Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BLADE MIC SAG 5.5X25.5 5023132

Facility

$69.50

Hospital Charge Code	270631073
Hospital Revenue Code	272
Min. Negotiated Rate	$10.43
Max. Negotiated Rate	$10.43
Rate for Payer: Qualcare PPO/HMO/WC	$10.43

BLADE MIC SAG 5.5X25.5 5023132

Facility

$69.50

Hospital Charge Code	270631073
Hospital Revenue Code	272
Min. Negotiated Rate	$1.67
Max. Negotiated Rate	$34.75
Rate for Payer: Aetna Commercial	$26.41
Rate for Payer: Aetna Medicare Advantage	$20.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.72
Rate for Payer: Cigna Commercial	$34.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.85
Rate for Payer: Oxford Commercial	$13.90
Rate for Payer: Qualcare PPO/HMO/WC	$10.43
Rate for Payer: UnitedHealthcare Commercial	$13.90
Rate for Payer: UnitedHealthcare Community & State	$1.67
Rate for Payer: Wellpoint Medicaid Managed Care	$1.84

BLADE MICS SAG 4X.38X15.2 MM

Facility

$395.00

Hospital Charge Code	270688511
Hospital Revenue Code	272
Min. Negotiated Rate	$9.52
Max. Negotiated Rate	$197.50
Rate for Payer: Aetna Commercial	$150.10
Rate for Payer: Aetna Medicare Advantage	$118.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.72
Rate for Payer: Cigna Commercial	$197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.50
Rate for Payer: Oxford Commercial	$79.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.25
Rate for Payer: UnitedHealthcare Commercial	$79.00
Rate for Payer: UnitedHealthcare Community & State	$9.52
Rate for Payer: Wellpoint Medicaid Managed Care	$10.47

BLADE MICS SAG 4X.38X15.2 MM

Facility

$395.00

Hospital Charge Code	270688511
Hospital Revenue Code	272
Min. Negotiated Rate	$59.25
Max. Negotiated Rate	$59.25
Rate for Payer: Qualcare PPO/HMO/WC	$59.25

BLADE MILLER F/O LARYNGO SZ

Facility

$450.00

Hospital Charge Code	270665588
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

BLADE MILLER F/O LARYNGO SZ

Facility

$450.00

Hospital Charge Code	270665588
Hospital Revenue Code	272
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.00
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$90.00
Rate for Payer: UnitedHealthcare Community & State	$10.85
Rate for Payer: Wellpoint Medicaid Managed Care	$11.93

BLADE MORCELLATOR CUTTER 15MM

Facility

$3,402.00

Hospital Charge Code	270662745
Hospital Revenue Code	270
Min. Negotiated Rate	$510.30
Max. Negotiated Rate	$510.30
Rate for Payer: Qualcare PPO/HMO/WC	$510.30

BLADE MORCELLATOR CUTTER 15MM

Facility

$3,402.00

Hospital Charge Code	270662745
Hospital Revenue Code	270
Min. Negotiated Rate	$81.99
Max. Negotiated Rate	$1,701.00
Rate for Payer: Aetna Commercial	$1,292.76
Rate for Payer: Aetna Medicare Advantage	$1,020.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$867.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$867.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$867.51
Rate for Payer: Cigna Commercial	$1,701.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,020.60
Rate for Payer: Oxford Commercial	$680.40
Rate for Payer: Qualcare PPO/HMO/WC	$510.30
Rate for Payer: UnitedHealthcare Commercial	$680.40
Rate for Payer: UnitedHealthcare Community & State	$81.99
Rate for Payer: Wellpoint Medicaid Managed Care	$90.15

BLADE MORCELLATOR DISP *****

Facility

$278.00

Hospital Charge Code	1608025
Hospital Revenue Code	251
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$139.00
Rate for Payer: Aetna Commercial	$105.64
Rate for Payer: Aetna Medicare Advantage	$83.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.89
Rate for Payer: Cigna Commercial	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.40
Rate for Payer: Oxford Commercial	$55.60
Rate for Payer: Qualcare PPO/HMO/WC	$41.70
Rate for Payer: UnitedHealthcare Commercial	$55.60
Rate for Payer: UnitedHealthcare Community & State	$6.70
Rate for Payer: Wellpoint Medicaid Managed Care	$7.37

BLADE MORCELLATOR DISP *****

Facility

$278.00

Hospital Charge Code	1608025
Hospital Revenue Code	251
Min. Negotiated Rate	$41.70
Max. Negotiated Rate	$41.70
Rate for Payer: Qualcare PPO/HMO/WC	$41.70

BLADE MORCEOR SAW 12m 26711250

Facility

$1,125.00

Hospital Charge Code	270633015
Hospital Revenue Code	272
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

BLADE MORCEOR SAW 12m 26711250

Facility

$1,125.00

Hospital Charge Code	270633015
Hospital Revenue Code	272
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Commercial	$225.00
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

BLADE MULTI ULTRACUT STER 5.5m

Facility

$437.75

Hospital Charge Code	270674988
Hospital Revenue Code	272
Min. Negotiated Rate	$65.66
Max. Negotiated Rate	$65.66
Rate for Payer: Qualcare PPO/HMO/WC	$65.66

BLADE MULTI ULTRACUT STER 5.5m

Facility

$437.75

Hospital Charge Code	270674988
Hospital Revenue Code	272
Min. Negotiated Rate	$10.55
Max. Negotiated Rate	$218.88
Rate for Payer: Aetna Commercial	$166.34
Rate for Payer: Aetna Medicare Advantage	$131.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.63
Rate for Payer: Cigna Commercial	$218.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.32
Rate for Payer: Oxford Commercial	$87.55
Rate for Payer: Qualcare PPO/HMO/WC	$65.66
Rate for Payer: UnitedHealthcare Commercial	$87.55
Rate for Payer: UnitedHealthcare Community & State	$10.55
Rate for Payer: Wellpoint Medicaid Managed Care	$11.60

BLADE MYRING DISP NO522

Facility

$63.25

Hospital Charge Code	270600305
Hospital Revenue Code	272
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$31.62
Rate for Payer: Aetna Commercial	$24.04
Rate for Payer: Aetna Medicare Advantage	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.13
Rate for Payer: Cigna Commercial	$31.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$12.65
Rate for Payer: Qualcare PPO/HMO/WC	$9.49
Rate for Payer: UnitedHealthcare Commercial	$12.65
Rate for Payer: UnitedHealthcare Community & State	$1.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1.68

BLADE MYRING DISP NO522

Facility

$63.25

Hospital Charge Code	270600305
Hospital Revenue Code	272
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$9.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

BLADE MYRINGTOMY SPEAR 45DEG

Facility

$68.62

Hospital Charge Code	270645139
Hospital Revenue Code	270
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$34.31
Rate for Payer: Aetna Commercial	$26.08
Rate for Payer: Aetna Medicare Advantage	$20.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.50
Rate for Payer: Cigna Commercial	$34.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.59
Rate for Payer: Oxford Commercial	$13.72
Rate for Payer: Qualcare PPO/HMO/WC	$10.29
Rate for Payer: UnitedHealthcare Commercial	$13.72
Rate for Payer: UnitedHealthcare Community & State	$1.65
Rate for Payer: Wellpoint Medicaid Managed Care	$1.82

BLADE MYRINGTOMY SPEAR 45DEG

Facility

$68.62

Hospital Charge Code	270645139
Hospital Revenue Code	270
Min. Negotiated Rate	$10.29
Max. Negotiated Rate	$10.29
Rate for Payer: Qualcare PPO/HMO/WC	$10.29

BLADE OMEGA OSC 40X11.1X0.58MM

Facility

$725.00

Service Code	HCPCS A4649
Hospital Charge Code	270698030
Hospital Revenue Code	272
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$108.75
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

BLADE OMEGA OSC 40X11.1X0.58MM

Facility

$725.00

Service Code	HCPCS A4649
Hospital Charge Code	270698030
Hospital Revenue Code	272
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.50
Rate for Payer: Oxford Commercial	$145.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Commercial	$145.00
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

BLADE OSCI FIN 10x12.4 5023161

Facility

$46.35

Hospital Charge Code	270631018
Hospital Revenue Code	272
Min. Negotiated Rate	$6.95
Max. Negotiated Rate	$6.95
Rate for Payer: Qualcare PPO/HMO/WC	$6.95

BLADE OSCI FIN 10x12.4 5023161

Facility

$46.35

Hospital Charge Code	270631018
Hospital Revenue Code	272
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$23.18
Rate for Payer: Aetna Commercial	$17.61
Rate for Payer: Aetna Medicare Advantage	$13.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.82
Rate for Payer: Cigna Commercial	$23.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.90
Rate for Payer: Oxford Commercial	$9.27
Rate for Payer: Qualcare PPO/HMO/WC	$6.95
Rate for Payer: UnitedHealthcare Commercial	$9.27
Rate for Payer: UnitedHealthcare Community & State	$1.12
Rate for Payer: Wellpoint Medicaid Managed Care	$1.23

BLADE OSCIL 5052-552

Facility

$57.00

Hospital Charge Code	1604958
Hospital Revenue Code	272
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$28.50
Rate for Payer: Aetna Commercial	$21.66
Rate for Payer: Aetna Medicare Advantage	$17.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.54
Rate for Payer: Cigna Commercial	$28.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.10
Rate for Payer: Oxford Commercial	$11.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.55
Rate for Payer: UnitedHealthcare Commercial	$11.40
Rate for Payer: UnitedHealthcare Community & State	$1.37
Rate for Payer: Wellpoint Medicaid Managed Care	$1.51

BLADE OSCIL 5052-552

Facility

$57.00

Hospital Charge Code	1604958
Hospital Revenue Code	272
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$8.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.55

BLADE OSCILL

Facility

$288.00

Hospital Charge Code	270657686
Hospital Revenue Code	272
Min. Negotiated Rate	$43.20
Max. Negotiated Rate	$43.20
Rate for Payer: Qualcare PPO/HMO/WC	$43.20

Know your out-of-pocket cost for care.

All Charges