Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TIGERSTICK

Facility

$250.00

Hospital Charge Code	270663951
Hospital Revenue Code	270
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

TIGER TAPE 2MM 7 WHITE/BLACK

Facility

$250.00

Hospital Charge Code	270673984
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

TIGER TAPE 2MM 7 WHITE/BLACK

Facility

$250.00

Hospital Charge Code	270673984
Hospital Revenue Code	272
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

TIGERTAPE CERCLAGE W/O NDL 2MM

Facility

$2,574.00

Service Code	HCPCS C1713
Hospital Charge Code	270698125
Hospital Revenue Code	278
Min. Negotiated Rate	$62.03
Max. Negotiated Rate	$1,287.00
Rate for Payer: Aetna Commercial	$978.12
Rate for Payer: Aetna Medicare Advantage	$772.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$656.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$656.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$514.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$656.37
Rate for Payer: Cigna Commercial	$1,287.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$622.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$566.28
Rate for Payer: Qualcare PPO/HMO/WC	$386.10
Rate for Payer: UnitedHealthcare Community & State	$62.03
Rate for Payer: Wellpoint Medicaid Managed Care	$68.21

TIGERTAPE CERCLAGE W/O NDL 2MM

Facility

$2,574.00

Service Code	HCPCS C1713
Hospital Charge Code	270698125
Hospital Revenue Code	278
Min. Negotiated Rate	$386.10
Max. Negotiated Rate	$622.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$514.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$622.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$566.28
Rate for Payer: Qualcare PPO/HMO/WC	$386.10

TIGERTAPE STERNAL CLOSURE 2MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270703523
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

TIGERTAPE STERNAL CLOSURE 2MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270703523
Hospital Revenue Code	278
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

TIGERTRIEVER 13 SYST 20.5M

Facility

$34,000.00

Service Code	HCPCS C1757
Hospital Charge Code	270698109S
Hospital Revenue Code	278
Min. Negotiated Rate	$819.40
Max. Negotiated Rate	$17,000.00
Rate for Payer: Aetna Commercial	$12,920.00
Rate for Payer: Aetna Medicare Advantage	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,670.00
Rate for Payer: Cigna Commercial	$17,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,228.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,480.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,100.00
Rate for Payer: UnitedHealthcare Community & State	$819.40
Rate for Payer: Wellpoint Medicaid Managed Care	$901.00

TIGERTRIEVER 13 SYST 20.5M

Facility

$34,000.00

Service Code	HCPCS C1757
Hospital Charge Code	270698109S
Hospital Revenue Code	278
Min. Negotiated Rate	$5,100.00
Max. Negotiated Rate	$8,228.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,228.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7,480.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,100.00

TIGHTROPE 1.1 MM IMPLANT

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684814
Hospital Revenue Code	278
Min. Negotiated Rate	$83.75
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,320.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$764.50
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Community & State	$83.75
Rate for Payer: Wellpoint Medicaid Managed Care	$92.09

TIGHTROPE 1.1 MM IMPLANT

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684814
Hospital Revenue Code	278
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$840.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$764.50
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

TIGHT ROPE ABS,14MM BUTTON

Facility

$1,070.00

Service Code	HCPCS C1713
Hospital Charge Code	270664774
Hospital Revenue Code	278
Min. Negotiated Rate	$25.79
Max. Negotiated Rate	$535.00
Rate for Payer: Aetna Commercial	$406.60
Rate for Payer: Aetna Medicare Advantage	$321.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.85
Rate for Payer: Cigna Commercial	$535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.40
Rate for Payer: Qualcare PPO/HMO/WC	$160.50
Rate for Payer: UnitedHealthcare Community & State	$25.79
Rate for Payer: Wellpoint Medicaid Managed Care	$28.36

TIGHT ROPE ABS,14MM BUTTON

Facility

$1,070.00

Service Code	HCPCS C1713
Hospital Charge Code	270664774
Hospital Revenue Code	278
Min. Negotiated Rate	$160.50
Max. Negotiated Rate	$258.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.94
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$235.40
Rate for Payer: Qualcare PPO/HMO/WC	$160.50

TIGHT ROPE ABS 14 MM CONVA

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270690220
Hospital Revenue Code	278
Min. Negotiated Rate	$26.99
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$425.60
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Community & State	$26.99
Rate for Payer: Wellpoint Medicaid Managed Care	$29.68

TIGHT ROPE ABS 14 MM CONVA

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270690220
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

TIGHTROPE ABS BUT RD CONC 17MM

Facility

$1,422.90

Hospital Charge Code	270702507
Hospital Revenue Code	278
Min. Negotiated Rate	$34.29
Max. Negotiated Rate	$711.45
Rate for Payer: Aetna Commercial	$540.70
Rate for Payer: Aetna Medicare Advantage	$426.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$362.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$362.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$362.84
Rate for Payer: Cigna Commercial	$711.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$313.04
Rate for Payer: Qualcare PPO/HMO/WC	$213.44
Rate for Payer: UnitedHealthcare Community & State	$34.29
Rate for Payer: Wellpoint Medicaid Managed Care	$37.71

TIGHTROPE ABS BUT RD CONC 17MM

Facility

$1,422.90

Hospital Charge Code	270702507
Hospital Revenue Code	278
Min. Negotiated Rate	$213.44
Max. Negotiated Rate	$344.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$313.04
Rate for Payer: Qualcare PPO/HMO/WC	$213.44

TIGHT ROPE ABS BUTTON 8X12MM

Facility

$715.00

Service Code	HCPCS C1713
Hospital Charge Code	270669603
Hospital Revenue Code	278
Min. Negotiated Rate	$107.25
Max. Negotiated Rate	$173.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$107.25

TIGHT ROPE ABS BUTTON 8X12MM

Facility

$715.00

Service Code	HCPCS C1713
Hospital Charge Code	270669603
Hospital Revenue Code	278
Min. Negotiated Rate	$17.23
Max. Negotiated Rate	$357.50
Rate for Payer: Aetna Commercial	$271.70
Rate for Payer: Aetna Medicare Advantage	$214.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.32
Rate for Payer: Cigna Commercial	$357.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$107.25
Rate for Payer: UnitedHealthcare Community & State	$17.23
Rate for Payer: Wellpoint Medicaid Managed Care	$18.95

TIGHTROPE ABS IMPLANT OPEN

Facility

$970.00

Service Code	HCPCS C1713
Hospital Charge Code	270666957
Hospital Revenue Code	278
Min. Negotiated Rate	$23.38
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$368.60
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$213.40
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Community & State	$23.38
Rate for Payer: Wellpoint Medicaid Managed Care	$25.70

TIGHTROPE ABS IMPLANT OPEN

Facility

$970.00

Service Code	HCPCS C1713
Hospital Charge Code	270666957
Hospital Revenue Code	278
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$234.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$213.40
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TIGHTROPE ABS ROUND 20MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270690896
Hospital Revenue Code	278
Min. Negotiated Rate	$26.99
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$425.60
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Community & State	$26.99
Rate for Payer: Wellpoint Medicaid Managed Care	$29.68

TIGHTROPE ABS ROUND 20MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270690896
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

TIGHT ROPE ACL FIBERTAG

Facility

$4,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270695231
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$1,179.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

TIGHT ROPE ACL FIBERTAG

Facility

$4,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270695231
Hospital Revenue Code	278
Min. Negotiated Rate	$117.49
Max. Negotiated Rate	$2,437.50
Rate for Payer: Aetna Commercial	$1,852.50
Rate for Payer: Aetna Medicare Advantage	$1,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,243.12
Rate for Payer: Cigna Commercial	$2,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,072.50
Rate for Payer: Qualcare PPO/HMO/WC	$731.25
Rate for Payer: UnitedHealthcare Community & State	$117.49
Rate for Payer: Wellpoint Medicaid Managed Care	$129.19

Know your out-of-pocket cost for care.

All Charges