Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BIOPATCH BLUE 1 IN DISK W/7MM

Facility

$34.98

Hospital Charge Code	270671184
Hospital Revenue Code	272
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

BioPatch protective disk 4.0mm

Facility

$53.80

Hospital Charge Code	6063943324
Hospital Revenue Code	250
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$26.90
Rate for Payer: Aetna Commercial	$20.44
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.14
Rate for Payer: Oxford Commercial	$10.76
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$10.76
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

BioPatch protective disk 4.0mm

Facility

$53.80

Hospital Charge Code	6063943324
Hospital Revenue Code	250
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

BioPatch protective disk 7.0mm

Facility

$54.35

Hospital Charge Code	6063943325
Hospital Revenue Code	250
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$27.18
Rate for Payer: Aetna Commercial	$20.65
Rate for Payer: Aetna Medicare Advantage	$16.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.86
Rate for Payer: Cigna Commercial	$27.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.30
Rate for Payer: Oxford Commercial	$10.87
Rate for Payer: Qualcare PPO/HMO/WC	$8.15
Rate for Payer: UnitedHealthcare Commercial	$10.87
Rate for Payer: UnitedHealthcare Community & State	$1.31
Rate for Payer: Wellpoint Medicaid Managed Care	$1.44

BioPatch protective disk 7.0mm

Facility

$54.35

Hospital Charge Code	6063943325
Hospital Revenue Code	250
Min. Negotiated Rate	$8.15
Max. Negotiated Rate	$8.15
Rate for Payer: Qualcare PPO/HMO/WC	$8.15

BIOPINCE DIP AUTOBIOPSY18GX15C

Facility

$260.00

Hospital Charge Code	270658282
Hospital Revenue Code	272
Min. Negotiated Rate	$6.27
Max. Negotiated Rate	$130.00
Rate for Payer: Aetna Commercial	$98.80
Rate for Payer: Aetna Medicare Advantage	$78.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.30
Rate for Payer: Cigna Commercial	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.00
Rate for Payer: Oxford Commercial	$52.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00
Rate for Payer: UnitedHealthcare Commercial	$52.00
Rate for Payer: UnitedHealthcare Community & State	$6.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.89

BIOPINCE DIP AUTOBIOPSY18GX15C

Facility

$260.00

Hospital Charge Code	270658282
Hospital Revenue Code	272
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00

BIOPINCE DISP AUTO BIOPSY INST

Facility

$223.58

Hospital Charge Code	270654226
Hospital Revenue Code	272
Min. Negotiated Rate	$33.54
Max. Negotiated Rate	$33.54
Rate for Payer: Qualcare PPO/HMO/WC	$33.54

BIOPINCE DISP AUTO BIOPSY INST

Facility

$223.58

Hospital Charge Code	270654226
Hospital Revenue Code	272
Min. Negotiated Rate	$5.39
Max. Negotiated Rate	$111.79
Rate for Payer: Aetna Commercial	$84.96
Rate for Payer: Aetna Medicare Advantage	$67.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.01
Rate for Payer: Cigna Commercial	$111.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.07
Rate for Payer: Oxford Commercial	$44.72
Rate for Payer: Qualcare PPO/HMO/WC	$33.54
Rate for Payer: UnitedHealthcare Commercial	$44.72
Rate for Payer: UnitedHealthcare Community & State	$5.39
Rate for Payer: Wellpoint Medicaid Managed Care	$5.92

BIOPIN DISPAUTOBIOPSY 18Gx10cm

Facility

$225.00

Hospital Charge Code	2709003583
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

BIOPIN DISPAUTOBIOPSY 18Gx10cm

Facility

$225.00

Hospital Charge Code	2709003583
Hospital Revenue Code	272
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.50
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$45.00
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

BIOPIN DISPAUTOBIOPSY 18Gx15cm

Facility

$225.00

Hospital Charge Code	2709003584
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

BIOPIN DISPAUTOBIOPSY 18Gx15cm

Facility

$225.00

Hospital Charge Code	2709003584
Hospital Revenue Code	272
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.50
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$45.00
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

BIOPOLAR COMPONENT 28x43MM

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270675090
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

BIOPOLAR COMPONENT 28x43MM

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270675090
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

BIOPOLAR SHELL (43)

Facility

$2,256.50

Hospital Charge Code	270656967
Hospital Revenue Code	278
Min. Negotiated Rate	$338.48
Max. Negotiated Rate	$546.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.43
Rate for Payer: Qualcare PPO/HMO/WC	$338.48

BIOPOLAR SHELL (43)

Facility

$2,256.50

Hospital Charge Code	270656967
Hospital Revenue Code	278
Min. Negotiated Rate	$54.38
Max. Negotiated Rate	$1,128.25
Rate for Payer: Aetna Commercial	$857.47
Rate for Payer: Aetna Medicare Advantage	$676.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$575.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$575.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$575.41
Rate for Payer: Cigna Commercial	$1,128.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.43
Rate for Payer: Qualcare PPO/HMO/WC	$338.48
Rate for Payer: UnitedHealthcare Community & State	$54.38
Rate for Payer: Wellpoint Medicaid Managed Care	$59.80

BIOP SALIVAR GLAND NDL-BI

Facility

$2,357.00

Service Code	HCPCS 4240050
Hospital Charge Code	2690585
Hospital Revenue Code	361
Min. Negotiated Rate	$353.55
Max. Negotiated Rate	$353.55
Rate for Payer: Qualcare PPO/HMO/WC	$353.55

BIOP SALIVAR GLAND NDL-BI

Facility

$2,357.00

Service Code	HCPCS 4240050
Hospital Charge Code	7411815
Hospital Revenue Code	361
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$895.66
Rate for Payer: Aetna Medicare Advantage	$707.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$601.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$601.03
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	$601.03
Rate for Payer: Cigna Commercial	$1,178.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.10
Rate for Payer: Qualcare PPO/HMO/WC	$353.55
Rate for Payer: UnitedHealthcare Community & State	$56.80
Rate for Payer: Wellpoint Medicaid Managed Care	$62.46

BIOP SALIVAR GLAND NDL-BI

Facility

$2,357.00

Service Code	HCPCS 4240050
Hospital Charge Code	7411815
Hospital Revenue Code	361
Min. Negotiated Rate	$353.55
Max. Negotiated Rate	$353.55
Rate for Payer: Qualcare PPO/HMO/WC	$353.55

BIOP SALIVAR GLAND NDL-BI

Facility

$2,357.00

Service Code	HCPCS 4240050
Hospital Charge Code	2690585
Hospital Revenue Code	361
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$895.66
Rate for Payer: Aetna Medicare Advantage	$707.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$601.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$601.03
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	$601.03
Rate for Payer: Cigna Commercial	$1,178.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.10
Rate for Payer: Qualcare PPO/HMO/WC	$353.55
Rate for Payer: UnitedHealthcare Community & State	$56.80
Rate for Payer: Wellpoint Medicaid Managed Care	$62.46

BIOP SALIVAR GLAND NDL-LT

Facility

$2,357.00

Service Code	HCPCS 42400LT
Hospital Charge Code	2691500
Hospital Revenue Code	361
Min. Negotiated Rate	$353.55
Max. Negotiated Rate	$353.55
Rate for Payer: Qualcare PPO/HMO/WC	$353.55

BIOP SALIVAR GLAND NDL-LT

Facility

$2,357.00

Service Code	HCPCS 42400LT
Hospital Charge Code	7411950
Hospital Revenue Code	361
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$895.66
Rate for Payer: Aetna Medicare Advantage	$707.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$601.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$601.03
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	$601.03
Rate for Payer: Cigna Commercial	$1,178.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.10
Rate for Payer: Qualcare PPO/HMO/WC	$353.55
Rate for Payer: UnitedHealthcare Community & State	$56.80
Rate for Payer: Wellpoint Medicaid Managed Care	$62.46

BIOP SALIVAR GLAND NDL-LT

Facility

$2,357.00

Service Code	HCPCS 42400LT
Hospital Charge Code	7411950
Hospital Revenue Code	361
Min. Negotiated Rate	$353.55
Max. Negotiated Rate	$353.55
Rate for Payer: Qualcare PPO/HMO/WC	$353.55

BIOP SALIVAR GLAND NDL-LT

Facility

$2,357.00

Service Code	HCPCS 42400LT
Hospital Charge Code	2691500
Hospital Revenue Code	361
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$895.66
Rate for Payer: Aetna Medicare Advantage	$707.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$601.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$601.03
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	$601.03
Rate for Payer: Cigna Commercial	$1,178.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.10
Rate for Payer: Qualcare PPO/HMO/WC	$353.55
Rate for Payer: UnitedHealthcare Community & State	$56.80
Rate for Payer: Wellpoint Medicaid Managed Care	$62.46

Know your out-of-pocket cost for care.

All Charges