Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BLADE LARGO MAC MILLER SZ 3

Facility

$72.14

Hospital Charge Code	270684544
Hospital Revenue Code	272
Min. Negotiated Rate	$10.82
Max. Negotiated Rate	$10.82
Rate for Payer: Qualcare PPO/HMO/WC	$10.82

BLADE LARGO MAC MILLER SZ 3

Facility

$72.14

Hospital Charge Code	270684544
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$36.07
Rate for Payer: Aetna Commercial	$27.41
Rate for Payer: Aetna Medicare Advantage	$21.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.40
Rate for Payer: Cigna Commercial	$36.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.64
Rate for Payer: Oxford Commercial	$14.43
Rate for Payer: Qualcare PPO/HMO/WC	$10.82
Rate for Payer: UnitedHealthcare Commercial	$14.43
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

BLADE LARGO MAC MILLER SZ 4

Facility

$72.14

Hospital Charge Code	270684545
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$36.07
Rate for Payer: Aetna Commercial	$27.41
Rate for Payer: Aetna Medicare Advantage	$21.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.40
Rate for Payer: Cigna Commercial	$36.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.64
Rate for Payer: Oxford Commercial	$14.43
Rate for Payer: Qualcare PPO/HMO/WC	$10.82
Rate for Payer: UnitedHealthcare Commercial	$14.43
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

BLADE LARGO MAC MILLER SZ 4

Facility

$72.14

Hospital Charge Code	270684545
Hospital Revenue Code	272
Min. Negotiated Rate	$10.82
Max. Negotiated Rate	$10.82
Rate for Payer: Qualcare PPO/HMO/WC	$10.82

BLADE LARYGO MAC SIZE 1 DISP

Facility

$72.14

Hospital Charge Code	270684536
Hospital Revenue Code	272
Min. Negotiated Rate	$10.82
Max. Negotiated Rate	$10.82
Rate for Payer: Qualcare PPO/HMO/WC	$10.82

BLADE LARYGO MAC SIZE 1 DISP

Facility

$72.14

Hospital Charge Code	270684536
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$36.07
Rate for Payer: Aetna Commercial	$27.41
Rate for Payer: Aetna Medicare Advantage	$21.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.40
Rate for Payer: Cigna Commercial	$36.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.64
Rate for Payer: Oxford Commercial	$14.43
Rate for Payer: Qualcare PPO/HMO/WC	$10.82
Rate for Payer: UnitedHealthcare Commercial	$14.43
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

BLADE LARYGO MAC SIZE 2 DISP

Facility

$72.14

Hospital Charge Code	270684537
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$36.07
Rate for Payer: Aetna Commercial	$27.41
Rate for Payer: Aetna Medicare Advantage	$21.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.40
Rate for Payer: Cigna Commercial	$36.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.64
Rate for Payer: Oxford Commercial	$14.43
Rate for Payer: Qualcare PPO/HMO/WC	$10.82
Rate for Payer: UnitedHealthcare Commercial	$14.43
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

BLADE LARYGO MAC SIZE 2 DISP

Facility

$72.14

Hospital Charge Code	270684537
Hospital Revenue Code	272
Min. Negotiated Rate	$10.82
Max. Negotiated Rate	$10.82
Rate for Payer: Qualcare PPO/HMO/WC	$10.82

BLADE LARYGO MAC SIZE 3 DISP

Facility

$72.14

Hospital Charge Code	270684538
Hospital Revenue Code	272
Min. Negotiated Rate	$10.82
Max. Negotiated Rate	$10.82
Rate for Payer: Qualcare PPO/HMO/WC	$10.82

BLADE LARYGO MAC SIZE 3 DISP

Facility

$72.14

Hospital Charge Code	270684538
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$36.07
Rate for Payer: Aetna Commercial	$27.41
Rate for Payer: Aetna Medicare Advantage	$21.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.40
Rate for Payer: Cigna Commercial	$36.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.64
Rate for Payer: Oxford Commercial	$14.43
Rate for Payer: Qualcare PPO/HMO/WC	$10.82
Rate for Payer: UnitedHealthcare Commercial	$14.43
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

BLADE LARYGO MAC SIZE 4 DISP

Facility

$72.14

Hospital Charge Code	270684539
Hospital Revenue Code	272
Min. Negotiated Rate	$10.82
Max. Negotiated Rate	$10.82
Rate for Payer: Qualcare PPO/HMO/WC	$10.82

BLADE LARYGO MAC SIZE 4 DISP

Facility

$72.14

Hospital Charge Code	270684539
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$36.07
Rate for Payer: Aetna Commercial	$27.41
Rate for Payer: Aetna Medicare Advantage	$21.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.40
Rate for Payer: Cigna Commercial	$36.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.64
Rate for Payer: Oxford Commercial	$14.43
Rate for Payer: Qualcare PPO/HMO/WC	$10.82
Rate for Payer: UnitedHealthcare Commercial	$14.43
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

BLADE LARYNG MILLER #00 PREMIE

Facility

$104.10

Hospital Charge Code	270677122
Hospital Revenue Code	272
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$52.05
Rate for Payer: Aetna Commercial	$39.56
Rate for Payer: Aetna Medicare Advantage	$31.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.55
Rate for Payer: Cigna Commercial	$52.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.23
Rate for Payer: Oxford Commercial	$20.82
Rate for Payer: Qualcare PPO/HMO/WC	$15.62
Rate for Payer: UnitedHealthcare Commercial	$20.82
Rate for Payer: UnitedHealthcare Community & State	$2.51
Rate for Payer: Wellpoint Medicaid Managed Care	$2.76

BLADE LARYNG MILLER #00 PREMIE

Facility

$104.10

Hospital Charge Code	270677122
Hospital Revenue Code	272
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$15.62
Rate for Payer: Qualcare PPO/HMO/WC	$15.62

BLADE LARYNG MILLER #0 NEWBORN

Facility

$105.20

Hospital Charge Code	270677123
Hospital Revenue Code	272
Min. Negotiated Rate	$15.78
Max. Negotiated Rate	$15.78
Rate for Payer: Qualcare PPO/HMO/WC	$15.78

BLADE LARYNG MILLER #0 NEWBORN

Facility

$105.20

Hospital Charge Code	270677123
Hospital Revenue Code	272
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$52.60
Rate for Payer: Aetna Commercial	$39.98
Rate for Payer: Aetna Medicare Advantage	$31.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.83
Rate for Payer: Cigna Commercial	$52.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.56
Rate for Payer: Oxford Commercial	$21.04
Rate for Payer: Qualcare PPO/HMO/WC	$15.78
Rate for Payer: UnitedHealthcare Commercial	$21.04
Rate for Payer: UnitedHealthcare Community & State	$2.54
Rate for Payer: Wellpoint Medicaid Managed Care	$2.79

BLADE LARYNG MILLER #1 INFANT

Facility

$102.10

Hospital Charge Code	270677124
Hospital Revenue Code	272
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$51.05
Rate for Payer: Aetna Commercial	$38.80
Rate for Payer: Aetna Medicare Advantage	$30.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.04
Rate for Payer: Cigna Commercial	$51.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.63
Rate for Payer: Oxford Commercial	$20.42
Rate for Payer: Qualcare PPO/HMO/WC	$15.31
Rate for Payer: UnitedHealthcare Commercial	$20.42
Rate for Payer: UnitedHealthcare Community & State	$2.46
Rate for Payer: Wellpoint Medicaid Managed Care	$2.71

BLADE LARYNG MILLER #1 INFANT

Facility

$102.10

Hospital Charge Code	270677124
Hospital Revenue Code	272
Min. Negotiated Rate	$15.31
Max. Negotiated Rate	$15.31
Rate for Payer: Qualcare PPO/HMO/WC	$15.31

BLADE LARYNG MILLER #3 ADULT M

Facility

$60.00

Hospital Charge Code	270678201
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.00
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

BLADE LARYNG MILLER #3 ADULT M

Facility

$60.00

Hospital Charge Code	270678201
Hospital Revenue Code	272
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

BLADE LARYNG MILLER #4 ADULT L

Facility

$54.50

Hospital Charge Code	270678202
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$27.25
Rate for Payer: Aetna Commercial	$20.71
Rate for Payer: Aetna Medicare Advantage	$16.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.90
Rate for Payer: Cigna Commercial	$27.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.35
Rate for Payer: Oxford Commercial	$10.90
Rate for Payer: Qualcare PPO/HMO/WC	$8.18
Rate for Payer: UnitedHealthcare Commercial	$10.90
Rate for Payer: UnitedHealthcare Community & State	$1.31
Rate for Payer: Wellpoint Medicaid Managed Care	$1.44

BLADE LARYNG MILLER #4 ADULT L

Facility

$54.50

Hospital Charge Code	270678202
Hospital Revenue Code	272
Min. Negotiated Rate	$8.18
Max. Negotiated Rate	$8.18
Rate for Payer: Qualcare PPO/HMO/WC	$8.18

BLADE LG HIP 4.0MM

Facility

$300.35

Hospital Charge Code	270688488
Hospital Revenue Code	272
Min. Negotiated Rate	$45.05
Max. Negotiated Rate	$45.05
Rate for Payer: Qualcare PPO/HMO/WC	$45.05

BLADE LG HIP 4.0MM

Facility

$300.35

Hospital Charge Code	270688488
Hospital Revenue Code	272
Min. Negotiated Rate	$7.24
Max. Negotiated Rate	$150.18
Rate for Payer: Aetna Commercial	$114.13
Rate for Payer: Aetna Medicare Advantage	$90.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.59
Rate for Payer: Cigna Commercial	$150.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.11
Rate for Payer: Oxford Commercial	$60.07
Rate for Payer: Qualcare PPO/HMO/WC	$45.05
Rate for Payer: UnitedHealthcare Commercial	$60.07
Rate for Payer: UnitedHealthcare Community & State	$7.24
Rate for Payer: Wellpoint Medicaid Managed Care	$7.96

BLADE LRG BONE 18.5x100x1.19mm

Facility

$200.00

Hospital Charge Code	270678715
Hospital Revenue Code	272
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.00
Rate for Payer: Oxford Commercial	$40.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$40.00
Rate for Payer: UnitedHealthcare Community & State	$4.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5.30

Know your out-of-pocket cost for care.

All Charges