Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BLADDER IRRIGATION

Facility

$1,253.65

Service Code	HCPCS 51700
Hospital Charge Code	93500183
Hospital Revenue Code	361
Min. Negotiated Rate	$188.05
Max. Negotiated Rate	$188.05
Rate for Payer: Qualcare PPO/HMO/WC	$188.05

BLADDER IRRIGATION

Facility

$1,253.65

Service Code	HCPCS 51700
Hospital Charge Code	93500183
Hospital Revenue Code	361
Min. Negotiated Rate	$30.21
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$807.38
Rate for Payer: Aetna Medicare Advantage	$961.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,071.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,071.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$296.83
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	$1,071.47
Rate for Payer: Cigna Commercial	$594.98
Rate for Payer: Cigna Medicare Advantage	$296.83
Rate for Payer: Clover Medicare Advantage	$281.99
Rate for Payer: EmblemHealth Commercial	$890.49
Rate for Payer: Humana Medicare Advantage	$305.73
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$296.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$376.10
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$188.05
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$30.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$296.83
Rate for Payer: Wellcare Medicare Advantage	$296.83
Rate for Payer: Wellpoint Medicaid Managed Care	$33.22

BLADDER WASHING

Facility

$264.85

Service Code	HCPCS 88104
Hospital Charge Code	3005346
Hospital Revenue Code	311
Min. Negotiated Rate	$7.02
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$120.69
Rate for Payer: Aetna Medicare Advantage	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.16
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$44.37
Rate for Payer: Clover Medicare Advantage	$42.15
Rate for Payer: EmblemHealth Commercial	$133.11
Rate for Payer: Humana Medicare Advantage	$45.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.73
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$61.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.37
Rate for Payer: Wellcare Medicare Advantage	$44.37
Rate for Payer: Wellpoint Medicaid Managed Care	$7.02

BLADDER WASHING

Facility

$264.85

Service Code	HCPCS 88104
Hospital Charge Code	3005346
Hospital Revenue Code	311
Min. Negotiated Rate	$39.73
Max. Negotiated Rate	$39.73
Rate for Payer: Qualcare PPO/HMO/WC	$39.73

BLADE 18.6 X 5.5 MM

Facility

$32.85

Hospital Charge Code	270664985
Hospital Revenue Code	270
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$16.43
Rate for Payer: Aetna Commercial	$12.48
Rate for Payer: Aetna Medicare Advantage	$9.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.38
Rate for Payer: Cigna Commercial	$16.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.86
Rate for Payer: Oxford Commercial	$6.57
Rate for Payer: Qualcare PPO/HMO/WC	$4.93
Rate for Payer: UnitedHealthcare Commercial	$6.57
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

BLADE 18.6 X 5.5 MM

Facility

$32.85

Hospital Charge Code	270664985
Hospital Revenue Code	270
Min. Negotiated Rate	$4.93
Max. Negotiated Rate	$4.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.93

BLADE 2-1/2 FOR CAST CUTTER

Facility

$154.00

Hospital Charge Code	270330633
Hospital Revenue Code	272
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$77.00
Rate for Payer: Aetna Commercial	$58.52
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.27
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.20
Rate for Payer: Oxford Commercial	$30.80
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
Rate for Payer: UnitedHealthcare Commercial	$30.80
Rate for Payer: UnitedHealthcare Community & State	$3.71
Rate for Payer: Wellpoint Medicaid Managed Care	$4.08

BLADE 2-1/2 FOR CAST CUTTER

Facility

$154.00

Hospital Charge Code	270330633
Hospital Revenue Code	272
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

BLADE 25.0 X1.19X 90MM

Facility

$300.25

Hospital Charge Code	270668541
Hospital Revenue Code	272
Min. Negotiated Rate	$7.24
Max. Negotiated Rate	$150.12
Rate for Payer: Aetna Commercial	$114.09
Rate for Payer: Aetna Medicare Advantage	$90.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.56
Rate for Payer: Cigna Commercial	$150.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.08
Rate for Payer: Oxford Commercial	$60.05
Rate for Payer: Qualcare PPO/HMO/WC	$45.04
Rate for Payer: UnitedHealthcare Commercial	$60.05
Rate for Payer: UnitedHealthcare Community & State	$7.24
Rate for Payer: Wellpoint Medicaid Managed Care	$7.96

BLADE 25.0 X1.19X 90MM

Facility

$300.25

Hospital Charge Code	270668541
Hospital Revenue Code	272
Min. Negotiated Rate	$45.04
Max. Negotiated Rate	$45.04
Rate for Payer: Qualcare PPO/HMO/WC	$45.04

BLADE 25.0 X1.37X 90MM

Facility

$300.25

Hospital Charge Code	270687657
Hospital Revenue Code	272
Min. Negotiated Rate	$7.24
Max. Negotiated Rate	$150.12
Rate for Payer: Aetna Commercial	$114.09
Rate for Payer: Aetna Medicare Advantage	$90.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.56
Rate for Payer: Cigna Commercial	$150.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.08
Rate for Payer: Oxford Commercial	$60.05
Rate for Payer: Qualcare PPO/HMO/WC	$45.04
Rate for Payer: UnitedHealthcare Commercial	$60.05
Rate for Payer: UnitedHealthcare Community & State	$7.24
Rate for Payer: Wellpoint Medicaid Managed Care	$7.96

BLADE 25.0 X1.37X 90MM

Facility

$300.25

Hospital Charge Code	270687657
Hospital Revenue Code	272
Min. Negotiated Rate	$45.04
Max. Negotiated Rate	$45.04
Rate for Payer: Qualcare PPO/HMO/WC	$45.04

BLADE 2.9 ABRADER 3530 ******

Facility

$124.00

Hospital Charge Code	1607001
Hospital Revenue Code	272
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$62.00
Rate for Payer: Aetna Commercial	$47.12
Rate for Payer: Aetna Medicare Advantage	$37.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.62
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.20
Rate for Payer: Oxford Commercial	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$24.80
Rate for Payer: UnitedHealthcare Community & State	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

BLADE 2.9 ABRADER 3530 ******

Facility

$124.00

Hospital Charge Code	1607001
Hospital Revenue Code	272
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

BLADE 2.9MM CUTTER ******

Facility

$124.00

Hospital Charge Code	1606672
Hospital Revenue Code	272
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$62.00
Rate for Payer: Aetna Commercial	$47.12
Rate for Payer: Aetna Medicare Advantage	$37.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.62
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.20
Rate for Payer: Oxford Commercial	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$24.80
Rate for Payer: UnitedHealthcare Community & State	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

BLADE 2.9MM CUTTER ******

Facility

$124.00

Hospital Charge Code	1606672
Hospital Revenue Code	272
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

BLADE 2.9MM CUTTER 3604 *****

Facility

$124.00

Hospital Charge Code	1606664
Hospital Revenue Code	272
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$62.00
Rate for Payer: Aetna Commercial	$47.12
Rate for Payer: Aetna Medicare Advantage	$37.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.62
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.20
Rate for Payer: Oxford Commercial	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$24.80
Rate for Payer: UnitedHealthcare Community & State	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

BLADE 2.9MM CUTTER 3604 *****

Facility

$124.00

Hospital Charge Code	1606664
Hospital Revenue Code	272
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

BLADE 3.5 INCISOR MINI 4225***

Facility

$124.00

Hospital Charge Code	1606698
Hospital Revenue Code	272
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

BLADE 3.5 INCISOR MINI 4225***

Facility

$124.00

Hospital Charge Code	1606698
Hospital Revenue Code	272
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$62.00
Rate for Payer: Aetna Commercial	$47.12
Rate for Payer: Aetna Medicare Advantage	$37.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.62
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.20
Rate for Payer: Oxford Commercial	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$24.80
Rate for Payer: UnitedHealthcare Community & State	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

BLADE 3M AGEE 81010A

Facility

$2,036.85

Hospital Charge Code	270608413
Hospital Revenue Code	272
Min. Negotiated Rate	$305.53
Max. Negotiated Rate	$305.53
Rate for Payer: Qualcare PPO/HMO/WC	$305.53

BLADE 3M AGEE 81010A

Facility

$2,036.85

Hospital Charge Code	270608413
Hospital Revenue Code	272
Min. Negotiated Rate	$49.09
Max. Negotiated Rate	$1,018.42
Rate for Payer: Aetna Commercial	$774.00
Rate for Payer: Aetna Medicare Advantage	$611.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$519.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$519.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$519.40
Rate for Payer: Cigna Commercial	$1,018.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$611.05
Rate for Payer: Oxford Commercial	$407.37
Rate for Payer: Qualcare PPO/HMO/WC	$305.53
Rate for Payer: UnitedHealthcare Commercial	$407.37
Rate for Payer: UnitedHealthcare Community & State	$49.09
Rate for Payer: Wellpoint Medicaid Managed Care	$53.98

BLADE 40.0 X 10.0MM 1.19MM

Facility

$127.00

Hospital Charge Code	270703058
Hospital Revenue Code	270
Min. Negotiated Rate	$19.05
Max. Negotiated Rate	$19.05
Rate for Payer: Qualcare PPO/HMO/WC	$19.05

BLADE 40.0 X 10.0MM 1.19MM

Facility

$127.00

Hospital Charge Code	270703058
Hospital Revenue Code	270
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$63.50
Rate for Payer: Aetna Commercial	$48.26
Rate for Payer: Aetna Medicare Advantage	$38.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.38
Rate for Payer: Cigna Commercial	$63.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.10
Rate for Payer: Oxford Commercial	$25.40
Rate for Payer: Qualcare PPO/HMO/WC	$19.05
Rate for Payer: UnitedHealthcare Commercial	$25.40
Rate for Payer: UnitedHealthcare Community & State	$3.06
Rate for Payer: Wellpoint Medicaid Managed Care	$3.37

BLADE 90X18 1.14 MAT 1.27CUT

Facility

$129.60

Hospital Charge Code	270699047
Hospital Revenue Code	279
Min. Negotiated Rate	$19.44
Max. Negotiated Rate	$19.44
Rate for Payer: Qualcare PPO/HMO/WC	$19.44

Know your out-of-pocket cost for care.

All Charges