Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TAP 4 5MM CANNULATED

Facility

$1,000.00

Hospital Charge Code	270680219
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

TAP 5.5MM 615.215

Facility

$2,600.00

Hospital Charge Code	270693629
Hospital Revenue Code	272
Min. Negotiated Rate	$62.66
Max. Negotiated Rate	$1,300.00
Rate for Payer: Aetna Commercial	$988.00
Rate for Payer: Aetna Medicare Advantage	$780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$663.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$663.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$663.00
Rate for Payer: Cigna Commercial	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.00
Rate for Payer: Oxford Commercial	$520.00
Rate for Payer: Qualcare PPO/HMO/WC	$390.00
Rate for Payer: UnitedHealthcare Commercial	$520.00
Rate for Payer: UnitedHealthcare Community & State	$62.66
Rate for Payer: Wellpoint Medicaid Managed Care	$68.90

TAP 5.5MM 615.215

Facility

$2,600.00

Hospital Charge Code	270693629
Hospital Revenue Code	272
Min. Negotiated Rate	$390.00
Max. Negotiated Rate	$390.00
Rate for Payer: Qualcare PPO/HMO/WC	$390.00

TAP 5.5MM CAN

Facility

$1,086.25

Hospital Charge Code	270701727
Hospital Revenue Code	278
Min. Negotiated Rate	$26.18
Max. Negotiated Rate	$543.12
Rate for Payer: Aetna Commercial	$412.77
Rate for Payer: Aetna Medicare Advantage	$325.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$276.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$276.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$276.99
Rate for Payer: Cigna Commercial	$543.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$238.97
Rate for Payer: Qualcare PPO/HMO/WC	$162.94
Rate for Payer: UnitedHealthcare Community & State	$26.18
Rate for Payer: Wellpoint Medicaid Managed Care	$28.79

TAP 5.5MM CAN

Facility

$1,086.25

Hospital Charge Code	270701727
Hospital Revenue Code	278
Min. Negotiated Rate	$162.94
Max. Negotiated Rate	$262.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$238.97
Rate for Payer: Qualcare PPO/HMO/WC	$162.94

TAP 6.5 MM

Facility

$1,890.00

Service Code	HCPCS C1713
Hospital Charge Code	270692306
Hospital Revenue Code	278
Min. Negotiated Rate	$283.50
Max. Negotiated Rate	$457.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$415.80
Rate for Payer: Qualcare PPO/HMO/WC	$283.50

TAP 6.5 MM

Facility

$1,890.00

Service Code	HCPCS C1713
Hospital Charge Code	270692306
Hospital Revenue Code	278
Min. Negotiated Rate	$45.55
Max. Negotiated Rate	$945.00
Rate for Payer: Aetna Commercial	$718.20
Rate for Payer: Aetna Medicare Advantage	$567.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$481.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$481.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$481.95
Rate for Payer: Cigna Commercial	$945.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$415.80
Rate for Payer: Qualcare PPO/HMO/WC	$283.50
Rate for Payer: UnitedHealthcare Community & State	$45.55
Rate for Payer: Wellpoint Medicaid Managed Care	$50.09

TAP 6.5mm 2346-066

Facility

$555.25

Hospital Charge Code	270610456
Hospital Revenue Code	278
Min. Negotiated Rate	$83.29
Max. Negotiated Rate	$134.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$122.16
Rate for Payer: Qualcare PPO/HMO/WC	$83.29

TAP 6.5mm 2346-066

Facility

$555.25

Hospital Charge Code	270610456
Hospital Revenue Code	278
Min. Negotiated Rate	$13.38
Max. Negotiated Rate	$277.62
Rate for Payer: Aetna Commercial	$211.00
Rate for Payer: Aetna Medicare Advantage	$166.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.59
Rate for Payer: Cigna Commercial	$277.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$122.16
Rate for Payer: Qualcare PPO/HMO/WC	$83.29
Rate for Payer: UnitedHealthcare Community & State	$13.38
Rate for Payer: Wellpoint Medicaid Managed Care	$14.71

TAP 6.5MM BONE

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270702587
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

TAP 6.5MM BONE

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270702587
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

TAPAZOLE/10MG/TAB

Facility

$3.00

Hospital Charge Code	60633964
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

TAPAZOLE/10MG/TAB

Facility

$3.00

Hospital Charge Code	60633964
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

TAPAZOLE/5MG/TAB

Facility

$4.00

Hospital Charge Code	60633965
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

TAPAZOLE/5MG/TAB

Facility

$4.00

Hospital Charge Code	60633965
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

TAP BIO TENODESIS 8mm

Facility

$975.00

Hospital Charge Code	270638709
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

TAP BIO TENODESIS 8mm

Facility

$975.00

Hospital Charge Code	270638709
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

TAP BLOCK

Facility

$2,196.25

Service Code	HCPCS 64486
Hospital Charge Code	1650116A
Hospital Revenue Code	361
Min. Negotiated Rate	$52.93
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$834.58
Rate for Payer: Aetna Medicare Advantage	$658.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$560.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$560.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$560.04
Rate for Payer: Cigna Commercial	$1,098.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$658.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$329.44
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$52.93
Rate for Payer: Wellpoint Medicaid Managed Care	$58.20

TAP BLOCK

Facility

$2,196.25

Service Code	HCPCS 64486
Hospital Charge Code	1650116A
Hospital Revenue Code	361
Min. Negotiated Rate	$329.44
Max. Negotiated Rate	$329.44
Rate for Payer: Qualcare PPO/HMO/WC	$329.44

TAP BLOCK BI INJECTION

Facility

$1,147.71

Service Code	HCPCS 64488
Hospital Charge Code	16000333
Hospital Revenue Code	360
Min. Negotiated Rate	$27.66
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$436.13
Rate for Payer: Aetna Medicare Advantage	$344.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.67
Rate for Payer: Cigna Commercial	$573.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.31
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.16
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$27.66
Rate for Payer: Wellpoint Medicaid Managed Care	$30.41

TAP BLOCK BI INJECTION

Facility

$1,147.71

Service Code	HCPCS 64488
Hospital Charge Code	16000333
Hospital Revenue Code	360
Min. Negotiated Rate	$172.16
Max. Negotiated Rate	$172.16
Rate for Payer: Qualcare PPO/HMO/WC	$172.16

TAP BLOCK BILATERAL

Facility

$2,296.25

Service Code	HCPCS 64488
Hospital Charge Code	1650119
Hospital Revenue Code	361
Min. Negotiated Rate	$55.34
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$872.58
Rate for Payer: Aetna Medicare Advantage	$688.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$585.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$585.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$585.54
Rate for Payer: Cigna Commercial	$1,148.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$344.44
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$55.34
Rate for Payer: Wellpoint Medicaid Managed Care	$60.85

TAP BLOCK BILATERAL

Facility

$2,296.25

Service Code	HCPCS 64488
Hospital Charge Code	1650119
Hospital Revenue Code	361
Min. Negotiated Rate	$344.44
Max. Negotiated Rate	$344.44
Rate for Payer: Qualcare PPO/HMO/WC	$344.44

TAP BLOCK BY INFUSION

Facility

$6,663.00

Service Code	HCPCS 64489
Hospital Charge Code	1600000859
Hospital Revenue Code	360
Min. Negotiated Rate	$160.58
Max. Negotiated Rate	$3,331.50
Rate for Payer: Aetna Commercial	$2,531.94
Rate for Payer: Aetna Medicare Advantage	$1,998.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,699.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,699.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,699.07
Rate for Payer: Cigna Commercial	$3,331.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,998.90
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$999.45
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$160.58
Rate for Payer: Wellpoint Medicaid Managed Care	$176.57

TAP BLOCK BY INFUSION

Facility

$6,663.00

Service Code	HCPCS 64489
Hospital Charge Code	1600000859
Hospital Revenue Code	360
Min. Negotiated Rate	$999.45
Max. Negotiated Rate	$999.45
Rate for Payer: Qualcare PPO/HMO/WC	$999.45

Know your out-of-pocket cost for care.

All Charges