealthcare Community & State	$47.60
Rate for Payer: Wellpoint Medicaid Managed Care	$52.34

SYST FIXAT LAP W/FASTNERS

Facility

$1,975.00

Hospital Charge Code	270644630
Hospital Revenue Code	272
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$296.25
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

SYSTM CLLCTION DUAL HYGIENIKIT

Facility

$557.25

Hospital Charge Code	270662661
Hospital Revenue Code	270
Min. Negotiated Rate	$83.59
Max. Negotiated Rate	$83.59
Rate for Payer: Qualcare PPO/HMO/WC	$83.59

Know your out-of-pocket cost for care.

All Charges