Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TARGET 360 ULTRA 5MM X 10CM

Facility

$10,426.25

Hospital Charge Code	270689888
Hospital Revenue Code	278
Min. Negotiated Rate	$251.27
Max. Negotiated Rate	$5,213.12
Rate for Payer: Aetna Commercial	$3,961.97
Rate for Payer: Aetna Medicare Advantage	$3,127.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,658.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,658.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,085.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,658.69
Rate for Payer: Cigna Commercial	$5,213.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,523.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,293.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,563.94
Rate for Payer: UnitedHealthcare Community & State	$251.27
Rate for Payer: Wellpoint Medicaid Managed Care	$276.30

TARGET 360 ULTRA 5MM X 15CM

Facility

$10,426.25

Hospital Charge Code	270689889S
Hospital Revenue Code	278
Min. Negotiated Rate	$251.27
Max. Negotiated Rate	$5,213.12
Rate for Payer: Aetna Commercial	$3,961.97
Rate for Payer: Aetna Medicare Advantage	$3,127.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,658.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,658.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,085.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,658.69
Rate for Payer: Cigna Commercial	$5,213.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,523.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,293.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,563.94
Rate for Payer: UnitedHealthcare Community & State	$251.27
Rate for Payer: Wellpoint Medicaid Managed Care	$276.30

TARGET 360 ULTRA 5MM X 15CM

Facility

$10,426.25

Hospital Charge Code	270689889S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,563.94
Max. Negotiated Rate	$2,523.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,085.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,523.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,293.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,563.94

TARGET 360 ULTRA 5MM X 15CM

Facility

$10,426.25

Hospital Charge Code	270689889
Hospital Revenue Code	278
Min. Negotiated Rate	$251.27
Max. Negotiated Rate	$5,213.12
Rate for Payer: Aetna Commercial	$3,961.97
Rate for Payer: Aetna Medicare Advantage	$3,127.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,658.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,658.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,085.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,658.69
Rate for Payer: Cigna Commercial	$5,213.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,523.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,293.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,563.94
Rate for Payer: UnitedHealthcare Community & State	$251.27
Rate for Payer: Wellpoint Medicaid Managed Care	$276.30

TARGET 360 ULTRA 5MM X 15CM

Facility

$10,426.25

Hospital Charge Code	270689889
Hospital Revenue Code	278
Min. Negotiated Rate	$1,563.94
Max. Negotiated Rate	$2,523.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,085.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,523.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,293.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,563.94

TARGET HELICAL ULTRA 1 MM X 1

Facility

$7,125.00

Hospital Charge Code	270689890
Hospital Revenue Code	278
Min. Negotiated Rate	$171.71
Max. Negotiated Rate	$3,562.50
Rate for Payer: Aetna Commercial	$2,707.50
Rate for Payer: Aetna Medicare Advantage	$2,137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,816.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,816.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,816.88
Rate for Payer: Cigna Commercial	$3,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,724.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,567.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,068.75
Rate for Payer: UnitedHealthcare Community & State	$171.71
Rate for Payer: Wellpoint Medicaid Managed Care	$188.81

TARGET HELICAL ULTRA 1 MM X 1

Facility

$7,125.00

Hospital Charge Code	270689890
Hospital Revenue Code	278
Min. Negotiated Rate	$1,068.75
Max. Negotiated Rate	$1,724.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,724.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,567.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,068.75

TARGET HMD TARGET 38152100

Facility

$1,035.25

Hospital Charge Code	270621065
Hospital Revenue Code	272
Min. Negotiated Rate	$155.29
Max. Negotiated Rate	$155.29
Rate for Payer: Qualcare PPO/HMO/WC	$155.29

TARGET HMD TARGET 38152100

Facility

$1,035.25

Hospital Charge Code	270621065
Hospital Revenue Code	272
Min. Negotiated Rate	$24.95
Max. Negotiated Rate	$517.62
Rate for Payer: Aetna Commercial	$393.39
Rate for Payer: Aetna Medicare Advantage	$310.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.99
Rate for Payer: Cigna Commercial	$517.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.57
Rate for Payer: Oxford Commercial	$207.05
Rate for Payer: Qualcare PPO/HMO/WC	$155.29
Rate for Payer: UnitedHealthcare Commercial	$207.05
Rate for Payer: UnitedHealthcare Community & State	$24.95
Rate for Payer: Wellpoint Medicaid Managed Care	$27.43

TARGETING DEVICE RADIOL

Facility

$1,452.00

Hospital Charge Code	270606459
Hospital Revenue Code	270
Min. Negotiated Rate	$217.80
Max. Negotiated Rate	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$217.80

TARGETING DEVICE RADIOL

Facility

$1,452.00

Hospital Charge Code	270606459
Hospital Revenue Code	270
Min. Negotiated Rate	$34.99
Max. Negotiated Rate	$726.00
Rate for Payer: Aetna Commercial	$551.76
Rate for Payer: Aetna Medicare Advantage	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$370.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$370.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$370.26
Rate for Payer: Cigna Commercial	$726.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: Oxford Commercial	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$217.80
Rate for Payer: UnitedHealthcare Commercial	$290.40
Rate for Payer: UnitedHealthcare Community & State	$34.99
Rate for Payer: Wellpoint Medicaid Managed Care	$38.48

TARGETING DEVICE RADIOLUCENT

Facility

$1,800.00

Hospital Charge Code	270614628
Hospital Revenue Code	272
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$540.00
Rate for Payer: Oxford Commercial	$360.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Commercial	$360.00
Rate for Payer: UnitedHealthcare Community & State	$43.38
Rate for Payer: Wellpoint Medicaid Managed Care	$47.70

TARGETING DEVICE RADIOLUCENT

Facility

$1,800.00

Hospital Charge Code	270614628
Hospital Revenue Code	272
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$270.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

TARSAL TUNNEL-RELEASE

Facility

$16,437.00

Service Code	HCPCS 28035
Hospital Charge Code	16000511
Hospital Revenue Code	360
Min. Negotiated Rate	$2,465.55
Max. Negotiated Rate	$2,465.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,465.55

TARSAL TUNNEL-RELEASE

Facility

$16,437.00

Service Code	HCPCS 28035
Hospital Charge Code	16000511
Hospital Revenue Code	360
Min. Negotiated Rate	$396.13
Max. Negotiated Rate	$8,374.11
Rate for Payer: Aetna Commercial	$6,310.10
Rate for Payer: Aetna Medicare Advantage	$7,516.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,374.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,374.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,319.89
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	$8,374.11
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: Cigna Medicare Advantage	$2,319.89
Rate for Payer: Clover Medicare Advantage	$2,203.90
Rate for Payer: EmblemHealth Commercial	$6,959.67
Rate for Payer: Humana Medicare Advantage	$2,389.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,319.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,931.10
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,465.55
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$396.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare Medicare Advantage	$2,319.89
Rate for Payer: Wellpoint Medicaid Managed Care	$435.58

TA SP BONE AGRFT LOCAL ADD-ON

Facility

$11,887.22

Service Code	HCPCS 20936
Hospital Charge Code	162005
Hospital Revenue Code	360
Min. Negotiated Rate	$286.48
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$4,517.14
Rate for Payer: Aetna Medicare Advantage	$3,566.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,031.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,031.24
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	$3,031.24
Rate for Payer: Cigna Commercial	$5,943.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,566.17
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,783.08
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$286.48

TA SP BONE AGRFT LOCAL ADD-ON

Facility

$11,887.22

Service Code	HCPCS 20936
Hospital Charge Code	162005
Hospital Revenue Code	360
Min. Negotiated Rate	$1,783.08
Max. Negotiated Rate	$1,783.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,783.08

TA SP BONE AGRFT LOCAL ADD-ONT

Facility

$11,887.22

Service Code	HCPCS 20936
Hospital Charge Code	16000286
Hospital Revenue Code	360
Min. Negotiated Rate	$1,783.08
Max. Negotiated Rate	$1,783.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,783.08

TA SP BONE AGRFT LOCAL ADD-ONT

Facility

$11,887.22

Service Code	HCPCS 20936
Hospital Charge Code	16000286
Hospital Revenue Code	360
Min. Negotiated Rate	$286.48
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$4,517.14
Rate for Payer: Aetna Medicare Advantage	$3,566.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,031.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,031.24
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	$3,031.24
Rate for Payer: Cigna Commercial	$5,943.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,566.17
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,783.08
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$286.48

TA THORAX SPINE FUSION

Facility

$14,222.30

Service Code	HCPCS 22610
Hospital Charge Code	16000804
Hospital Revenue Code	360
Min. Negotiated Rate	$342.76
Max. Negotiated Rate	$75,192.36
Rate for Payer: Aetna Commercial	$56,659.34
Rate for Payer: Aetna Medicare Advantage	$67,491.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75,192.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75,192.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,830.64
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	$75,192.36
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: Cigna Medicare Advantage	$20,830.64
Rate for Payer: Clover Medicare Advantage	$19,789.11
Rate for Payer: EmblemHealth Commercial	$62,491.92
Rate for Payer: Humana Medicare Advantage	$21,455.56
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,830.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,266.69
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.34
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$342.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,830.64
Rate for Payer: Wellcare Medicare Advantage	$20,830.64
Rate for Payer: Wellpoint Medicaid Managed Care	$376.89

TA THORAX SPINE FUSION

Facility

$14,222.30

Service Code	HCPCS 22610
Hospital Charge Code	16000804
Hospital Revenue Code	360
Min. Negotiated Rate	$2,133.34
Max. Negotiated Rate	$2,133.34
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.34

TAVIST/2.68MG/TAB

Facility

$4.00

Hospital Charge Code	60633966
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

TAVIST/2.68MG/TAB

Facility

$4.00

Hospital Charge Code	60633966
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

TAVIST-D/TAB

Facility

$4.00

Hospital Charge Code	60633967
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

TAVIST-D/TAB

Facility

$4.00

Hospital Charge Code	60633967
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

Know your out-of-pocket cost for care.

All Charges