Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BIOFIRE RESP VIR PCR RP2 COVID

Facility

$275.00

Service Code	HCPCS 0100U
Hospital Charge Code	40130100U
Hospital Revenue Code	306
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

BIOFIX PLUS 4x4

Facility

$9,945.00

Service Code	HCPCS Q4100
Hospital Charge Code	270685217
Hospital Revenue Code	636
Min. Negotiated Rate	$239.67
Max. Negotiated Rate	$4,972.50
Rate for Payer: Aetna Commercial	$3,779.10
Rate for Payer: Aetna Medicare Advantage	$2,983.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,535.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,535.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,535.97
Rate for Payer: Cigna Commercial	$4,972.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,406.69
Rate for Payer: Qualcare PPO/HMO/WC	$1,491.75
Rate for Payer: UnitedHealthcare Community & State	$239.67
Rate for Payer: Wellpoint Medicaid Managed Care	$263.54

BIOFIX PLUS 4x4

Facility

$9,945.00

Service Code	HCPCS Q4100
Hospital Charge Code	270685217
Hospital Revenue Code	636
Min. Negotiated Rate	$1,491.75
Max. Negotiated Rate	$2,406.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,406.69
Rate for Payer: Qualcare PPO/HMO/WC	$1,491.75

BIOFOAM COTTON WEDGE

Facility

$840.00

Service Code	HCPCS C1713
Hospital Charge Code	270681265
Hospital Revenue Code	278
Min. Negotiated Rate	$20.24
Max. Negotiated Rate	$420.00
Rate for Payer: Aetna Commercial	$319.20
Rate for Payer: Aetna Medicare Advantage	$252.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.20
Rate for Payer: Cigna Commercial	$420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$184.80
Rate for Payer: Qualcare PPO/HMO/WC	$126.00
Rate for Payer: UnitedHealthcare Community & State	$20.24
Rate for Payer: Wellpoint Medicaid Managed Care	$22.26

BIOFOAM COTTON WEDGE

Facility

$840.00

Service Code	HCPCS C1713
Hospital Charge Code	270681265
Hospital Revenue Code	278
Min. Negotiated Rate	$126.00
Max. Negotiated Rate	$203.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$168.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$184.80
Rate for Payer: Qualcare PPO/HMO/WC	$126.00

Biofreeze 32oz pump

Facility

$255.00

Hospital Charge Code	270665774
Hospital Revenue Code	270
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$96.90
Rate for Payer: Aetna Medicare Advantage	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.03
Rate for Payer: Cigna Commercial	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.50
Rate for Payer: Oxford Commercial	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.25
Rate for Payer: UnitedHealthcare Commercial	$51.00
Rate for Payer: UnitedHealthcare Community & State	$6.15
Rate for Payer: Wellpoint Medicaid Managed Care	$6.76

Biofreeze 32oz pump

Facility

$255.00

Hospital Charge Code	270665774
Hospital Revenue Code	270
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$38.25
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

BIOGUARD CLEANING ADPT

Facility

$750.00

Hospital Charge Code	270687384
Hospital Revenue Code	272
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

BIOGUARD CLEANING ADPT

Facility

$750.00

Hospital Charge Code	270687384
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

BIOGUARD VALVES

Facility

$47.50

Hospital Charge Code	270688404
Hospital Revenue Code	272
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

BIOGUARD VALVES

Facility

$47.50

Hospital Charge Code	270688404
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$18.05
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.25
Rate for Payer: Oxford Commercial	$9.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.12
Rate for Payer: UnitedHealthcare Commercial	$9.50
Rate for Payer: UnitedHealthcare Community & State	$1.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.26

BIO-INTERFERENCE TRAY FEE

Facility

$500.00

Hospital Charge Code	270641555
Hospital Revenue Code	270
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

BIO-INTERFERENCE TRAY FEE

Facility

$500.00

Hospital Charge Code	270641555
Hospital Revenue Code	270
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

BIOLOX 36MM -3.0 FEM HD SYS

Facility

$13,528.35

Hospital Charge Code	270656961
Hospital Revenue Code	278
Min. Negotiated Rate	$326.03
Max. Negotiated Rate	$6,764.18
Rate for Payer: Aetna Commercial	$5,140.77
Rate for Payer: Aetna Medicare Advantage	$4,058.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,449.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,449.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,705.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,449.73
Rate for Payer: Cigna Commercial	$6,764.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,273.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,976.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,029.25
Rate for Payer: UnitedHealthcare Community & State	$326.03
Rate for Payer: Wellpoint Medicaid Managed Care	$358.50

BIOLOX 36MM -3.0 FEM HD SYS

Facility

$13,528.35

Hospital Charge Code	270656961
Hospital Revenue Code	278
Min. Negotiated Rate	$2,029.25
Max. Negotiated Rate	$3,273.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,705.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,273.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,976.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,029.25

BIOLOX CERAMIC HEAD

Facility

$13,493.90

Hospital Charge Code	27065694
Hospital Revenue Code	278
Min. Negotiated Rate	$325.20
Max. Negotiated Rate	$6,746.95
Rate for Payer: Aetna Commercial	$5,127.68
Rate for Payer: Aetna Medicare Advantage	$4,048.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,440.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,440.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,698.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,440.94
Rate for Payer: Cigna Commercial	$6,746.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,265.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,968.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,024.09
Rate for Payer: UnitedHealthcare Community & State	$325.20
Rate for Payer: Wellpoint Medicaid Managed Care	$357.59

BIOLOX CERAMIC HEAD

Facility

$13,493.90

Service Code	HCPCS C1776
Hospital Charge Code	270656964
Hospital Revenue Code	278
Min. Negotiated Rate	$325.20
Max. Negotiated Rate	$6,746.95
Rate for Payer: Aetna Commercial	$5,127.68
Rate for Payer: Aetna Medicare Advantage	$4,048.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,440.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,440.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,698.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,440.94
Rate for Payer: Cigna Commercial	$6,746.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,265.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,968.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,024.09
Rate for Payer: UnitedHealthcare Community & State	$325.20
Rate for Payer: Wellpoint Medicaid Managed Care	$357.59

BIOLOX CERAMIC HEAD

Facility

$13,493.90

Service Code	HCPCS C1776
Hospital Charge Code	270656964
Hospital Revenue Code	278
Min. Negotiated Rate	$2,024.09
Max. Negotiated Rate	$3,265.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,698.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,265.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,968.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,024.09

BIOLOX CERAMIC HEAD

Facility

$13,493.90

Hospital Charge Code	27065694
Hospital Revenue Code	278
Min. Negotiated Rate	$2,024.09
Max. Negotiated Rate	$3,265.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,698.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,265.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,968.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,024.09

BIOLOX DELTA CERAMIC FE

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270688885
Hospital Revenue Code	278
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

BIOLOX DELTA CERAMIC FE

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270688885
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

BIOLOX DELTA CERAMIC HEAD +8.5

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690556
Hospital Revenue Code	278
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

BIOLOX DELTA CERAMIC HEAD +8.5

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690556
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

BIOLOXDELTA FEM HEAD36MM-3.5MM

Facility

$13,493.90

Hospital Charge Code	270663139
Hospital Revenue Code	278
Min. Negotiated Rate	$325.20
Max. Negotiated Rate	$6,746.95
Rate for Payer: Aetna Commercial	$5,127.68
Rate for Payer: Aetna Medicare Advantage	$4,048.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,440.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,440.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,698.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,440.94
Rate for Payer: Cigna Commercial	$6,746.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,265.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,968.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,024.09
Rate for Payer: UnitedHealthcare Community & State	$325.20
Rate for Payer: Wellpoint Medicaid Managed Care	$357.59

BIOLOXDELTA FEM HEAD36MM-3.5MM

Facility

$13,493.90

Hospital Charge Code	270663139
Hospital Revenue Code	278
Min. Negotiated Rate	$2,024.09
Max. Negotiated Rate	$3,265.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,698.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,265.52
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,968.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,024.09

Know your out-of-pocket cost for care.

All Charges