Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TROCAR SLEEVE ETHICON 10 MM

Facility

$125.00

Hospital Charge Code	270338721
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

TROCAR SLEEVE ETHICON 12MM

Facility

$71.00

Hospital Charge Code	270338722
Hospital Revenue Code	272
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$35.50
Rate for Payer: Aetna Commercial	$26.98
Rate for Payer: Aetna Medicare Advantage	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.11
Rate for Payer: Cigna Commercial	$35.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.30
Rate for Payer: Oxford Commercial	$14.20
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$14.20
Rate for Payer: UnitedHealthcare Community & State	$1.71
Rate for Payer: Wellpoint Medicaid Managed Care	$1.88

TROCAR SLEEVE ETHICON 12MM

Facility

$71.00

Hospital Charge Code	270338722
Hospital Revenue Code	272
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

TROCAR SLEEVE ETHICON 5MM

Facility

$85.00

Hospital Charge Code	270338720
Hospital Revenue Code	272
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

TROCAR SLEEVE ETHICON 5MM

Facility

$85.00

Hospital Charge Code	270338720
Hospital Revenue Code	272
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$42.50
Rate for Payer: Aetna Commercial	$32.30
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.50
Rate for Payer: Oxford Commercial	$17.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
Rate for Payer: UnitedHealthcare Commercial	$17.00
Rate for Payer: UnitedHealthcare Community & State	$2.05
Rate for Payer: Wellpoint Medicaid Managed Care	$2.25

TROCAR SOFT THORACOPORT 12MM

Facility

$102.00

Hospital Charge Code	270660798
Hospital Revenue Code	272
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$51.00
Rate for Payer: Aetna Commercial	$38.76
Rate for Payer: Aetna Medicare Advantage	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.01
Rate for Payer: Cigna Commercial	$51.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.60
Rate for Payer: Oxford Commercial	$20.40
Rate for Payer: Qualcare PPO/HMO/WC	$15.30
Rate for Payer: UnitedHealthcare Commercial	$20.40
Rate for Payer: UnitedHealthcare Community & State	$2.46
Rate for Payer: Wellpoint Medicaid Managed Care	$2.70

TROCAR SOFT THORACOPORT 12MM

Facility

$102.00

Hospital Charge Code	270660798
Hospital Revenue Code	272
Min. Negotiated Rate	$15.30
Max. Negotiated Rate	$15.30
Rate for Payer: Qualcare PPO/HMO/WC	$15.30

TROCAR SPACEMAKER BLUNT 12MM

Facility

$1,020.49

Hospital Charge Code	270622300
Hospital Revenue Code	272
Min. Negotiated Rate	$24.59
Max. Negotiated Rate	$510.25
Rate for Payer: Aetna Commercial	$387.79
Rate for Payer: Aetna Medicare Advantage	$306.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.22
Rate for Payer: Cigna Commercial	$510.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$306.15
Rate for Payer: Oxford Commercial	$204.10
Rate for Payer: Qualcare PPO/HMO/WC	$153.07
Rate for Payer: UnitedHealthcare Commercial	$204.10
Rate for Payer: UnitedHealthcare Community & State	$24.59
Rate for Payer: Wellpoint Medicaid Managed Care	$27.04

TROCAR SPACEMAKER BLUNT 12MM

Facility

$1,020.49

Hospital Charge Code	270622300
Hospital Revenue Code	272
Min. Negotiated Rate	$153.07
Max. Negotiated Rate	$153.07
Rate for Payer: Qualcare PPO/HMO/WC	$153.07

TROCAR SURGIPORT 10.5MM 179405

Facility

$392.45

Hospital Charge Code	270600097
Hospital Revenue Code	272
Min. Negotiated Rate	$58.87
Max. Negotiated Rate	$58.87
Rate for Payer: Qualcare PPO/HMO/WC	$58.87

TROCAR SURGIPORT 10.5MM 179405

Facility

$392.45

Hospital Charge Code	270600097
Hospital Revenue Code	272
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$196.22
Rate for Payer: Aetna Commercial	$149.13
Rate for Payer: Aetna Medicare Advantage	$117.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.07
Rate for Payer: Cigna Commercial	$196.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.73
Rate for Payer: Oxford Commercial	$78.49
Rate for Payer: Qualcare PPO/HMO/WC	$58.87
Rate for Payer: UnitedHealthcare Commercial	$78.49
Rate for Payer: UnitedHealthcare Community & State	$9.46
Rate for Payer: Wellpoint Medicaid Managed Care	$10.40

TROCAR SURGIPORT 10MM 171028

Facility

$71.40

Hospital Charge Code	270600072
Hospital Revenue Code	272
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$35.70
Rate for Payer: Aetna Commercial	$27.13
Rate for Payer: Aetna Medicare Advantage	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.21
Rate for Payer: Cigna Commercial	$35.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.42
Rate for Payer: Oxford Commercial	$14.28
Rate for Payer: Qualcare PPO/HMO/WC	$10.71
Rate for Payer: UnitedHealthcare Commercial	$14.28
Rate for Payer: UnitedHealthcare Community & State	$1.72
Rate for Payer: Wellpoint Medicaid Managed Care	$1.89

TROCAR SURGIPORT 10MM 171028

Facility

$71.40

Hospital Charge Code	270600072
Hospital Revenue Code	272
Min. Negotiated Rate	$10.71
Max. Negotiated Rate	$10.71
Rate for Payer: Qualcare PPO/HMO/WC	$10.71

TROCAR SURGIPORT 10MM L 171026

Facility

$750.45

Hospital Charge Code	270600069
Hospital Revenue Code	272
Min. Negotiated Rate	$18.09
Max. Negotiated Rate	$375.23
Rate for Payer: Aetna Commercial	$285.17
Rate for Payer: Aetna Medicare Advantage	$225.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.36
Rate for Payer: Cigna Commercial	$375.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.13
Rate for Payer: Oxford Commercial	$150.09
Rate for Payer: Qualcare PPO/HMO/WC	$112.57
Rate for Payer: UnitedHealthcare Commercial	$150.09
Rate for Payer: UnitedHealthcare Community & State	$18.09
Rate for Payer: Wellpoint Medicaid Managed Care	$19.89

TROCAR SURGIPORT 10MM L 171026

Facility

$750.45

Hospital Charge Code	270600069
Hospital Revenue Code	272
Min. Negotiated Rate	$112.57
Max. Negotiated Rate	$112.57
Rate for Payer: Qualcare PPO/HMO/WC	$112.57

TROCAR SURGIPORT 11.5MM 179407

Facility

$409.45

Hospital Charge Code	270600105
Hospital Revenue Code	272
Min. Negotiated Rate	$9.87
Max. Negotiated Rate	$204.72
Rate for Payer: Aetna Commercial	$155.59
Rate for Payer: Aetna Medicare Advantage	$122.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.41
Rate for Payer: Cigna Commercial	$204.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.83
Rate for Payer: Oxford Commercial	$81.89
Rate for Payer: Qualcare PPO/HMO/WC	$61.42
Rate for Payer: UnitedHealthcare Commercial	$81.89
Rate for Payer: UnitedHealthcare Community & State	$9.87
Rate for Payer: Wellpoint Medicaid Managed Care	$10.85

TROCAR SURGIPORT 11.5MM 179407

Facility

$409.45

Hospital Charge Code	270600105
Hospital Revenue Code	272
Min. Negotiated Rate	$61.42
Max. Negotiated Rate	$61.42
Rate for Payer: Qualcare PPO/HMO/WC	$61.42

TROCAR SURGIPORT 11MM 171035

Facility

$750.45

Hospital Charge Code	270600073
Hospital Revenue Code	272
Min. Negotiated Rate	$18.09
Max. Negotiated Rate	$375.23
Rate for Payer: Aetna Commercial	$285.17
Rate for Payer: Aetna Medicare Advantage	$225.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.36
Rate for Payer: Cigna Commercial	$375.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.13
Rate for Payer: Oxford Commercial	$150.09
Rate for Payer: Qualcare PPO/HMO/WC	$112.57
Rate for Payer: UnitedHealthcare Commercial	$150.09
Rate for Payer: UnitedHealthcare Community & State	$18.09
Rate for Payer: Wellpoint Medicaid Managed Care	$19.89

TROCAR SURGIPORT 11MM 171035

Facility

$750.45

Hospital Charge Code	270600073
Hospital Revenue Code	272
Min. Negotiated Rate	$112.57
Max. Negotiated Rate	$112.57
Rate for Payer: Qualcare PPO/HMO/WC	$112.57

TROCAR SURGIPORT 12MM 171036

Facility

$783.25

Hospital Charge Code	270600070
Hospital Revenue Code	272
Min. Negotiated Rate	$18.88
Max. Negotiated Rate	$391.62
Rate for Payer: Aetna Commercial	$297.63
Rate for Payer: Aetna Medicare Advantage	$234.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.73
Rate for Payer: Cigna Commercial	$391.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.97
Rate for Payer: Oxford Commercial	$156.65
Rate for Payer: Qualcare PPO/HMO/WC	$117.49
Rate for Payer: UnitedHealthcare Commercial	$156.65
Rate for Payer: UnitedHealthcare Community & State	$18.88
Rate for Payer: Wellpoint Medicaid Managed Care	$20.76

TROCAR SURGIPORT 12MM 171036

Facility

$783.25

Hospital Charge Code	270600070
Hospital Revenue Code	272
Min. Negotiated Rate	$117.49
Max. Negotiated Rate	$117.49
Rate for Payer: Qualcare PPO/HMO/WC	$117.49

TROCAR SURGIPORT 15MM 179032

Facility

$816.00

Hospital Charge Code	270600071
Hospital Revenue Code	272
Min. Negotiated Rate	$122.40
Max. Negotiated Rate	$122.40
Rate for Payer: Qualcare PPO/HMO/WC	$122.40

TROCAR SURGIPORT 15MM 179032

Facility

$816.00

Hospital Charge Code	270600071
Hospital Revenue Code	272
Min. Negotiated Rate	$19.67
Max. Negotiated Rate	$408.00
Rate for Payer: Aetna Commercial	$310.08
Rate for Payer: Aetna Medicare Advantage	$244.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.08
Rate for Payer: Cigna Commercial	$408.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.80
Rate for Payer: Oxford Commercial	$163.20
Rate for Payer: Qualcare PPO/HMO/WC	$122.40
Rate for Payer: UnitedHealthcare Commercial	$163.20
Rate for Payer: UnitedHealthcare Community & State	$19.67
Rate for Payer: Wellpoint Medicaid Managed Care	$21.62

TROCAR SURGIPORT 15MM 179078

Facility

$344.85

Hospital Charge Code	270614794
Hospital Revenue Code	272
Min. Negotiated Rate	$8.31
Max. Negotiated Rate	$172.43
Rate for Payer: Aetna Commercial	$131.04
Rate for Payer: Aetna Medicare Advantage	$103.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.94
Rate for Payer: Cigna Commercial	$172.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.45
Rate for Payer: Oxford Commercial	$68.97
Rate for Payer: Qualcare PPO/HMO/WC	$51.73
Rate for Payer: UnitedHealthcare Commercial	$68.97
Rate for Payer: UnitedHealthcare Community & State	$8.31
Rate for Payer: Wellpoint Medicaid Managed Care	$9.14

TROCAR SURGIPORT 15MM 179078

Facility

$344.85

Hospital Charge Code	270614794
Hospital Revenue Code	272
Min. Negotiated Rate	$51.73
Max. Negotiated Rate	$51.73
Rate for Payer: Qualcare PPO/HMO/WC	$51.73

Know your out-of-pocket cost for care.

All Charges