Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TURBINATE GYR SOMNUS 112041105

Facility

$719.25

Hospital Charge Code	270628502
Hospital Revenue Code	272
Min. Negotiated Rate	$107.89
Max. Negotiated Rate	$107.89
Rate for Payer: Qualcare PPO/HMO/WC	$107.89

TURBINATE HP 1120411001

Facility

$719.25

Hospital Charge Code	270629508
Hospital Revenue Code	272
Min. Negotiated Rate	$107.89
Max. Negotiated Rate	$107.89
Rate for Payer: Qualcare PPO/HMO/WC	$107.89

TURBINATE HP 1120411001

Facility

$719.25

Hospital Charge Code	270629508
Hospital Revenue Code	272
Min. Negotiated Rate	$17.33
Max. Negotiated Rate	$359.62
Rate for Payer: Aetna Commercial	$273.31
Rate for Payer: Aetna Medicare Advantage	$215.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.41
Rate for Payer: Cigna Commercial	$359.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.78
Rate for Payer: Oxford Commercial	$143.85
Rate for Payer: Qualcare PPO/HMO/WC	$107.89
Rate for Payer: UnitedHealthcare Commercial	$143.85
Rate for Payer: UnitedHealthcare Community & State	$17.33
Rate for Payer: Wellpoint Medicaid Managed Care	$19.06

TUTOPLAST/ALLOGRAFT

Facility

$1,325.00

Hospital Charge Code	270663906
Hospital Revenue Code	278
Min. Negotiated Rate	$31.93
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$31.93
Rate for Payer: Wellpoint Medicaid Managed Care	$35.11

TUTOPLAST/ALLOGRAFT

Facility

$1,325.00

Hospital Charge Code	270663906
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$291.50
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

TUTOPLAST DERMIS 2X2cm 93-9212

Facility

$3,521.65

Hospital Charge Code	270630854
Hospital Revenue Code	272
Min. Negotiated Rate	$84.87
Max. Negotiated Rate	$1,760.83
Rate for Payer: Aetna Commercial	$1,338.23
Rate for Payer: Aetna Medicare Advantage	$1,056.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$898.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$898.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$898.02
Rate for Payer: Cigna Commercial	$1,760.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,056.49
Rate for Payer: Oxford Commercial	$704.33
Rate for Payer: Qualcare PPO/HMO/WC	$528.25
Rate for Payer: UnitedHealthcare Commercial	$704.33
Rate for Payer: UnitedHealthcare Community & State	$84.87
Rate for Payer: Wellpoint Medicaid Managed Care	$93.32

TUTOPLAST DERMIS 2X2cm 93-9212

Facility

$3,521.65

Hospital Charge Code	270630854
Hospital Revenue Code	272
Min. Negotiated Rate	$528.25
Max. Negotiated Rate	$528.25
Rate for Payer: Qualcare PPO/HMO/WC	$528.25

TUTOPLAST FASCA LATA4x7 937201

Facility

$3,968.00

Hospital Charge Code	270630172
Hospital Revenue Code	272
Min. Negotiated Rate	$595.20
Max. Negotiated Rate	$595.20
Rate for Payer: Qualcare PPO/HMO/WC	$595.20

TUTOPLAST FASCA LATA4x7 937201

Facility

$3,968.00

Hospital Charge Code	270630172
Hospital Revenue Code	272
Min. Negotiated Rate	$95.63
Max. Negotiated Rate	$1,984.00
Rate for Payer: Aetna Commercial	$1,507.84
Rate for Payer: Aetna Medicare Advantage	$1,190.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,011.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,011.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,011.84
Rate for Payer: Cigna Commercial	$1,984.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,190.40
Rate for Payer: Oxford Commercial	$793.60
Rate for Payer: Qualcare PPO/HMO/WC	$595.20
Rate for Payer: UnitedHealthcare Commercial	$793.60
Rate for Payer: UnitedHealthcare Community & State	$95.63
Rate for Payer: Wellpoint Medicaid Managed Care	$105.15

TUTOPLAST PERICARDIUM PATCH

Facility

$702.00

Hospital Charge Code	270335537
Hospital Revenue Code	278
Min. Negotiated Rate	$105.30
Max. Negotiated Rate	$169.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.44
Rate for Payer: Qualcare PPO/HMO/WC	$105.30

TUTOPLAST PERICARDIUM PATCH

Facility

$702.00

Hospital Charge Code	270335537
Hospital Revenue Code	278
Min. Negotiated Rate	$16.92
Max. Negotiated Rate	$351.00
Rate for Payer: Aetna Commercial	$266.76
Rate for Payer: Aetna Medicare Advantage	$210.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.01
Rate for Payer: Cigna Commercial	$351.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.44
Rate for Payer: Qualcare PPO/HMO/WC	$105.30
Rate for Payer: UnitedHealthcare Community & State	$16.92
Rate for Payer: Wellpoint Medicaid Managed Care	$18.60

TUTOPLAST SCLERA

Facility

$1,450.00

Service Code	HCPCS L8610
Hospital Charge Code	270688403
Hospital Revenue Code	278
Min. Negotiated Rate	$34.95
Max. Negotiated Rate	$725.00
Rate for Payer: Aetna Commercial	$551.00
Rate for Payer: Aetna Medicare Advantage	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.75
Rate for Payer: Cigna Commercial	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$319.00
Rate for Payer: Qualcare PPO/HMO/WC	$217.50
Rate for Payer: UnitedHealthcare Community & State	$34.95
Rate for Payer: Wellpoint Medicaid Managed Care	$38.42

TUTOPLAST SCLERA

Facility

$1,450.00

Service Code	HCPCS L8610
Hospital Charge Code	270688403
Hospital Revenue Code	278
Min. Negotiated Rate	$217.50
Max. Negotiated Rate	$350.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$319.00
Rate for Payer: Qualcare PPO/HMO/WC	$217.50

T.VAGINALIS CULTURE

Facility

$45.60

Service Code	HCPCS 87081
Hospital Charge Code	39900530
Hospital Revenue Code	309
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$6.84
Rate for Payer: Qualcare PPO/HMO/WC	$6.84

T.VAGINALIS CULTURE

Facility

$45.60

Service Code	HCPCS 87081
Hospital Charge Code	39900530
Hospital Revenue Code	309
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$18.03
Rate for Payer: Aetna Medicare Advantage	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.93
Rate for Payer: Cigna Commercial	$22.80
Rate for Payer: Cigna Medicare Advantage	$6.63
Rate for Payer: Clover Medicare Advantage	$6.30
Rate for Payer: EmblemHealth Commercial	$19.89
Rate for Payer: Humana Medicare Advantage	$6.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.68
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.84
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.63
Rate for Payer: Wellcare Medicare Advantage	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$1.21

TVT-O SLING W/OBTURATOR 810081

Facility

$4,975.00

Hospital Charge Code	270638390
Hospital Revenue Code	278
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$1,203.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,094.50
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

TVT-O SLING W/OBTURATOR 810081

Facility

$4,975.00

Hospital Charge Code	270638390
Hospital Revenue Code	278
Min. Negotiated Rate	$119.90
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,890.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,094.50
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Community & State	$119.90
Rate for Payer: Wellpoint Medicaid Managed Care	$131.84

T WHIPPLEI DNA QUAL RTPCR

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	3000376
Hospital Revenue Code	306
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.66
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

T WHIPPLEI DNA QUAL RTPCR

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	3000376
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TWINFIX 2.8 Ti W/NDL 2 #2.0

Facility

$1,300.00

Hospital Charge Code	270649964
Hospital Revenue Code	272
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

TWINFIX 2.8 Ti W/NDL 2 #2.0

Facility

$1,300.00

Hospital Charge Code	270649964
Hospital Revenue Code	272
Min. Negotiated Rate	$31.33
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$494.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.00
Rate for Payer: Oxford Commercial	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00
Rate for Payer: UnitedHealthcare Commercial	$260.00
Rate for Payer: UnitedHealthcare Community & State	$31.33
Rate for Payer: Wellpoint Medicaid Managed Care	$34.45

TWIST DRILL 2.0mm REPLACEMENT

Facility

$107.80

Hospital Charge Code	270665031
Hospital Revenue Code	272
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$16.17
Rate for Payer: Qualcare PPO/HMO/WC	$16.17

TWIST DRILL 2.0mm REPLACEMENT

Facility

$107.80

Hospital Charge Code	270665031
Hospital Revenue Code	272
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$53.90
Rate for Payer: Aetna Commercial	$40.96
Rate for Payer: Aetna Medicare Advantage	$32.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.49
Rate for Payer: Cigna Commercial	$53.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.34
Rate for Payer: Oxford Commercial	$21.56
Rate for Payer: Qualcare PPO/HMO/WC	$16.17
Rate for Payer: UnitedHealthcare Commercial	$21.56
Rate for Payer: UnitedHealthcare Community & State	$2.60
Rate for Payer: Wellpoint Medicaid Managed Care	$2.86

TWIST DRILL 4.3mmx203mm W/STOP

Facility

$825.00

Hospital Charge Code	270643632
Hospital Revenue Code	272
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$123.75
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

TWIST DRILL 4.3mmx203mm W/STOP

Facility

$825.00

Hospital Charge Code	270643632
Hospital Revenue Code	272
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.50
Rate for Payer: Oxford Commercial	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Commercial	$165.00
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

Know your out-of-pocket cost for care.

All Charges