Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TROCAR LONG 5MM

Facility

$97.00

Hospital Charge Code	270335696
Hospital Revenue Code	272
Min. Negotiated Rate	$14.55
Max. Negotiated Rate	$14.55
Rate for Payer: Qualcare PPO/HMO/WC	$14.55

TROCAR LONG 5MM

Facility

$97.00

Hospital Charge Code	270335696
Hospital Revenue Code	272
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$48.50
Rate for Payer: Aetna Commercial	$36.86
Rate for Payer: Aetna Medicare Advantage	$29.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.73
Rate for Payer: Cigna Commercial	$48.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.10
Rate for Payer: Oxford Commercial	$19.40
Rate for Payer: Qualcare PPO/HMO/WC	$14.55
Rate for Payer: UnitedHealthcare Commercial	$19.40
Rate for Payer: UnitedHealthcare Community & State	$2.34
Rate for Payer: Wellpoint Medicaid Managed Care	$2.57

TROCAR N/BLADE 5mm 2299035NLT

Facility

$195.57

Hospital Charge Code	270628302
Hospital Revenue Code	272
Min. Negotiated Rate	$29.34
Max. Negotiated Rate	$29.34
Rate for Payer: Qualcare PPO/HMO/WC	$29.34

TROCAR N/BLADE 5mm 2299035NLT

Facility

$195.57

Hospital Charge Code	270628302
Hospital Revenue Code	272
Min. Negotiated Rate	$4.71
Max. Negotiated Rate	$97.78
Rate for Payer: Aetna Commercial	$74.32
Rate for Payer: Aetna Medicare Advantage	$58.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.87
Rate for Payer: Cigna Commercial	$97.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.67
Rate for Payer: Oxford Commercial	$39.11
Rate for Payer: Qualcare PPO/HMO/WC	$29.34
Rate for Payer: UnitedHealthcare Commercial	$39.11
Rate for Payer: UnitedHealthcare Community & State	$4.71
Rate for Payer: Wellpoint Medicaid Managed Care	$5.18

TROCAR N/BLDE 10/12 22990512HT

Facility

$616.85

Hospital Charge Code	270628301
Hospital Revenue Code	272
Min. Negotiated Rate	$92.53
Max. Negotiated Rate	$92.53
Rate for Payer: Qualcare PPO/HMO/WC	$92.53

TROCAR N/BLDE 10/12 22990512HT

Facility

$616.85

Hospital Charge Code	270628301
Hospital Revenue Code	272
Min. Negotiated Rate	$14.87
Max. Negotiated Rate	$308.43
Rate for Payer: Aetna Commercial	$234.40
Rate for Payer: Aetna Medicare Advantage	$185.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.30
Rate for Payer: Cigna Commercial	$308.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.06
Rate for Payer: Oxford Commercial	$123.37
Rate for Payer: Qualcare PPO/HMO/WC	$92.53
Rate for Payer: UnitedHealthcare Commercial	$123.37
Rate for Payer: UnitedHealthcare Community & State	$14.87
Rate for Payer: Wellpoint Medicaid Managed Care	$16.35

TROCAR N/BLDE 10/12 22990512HT

Facility

$770.98

Hospital Charge Code	270628101
Hospital Revenue Code	272
Min. Negotiated Rate	$115.65
Max. Negotiated Rate	$115.65
Rate for Payer: Qualcare PPO/HMO/WC	$115.65

TROCAR N/BLDE 10/12 22990512HT

Facility

$770.98

Hospital Charge Code	270628101
Hospital Revenue Code	272
Min. Negotiated Rate	$18.58
Max. Negotiated Rate	$385.49
Rate for Payer: Aetna Commercial	$292.97
Rate for Payer: Aetna Medicare Advantage	$231.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.60
Rate for Payer: Cigna Commercial	$385.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.29
Rate for Payer: Oxford Commercial	$154.20
Rate for Payer: Qualcare PPO/HMO/WC	$115.65
Rate for Payer: UnitedHealthcare Commercial	$154.20
Rate for Payer: UnitedHealthcare Community & State	$18.58
Rate for Payer: Wellpoint Medicaid Managed Care	$20.43

TROCAR OPT BLADELESS 12x100MM

Facility

$125.00

Hospital Charge Code	270676769
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

TROCAR OPT BLADELESS 12x100MM

Facility

$125.00

Hospital Charge Code	270676769
Hospital Revenue Code	272
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

TROCAR OPTICAL 5MM W/2 SLEEVES

Facility

$213.16

Hospital Charge Code	270669883
Hospital Revenue Code	272
Min. Negotiated Rate	$31.97
Max. Negotiated Rate	$31.97
Rate for Payer: Qualcare PPO/HMO/WC	$31.97

TROCAR OPTICAL 5MM W/2 SLEEVES

Facility

$213.16

Hospital Charge Code	270669883
Hospital Revenue Code	272
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$106.58
Rate for Payer: Aetna Commercial	$81.00
Rate for Payer: Aetna Medicare Advantage	$63.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.36
Rate for Payer: Cigna Commercial	$106.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.95
Rate for Payer: Oxford Commercial	$42.63
Rate for Payer: Qualcare PPO/HMO/WC	$31.97
Rate for Payer: UnitedHealthcare Commercial	$42.63
Rate for Payer: UnitedHealthcare Community & State	$5.14
Rate for Payer: Wellpoint Medicaid Managed Care	$5.65

TROCAR OPTICAL VERSA CANNULA 5

Facility

$140.95

Hospital Charge Code	270697814
Hospital Revenue Code	272
Min. Negotiated Rate	$21.14
Max. Negotiated Rate	$21.14
Rate for Payer: Qualcare PPO/HMO/WC	$21.14

TROCAR OPTICAL VERSA CANNULA 5

Facility

$140.95

Hospital Charge Code	270697814
Hospital Revenue Code	272
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$70.47
Rate for Payer: Aetna Commercial	$53.56
Rate for Payer: Aetna Medicare Advantage	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.94
Rate for Payer: Cigna Commercial	$70.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.28
Rate for Payer: Oxford Commercial	$28.19
Rate for Payer: Qualcare PPO/HMO/WC	$21.14
Rate for Payer: UnitedHealthcare Commercial	$28.19
Rate for Payer: UnitedHealthcare Community & State	$3.40
Rate for Payer: Wellpoint Medicaid Managed Care	$3.74

TROCAR OPTIVIEW 5 MM 75 MM

Facility

$115.00

Hospital Charge Code	270690127
Hospital Revenue Code	272
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

TROCAR OPTIVIEW 5 MM 75 MM

Facility

$115.00

Hospital Charge Code	270690127
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$57.50
Rate for Payer: Aetna Commercial	$43.70
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.50
Rate for Payer: Oxford Commercial	$23.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Commercial	$23.00
Rate for Payer: UnitedHealthcare Community & State	$2.77
Rate for Payer: Wellpoint Medicaid Managed Care	$3.05

TROCAR POINT PIN 3.2MM SZ 2.6

Facility

$650.00

Hospital Charge Code	270673733
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

TROCAR POINT PIN 3.2MM SZ 2.6

Facility

$650.00

Hospital Charge Code	270673733
Hospital Revenue Code	272
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$130.00
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

TROCAR POINT PIN 3.2MM SZ 5.1

Facility

$650.00

Hospital Charge Code	270673923
Hospital Revenue Code	272
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$130.00
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

TROCAR POINT PIN 3.2MM SZ 5.1

Facility

$650.00

Hospital Charge Code	270673923
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

TROCAR PORT 8FR ATTACHABLE

Facility

$1,390.00

Hospital Charge Code	270653936
Hospital Revenue Code	272
Min. Negotiated Rate	$208.50
Max. Negotiated Rate	$208.50
Rate for Payer: Qualcare PPO/HMO/WC	$208.50

TROCAR PORT 8FR ATTACHABLE

Facility

$1,390.00

Hospital Charge Code	270653936
Hospital Revenue Code	272
Min. Negotiated Rate	$33.50
Max. Negotiated Rate	$695.00
Rate for Payer: Aetna Commercial	$528.20
Rate for Payer: Aetna Medicare Advantage	$417.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$354.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$354.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$354.45
Rate for Payer: Cigna Commercial	$695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.00
Rate for Payer: Oxford Commercial	$278.00
Rate for Payer: Qualcare PPO/HMO/WC	$208.50
Rate for Payer: UnitedHealthcare Commercial	$278.00
Rate for Payer: UnitedHealthcare Community & State	$33.50
Rate for Payer: Wellpoint Medicaid Managed Care	$36.84

TROCAR SLEEVE 5MM

Facility

$43.35

Hospital Charge Code	270655182
Hospital Revenue Code	270
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.68
Rate for Payer: Aetna Commercial	$16.47
Rate for Payer: Aetna Medicare Advantage	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.05
Rate for Payer: Cigna Commercial	$21.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.01
Rate for Payer: Oxford Commercial	$8.67
Rate for Payer: Qualcare PPO/HMO/WC	$6.50
Rate for Payer: UnitedHealthcare Commercial	$8.67
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

TROCAR SLEEVE 5MM

Facility

$43.35

Hospital Charge Code	270655182
Hospital Revenue Code	270
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.50

TROCAR SLEEVE ETHICON 10 MM

Facility

$125.00

Hospital Charge Code	270338721
Hospital Revenue Code	272
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

Know your out-of-pocket cost for care.

All Charges