Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TAP BLOCK UNILATERAL

Facility

$2,296.25

Service Code	HCPCS 64486
Hospital Charge Code	1650118
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 UNILATERAL

Facility

$2,296.25

Service Code	HCPCS 64486
Hospital Charge Code	1650118
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 UNIL BY INJ

Facility

$1,147.71

Service Code	HCPCS 64486
Hospital Charge Code	16000461
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 UNIL BY INJ

Facility

$1,147.71

Service Code	HCPCS 64486
Hospital Charge Code	16000461
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 BX 2.7MM BT2703

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270620188
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

TAP BX 2.7MM BT2703

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270620188
Hospital Revenue Code	278
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

TAP CANCELLOUS 4mm 2346-036

Facility

$152.00

Hospital Charge Code	270610291
Hospital Revenue Code	278
Min. Negotiated Rate	$3.66
Max. Negotiated Rate	$76.00
Rate for Payer: Aetna Commercial	$57.76
Rate for Payer: Aetna Medicare Advantage	$45.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.76
Rate for Payer: Cigna Commercial	$76.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.44
Rate for Payer: Qualcare PPO/HMO/WC	$22.80
Rate for Payer: UnitedHealthcare Community & State	$3.66
Rate for Payer: Wellpoint Medicaid Managed Care	$4.03

TAP CANCELLOUS 4mm 2346-036

Facility

$152.00

Hospital Charge Code	270610291
Hospital Revenue Code	278
Min. Negotiated Rate	$22.80
Max. Negotiated Rate	$36.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.44
Rate for Payer: Qualcare PPO/HMO/WC	$22.80

TAP CANN CREO MIS 6.5MM

Facility

$2,055.00

Hospital Charge Code	270698075
Hospital Revenue Code	272
Min. Negotiated Rate	$49.53
Max. Negotiated Rate	$1,027.50
Rate for Payer: Aetna Commercial	$780.90
Rate for Payer: Aetna Medicare Advantage	$616.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$524.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$524.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$524.02
Rate for Payer: Cigna Commercial	$1,027.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$616.50
Rate for Payer: Oxford Commercial	$411.00
Rate for Payer: Qualcare PPO/HMO/WC	$308.25
Rate for Payer: UnitedHealthcare Commercial	$411.00
Rate for Payer: UnitedHealthcare Community & State	$49.53
Rate for Payer: Wellpoint Medicaid Managed Care	$54.46

TAP CANN CREO MIS 6.5MM

Facility

$2,055.00

Hospital Charge Code	270698075
Hospital Revenue Code	272
Min. Negotiated Rate	$308.25
Max. Negotiated Rate	$308.25
Rate for Payer: Qualcare PPO/HMO/WC	$308.25

TAP CANNULATED 4.5MM

Facility

$875.00

Hospital Charge Code	270673452
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

TAP CANNULATED 4.5MM

Facility

$875.00

Hospital Charge Code	270673452
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

TAPE ADHESIVE 1

Facility

$7.25

Hospital Charge Code	270350130
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

TAPE ADHESIVE 1

Facility

$7.25

Hospital Charge Code	270350130
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.75
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.17
Rate for Payer: Oxford Commercial	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$1.45
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

TAPE ADHESIVE 3

Facility

$11.25

Hospital Charge Code	270350140
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

TAPE ADHESIVE 3

Facility

$11.25

Hospital Charge Code	270350140
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

TAPE AUTOCLAVE BULK 3/4

Facility

$135.07

Hospital Charge Code	270656255
Hospital Revenue Code	271
Min. Negotiated Rate	$3.26
Max. Negotiated Rate	$67.53
Rate for Payer: Aetna Commercial	$51.33
Rate for Payer: Aetna Medicare Advantage	$40.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.44
Rate for Payer: Cigna Commercial	$67.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.52
Rate for Payer: Oxford Commercial	$27.01
Rate for Payer: Qualcare PPO/HMO/WC	$20.26
Rate for Payer: UnitedHealthcare Commercial	$27.01
Rate for Payer: UnitedHealthcare Community & State	$3.26
Rate for Payer: Wellpoint Medicaid Managed Care	$3.58

TAPE AUTOCLAVE BULK 3/4

Facility

$135.07

Hospital Charge Code	270656255
Hospital Revenue Code	271
Min. Negotiated Rate	$20.26
Max. Negotiated Rate	$20.26
Rate for Payer: Qualcare PPO/HMO/WC	$20.26

TAPE CASTING 2

Facility

$10.21

Hospital Charge Code	270300825
Hospital Revenue Code	270
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$1.53
Rate for Payer: Qualcare PPO/HMO/WC	$1.53

TAPE CASTING 2

Facility

$10.21

Hospital Charge Code	270300825
Hospital Revenue Code	270
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.11
Rate for Payer: Aetna Commercial	$3.88
Rate for Payer: Aetna Medicare Advantage	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.60
Rate for Payer: Cigna Commercial	$5.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.06
Rate for Payer: Oxford Commercial	$2.04
Rate for Payer: Qualcare PPO/HMO/WC	$1.53
Rate for Payer: UnitedHealthcare Commercial	$2.04
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

TAPE CASTING 3

Facility

$11.85

Hospital Charge Code	270300830
Hospital Revenue Code	270
Min. Negotiated Rate	$1.78
Max. Negotiated Rate	$1.78
Rate for Payer: Qualcare PPO/HMO/WC	$1.78

TAPE CASTING 3

Facility

$11.85

Hospital Charge Code	270300830
Hospital Revenue Code	270
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$5.92
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$3.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.02
Rate for Payer: Cigna Commercial	$5.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.56
Rate for Payer: Oxford Commercial	$2.37
Rate for Payer: Qualcare PPO/HMO/WC	$1.78
Rate for Payer: UnitedHealthcare Commercial	$2.37
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.31

TAPE CASTING 3

Facility

$11.85

Hospital Charge Code	270300830W
Hospital Revenue Code	270
Min. Negotiated Rate	$1.78
Max. Negotiated Rate	$1.78
Rate for Payer: Qualcare PPO/HMO/WC	$1.78

TAPE CASTING 3

Facility

$11.85

Hospital Charge Code	270300830W
Hospital Revenue Code	270
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$5.92
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$3.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.02
Rate for Payer: Cigna Commercial	$5.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.56
Rate for Payer: Oxford Commercial	$2.37
Rate for Payer: Qualcare PPO/HMO/WC	$1.78
Rate for Payer: UnitedHealthcare Commercial	$2.37
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.31

TAPE CASTING 4

Facility

$16.15

Hospital Charge Code	270300835W
Hospital Revenue Code	270
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$8.07
Rate for Payer: Aetna Commercial	$6.14
Rate for Payer: Aetna Medicare Advantage	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.12
Rate for Payer: Cigna Commercial	$8.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.84
Rate for Payer: Oxford Commercial	$3.23
Rate for Payer: Qualcare PPO/HMO/WC	$2.42
Rate for Payer: UnitedHealthcare Commercial	$3.23
Rate for Payer: UnitedHealthcare Community & State	$0.39
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

Know your out-of-pocket cost for care.

All Charges