Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BIOSYNEEDLEFRANSEENLUNG20G 10C

Facility

$105.20

Hospital Charge Code	2709005726
Hospital Revenue Code	272
Min. Negotiated Rate	$15.78
Max. Negotiated Rate	$15.78
Rate for Payer: Qualcare PPO/HMO/WC	$15.78

BIO TENDESIS SCREW 11 X 10

Facility

$590.00

Hospital Charge Code	270335619
Hospital Revenue Code	278
Min. Negotiated Rate	$14.22
Max. Negotiated Rate	$295.00
Rate for Payer: Aetna Commercial	$224.20
Rate for Payer: Aetna Medicare Advantage	$177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.45
Rate for Payer: Cigna Commercial	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$129.80
Rate for Payer: Qualcare PPO/HMO/WC	$88.50
Rate for Payer: UnitedHealthcare Community & State	$14.22
Rate for Payer: Wellpoint Medicaid Managed Care	$15.63

BIO TENDESIS SCREW 11 X 10

Facility

$590.00

Hospital Charge Code	270335619
Hospital Revenue Code	278
Min. Negotiated Rate	$88.50
Max. Negotiated Rate	$142.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$129.80
Rate for Payer: Qualcare PPO/HMO/WC	$88.50

BIOTENE LOZENGE

Facility

$4.00

Service Code	NDC 48582051201
Hospital Charge Code	606390544
Hospital Revenue Code	259
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

BIOTENE LOZENGE

Facility

$4.00

Service Code	NDC 48582051201
Hospital Charge Code	606390544
Hospital Revenue Code	259
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

BIO-TENODESIS SCREW INSTS KIT

Facility

$975.00

Hospital Charge Code	270638707
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

BIO-TENODESIS SCREW INSTS KIT

Facility

$975.00

Hospital Charge Code	270638707
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

BIOTINIDASE SERUM

Facility

$390.00

Service Code	HCPCS 82261
Hospital Charge Code	39708051
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$45.89
Rate for Payer: Aetna Medicare Advantage	$54.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.90
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.87
Rate for Payer: Clover Medicare Advantage	$16.03
Rate for Payer: EmblemHealth Commercial	$50.61
Rate for Payer: Humana Medicare Advantage	$17.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.87
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	$13.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.87
Rate for Payer: Wellcare Medicare Advantage	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

BIOTINIDASE SERUM

Facility

$390.00

Service Code	HCPCS 82261
Hospital Charge Code	39708051
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BIOTIN LEVEL

Facility

$80.40

Service Code	HCPCS 84591
Hospital Charge Code	3007789
Hospital Revenue Code	301
Min. Negotiated Rate	$12.06
Max. Negotiated Rate	$12.06
Rate for Payer: Qualcare PPO/HMO/WC	$12.06

BIOTIN LEVEL

Facility

$80.40

Service Code	HCPCS 84591
Hospital Charge Code	3007789
Hospital Revenue Code	301
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$46.40
Rate for Payer: Aetna Medicare Advantage	$55.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.58
Rate for Payer: Cigna Commercial	$40.20
Rate for Payer: Cigna Medicare Advantage	$17.06
Rate for Payer: Clover Medicare Advantage	$16.21
Rate for Payer: EmblemHealth Commercial	$51.18
Rate for Payer: Humana Medicare Advantage	$17.57
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.06
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.06
Rate for Payer: Wellcare Medicare Advantage	$17.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

BIOXPRESS GRAFT DELIVERY SYSTE

Facility

$750.00

Service Code	HCPCS C1762
Hospital Charge Code	270705016
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

BIOXPRESS GRAFT DELIVERY SYSTE

Facility

$750.00

Service Code	HCPCS C1762
Hospital Charge Code	270705016
Hospital Revenue Code	278
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) NJ Health	$150.00
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	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

BIPAP CIRCUIT W/ACCESSO

Facility

$862.45

Hospital Charge Code	270606307
Hospital Revenue Code	272
Min. Negotiated Rate	$129.37
Max. Negotiated Rate	$129.37
Rate for Payer: Qualcare PPO/HMO/WC	$129.37

BIPAP CIRCUIT W/ACCESSO

Facility

$862.45

Hospital Charge Code	270606307
Hospital Revenue Code	272
Min. Negotiated Rate	$20.79
Max. Negotiated Rate	$431.23
Rate for Payer: Aetna Commercial	$327.73
Rate for Payer: Aetna Medicare Advantage	$258.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.92
Rate for Payer: Cigna Commercial	$431.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.74
Rate for Payer: Oxford Commercial	$172.49
Rate for Payer: Qualcare PPO/HMO/WC	$129.37
Rate for Payer: UnitedHealthcare Commercial	$172.49
Rate for Payer: UnitedHealthcare Community & State	$20.79
Rate for Payer: Wellpoint Medicaid Managed Care	$22.85

BIPAP PROCEDURE

Facility

$1,205.70

Service Code	HCPCS 94660
Hospital Charge Code	9500175
Hospital Revenue Code	410
Min. Negotiated Rate	$180.85
Max. Negotiated Rate	$180.85
Rate for Payer: Qualcare PPO/HMO/WC	$180.85

BIPAP PROCEDURE

Facility

$1,205.70

Service Code	HCPCS 94660
Hospital Charge Code	9500175
Hospital Revenue Code	410
Min. Negotiated Rate	$29.06
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$707.61
Rate for Payer: Aetna Medicare Advantage	$842.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$939.06
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: Cigna Medicare Advantage	$260.15
Rate for Payer: Clover Medicare Advantage	$247.14
Rate for Payer: EmblemHealth Commercial	$780.45
Rate for Payer: Humana Medicare Advantage	$267.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$260.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.71
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.85
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$29.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$31.95

BIPAP PROCEDURE*****

Facility

$418.00

Service Code	HCPCS 94660
Hospital Charge Code	9500174
Hospital Revenue Code	419
Min. Negotiated Rate	$62.70
Max. Negotiated Rate	$62.70
Rate for Payer: Qualcare PPO/HMO/WC	$62.70

BIPAP PROCEDURE*****

Facility

$418.00

Service Code	HCPCS 94660
Hospital Charge Code	9500174
Hospital Revenue Code	419
Min. Negotiated Rate	$10.07
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$707.61
Rate for Payer: Aetna Medicare Advantage	$842.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$939.06
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: Cigna Medicare Advantage	$260.15
Rate for Payer: Clover Medicare Advantage	$247.14
Rate for Payer: EmblemHealth Commercial	$780.45
Rate for Payer: Humana Medicare Advantage	$267.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$260.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.40
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.70
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$10.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

BIPOLAR 28 MM 46MM OD

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270701914
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

BIPOLAR 28 MM 46MM OD

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270701914
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

BIPOLAR COMPONENT

Facility

$7,675.00

Hospital Charge Code	270656481
Hospital Revenue Code	271
Min. Negotiated Rate	$1,151.25
Max. Negotiated Rate	$1,151.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,151.25

BIPOLAR COMPONENT

Facility

$7,675.00

Hospital Charge Code	270656481
Hospital Revenue Code	271
Min. Negotiated Rate	$184.97
Max. Negotiated Rate	$3,837.50
Rate for Payer: Aetna Commercial	$2,916.50
Rate for Payer: Aetna Medicare Advantage	$2,302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,957.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,957.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,957.12
Rate for Payer: Cigna Commercial	$3,837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,302.50
Rate for Payer: Oxford Commercial	$1,535.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,151.25
Rate for Payer: UnitedHealthcare Commercial	$1,535.00
Rate for Payer: UnitedHealthcare Community & State	$184.97
Rate for Payer: Wellpoint Medicaid Managed Care	$203.39

BIPOLAR COMPONENT 25x50mm

Facility

$3,000.00

Hospital Charge Code	270675125
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

BIPOLAR COMPONENT 25x50mm

Facility

$3,000.00

Hospital Charge Code	270675125
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

Know your out-of-pocket cost for care.

All Charges