Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

VAR ANG SCREW-SEL DRL PAIR

Facility

$2,500.00

Hospital Charge Code	270702368
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

VAR ANG SCREW-SEL DRL PAIR

Facility

$2,500.00

Hospital Charge Code	270702368
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

VARIABLE ANG SCREW 5X27MM

Facility

$1,500.00

Service Code	HCPCS 1500
Hospital Charge Code	270704955
Hospital Revenue Code	278
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

VARIABLE ANG SCREW 5X27MM

Facility

$1,500.00

Service Code	HCPCS 1500
Hospital Charge Code	270704955
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

VARIABLE ANKLE FIXATOR COMP

Facility

$27,770.00

Hospital Charge Code	270673484
Hospital Revenue Code	272
Min. Negotiated Rate	$669.26
Max. Negotiated Rate	$13,885.00
Rate for Payer: Aetna Commercial	$10,552.60
Rate for Payer: Aetna Medicare Advantage	$8,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,081.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,081.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,081.35
Rate for Payer: Cigna Commercial	$13,885.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,331.00
Rate for Payer: Oxford Commercial	$5,554.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,165.50
Rate for Payer: UnitedHealthcare Commercial	$5,554.00
Rate for Payer: UnitedHealthcare Community & State	$669.26
Rate for Payer: Wellpoint Medicaid Managed Care	$735.90

VARIABLE ANKLE FIXATOR COMP

Facility

$27,770.00

Hospital Charge Code	270673484
Hospital Revenue Code	272
Min. Negotiated Rate	$4,165.50
Max. Negotiated Rate	$4,165.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,165.50

VARIABLE SCREW 4X16MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705475
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

VARIABLE SCREW 4X16MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705475
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

VARIABLE SCREWS 16MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270703879
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

VARIABLE SCREWS 16MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270703879
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

VARIAX FIBULA STRAIGHT PLATES,

Facility

$3,120.00

Hospital Charge Code	270665481
Hospital Revenue Code	278
Min. Negotiated Rate	$75.19
Max. Negotiated Rate	$1,560.00
Rate for Payer: Aetna Commercial	$1,185.60
Rate for Payer: Aetna Medicare Advantage	$936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$795.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$795.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$624.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$795.60
Rate for Payer: Cigna Commercial	$1,560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$755.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$686.40
Rate for Payer: Qualcare PPO/HMO/WC	$468.00
Rate for Payer: UnitedHealthcare Community & State	$75.19
Rate for Payer: Wellpoint Medicaid Managed Care	$82.68

VARIAX FIBULA STRAIGHT PLATES,

Facility

$3,120.00

Hospital Charge Code	270665481
Hospital Revenue Code	278
Min. Negotiated Rate	$468.00
Max. Negotiated Rate	$755.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$624.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$755.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$686.40
Rate for Payer: Qualcare PPO/HMO/WC	$468.00

VARIBAR HONEY BARIUM SULFATE

Facility

$5,014.82

Service Code	NDC 32909012207
Hospital Charge Code	606390509
Hospital Revenue Code	250
Min. Negotiated Rate	$120.86
Max. Negotiated Rate	$2,507.41
Rate for Payer: Aetna Commercial	$1,905.63
Rate for Payer: Aetna Medicare Advantage	$1,504.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,278.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,278.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,278.78
Rate for Payer: Cigna Commercial	$2,507.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,504.45
Rate for Payer: Oxford Commercial	$1,002.96
Rate for Payer: Qualcare PPO/HMO/WC	$752.22
Rate for Payer: UnitedHealthcare Commercial	$1,002.96
Rate for Payer: UnitedHealthcare Community & State	$120.86
Rate for Payer: Wellpoint Medicaid Managed Care	$132.89

VARIBAR HONEY BARIUM SULFATE

Facility

$5,014.82

Service Code	NDC 32909012207
Hospital Charge Code	606390509
Hospital Revenue Code	250
Min. Negotiated Rate	$752.22
Max. Negotiated Rate	$752.22
Rate for Payer: Qualcare PPO/HMO/WC	$752.22

VARIBAR NECTAR BARIUM SULFATE

Facility

$127.30

Service Code	NDC 32909011600
Hospital Charge Code	606390510
Hospital Revenue Code	250
Min. Negotiated Rate	$3.07
Max. Negotiated Rate	$63.65
Rate for Payer: Aetna Commercial	$48.37
Rate for Payer: Aetna Medicare Advantage	$38.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.46
Rate for Payer: Cigna Commercial	$63.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.19
Rate for Payer: Oxford Commercial	$25.46
Rate for Payer: Qualcare PPO/HMO/WC	$19.09
Rate for Payer: UnitedHealthcare Commercial	$25.46
Rate for Payer: UnitedHealthcare Community & State	$3.07
Rate for Payer: Wellpoint Medicaid Managed Care	$3.37

VARIBAR NECTAR BARIUM SULFATE

Facility

$127.30

Service Code	NDC 32909011600
Hospital Charge Code	606390510
Hospital Revenue Code	250
Min. Negotiated Rate	$19.09
Max. Negotiated Rate	$19.09
Rate for Payer: Qualcare PPO/HMO/WC	$19.09

VARIBAR THIN LIQ BARIUM SULFAT

Facility

$46.30

Service Code	NDC 32909010510
Hospital Charge Code	606390511
Hospital Revenue Code	250
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$23.15
Rate for Payer: Aetna Commercial	$17.59
Rate for Payer: Aetna Medicare Advantage	$13.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.81
Rate for Payer: Cigna Commercial	$23.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.89
Rate for Payer: Oxford Commercial	$9.26
Rate for Payer: Qualcare PPO/HMO/WC	$6.95
Rate for Payer: UnitedHealthcare Commercial	$9.26
Rate for Payer: UnitedHealthcare Community & State	$1.12
Rate for Payer: Wellpoint Medicaid Managed Care	$1.23

VARIBAR THIN LIQ BARIUM SULFAT

Facility

$46.30

Service Code	NDC 32909010510
Hospital Charge Code	606390511
Hospital Revenue Code	250
Min. Negotiated Rate	$6.95
Max. Negotiated Rate	$6.95
Rate for Payer: Qualcare PPO/HMO/WC	$6.95

VARIBLE ANGLED DK 10CM

Facility

$10,470.00

Hospital Charge Code	270657237
Hospital Revenue Code	278
Min. Negotiated Rate	$1,570.50
Max. Negotiated Rate	$2,533.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,094.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,533.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,303.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,570.50

VARIBLE ANGLED DK 10CM

Facility

$10,470.00

Hospital Charge Code	270657237
Hospital Revenue Code	278
Min. Negotiated Rate	$252.33
Max. Negotiated Rate	$5,235.00
Rate for Payer: Aetna Commercial	$3,978.60
Rate for Payer: Aetna Medicare Advantage	$3,141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,669.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,669.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,094.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,669.85
Rate for Payer: Cigna Commercial	$5,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,533.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,303.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,570.50
Rate for Payer: UnitedHealthcare Community & State	$252.33
Rate for Payer: Wellpoint Medicaid Managed Care	$277.45

VARICELLA VIRUS VACCINE - INJ

Facility

$848.02

Service Code	HCPCS 90716
Hospital Charge Code	60628312
Hospital Revenue Code	636
Min. Negotiated Rate	$127.20
Max. Negotiated Rate	$205.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.22
Rate for Payer: Qualcare PPO/HMO/WC	$127.20

VARICELLA VIRUS VACCINE - INJ

Facility

$848.02

Service Code	HCPCS 90716
Hospital Charge Code	60628312
Hospital Revenue Code	636
Min. Negotiated Rate	$20.44
Max. Negotiated Rate	$424.01
Rate for Payer: Aetna Commercial	$322.25
Rate for Payer: Aetna Medicare Advantage	$254.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.25
Rate for Payer: Cigna Commercial	$424.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.22
Rate for Payer: Qualcare PPO/HMO/WC	$127.20
Rate for Payer: UnitedHealthcare Community & State	$20.44
Rate for Payer: Wellpoint Medicaid Managed Care	$22.47

VARICELLA VIRUS VACC (LIVE)0.5

Facility

$215.05

Hospital Charge Code	6011100
Hospital Revenue Code	250
Min. Negotiated Rate	$32.26
Max. Negotiated Rate	$32.26
Rate for Payer: Qualcare PPO/HMO/WC	$32.26

VARICELLA VIRUS VACC (LIVE)0.5

Facility

$215.05

Hospital Charge Code	6011100
Hospital Revenue Code	250
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$107.53
Rate for Payer: Aetna Commercial	$81.72
Rate for Payer: Aetna Medicare Advantage	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.84
Rate for Payer: Cigna Commercial	$107.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.52
Rate for Payer: Oxford Commercial	$43.01
Rate for Payer: Qualcare PPO/HMO/WC	$32.26
Rate for Payer: UnitedHealthcare Commercial	$43.01
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$5.70

VARICELLA ZOSTER ANTIBODIE,IGG

Facility

$424.00

Service Code	HCPCS 86787
Hospital Charge Code	38476146
Hospital Revenue Code	302
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$212.00
Rate for Payer: Aetna Commercial	$35.03
Rate for Payer: Aetna Medicare Advantage	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.49
Rate for Payer: Cigna Commercial	$212.00
Rate for Payer: Cigna Medicare Advantage	$12.88
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Medicare Advantage	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$11.24

Know your out-of-pocket cost for care.

All Charges