Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

UNIV. CEMENT DISP. INST-SZ SM

Facility

$930.00

Hospital Charge Code	270656569
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$225.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.60
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

UNIVERSAL 5TH METATRSAL HOOK P

Facility

$6,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270686301
Hospital Revenue Code	278
Min. Negotiated Rate	$159.30
Max. Negotiated Rate	$3,305.00
Rate for Payer: Aetna Commercial	$2,511.80
Rate for Payer: Aetna Medicare Advantage	$1,983.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,685.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,685.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,322.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,685.55
Rate for Payer: Cigna Commercial	$3,305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,599.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,454.20
Rate for Payer: Qualcare PPO/HMO/WC	$991.50
Rate for Payer: UnitedHealthcare Community & State	$159.30
Rate for Payer: Wellpoint Medicaid Managed Care	$175.16

UNIVERSAL 5TH METATRSAL HOOK P

Facility

$6,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270686301
Hospital Revenue Code	278
Min. Negotiated Rate	$991.50
Max. Negotiated Rate	$1,599.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,322.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,599.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,454.20
Rate for Payer: Qualcare PPO/HMO/WC	$991.50

Universal Bandage Scissors w/

Facility

$52.50

Hospital Charge Code	270662585
Hospital Revenue Code	270
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$7.88
Rate for Payer: Qualcare PPO/HMO/WC	$7.88

Universal Bandage Scissors w/

Facility

$52.50

Hospital Charge Code	270662585
Hospital Revenue Code	270
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$26.25
Rate for Payer: Aetna Commercial	$19.95
Rate for Payer: Aetna Medicare Advantage	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.39
Rate for Payer: Cigna Commercial	$26.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.75
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.88
Rate for Payer: UnitedHealthcare Commercial	$10.50
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.39

UNIVERSAL CEMENT RESTRICTOR

Facility

$960.00

Service Code	HCPCS C1713
Hospital Charge Code	270664954
Hospital Revenue Code	278
Min. Negotiated Rate	$144.00
Max. Negotiated Rate	$232.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.20
Rate for Payer: Qualcare PPO/HMO/WC	$144.00

UNIVERSAL CEMENT RESTRICTOR

Facility

$960.00

Service Code	HCPCS C1713
Hospital Charge Code	270664954
Hospital Revenue Code	278
Min. Negotiated Rate	$23.14
Max. Negotiated Rate	$480.00
Rate for Payer: Aetna Commercial	$364.80
Rate for Payer: Aetna Medicare Advantage	$288.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.80
Rate for Payer: Cigna Commercial	$480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.20
Rate for Payer: Qualcare PPO/HMO/WC	$144.00
Rate for Payer: UnitedHealthcare Community & State	$23.14
Rate for Payer: Wellpoint Medicaid Managed Care	$25.44

UNIVERSAL HEAD 50 X 26MM

Facility

$3,763.65

Service Code	HCPCS C1776
Hospital Charge Code	270685005
Hospital Revenue Code	278
Min. Negotiated Rate	$564.55
Max. Negotiated Rate	$910.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$752.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$910.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$828.00
Rate for Payer: Qualcare PPO/HMO/WC	$564.55

UNIVERSAL HEAD 50 X 26MM

Facility

$3,763.65

Service Code	HCPCS C1776
Hospital Charge Code	270685005
Hospital Revenue Code	278
Min. Negotiated Rate	$90.70
Max. Negotiated Rate	$1,881.83
Rate for Payer: Aetna Commercial	$1,430.19
Rate for Payer: Aetna Medicare Advantage	$1,129.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$959.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$959.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$752.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$959.73
Rate for Payer: Cigna Commercial	$1,881.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$910.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$828.00
Rate for Payer: Qualcare PPO/HMO/WC	$564.55
Rate for Payer: UnitedHealthcare Community & State	$90.70
Rate for Payer: Wellpoint Medicaid Managed Care	$99.74

UNIVERSAL HEAD UHR 55MM 28MM

Facility

$4,125.00

Hospital Charge Code	270669390
Hospital Revenue Code	278
Min. Negotiated Rate	$618.75
Max. Negotiated Rate	$998.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$618.75

UNIVERSAL HEAD UHR 55MM 28MM

Facility

$4,125.00

Hospital Charge Code	270669390
Hospital Revenue Code	278
Min. Negotiated Rate	$99.41
Max. Negotiated Rate	$2,062.50
Rate for Payer: Aetna Commercial	$1,567.50
Rate for Payer: Aetna Medicare Advantage	$1,237.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,051.88
Rate for Payer: Cigna Commercial	$2,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$618.75
Rate for Payer: UnitedHealthcare Community & State	$99.41
Rate for Payer: Wellpoint Medicaid Managed Care	$109.31

UNIVERSAL HUM NAIL 7 X 240MM

Facility

$6,525.00

Service Code	HCPCS C1713
Hospital Charge Code	270685092
Hospital Revenue Code	278
Min. Negotiated Rate	$978.75
Max. Negotiated Rate	$1,579.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,579.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,435.50
Rate for Payer: Qualcare PPO/HMO/WC	$978.75

UNIVERSAL HUM NAIL 7 X 240MM

Facility

$6,525.00

Service Code	HCPCS C1713
Hospital Charge Code	270685092
Hospital Revenue Code	278
Min. Negotiated Rate	$157.25
Max. Negotiated Rate	$3,262.50
Rate for Payer: Aetna Commercial	$2,479.50
Rate for Payer: Aetna Medicare Advantage	$1,957.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,663.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,663.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,663.88
Rate for Payer: Cigna Commercial	$3,262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,579.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,435.50
Rate for Payer: Qualcare PPO/HMO/WC	$978.75
Rate for Payer: UnitedHealthcare Community & State	$157.25
Rate for Payer: Wellpoint Medicaid Managed Care	$172.91

UNIVERSAL SLING KIT

Facility

$2,975.00

Hospital Charge Code	270642135
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$719.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$654.50
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

UNIVERSAL SLING KIT

Facility

$2,975.00

Hospital Charge Code	270642135
Hospital Revenue Code	278
Min. Negotiated Rate	$71.70
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$1,130.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$654.50
Rate for Payer: Qualcare PPO/HMO/WC	$446.25
Rate for Payer: UnitedHealthcare Community & State	$71.70
Rate for Payer: Wellpoint Medicaid Managed Care	$78.84

UNIVERSAL STREE POST

Facility

$2,970.00

Hospital Charge Code	270665319
Hospital Revenue Code	270
Min. Negotiated Rate	$445.50
Max. Negotiated Rate	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$445.50

UNIVERSAL STREE POST

Facility

$2,970.00

Hospital Charge Code	270665319
Hospital Revenue Code	270
Min. Negotiated Rate	$71.58
Max. Negotiated Rate	$1,485.00
Rate for Payer: Aetna Commercial	$1,128.60
Rate for Payer: Aetna Medicare Advantage	$891.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$757.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$757.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$757.35
Rate for Payer: Cigna Commercial	$1,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$891.00
Rate for Payer: Oxford Commercial	$594.00
Rate for Payer: Qualcare PPO/HMO/WC	$445.50
Rate for Payer: UnitedHealthcare Commercial	$594.00
Rate for Payer: UnitedHealthcare Community & State	$71.58
Rate for Payer: Wellpoint Medicaid Managed Care	$78.70

UNIVERSAL TENODESIS

Facility

$2,227.50

Hospital Charge Code	270678631
Hospital Revenue Code	272
Min. Negotiated Rate	$334.12
Max. Negotiated Rate	$334.12
Rate for Payer: Qualcare PPO/HMO/WC	$334.12

UNIVERSAL TENODESIS

Facility

$2,227.50

Hospital Charge Code	270678631
Hospital Revenue Code	272
Min. Negotiated Rate	$53.68
Max. Negotiated Rate	$1,113.75
Rate for Payer: Aetna Commercial	$846.45
Rate for Payer: Aetna Medicare Advantage	$668.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$568.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$568.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$568.01
Rate for Payer: Cigna Commercial	$1,113.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$668.25
Rate for Payer: Oxford Commercial	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$334.12
Rate for Payer: UnitedHealthcare Commercial	$445.50
Rate for Payer: UnitedHealthcare Community & State	$53.68
Rate for Payer: Wellpoint Medicaid Managed Care	$59.03

UNIVERSAL XTRACT SET

Facility

$9,000.00

Hospital Charge Code	270687383
Hospital Revenue Code	272
Min. Negotiated Rate	$216.90
Max. Negotiated Rate	$4,500.00
Rate for Payer: Aetna Commercial	$3,420.00
Rate for Payer: Aetna Medicare Advantage	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,295.00
Rate for Payer: Cigna Commercial	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,700.00
Rate for Payer: Oxford Commercial	$1,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00
Rate for Payer: UnitedHealthcare Commercial	$1,800.00
Rate for Payer: UnitedHealthcare Community & State	$216.90
Rate for Payer: Wellpoint Medicaid Managed Care	$238.50

UNIVERSAL XTRACT SET

Facility

$9,000.00

Hospital Charge Code	270687383
Hospital Revenue Code	272
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$1,350.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

UNIV HEADBIPO COMP 45MM X 26MM

Facility

$7,945.00

Hospital Charge Code	270656566
Hospital Revenue Code	278
Min. Negotiated Rate	$191.47
Max. Negotiated Rate	$3,972.50
Rate for Payer: Aetna Commercial	$3,019.10
Rate for Payer: Aetna Medicare Advantage	$2,383.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,025.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,025.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,589.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,025.97
Rate for Payer: Cigna Commercial	$3,972.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,922.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,747.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,191.75
Rate for Payer: UnitedHealthcare Community & State	$191.47
Rate for Payer: Wellpoint Medicaid Managed Care	$210.54

UNIV HEADBIPO COMP 45MM X 26MM

Facility

$7,945.00

Hospital Charge Code	270656566
Hospital Revenue Code	278
Min. Negotiated Rate	$1,191.75
Max. Negotiated Rate	$1,922.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,589.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,922.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,747.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,191.75

UNI WASH ******

Facility

$65.00

Hospital Charge Code	8002099
Hospital Revenue Code	279
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

UNI WASH ******

Facility

$65.00

Hospital Charge Code	8002099
Hospital Revenue Code	279
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$32.50
Rate for Payer: Aetna Commercial	$24.70
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$13.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$13.00
Rate for Payer: UnitedHealthcare Community & State	$1.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

Know your out-of-pocket cost for care.

All Charges