Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TOTAL PROT.RDM UR

Facility

$116.00

Service Code	HCPCS 84156
Hospital Charge Code	38479042
Hospital Revenue Code	301
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$9.98
Rate for Payer: Aetna Medicare Advantage	$11.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.25
Rate for Payer: Cigna Commercial	$58.00
Rate for Payer: Cigna Medicare Advantage	$3.67
Rate for Payer: Clover Medicare Advantage	$3.49
Rate for Payer: EmblemHealth Commercial	$11.01
Rate for Payer: Humana Medicare Advantage	$3.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.67
Rate for Payer: Wellcare Medicare Advantage	$3.67
Rate for Payer: Wellpoint Medicaid Managed Care	$3.07

TOTAL STABILIZER + TIBIAL INSE

Facility

$29,468.25

Service Code	HCPCS C1713
Hospital Charge Code	270704574
Hospital Revenue Code	278
Min. Negotiated Rate	$710.18
Max. Negotiated Rate	$14,734.12
Rate for Payer: Aetna Commercial	$11,197.93
Rate for Payer: Aetna Medicare Advantage	$8,840.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,514.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,514.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,893.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,514.40
Rate for Payer: Cigna Commercial	$14,734.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,131.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,483.02
Rate for Payer: Qualcare PPO/HMO/WC	$4,420.24
Rate for Payer: UnitedHealthcare Community & State	$710.18
Rate for Payer: Wellpoint Medicaid Managed Care	$780.91

TOTAL STABILIZER + TIBIAL INSE

Facility

$29,468.25

Service Code	HCPCS C1713
Hospital Charge Code	270704574
Hospital Revenue Code	278
Min. Negotiated Rate	$4,420.24
Max. Negotiated Rate	$7,131.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,893.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,131.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,483.02
Rate for Payer: Qualcare PPO/HMO/WC	$4,420.24

TOT KNEE ARTHROPLASTY

Facility

$24,330.17

Service Code	HCPCS 27447
Hospital Charge Code	1600000372
Hospital Revenue Code	360
Min. Negotiated Rate	$586.36
Max. Negotiated Rate	$55,057.64
Rate for Payer: Aetna Commercial	$41,487.32
Rate for Payer: Aetna Medicare Advantage	$49,418.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,057.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,057.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,252.69
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	$55,057.64
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: Cigna Medicare Advantage	$15,252.69
Rate for Payer: Clover Medicare Advantage	$14,490.06
Rate for Payer: EmblemHealth Commercial	$45,758.07
Rate for Payer: Humana Medicare Advantage	$15,710.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,252.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,299.05
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,649.53
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$586.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,252.69
Rate for Payer: Wellcare Medicare Advantage	$15,252.69
Rate for Payer: Wellpoint Medicaid Managed Care	$644.75

TOT KNEE ARTHROPLASTY

Facility

$24,330.17

Service Code	HCPCS 27447
Hospital Charge Code	16000270
Hospital Revenue Code	360
Min. Negotiated Rate	$3,649.53
Max. Negotiated Rate	$3,649.53
Rate for Payer: Qualcare PPO/HMO/WC	$3,649.53

TOT KNEE ARTHROPLASTY

Facility

$24,330.17

Service Code	HCPCS 27447
Hospital Charge Code	16000270
Hospital Revenue Code	360
Min. Negotiated Rate	$586.36
Max. Negotiated Rate	$55,057.64
Rate for Payer: Aetna Commercial	$41,487.32
Rate for Payer: Aetna Medicare Advantage	$49,418.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,057.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,057.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,252.69
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	$55,057.64
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: Cigna Medicare Advantage	$15,252.69
Rate for Payer: Clover Medicare Advantage	$14,490.06
Rate for Payer: EmblemHealth Commercial	$45,758.07
Rate for Payer: Humana Medicare Advantage	$15,710.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,252.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,299.05
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,649.53
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$586.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,252.69
Rate for Payer: Wellcare Medicare Advantage	$15,252.69
Rate for Payer: Wellpoint Medicaid Managed Care	$644.75

TOT KNEE ARTHROPLASTY

Facility

$24,330.17

Service Code	HCPCS 27447
Hospital Charge Code	1600000372
Hospital Revenue Code	360
Min. Negotiated Rate	$3,649.53
Max. Negotiated Rate	$3,649.53
Rate for Payer: Qualcare PPO/HMO/WC	$3,649.53

TOURNIQUET L/F 1x18

Facility

$0.53

Hospital Charge Code	270649851
Hospital Revenue Code	270
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.08
Rate for Payer: Qualcare PPO/HMO/WC	$0.08

TOURNIQUET L/F 1x18

Facility

$0.53

Hospital Charge Code	270649851
Hospital Revenue Code	270
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.27
Rate for Payer: Aetna Commercial	$0.20
Rate for Payer: Aetna Medicare Advantage	$0.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.14
Rate for Payer: Cigna Commercial	$0.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.16
Rate for Payer: Oxford Commercial	$0.11
Rate for Payer: Qualcare PPO/HMO/WC	$0.08
Rate for Payer: UnitedHealthcare Commercial	$0.11
Rate for Payer: UnitedHealthcare Community & State	$0.01
Rate for Payer: Wellpoint Medicaid Managed Care	$0.01

TOURNIQUET VASCULAR KIT

Facility

$33.35

Hospital Charge Code	270686313
Hospital Revenue Code	272
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$16.68
Rate for Payer: Aetna Commercial	$12.67
Rate for Payer: Aetna Medicare Advantage	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.50
Rate for Payer: Cigna Commercial	$16.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.01
Rate for Payer: Oxford Commercial	$6.67
Rate for Payer: Qualcare PPO/HMO/WC	$5.00
Rate for Payer: UnitedHealthcare Commercial	$6.67
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.88

TOURNIQUET VASCULAR KIT

Facility

$33.35

Hospital Charge Code	270686313
Hospital Revenue Code	272
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.00

TOWEL ABSORBENT

Facility

$1.03

Hospital Charge Code	270654107
Hospital Revenue Code	270
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.52
Rate for Payer: Aetna Commercial	$0.39
Rate for Payer: Aetna Medicare Advantage	$0.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.31
Rate for Payer: Oxford Commercial	$0.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.21
Rate for Payer: UnitedHealthcare Community & State	$0.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.03

TOWEL ABSORBENT

Facility

$1.03

Hospital Charge Code	270654107
Hospital Revenue Code	270
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

TOWEL ABSORBENT 89701/7550

Facility

$2.27

Hospital Charge Code	270649127
Hospital Revenue Code	270
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.34
Rate for Payer: Qualcare PPO/HMO/WC	$0.34

TOWEL ABSORBENT 89701/7550

Facility

$2.27

Hospital Charge Code	270649127
Hospital Revenue Code	270
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$1.14
Rate for Payer: Aetna Commercial	$0.86
Rate for Payer: Aetna Medicare Advantage	$0.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.58
Rate for Payer: Cigna Commercial	$1.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.68
Rate for Payer: Oxford Commercial	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.34
Rate for Payer: UnitedHealthcare Commercial	$0.45
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

TOWEL BLUE STERILE DISP 704B

Facility

$3.51

Hospital Charge Code	270618060
Hospital Revenue Code	272
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$1.75
Rate for Payer: Aetna Commercial	$1.33
Rate for Payer: Aetna Medicare Advantage	$1.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.90
Rate for Payer: Cigna Commercial	$1.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.05
Rate for Payer: Oxford Commercial	$0.70
Rate for Payer: Qualcare PPO/HMO/WC	$0.53
Rate for Payer: UnitedHealthcare Commercial	$0.70
Rate for Payer: UnitedHealthcare Community & State	$0.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.09

TOWEL BLUE STERILE DISP 704B

Facility

$3.51

Hospital Charge Code	270618060
Hospital Revenue Code	272
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$0.53
Rate for Payer: Qualcare PPO/HMO/WC	$0.53

TOWELLETS DISINFECTING CAVI

Facility

$22.53

Hospital Charge Code	270659016
Hospital Revenue Code	270
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

TOWELLETS DISINFECTING CAVI

Facility

$22.53

Hospital Charge Code	270659016
Hospital Revenue Code	270
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.27
Rate for Payer: Aetna Commercial	$8.56
Rate for Payer: Aetna Medicare Advantage	$6.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.75
Rate for Payer: Cigna Commercial	$11.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.76
Rate for Payer: Oxford Commercial	$4.51
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$4.51
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.60

TOWEL OR BLUE DISPOSABLE STRLE

Facility

$4.00

Hospital Charge Code	270619839
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

TOWEL OR BLUE DISPOSABLE STRLE

Facility

$4.00

Hospital Charge Code	270619839
Hospital Revenue Code	272
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

TOWEL OR BLUE STERILE DISP

Facility

$3.33

Hospital Charge Code	270617993C
Hospital Revenue Code	272
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$0.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.50

TOWEL OR BLUE STERILE DISP

Facility

$3.33

Hospital Charge Code	270617993C
Hospital Revenue Code	272
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$1.67
Rate for Payer: Aetna Commercial	$1.27
Rate for Payer: Aetna Medicare Advantage	$1.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.85
Rate for Payer: Cigna Commercial	$1.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.00
Rate for Payer: Oxford Commercial	$0.67
Rate for Payer: Qualcare PPO/HMO/WC	$0.50
Rate for Payer: UnitedHealthcare Commercial	$0.67
Rate for Payer: UnitedHealthcare Community & State	$0.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.09

TOWER

Facility

$3,300.00

Hospital Charge Code	270702853
Hospital Revenue Code	278
Min. Negotiated Rate	$79.53
Max. Negotiated Rate	$1,650.00
Rate for Payer: Aetna Commercial	$1,254.00
Rate for Payer: Aetna Medicare Advantage	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$841.50
Rate for Payer: Cigna Commercial	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$495.00
Rate for Payer: UnitedHealthcare Community & State	$79.53
Rate for Payer: Wellpoint Medicaid Managed Care	$87.45

TOWER

Facility

$3,300.00

Hospital Charge Code	270702853
Hospital Revenue Code	278
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$798.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

Know your out-of-pocket cost for care.

All Charges