Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BEARIN TIB PS+ 18x79/83 183768

Facility

$5,875.00

Hospital Charge Code	270640151
Hospital Revenue Code	278
Min. Negotiated Rate	$141.59
Max. Negotiated Rate	$2,937.50
Rate for Payer: Aetna Commercial	$2,232.50
Rate for Payer: Aetna Medicare Advantage	$1,762.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,498.12
Rate for Payer: Cigna Commercial	$2,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,292.50
Rate for Payer: Qualcare PPO/HMO/WC	$881.25
Rate for Payer: UnitedHealthcare Community & State	$141.59
Rate for Payer: Wellpoint Medicaid Managed Care	$155.69

BEARIN TIB PS+ 18x79/83 183768

Facility

$5,875.00

Hospital Charge Code	270640151
Hospital Revenue Code	278
Min. Negotiated Rate	$881.25
Max. Negotiated Rate	$1,421.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,292.50
Rate for Payer: Qualcare PPO/HMO/WC	$881.25

BEAR OXFORD RT 4mm MED 159576

Facility

$3,605.00

Hospital Charge Code	270639866
Hospital Revenue Code	278
Min. Negotiated Rate	$540.75
Max. Negotiated Rate	$872.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$721.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$793.10
Rate for Payer: Qualcare PPO/HMO/WC	$540.75

BEAR OXFORD RT 4mm MED 159576

Facility

$3,605.00

Hospital Charge Code	270639866
Hospital Revenue Code	278
Min. Negotiated Rate	$86.88
Max. Negotiated Rate	$1,802.50
Rate for Payer: Aetna Commercial	$1,369.90
Rate for Payer: Aetna Medicare Advantage	$1,081.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$721.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.27
Rate for Payer: Cigna Commercial	$1,802.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$793.10
Rate for Payer: Qualcare PPO/HMO/WC	$540.75
Rate for Payer: UnitedHealthcare Community & State	$86.88
Rate for Payer: Wellpoint Medicaid Managed Care	$95.53

BEAR TIB 10mmk X 71/75m 183540

Facility

$5,260.00

Hospital Charge Code	270639971
Hospital Revenue Code	278
Min. Negotiated Rate	$789.00
Max. Negotiated Rate	$1,272.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,052.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,272.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,157.20
Rate for Payer: Qualcare PPO/HMO/WC	$789.00

BEAR TIB 10mmk X 71/75m 183540

Facility

$5,260.00

Hospital Charge Code	270639971
Hospital Revenue Code	278
Min. Negotiated Rate	$126.77
Max. Negotiated Rate	$2,630.00
Rate for Payer: Aetna Commercial	$1,998.80
Rate for Payer: Aetna Medicare Advantage	$1,578.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,341.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,341.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,052.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,341.30
Rate for Payer: Cigna Commercial	$2,630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,272.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,157.20
Rate for Payer: Qualcare PPO/HMO/WC	$789.00
Rate for Payer: UnitedHealthcare Community & State	$126.77
Rate for Payer: Wellpoint Medicaid Managed Care	$139.39

BEAR TIB 16x63/67 MAX11146736

Facility

$7,628.50

Hospital Charge Code	270635584
Hospital Revenue Code	278
Min. Negotiated Rate	$183.85
Max. Negotiated Rate	$3,814.25
Rate for Payer: Aetna Commercial	$2,898.83
Rate for Payer: Aetna Medicare Advantage	$2,288.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,945.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,945.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,525.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,945.27
Rate for Payer: Cigna Commercial	$3,814.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,846.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,678.27
Rate for Payer: Qualcare PPO/HMO/WC	$1,144.28
Rate for Payer: UnitedHealthcare Community & State	$183.85
Rate for Payer: Wellpoint Medicaid Managed Care	$202.16

BEAR TIB 16x63/67 MAX11146736

Facility

$7,628.50

Hospital Charge Code	270635584
Hospital Revenue Code	278
Min. Negotiated Rate	$1,144.28
Max. Negotiated Rate	$1,846.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,525.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,846.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,678.27
Rate for Payer: Qualcare PPO/HMO/WC	$1,144.28

BEAR TIB CR 10Mx79/83M 183560

Facility

$5,260.00

Hospital Charge Code	270640762
Hospital Revenue Code	278
Min. Negotiated Rate	$789.00
Max. Negotiated Rate	$1,272.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,052.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,272.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,157.20
Rate for Payer: Qualcare PPO/HMO/WC	$789.00

BEAR TIB CR 10Mx79/83M 183560

Facility

$5,260.00

Hospital Charge Code	270640762
Hospital Revenue Code	278
Min. Negotiated Rate	$126.77
Max. Negotiated Rate	$2,630.00
Rate for Payer: Aetna Commercial	$1,998.80
Rate for Payer: Aetna Medicare Advantage	$1,578.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,341.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,341.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,052.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,341.30
Rate for Payer: Cigna Commercial	$2,630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,272.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,157.20
Rate for Payer: Qualcare PPO/HMO/WC	$789.00
Rate for Payer: UnitedHealthcare Community & State	$126.77
Rate for Payer: Wellpoint Medicaid Managed Care	$139.39

BEAR TIBIA 10mm 79/83mm 183660

Facility

$5,520.00

Hospital Charge Code	270639713
Hospital Revenue Code	278
Min. Negotiated Rate	$828.00
Max. Negotiated Rate	$1,335.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,335.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,214.40
Rate for Payer: Qualcare PPO/HMO/WC	$828.00

BEAR TIBIA 10mm 79/83mm 183660

Facility

$5,520.00

Hospital Charge Code	270639713
Hospital Revenue Code	278
Min. Negotiated Rate	$133.03
Max. Negotiated Rate	$2,760.00
Rate for Payer: Aetna Commercial	$2,097.60
Rate for Payer: Aetna Medicare Advantage	$1,656.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,407.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,407.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,104.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,407.60
Rate for Payer: Cigna Commercial	$2,760.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,335.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,214.40
Rate for Payer: Qualcare PPO/HMO/WC	$828.00
Rate for Payer: UnitedHealthcare Community & State	$133.03
Rate for Payer: Wellpoint Medicaid Managed Care	$146.28

BEAR TIB PS+14Mx79/83M 183764

Facility

$5,875.00

Hospital Charge Code	270640787
Hospital Revenue Code	278
Min. Negotiated Rate	$141.59
Max. Negotiated Rate	$2,937.50
Rate for Payer: Aetna Commercial	$2,232.50
Rate for Payer: Aetna Medicare Advantage	$1,762.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,498.12
Rate for Payer: Cigna Commercial	$2,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,292.50
Rate for Payer: Qualcare PPO/HMO/WC	$881.25
Rate for Payer: UnitedHealthcare Community & State	$141.59
Rate for Payer: Wellpoint Medicaid Managed Care	$155.69

BEAR TIB PS+14Mx79/83M 183764

Facility

$5,875.00

Hospital Charge Code	270640787
Hospital Revenue Code	278
Min. Negotiated Rate	$881.25
Max. Negotiated Rate	$1,421.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,292.50
Rate for Payer: Qualcare PPO/HMO/WC	$881.25

BEAR TIB PS+16MMx79/83M 183766

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270640903
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

BEAR TIB PS+16MMx79/83M 183766

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270640903
Hospital Revenue Code	278
Min. Negotiated Rate	$241.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$241.00
Rate for Payer: Wellpoint Medicaid Managed Care	$265.00

BEAVER BLADE #67

Facility

$7.88

Hospital Charge Code	270650779
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.94
Rate for Payer: Aetna Commercial	$2.99
Rate for Payer: Aetna Medicare Advantage	$2.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.01
Rate for Payer: Cigna Commercial	$3.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.36
Rate for Payer: Oxford Commercial	$1.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.18
Rate for Payer: UnitedHealthcare Commercial	$1.58
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

BEAVER BLADE #67

Facility

$7.88

Hospital Charge Code	270650779
Hospital Revenue Code	272
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$1.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.18

BEAVER OPTUMUM KNIFE 15 DEG

Facility

$250.00

Hospital Charge Code	270656603
Hospital Revenue Code	272
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.00
Rate for Payer: Oxford Commercial	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$50.00
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

BEAVER OPTUMUM KNIFE 15 DEG

Facility

$250.00

Hospital Charge Code	270656603
Hospital Revenue Code	272
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

BEBTELOVIMAB INJ AND MONITOR

Facility

$2,250.00

Service Code	HCPCS M0222
Hospital Charge Code	3035M0222
Hospital Revenue Code	771
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	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

BEBTELOVIMAB INJ AND MONITOR

Facility

$2,250.00

Service Code	HCPCS M0222
Hospital Charge Code	3235M0222
Hospital Revenue Code	771
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	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

BEBTELOVIMAB INJ AND MONITOR

Facility

$2,250.00

Service Code	HCPCS M0222
Hospital Charge Code	3240M0222
Hospital Revenue Code	771
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	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

BEBTELOVIMAB INJ AND MONITOR

Facility

$2,250.00

Service Code	HCPCS M0222
Hospital Charge Code	3950M0222
Hospital Revenue Code	771
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

BEBTELOVIMAB INJ AND MONITOR

Facility

$2,250.00

Service Code	HCPCS M0222
Hospital Charge Code	3246M0222
Hospital Revenue Code	771
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	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$59.62

Know your out-of-pocket cost for care.

All Charges