Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

Tis trnfr s/a/l 10 sq cm/<

Facility

$8,616.84

Service Code	HCPCS 14020
Hospital Charge Code	16000171
Hospital Revenue Code	360
Min. Negotiated Rate	$207.67
Max. Negotiated Rate	$8,848.20
Rate for Payer: Aetna Commercial	$6,667.35
Rate for Payer: Aetna Medicare Advantage	$7,941.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,848.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,848.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,451.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,848.20
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: Cigna Medicare Advantage	$2,451.23
Rate for Payer: Clover Medicare Advantage	$2,328.67
Rate for Payer: EmblemHealth Commercial	$7,353.69
Rate for Payer: Humana Medicare Advantage	$2,524.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,451.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,585.05
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,292.53
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$207.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,451.23
Rate for Payer: Wellcare Medicare Advantage	$2,451.23
Rate for Payer: Wellpoint Medicaid Managed Care	$228.35

Tis trnfr s/a/l 10 sq cm/<

Facility

$8,616.84

Service Code	HCPCS 14020
Hospital Charge Code	16000171
Hospital Revenue Code	360
Min. Negotiated Rate	$1,292.53
Max. Negotiated Rate	$1,292.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,292.53

TIS TXFR FCCMNAGHF 10.1-30SQCM

Facility

$10,361.45

Service Code	HCPCS 14041
Hospital Charge Code	323014041
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$8,848.20
Rate for Payer: Aetna Commercial	$6,667.35
Rate for Payer: Aetna Medicare Advantage	$7,941.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,848.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,848.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,451.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$738.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,848.20
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: Cigna Medicare Advantage	$2,451.23
Rate for Payer: Clover Medicare Advantage	$2,328.67
Rate for Payer: EmblemHealth Commercial	$7,353.69
Rate for Payer: Humana Medicare Advantage	$2,524.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,451.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,108.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,554.22
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,451.23
Rate for Payer: Wellcare Medicare Advantage	$2,451.23
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,165.88
Rate for Payer: Wellpoint Medicaid Managed Care	$274.58

TIS TXFR FCCMNAGHF 10.1-30SQCM

Facility

$10,361.45

Service Code	HCPCS 14041
Hospital Charge Code	323014041
Hospital Revenue Code	450
Min. Negotiated Rate	$1,554.22
Max. Negotiated Rate	$1,554.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,554.22

TITAN 3D WEDGE COTTON 5MM

Facility

$10,412.50

Service Code	HCPCS C1713
Hospital Charge Code	270701425
Hospital Revenue Code	278
Min. Negotiated Rate	$1,561.88
Max. Negotiated Rate	$2,519.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,082.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,519.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,290.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,561.88

TITAN 3D WEDGE COTTON 5MM

Facility

$10,412.50

Service Code	HCPCS C1713
Hospital Charge Code	270701425
Hospital Revenue Code	278
Min. Negotiated Rate	$250.94
Max. Negotiated Rate	$5,206.25
Rate for Payer: Aetna Commercial	$3,956.75
Rate for Payer: Aetna Medicare Advantage	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,655.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,655.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,082.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,655.19
Rate for Payer: Cigna Commercial	$5,206.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,519.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,290.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,561.88
Rate for Payer: UnitedHealthcare Community & State	$250.94
Rate for Payer: Wellpoint Medicaid Managed Care	$275.93

TITAN 3D WEDGE SYSTEM 8MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704487
Hospital Revenue Code	279
Min. Negotiated Rate	$241.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,000.00
Rate for Payer: Oxford Commercial	$2,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Commercial	$2,000.00
Rate for Payer: UnitedHealthcare Community & State	$241.00
Rate for Payer: Wellpoint Medicaid Managed Care	$265.00

TITAN 3D WEDGE SYSTEM 8MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704487
Hospital Revenue Code	279
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

TITANIUMCORTXSCREW W/CRUCIFORM

Facility

$2,675.00

Hospital Charge Code	270634480
Hospital Revenue Code	278
Min. Negotiated Rate	$64.47
Max. Negotiated Rate	$1,337.50
Rate for Payer: Aetna Commercial	$1,016.50
Rate for Payer: Aetna Medicare Advantage	$802.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$682.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$682.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$682.12
Rate for Payer: Cigna Commercial	$1,337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$647.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$588.50
Rate for Payer: Qualcare PPO/HMO/WC	$401.25
Rate for Payer: UnitedHealthcare Community & State	$64.47
Rate for Payer: Wellpoint Medicaid Managed Care	$70.89

TITANIUMCORTXSCREW W/CRUCIFORM

Facility

$2,675.00

Hospital Charge Code	270634480
Hospital Revenue Code	278
Min. Negotiated Rate	$401.25
Max. Negotiated Rate	$647.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$647.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$588.50
Rate for Payer: Qualcare PPO/HMO/WC	$401.25

TITANIUM HUMERAL NAIL 7MM

Facility

$7,605.00

Hospital Charge Code	270656701
Hospital Revenue Code	278
Min. Negotiated Rate	$183.28
Max. Negotiated Rate	$3,802.50
Rate for Payer: Aetna Commercial	$2,889.90
Rate for Payer: Aetna Medicare Advantage	$2,281.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,939.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,939.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,521.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,939.28
Rate for Payer: Cigna Commercial	$3,802.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,840.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,673.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,140.75
Rate for Payer: UnitedHealthcare Community & State	$183.28
Rate for Payer: Wellpoint Medicaid Managed Care	$201.53

TITANIUM HUMERAL NAIL 7MM

Facility

$7,605.00

Hospital Charge Code	270656701
Hospital Revenue Code	278
Min. Negotiated Rate	$1,140.75
Max. Negotiated Rate	$1,840.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,521.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,840.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,673.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,140.75

TITANIUM MINI DCP

Facility

$492.00

Hospital Charge Code	270335049
Hospital Revenue Code	278
Min. Negotiated Rate	$73.80
Max. Negotiated Rate	$119.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.24
Rate for Payer: Qualcare PPO/HMO/WC	$73.80

TITANIUM MINI DCP

Facility

$492.00

Hospital Charge Code	270335049
Hospital Revenue Code	278
Min. Negotiated Rate	$11.86
Max. Negotiated Rate	$246.00
Rate for Payer: Aetna Commercial	$186.96
Rate for Payer: Aetna Medicare Advantage	$147.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.46
Rate for Payer: Cigna Commercial	$246.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.24
Rate for Payer: Qualcare PPO/HMO/WC	$73.80
Rate for Payer: UnitedHealthcare Community & State	$11.86
Rate for Payer: Wellpoint Medicaid Managed Care	$13.04

TITANIUMTIP CYLDRICL TUBE SET

Facility

$2,475.00

Hospital Charge Code	270663200
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

TITANIUMTIP CYLDRICL TUBE SET

Facility

$2,475.00

Hospital Charge Code	270663200
Hospital Revenue Code	272
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$742.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

TITER

Facility

$98.00

Service Code	HCPCS 86256
Hospital Charge Code	3035001B
Hospital Revenue Code	302
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$14.70
Rate for Payer: Qualcare PPO/HMO/WC	$14.70

TITER

Facility

$98.00

Service Code	HCPCS 86256
Hospital Charge Code	3035001B
Hospital Revenue Code	302
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$49.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$2.60

TITER REFLEX RPR ANTIBODY

Facility

$42.06

Service Code	HCPCS 86592
Hospital Charge Code	397031151
Hospital Revenue Code	302
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$11.61
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.41
Rate for Payer: Cigna Commercial	$21.03
Rate for Payer: Cigna Medicare Advantage	$4.27
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.31
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Medicare Advantage	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.11

TITER REFLEX RPR ANTIBODY

Facility

$42.06

Service Code	HCPCS 86592
Hospital Charge Code	397031151
Hospital Revenue Code	302
Min. Negotiated Rate	$6.31
Max. Negotiated Rate	$6.31
Rate for Payer: Qualcare PPO/HMO/WC	$6.31

TITNUMCOMPRESNTNSIONBANDPLATE

Facility

$2,130.00

Hospital Charge Code	270635602
Hospital Revenue Code	278
Min. Negotiated Rate	$51.33
Max. Negotiated Rate	$1,065.00
Rate for Payer: Aetna Commercial	$809.40
Rate for Payer: Aetna Medicare Advantage	$639.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$543.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$543.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$543.15
Rate for Payer: Cigna Commercial	$1,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$468.60
Rate for Payer: Qualcare PPO/HMO/WC	$319.50
Rate for Payer: UnitedHealthcare Community & State	$51.33
Rate for Payer: Wellpoint Medicaid Managed Care	$56.45

TITNUMCOMPRESNTNSIONBANDPLATE

Facility

$2,130.00

Hospital Charge Code	270635602
Hospital Revenue Code	278
Min. Negotiated Rate	$319.50
Max. Negotiated Rate	$515.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$468.60
Rate for Payer: Qualcare PPO/HMO/WC	$319.50

TITNUMCRTXSCWSELFTAP2.4MMX14MM

Facility

$2,675.00

Hospital Charge Code	270639270
Hospital Revenue Code	278
Min. Negotiated Rate	$64.47
Max. Negotiated Rate	$1,337.50
Rate for Payer: Aetna Commercial	$1,016.50
Rate for Payer: Aetna Medicare Advantage	$802.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$682.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$682.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$682.12
Rate for Payer: Cigna Commercial	$1,337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$647.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$588.50
Rate for Payer: Qualcare PPO/HMO/WC	$401.25
Rate for Payer: UnitedHealthcare Community & State	$64.47
Rate for Payer: Wellpoint Medicaid Managed Care	$70.89

TITNUMCRTXSCWSELFTAP2.4MMX14MM

Facility

$2,675.00

Hospital Charge Code	270639270
Hospital Revenue Code	278
Min. Negotiated Rate	$401.25
Max. Negotiated Rate	$647.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$647.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$588.50
Rate for Payer: Qualcare PPO/HMO/WC	$401.25

TIZANIDINE 4 MG TAB

Facility

$11.79

Service Code	NDC 904641861
Hospital Charge Code	60629865
Hospital Revenue Code	250
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$5.89
Rate for Payer: Aetna Commercial	$4.48
Rate for Payer: Aetna Medicare Advantage	$3.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.01
Rate for Payer: Cigna Commercial	$5.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.54
Rate for Payer: Oxford Commercial	$2.36
Rate for Payer: Qualcare PPO/HMO/WC	$1.77
Rate for Payer: UnitedHealthcare Commercial	$2.36
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.31

Know your out-of-pocket cost for care.

All Charges