Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TISSU CANCELL CUBES 20c 450488

Facility

$1,500.00

Hospital Charge Code	270638783
Hospital Revenue Code	278
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

TISSUE ATX TAK II 5 AR1935B30

Facility

$1,416.00

Hospital Charge Code	270622381
Hospital Revenue Code	272
Min. Negotiated Rate	$212.40
Max. Negotiated Rate	$212.40
Rate for Payer: Qualcare PPO/HMO/WC	$212.40

TISSUE ATX TAK II 5 AR1935B30

Facility

$1,416.00

Hospital Charge Code	270622381
Hospital Revenue Code	272
Min. Negotiated Rate	$34.13
Max. Negotiated Rate	$708.00
Rate for Payer: Aetna Commercial	$538.08
Rate for Payer: Aetna Medicare Advantage	$424.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$361.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$361.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$361.08
Rate for Payer: Cigna Commercial	$708.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$424.80
Rate for Payer: Oxford Commercial	$283.20
Rate for Payer: Qualcare PPO/HMO/WC	$212.40
Rate for Payer: UnitedHealthcare Commercial	$283.20
Rate for Payer: UnitedHealthcare Community & State	$34.13
Rate for Payer: Wellpoint Medicaid Managed Care	$37.52

TISSUE ATX TAK II 5 ST AR1935B

Facility

$2,832.00

Hospital Charge Code	270622380
Hospital Revenue Code	274
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$1,416.00
Rate for Payer: Aetna Commercial	$1,076.16
Rate for Payer: Aetna Medicare Advantage	$849.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$722.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$722.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$566.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$722.16
Rate for Payer: Cigna Commercial	$1,416.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$685.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$623.04
Rate for Payer: Qualcare PPO/HMO/WC	$424.80
Rate for Payer: UnitedHealthcare Community & State	$68.25
Rate for Payer: Wellpoint Medicaid Managed Care	$75.05

TISSUE ATX TAK II 5 ST AR1935B

Facility

$2,832.00

Hospital Charge Code	270622380
Hospital Revenue Code	274
Min. Negotiated Rate	$424.80
Max. Negotiated Rate	$685.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$566.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$685.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$623.04
Rate for Payer: Qualcare PPO/HMO/WC	$424.80

TISSUE AUGMENT 3 CC

Facility

$17,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270678103
Hospital Revenue Code	278
Min. Negotiated Rate	$421.15
Max. Negotiated Rate	$8,737.50
Rate for Payer: Aetna Commercial	$6,640.50
Rate for Payer: Aetna Medicare Advantage	$5,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,456.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,456.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,456.12
Rate for Payer: Cigna Commercial	$8,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,228.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,844.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,621.25
Rate for Payer: UnitedHealthcare Community & State	$421.15
Rate for Payer: Wellpoint Medicaid Managed Care	$463.09

TISSUE AUGMENT 3 CC

Facility

$17,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270678103
Hospital Revenue Code	278
Min. Negotiated Rate	$2,621.25
Max. Negotiated Rate	$4,228.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,228.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,844.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,621.25

TISSUE BIOFIX FLOW PLACENT 1CC

Facility

$10,875.00

Service Code	HCPCS Q4114
Hospital Charge Code	270681641
Hospital Revenue Code	636
Min. Negotiated Rate	$262.09
Max. Negotiated Rate	$5,437.50
Rate for Payer: Aetna Commercial	$4,132.50
Rate for Payer: Aetna Medicare Advantage	$3,262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,773.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,773.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,773.12
Rate for Payer: Cigna Commercial	$5,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,631.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,631.25
Rate for Payer: UnitedHealthcare Community & State	$262.09
Rate for Payer: Wellpoint Medicaid Managed Care	$288.19

TISSUE BIOFIX FLOW PLACENT 1CC

Facility

$10,875.00

Service Code	HCPCS Q4114
Hospital Charge Code	270681641
Hospital Revenue Code	636
Min. Negotiated Rate	$1,631.25
Max. Negotiated Rate	$2,631.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,631.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,631.25

TISSUE CANCELLOUS 5/100MM MSL

Facility

$4,596.85

Hospital Charge Code	270608086
Hospital Revenue Code	278
Min. Negotiated Rate	$110.78
Max. Negotiated Rate	$2,298.43
Rate for Payer: Aetna Commercial	$1,746.80
Rate for Payer: Aetna Medicare Advantage	$1,379.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,172.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,172.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$919.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,172.20
Rate for Payer: Cigna Commercial	$2,298.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,112.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,011.31
Rate for Payer: Qualcare PPO/HMO/WC	$689.53
Rate for Payer: UnitedHealthcare Community & State	$110.78
Rate for Payer: Wellpoint Medicaid Managed Care	$121.82

TISSUE CANCELLOUS 5/100MM MSL

Facility

$4,596.85

Hospital Charge Code	270608086
Hospital Revenue Code	278
Min. Negotiated Rate	$689.53
Max. Negotiated Rate	$1,112.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$919.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,112.44
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,011.31
Rate for Payer: Qualcare PPO/HMO/WC	$689.53

TISSUE CANCELLOUS CUBE 30CC

Facility

$2,681.65

Hospital Charge Code	270608089
Hospital Revenue Code	278
Min. Negotiated Rate	$402.25
Max. Negotiated Rate	$648.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$536.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$589.96
Rate for Payer: Qualcare PPO/HMO/WC	$402.25

TISSUE CANCELLOUS CUBE 30CC

Facility

$2,681.65

Hospital Charge Code	270608089
Hospital Revenue Code	278
Min. Negotiated Rate	$64.63
Max. Negotiated Rate	$1,340.83
Rate for Payer: Aetna Commercial	$1,019.03
Rate for Payer: Aetna Medicare Advantage	$804.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$683.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$683.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$536.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$683.82
Rate for Payer: Cigna Commercial	$1,340.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$589.96
Rate for Payer: Qualcare PPO/HMO/WC	$402.25
Rate for Payer: UnitedHealthcare Community & State	$64.63
Rate for Payer: Wellpoint Medicaid Managed Care	$71.06

TISSUE CANCELLOUS CUBES 20ML

Facility

$1,665.00

Hospital Charge Code	270644806
Hospital Revenue Code	278
Min. Negotiated Rate	$40.13
Max. Negotiated Rate	$832.50
Rate for Payer: Aetna Commercial	$632.70
Rate for Payer: Aetna Medicare Advantage	$499.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$424.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$424.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$424.57
Rate for Payer: Cigna Commercial	$832.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$402.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$366.30
Rate for Payer: Qualcare PPO/HMO/WC	$249.75
Rate for Payer: UnitedHealthcare Community & State	$40.13
Rate for Payer: Wellpoint Medicaid Managed Care	$44.12

TISSUE CANCELLOUS CUBES 20ML

Facility

$1,665.00

Hospital Charge Code	270644806
Hospital Revenue Code	278
Min. Negotiated Rate	$249.75
Max. Negotiated Rate	$402.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$402.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$366.30
Rate for Payer: Qualcare PPO/HMO/WC	$249.75

TISSUE CLARIX COR 1K 1.5x1.5cm

Facility

$5,975.00

Service Code	HCPCS Q4100
Hospital Charge Code	270679120
Hospital Revenue Code	636
Min. Negotiated Rate	$896.25
Max. Negotiated Rate	$1,445.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.95
Rate for Payer: Qualcare PPO/HMO/WC	$896.25

TISSUE CLARIX COR 1K 1.5x1.5cm

Facility

$5,975.00

Service Code	HCPCS Q4100
Hospital Charge Code	270679120
Hospital Revenue Code	636
Min. Negotiated Rate	$144.00
Max. Negotiated Rate	$2,987.50
Rate for Payer: Aetna Commercial	$2,270.50
Rate for Payer: Aetna Medicare Advantage	$1,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,523.62
Rate for Payer: Cigna Commercial	$2,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.95
Rate for Payer: Qualcare PPO/HMO/WC	$896.25
Rate for Payer: UnitedHealthcare Community & State	$144.00
Rate for Payer: Wellpoint Medicaid Managed Care	$158.34

TISSUE CORNEA

Facility

$4,569.65

Hospital Charge Code	270608603
Hospital Revenue Code	278
Min. Negotiated Rate	$685.45
Max. Negotiated Rate	$1,105.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$913.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,105.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,005.32
Rate for Payer: Qualcare PPO/HMO/WC	$685.45

TISSUE CORNEA

Facility

$4,569.65

Hospital Charge Code	270608603
Hospital Revenue Code	278
Min. Negotiated Rate	$110.13
Max. Negotiated Rate	$2,284.82
Rate for Payer: Aetna Commercial	$1,736.47
Rate for Payer: Aetna Medicare Advantage	$1,370.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,165.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,165.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$913.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,165.26
Rate for Payer: Cigna Commercial	$2,284.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,105.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,005.32
Rate for Payer: Qualcare PPO/HMO/WC	$685.45
Rate for Payer: UnitedHealthcare Community & State	$110.13
Rate for Payer: Wellpoint Medicaid Managed Care	$121.10

TISSUE CULT, ADDL STUDY

Facility

$156.00

Service Code	HCPCS 87253
Hospital Charge Code	38475118
Hospital Revenue Code	309
Min. Negotiated Rate	$4.13
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$54.94
Rate for Payer: Aetna Medicare Advantage	$65.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.92
Rate for Payer: Cigna Commercial	$78.00
Rate for Payer: Cigna Medicare Advantage	$20.20
Rate for Payer: Clover Medicare Advantage	$19.19
Rate for Payer: EmblemHealth Commercial	$60.60
Rate for Payer: Humana Medicare Advantage	$20.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.20
Rate for Payer: Wellcare Medicare Advantage	$20.20
Rate for Payer: Wellpoint Medicaid Managed Care	$4.13

TISSUE CULT, ADDL STUDY

Facility

$156.00

Service Code	HCPCS 87253
Hospital Charge Code	38475118
Hospital Revenue Code	309
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$23.40
Rate for Payer: Qualcare PPO/HMO/WC	$23.40

TISSUE CULT,NEOPLASTIC;BONE,BL

Facility

$894.49

Service Code	HCPCS 88237
Hospital Charge Code	38474056
Hospital Revenue Code	311
Min. Negotiated Rate	$23.70
Max. Negotiated Rate	$518.89
Rate for Payer: Aetna Commercial	$391.00
Rate for Payer: Aetna Medicare Advantage	$465.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$518.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$518.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$143.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$518.89
Rate for Payer: Cigna Commercial	$447.25
Rate for Payer: Cigna Medicare Advantage	$143.75
Rate for Payer: Clover Medicare Advantage	$136.56
Rate for Payer: EmblemHealth Commercial	$431.25
Rate for Payer: Humana Medicare Advantage	$148.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$143.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$134.17
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$115.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$143.75
Rate for Payer: Wellcare Medicare Advantage	$143.75
Rate for Payer: Wellpoint Medicaid Managed Care	$23.70

TISSUE CULT,NEOPLASTIC;BONE,BL

Facility

$894.49

Service Code	HCPCS 88237
Hospital Charge Code	38474056
Hospital Revenue Code	311
Min. Negotiated Rate	$134.17
Max. Negotiated Rate	$134.17
Rate for Payer: Qualcare PPO/HMO/WC	$134.17

TISSUE CULT NEOPLASTIC SOLID

Facility

$1,044.74

Service Code	HCPCS 88239
Hospital Charge Code	38477212
Hospital Revenue Code	311
Min. Negotiated Rate	$27.69
Max. Negotiated Rate	$532.50
Rate for Payer: Aetna Commercial	$401.25
Rate for Payer: Aetna Medicare Advantage	$477.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$532.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$532.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$532.50
Rate for Payer: Cigna Commercial	$522.37
Rate for Payer: Cigna Medicare Advantage	$147.52
Rate for Payer: Clover Medicare Advantage	$140.14
Rate for Payer: EmblemHealth Commercial	$442.56
Rate for Payer: Humana Medicare Advantage	$151.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.42
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.71
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$118.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.52
Rate for Payer: Wellcare Medicare Advantage	$147.52
Rate for Payer: Wellpoint Medicaid Managed Care	$27.69

TISSUE CULT NEOPLASTIC SOLID

Facility

$1,044.74

Service Code	HCPCS 88239
Hospital Charge Code	38477212
Hospital Revenue Code	311
Min. Negotiated Rate	$156.71
Max. Negotiated Rate	$156.71
Rate for Payer: Qualcare PPO/HMO/WC	$156.71

Know your out-of-pocket cost for care.

All Charges