Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BLADE TYMPANOPLASTY ANGLE 7200

Facility

$87.50

Hospital Charge Code	270639278
Hospital Revenue Code	272
Min. Negotiated Rate	$13.12
Max. Negotiated Rate	$13.12
Rate for Payer: Qualcare PPO/HMO/WC	$13.12

BLADE TYMPANOPLASTY ANGLE 7200

Facility

$87.50

Hospital Charge Code	270639278
Hospital Revenue Code	272
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$43.75
Rate for Payer: Aetna Commercial	$33.25
Rate for Payer: Aetna Medicare Advantage	$26.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.31
Rate for Payer: Cigna Commercial	$43.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.25
Rate for Payer: Oxford Commercial	$17.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.12
Rate for Payer: UnitedHealthcare Commercial	$17.50
Rate for Payer: UnitedHealthcare Community & State	$2.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.32

BLADE TYMPANOPLSTY STRT 377200

Facility

$65.30

Hospital Charge Code	270639266
Hospital Revenue Code	272
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$32.65
Rate for Payer: Aetna Commercial	$24.81
Rate for Payer: Aetna Medicare Advantage	$19.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.65
Rate for Payer: Cigna Commercial	$32.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.59
Rate for Payer: Oxford Commercial	$13.06
Rate for Payer: Qualcare PPO/HMO/WC	$9.79
Rate for Payer: UnitedHealthcare Commercial	$13.06
Rate for Payer: UnitedHealthcare Community & State	$1.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1.73

BLADE TYMPANOPLSTY STRT 377200

Facility

$65.30

Hospital Charge Code	270639266
Hospital Revenue Code	272
Min. Negotiated Rate	$9.79
Max. Negotiated Rate	$9.79
Rate for Payer: Qualcare PPO/HMO/WC	$9.79

BLADE UNIVERSAL FOR MEDICLIP

Facility

$10.96

Hospital Charge Code	270645783C
Hospital Revenue Code	272
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

BLADE UNIVERSAL FOR MEDICLIP

Facility

$10.96

Hospital Charge Code	270645783C
Hospital Revenue Code	272
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$5.48
Rate for Payer: Aetna Commercial	$4.16
Rate for Payer: Aetna Medicare Advantage	$3.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.79
Rate for Payer: Cigna Commercial	$5.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.29
Rate for Payer: Oxford Commercial	$2.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Commercial	$2.19
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

BLADE XTRACT FULL 62MM

Facility

$3,420.00

Service Code	HCPCS A4649
Hospital Charge Code	270697340
Hospital Revenue Code	272
Min. Negotiated Rate	$513.00
Max. Negotiated Rate	$513.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00

BLADE XTRACT FULL 62MM

Facility

$3,420.00

Service Code	HCPCS A4649
Hospital Charge Code	270697340
Hospital Revenue Code	272
Min. Negotiated Rate	$82.42
Max. Negotiated Rate	$1,710.00
Rate for Payer: Aetna Commercial	$1,299.60
Rate for Payer: Aetna Medicare Advantage	$1,026.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$872.10
Rate for Payer: Cigna Commercial	$1,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,026.00
Rate for Payer: Oxford Commercial	$684.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00
Rate for Payer: UnitedHealthcare Commercial	$684.00
Rate for Payer: UnitedHealthcare Community & State	$82.42
Rate for Payer: Wellpoint Medicaid Managed Care	$90.63

BLADE XTRACT TRUNC 62MM

Facility

$3,420.00

Service Code	HCPCS A4649
Hospital Charge Code	270697339
Hospital Revenue Code	272
Min. Negotiated Rate	$82.42
Max. Negotiated Rate	$1,710.00
Rate for Payer: Aetna Commercial	$1,299.60
Rate for Payer: Aetna Medicare Advantage	$1,026.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$872.10
Rate for Payer: Cigna Commercial	$1,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,026.00
Rate for Payer: Oxford Commercial	$684.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00
Rate for Payer: UnitedHealthcare Commercial	$684.00
Rate for Payer: UnitedHealthcare Community & State	$82.42
Rate for Payer: Wellpoint Medicaid Managed Care	$90.63

BLADE XTRACT TRUNC 62MM

Facility

$3,420.00

Service Code	HCPCS A4649
Hospital Charge Code	270697339
Hospital Revenue Code	272
Min. Negotiated Rate	$513.00
Max. Negotiated Rate	$513.00
Rate for Payer: Qualcare PPO/HMO/WC	$513.00

BLADE ZIM 19.5/86/1.27 5071-20

Facility

$558.45

Hospital Charge Code	270606468
Hospital Revenue Code	272
Min. Negotiated Rate	$13.46
Max. Negotiated Rate	$279.23
Rate for Payer: Aetna Commercial	$212.21
Rate for Payer: Aetna Medicare Advantage	$167.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.40
Rate for Payer: Cigna Commercial	$279.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.53
Rate for Payer: Oxford Commercial	$111.69
Rate for Payer: Qualcare PPO/HMO/WC	$83.77
Rate for Payer: UnitedHealthcare Commercial	$111.69
Rate for Payer: UnitedHealthcare Community & State	$13.46
Rate for Payer: Wellpoint Medicaid Managed Care	$14.80

BLADE ZIM 19.5/86/1.27 5071-20

Facility

$558.45

Hospital Charge Code	270606468
Hospital Revenue Code	272
Min. Negotiated Rate	$83.77
Max. Negotiated Rate	$83.77
Rate for Payer: Qualcare PPO/HMO/WC	$83.77

BLADE ZIM 6.5/25.5MM 5023-232

Facility

$46.35

Hospital Charge Code	270601042
Hospital Revenue Code	272
Min. Negotiated Rate	$6.95
Max. Negotiated Rate	$6.95
Rate for Payer: Qualcare PPO/HMO/WC	$6.95

BLADE ZIM 6.5/25.5MM 5023-232

Facility

$46.35

Hospital Charge Code	270601042
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 ZIM 9.5/25.5MM 5023-238

Facility

$46.35

Hospital Charge Code	270601048
Hospital Revenue Code	272
Min. Negotiated Rate	$6.95
Max. Negotiated Rate	$6.95
Rate for Payer: Qualcare PPO/HMO/WC	$6.95

BLADE ZIM 9.5/25.5MM 5023-238

Facility

$46.35

Hospital Charge Code	270601048
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 ZIM BRZ TOT KNE 5052-279

Facility

$246.45

Hospital Charge Code	270601049
Hospital Revenue Code	272
Min. Negotiated Rate	$5.94
Max. Negotiated Rate	$123.22
Rate for Payer: Aetna Commercial	$93.65
Rate for Payer: Aetna Medicare Advantage	$73.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.84
Rate for Payer: Cigna Commercial	$123.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.94
Rate for Payer: Oxford Commercial	$49.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.97
Rate for Payer: UnitedHealthcare Commercial	$49.29
Rate for Payer: UnitedHealthcare Community & State	$5.94
Rate for Payer: Wellpoint Medicaid Managed Care	$6.53

BLADE ZIM BRZ TOT KNE 5052-279

Facility

$246.45

Hospital Charge Code	270601049
Hospital Revenue Code	272
Min. Negotiated Rate	$36.97
Max. Negotiated Rate	$36.97
Rate for Payer: Qualcare PPO/HMO/WC	$36.97

BLADE ZIM ME92 RIBBED 5071-595

Facility

$380.00

Hospital Charge Code	270601061
Hospital Revenue Code	272
Min. Negotiated Rate	$57.00
Max. Negotiated Rate	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.00

BLADE ZIM ME92 RIBBED 5071-595

Facility

$380.00

Hospital Charge Code	270601061
Hospital Revenue Code	272
Min. Negotiated Rate	$9.16
Max. Negotiated Rate	$190.00
Rate for Payer: Aetna Commercial	$144.40
Rate for Payer: Aetna Medicare Advantage	$114.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.90
Rate for Payer: Cigna Commercial	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.00
Rate for Payer: Oxford Commercial	$76.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.00
Rate for Payer: UnitedHealthcare Commercial	$76.00
Rate for Payer: UnitedHealthcare Community & State	$9.16
Rate for Payer: Wellpoint Medicaid Managed Care	$10.07

BLADE ZIM NXG PATELLA 51209541

Facility

$272.85

Hospital Charge Code	270617626
Hospital Revenue Code	272
Min. Negotiated Rate	$40.93
Max. Negotiated Rate	$40.93
Rate for Payer: Qualcare PPO/HMO/WC	$40.93

BLADE ZIM NXG PATELLA 51209541

Facility

$272.85

Hospital Charge Code	270617626
Hospital Revenue Code	272
Min. Negotiated Rate	$6.58
Max. Negotiated Rate	$136.43
Rate for Payer: Aetna Commercial	$103.68
Rate for Payer: Aetna Medicare Advantage	$81.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.58
Rate for Payer: Cigna Commercial	$136.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.86
Rate for Payer: Oxford Commercial	$54.57
Rate for Payer: Qualcare PPO/HMO/WC	$40.93
Rate for Payer: UnitedHealthcare Commercial	$54.57
Rate for Payer: UnitedHealthcare Community & State	$6.58
Rate for Payer: Wellpoint Medicaid Managed Care	$7.23

BLADE ZIM OSCIL CRES 5023-170

Facility

$598.45

Hospital Charge Code	270610639
Hospital Revenue Code	272
Min. Negotiated Rate	$89.77
Max. Negotiated Rate	$89.77
Rate for Payer: Qualcare PPO/HMO/WC	$89.77

BLADE ZIM OSCIL CRES 5023-170

Facility

$598.45

Hospital Charge Code	270610639
Hospital Revenue Code	272
Min. Negotiated Rate	$14.42
Max. Negotiated Rate	$299.23
Rate for Payer: Aetna Commercial	$227.41
Rate for Payer: Aetna Medicare Advantage	$179.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$152.60
Rate for Payer: Cigna Commercial	$299.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.53
Rate for Payer: Oxford Commercial	$119.69
Rate for Payer: Qualcare PPO/HMO/WC	$89.77
Rate for Payer: UnitedHealthcare Commercial	$119.69
Rate for Payer: UnitedHealthcare Community & State	$14.42
Rate for Payer: Wellpoint Medicaid Managed Care	$15.86

BLADE ZIM OSCIL CRES 5023-171

Facility

$573.65

Hospital Charge Code	270610642
Hospital Revenue Code	272
Min. Negotiated Rate	$86.05
Max. Negotiated Rate	$86.05
Rate for Payer: Qualcare PPO/HMO/WC	$86.05

Know your out-of-pocket cost for care.

All Charges