Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

WIRE SYN K 2.0 150MM 292.20

Facility

$40.85

Hospital Charge Code	270604418
Hospital Revenue Code	272
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$20.43
Rate for Payer: Aetna Commercial	$15.52
Rate for Payer: Aetna Medicare Advantage	$12.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.42
Rate for Payer: Cigna Commercial	$20.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.26
Rate for Payer: Oxford Commercial	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$6.13
Rate for Payer: UnitedHealthcare Commercial	$8.17
Rate for Payer: UnitedHealthcare Community & State	$0.98
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

WIRE SYN K 2.0 150MM 292.20

Facility

$40.85

Hospital Charge Code	270601827
Hospital Revenue Code	272
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$20.43
Rate for Payer: Aetna Commercial	$15.52
Rate for Payer: Aetna Medicare Advantage	$12.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.42
Rate for Payer: Cigna Commercial	$20.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.26
Rate for Payer: Oxford Commercial	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$6.13
Rate for Payer: UnitedHealthcare Commercial	$8.17
Rate for Payer: UnitedHealthcare Community & State	$0.98
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

WIRE SYN K 2.0 150MM 292.20

Facility

$40.85

Hospital Charge Code	270601827
Hospital Revenue Code	272
Min. Negotiated Rate	$6.13
Max. Negotiated Rate	$6.13
Rate for Payer: Qualcare PPO/HMO/WC	$6.13

WIRE SYN K 2.0 150MM 292.58

Facility

$43.25

Hospital Charge Code	270604433
Hospital Revenue Code	272
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

WIRE SYN K 2.0 150MM 292.58

Facility

$43.25

Hospital Charge Code	270604433
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.62
Rate for Payer: Aetna Commercial	$16.43
Rate for Payer: Aetna Medicare Advantage	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.97
Rate for Payer: Oxford Commercial	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$8.65
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

WIRE SYN K 2.0 285MM 292.21

Facility

$49.65

Hospital Charge Code	270604419
Hospital Revenue Code	272
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$24.82
Rate for Payer: Aetna Commercial	$18.87
Rate for Payer: Aetna Medicare Advantage	$14.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.66
Rate for Payer: Cigna Commercial	$24.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.89
Rate for Payer: Oxford Commercial	$9.93
Rate for Payer: Qualcare PPO/HMO/WC	$7.45
Rate for Payer: UnitedHealthcare Commercial	$9.93
Rate for Payer: UnitedHealthcare Community & State	$1.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

WIRE SYN K 2.0 285MM 292.21

Facility

$49.65

Hospital Charge Code	270604419
Hospital Revenue Code	272
Min. Negotiated Rate	$7.45
Max. Negotiated Rate	$7.45
Rate for Payer: Qualcare PPO/HMO/WC	$7.45

WIRE SYN K 2.0 285MM 492.21

Facility

$56.00

Hospital Charge Code	270603559
Hospital Revenue Code	272
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$28.00
Rate for Payer: Aetna Commercial	$21.28
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.28
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.80
Rate for Payer: Oxford Commercial	$11.20
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$11.20
Rate for Payer: UnitedHealthcare Community & State	$1.35
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

WIRE SYN K 2.0 285MM 492.21

Facility

$56.00

Hospital Charge Code	270603559
Hospital Revenue Code	272
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

WIRE TAC SMOOTH OLIVE 1.6X30MM

Facility

$465.00

Hospital Charge Code	270698542
Hospital Revenue Code	272
Min. Negotiated Rate	$69.75
Max. Negotiated Rate	$69.75
Rate for Payer: Qualcare PPO/HMO/WC	$69.75

WIRE TAC SMOOTH OLIVE 1.6X30MM

Facility

$465.00

Hospital Charge Code	270698542
Hospital Revenue Code	272
Min. Negotiated Rate	$11.21
Max. Negotiated Rate	$232.50
Rate for Payer: Aetna Commercial	$176.70
Rate for Payer: Aetna Medicare Advantage	$139.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.58
Rate for Payer: Cigna Commercial	$232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.50
Rate for Payer: Oxford Commercial	$93.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.75
Rate for Payer: UnitedHealthcare Commercial	$93.00
Rate for Payer: UnitedHealthcare Community & State	$11.21
Rate for Payer: Wellpoint Medicaid Managed Care	$12.32

WIRE THRD TIP 3.2x460mm

Facility

$780.00

Service Code	HCPCS C1769
Hospital Charge Code	270641740
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$188.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$171.60
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

WIRE THRD TIP 3.2x460mm

Facility

$780.00

Service Code	HCPCS C1769
Hospital Charge Code	270641740
Hospital Revenue Code	278
Min. Negotiated Rate	$18.80
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$296.40
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$171.60
Rate for Payer: Qualcare PPO/HMO/WC	$117.00
Rate for Payer: UnitedHealthcare Community & State	$18.80
Rate for Payer: Wellpoint Medicaid Managed Care	$20.67

WIRE THREADED .035x4

Facility

$150.00

Hospital Charge Code	270673752
Hospital Revenue Code	272
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.00
Rate for Payer: Oxford Commercial	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$30.00
Rate for Payer: UnitedHealthcare Community & State	$3.62
Rate for Payer: Wellpoint Medicaid Managed Care	$3.98

WIRE THREADED .035x4

Facility

$150.00

Hospital Charge Code	270673752
Hospital Revenue Code	272
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

WIRE TIGHTENER W/EYE

Facility

$1,566.00

Hospital Charge Code	270672159
Hospital Revenue Code	272
Min. Negotiated Rate	$37.74
Max. Negotiated Rate	$783.00
Rate for Payer: Aetna Commercial	$595.08
Rate for Payer: Aetna Medicare Advantage	$469.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$399.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$399.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$399.33
Rate for Payer: Cigna Commercial	$783.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$469.80
Rate for Payer: Oxford Commercial	$313.20
Rate for Payer: Qualcare PPO/HMO/WC	$234.90
Rate for Payer: UnitedHealthcare Commercial	$313.20
Rate for Payer: UnitedHealthcare Community & State	$37.74
Rate for Payer: Wellpoint Medicaid Managed Care	$41.50

WIRE TIGHTENER W/EYE

Facility

$1,566.00

Hospital Charge Code	270672159
Hospital Revenue Code	272
Min. Negotiated Rate	$234.90
Max. Negotiated Rate	$234.90
Rate for Payer: Qualcare PPO/HMO/WC	$234.90

WIRE TIP NITI 1.1 2 ZONE

Facility

$695.00

Service Code	HCPCS C1713
Hospital Charge Code	270690432
Hospital Revenue Code	278
Min. Negotiated Rate	$16.75
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$264.10
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$152.90
Rate for Payer: Qualcare PPO/HMO/WC	$104.25
Rate for Payer: UnitedHealthcare Community & State	$16.75
Rate for Payer: Wellpoint Medicaid Managed Care	$18.42

WIRE TIP NITI 1.1 2 ZONE

Facility

$695.00

Service Code	HCPCS C1713
Hospital Charge Code	270690432
Hospital Revenue Code	278
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$168.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$152.90
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

WIRE TREASURE 12FR 0.018X300

Facility

$875.00

Service Code	HCPCS C1769
Hospital Charge Code	270643115
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

WIRE TREASURE 12FR 0.018X300

Facility

$875.00

Service Code	HCPCS C1769
Hospital Charge Code	270643115
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$192.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

WIRE UNIGLIDE ANGL .035x150

Facility

$175.00

Hospital Charge Code	270677155
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

WIRE UNIGLIDE ANGL .035x150

Facility

$175.00

Hospital Charge Code	270677155
Hospital Revenue Code	272
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.50
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$35.00
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

WIRE UNIGLIDE ANGL .035x180

Facility

$1,092.45

Hospital Charge Code	270677156
Hospital Revenue Code	272
Min. Negotiated Rate	$26.33
Max. Negotiated Rate	$546.23
Rate for Payer: Aetna Commercial	$415.13
Rate for Payer: Aetna Medicare Advantage	$327.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$278.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$278.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$278.57
Rate for Payer: Cigna Commercial	$546.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$327.74
Rate for Payer: Oxford Commercial	$218.49
Rate for Payer: Qualcare PPO/HMO/WC	$163.87
Rate for Payer: UnitedHealthcare Commercial	$218.49
Rate for Payer: UnitedHealthcare Community & State	$26.33
Rate for Payer: Wellpoint Medicaid Managed Care	$28.95

WIRE UNIGLIDE ANGL .035x180

Facility

$175.00

Hospital Charge Code	270677156N
Hospital Revenue Code	272
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.50
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$35.00
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

Know your out-of-pocket cost for care.

All Charges