Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BLUNT TROCAR 10MM

Facility

$128.00

Hospital Charge Code	270338716
Hospital Revenue Code	272
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

BLUNT TROCAR 10MM

Facility

$128.00

Hospital Charge Code	270338716
Hospital Revenue Code	272
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$64.00
Rate for Payer: Aetna Commercial	$48.64
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.40
Rate for Payer: Oxford Commercial	$25.60
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$25.60
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

BLUNT TROCAR & SYRINGE

Facility

$554.00

Hospital Charge Code	270332619
Hospital Revenue Code	272
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$277.00
Rate for Payer: Aetna Commercial	$210.52
Rate for Payer: Aetna Medicare Advantage	$166.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.27
Rate for Payer: Cigna Commercial	$277.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.20
Rate for Payer: Oxford Commercial	$110.80
Rate for Payer: Qualcare PPO/HMO/WC	$83.10
Rate for Payer: UnitedHealthcare Commercial	$110.80
Rate for Payer: UnitedHealthcare Community & State	$13.35
Rate for Payer: Wellpoint Medicaid Managed Care	$14.68

BLUNT TROCAR & SYRINGE

Facility

$554.00

Hospital Charge Code	270332619
Hospital Revenue Code	272
Min. Negotiated Rate	$83.10
Max. Negotiated Rate	$83.10
Rate for Payer: Qualcare PPO/HMO/WC	$83.10

BMAC

Facility

$4,900.00

Hospital Charge Code	270686678
Hospital Revenue Code	272
Min. Negotiated Rate	$735.00
Max. Negotiated Rate	$735.00
Rate for Payer: Qualcare PPO/HMO/WC	$735.00

BMAC

Facility

$4,900.00

Hospital Charge Code	270686679
Hospital Revenue Code	272
Min. Negotiated Rate	$735.00
Max. Negotiated Rate	$735.00
Rate for Payer: Qualcare PPO/HMO/WC	$735.00

BMAC

Facility

$4,900.00

Hospital Charge Code	270686679
Hospital Revenue Code	272
Min. Negotiated Rate	$118.09
Max. Negotiated Rate	$2,450.00
Rate for Payer: Aetna Commercial	$1,862.00
Rate for Payer: Aetna Medicare Advantage	$1,470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,249.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,249.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,249.50
Rate for Payer: Cigna Commercial	$2,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,470.00
Rate for Payer: Oxford Commercial	$980.00
Rate for Payer: Qualcare PPO/HMO/WC	$735.00
Rate for Payer: UnitedHealthcare Commercial	$980.00
Rate for Payer: UnitedHealthcare Community & State	$118.09
Rate for Payer: Wellpoint Medicaid Managed Care	$129.85

BMAC

Facility

$4,900.00

Hospital Charge Code	270686678
Hospital Revenue Code	272
Min. Negotiated Rate	$118.09
Max. Negotiated Rate	$2,450.00
Rate for Payer: Aetna Commercial	$1,862.00
Rate for Payer: Aetna Medicare Advantage	$1,470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,249.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,249.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,249.50
Rate for Payer: Cigna Commercial	$2,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,470.00
Rate for Payer: Oxford Commercial	$980.00
Rate for Payer: Qualcare PPO/HMO/WC	$735.00
Rate for Payer: UnitedHealthcare Commercial	$980.00
Rate for Payer: UnitedHealthcare Community & State	$118.09
Rate for Payer: Wellpoint Medicaid Managed Care	$129.85

BME ELITE 5 X 15 X15

Facility

$6,822.35

Service Code	HCPCS C1713
Hospital Charge Code	270689663
Hospital Revenue Code	278
Min. Negotiated Rate	$1,023.35
Max. Negotiated Rate	$1,651.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,651.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,500.92
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.35

BME ELITE 5 X 15 X15

Facility

$6,822.35

Service Code	HCPCS C1713
Hospital Charge Code	270689663
Hospital Revenue Code	278
Min. Negotiated Rate	$164.42
Max. Negotiated Rate	$3,411.18
Rate for Payer: Aetna Commercial	$2,592.49
Rate for Payer: Aetna Medicare Advantage	$2,046.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,739.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,739.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,739.70
Rate for Payer: Cigna Commercial	$3,411.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,651.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,500.92
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.35
Rate for Payer: UnitedHealthcare Community & State	$164.42
Rate for Payer: Wellpoint Medicaid Managed Care	$180.79

BMT 360 TIB AUG 67 X 10MM

Facility

$5,670.00

Service Code	HCPCS C1776
Hospital Charge Code	270687530
Hospital Revenue Code	278
Min. Negotiated Rate	$850.50
Max. Negotiated Rate	$1,372.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,134.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,372.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,247.40
Rate for Payer: Qualcare PPO/HMO/WC	$850.50

BMT 360 TIB AUG 67 X 10MM

Facility

$5,670.00

Service Code	HCPCS C1776
Hospital Charge Code	270687530
Hospital Revenue Code	278
Min. Negotiated Rate	$136.65
Max. Negotiated Rate	$2,835.00
Rate for Payer: Aetna Commercial	$2,154.60
Rate for Payer: Aetna Medicare Advantage	$1,701.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,445.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,445.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,134.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,445.85
Rate for Payer: Cigna Commercial	$2,835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,372.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,247.40
Rate for Payer: Qualcare PPO/HMO/WC	$850.50
Rate for Payer: UnitedHealthcare Community & State	$136.65
Rate for Payer: Wellpoint Medicaid Managed Care	$150.25

BMT 360 TIB AUG 71 X 10MM

Facility

$5,670.00

Service Code	HCPCS C1776
Hospital Charge Code	270687271
Hospital Revenue Code	278
Min. Negotiated Rate	$850.50
Max. Negotiated Rate	$1,372.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,134.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,372.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,247.40
Rate for Payer: Qualcare PPO/HMO/WC	$850.50

BMT 360 TIB AUG 71 X 10MM

Facility

$5,670.00

Service Code	HCPCS C1776
Hospital Charge Code	270687271
Hospital Revenue Code	278
Min. Negotiated Rate	$136.65
Max. Negotiated Rate	$2,835.00
Rate for Payer: Aetna Commercial	$2,154.60
Rate for Payer: Aetna Medicare Advantage	$1,701.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,445.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,445.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,134.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,445.85
Rate for Payer: Cigna Commercial	$2,835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,372.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,247.40
Rate for Payer: Qualcare PPO/HMO/WC	$850.50
Rate for Payer: UnitedHealthcare Community & State	$136.65
Rate for Payer: Wellpoint Medicaid Managed Care	$150.25

BMT 360 TIB TRAY 67MM

Facility

$14,160.00

Service Code	HCPCS C1776
Hospital Charge Code	270687529
Hospital Revenue Code	278
Min. Negotiated Rate	$2,124.00
Max. Negotiated Rate	$3,426.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,832.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,426.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,115.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,124.00

BMT 360 TIB TRAY 67MM

Facility

$14,160.00

Service Code	HCPCS C1776
Hospital Charge Code	270687529
Hospital Revenue Code	278
Min. Negotiated Rate	$341.26
Max. Negotiated Rate	$7,080.00
Rate for Payer: Aetna Commercial	$5,380.80
Rate for Payer: Aetna Medicare Advantage	$4,248.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,610.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,610.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,832.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,610.80
Rate for Payer: Cigna Commercial	$7,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,426.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,115.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,124.00
Rate for Payer: UnitedHealthcare Community & State	$341.26
Rate for Payer: Wellpoint Medicaid Managed Care	$375.24

BMT 360 TIOB TRAY 71MM

Facility

$14,160.00

Service Code	HCPCS C1776
Hospital Charge Code	270687272
Hospital Revenue Code	278
Min. Negotiated Rate	$2,124.00
Max. Negotiated Rate	$3,426.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,832.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,426.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,115.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,124.00

BMT 360 TIOB TRAY 71MM

Facility

$14,160.00

Service Code	HCPCS C1776
Hospital Charge Code	270687272
Hospital Revenue Code	278
Min. Negotiated Rate	$341.26
Max. Negotiated Rate	$7,080.00
Rate for Payer: Aetna Commercial	$5,380.80
Rate for Payer: Aetna Medicare Advantage	$4,248.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,610.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,610.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,832.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,610.80
Rate for Payer: Cigna Commercial	$7,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,426.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,115.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,124.00
Rate for Payer: UnitedHealthcare Community & State	$341.26
Rate for Payer: Wellpoint Medicaid Managed Care	$375.24

BMT SMOOTH KNEE STM 14X120

Facility

$7,620.00

Service Code	HCPCS C1776
Hospital Charge Code	270679804
Hospital Revenue Code	278
Min. Negotiated Rate	$183.64
Max. Negotiated Rate	$3,810.00
Rate for Payer: Aetna Commercial	$2,895.60
Rate for Payer: Aetna Medicare Advantage	$2,286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,943.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,943.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,524.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,943.10
Rate for Payer: Cigna Commercial	$3,810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,844.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,676.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.00
Rate for Payer: UnitedHealthcare Community & State	$183.64
Rate for Payer: Wellpoint Medicaid Managed Care	$201.93

BMT SMOOTH KNEE STM 14X120

Facility

$7,620.00

Service Code	HCPCS C1776
Hospital Charge Code	270679804
Hospital Revenue Code	278
Min. Negotiated Rate	$1,143.00
Max. Negotiated Rate	$1,844.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,524.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,844.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,676.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.00

BMT SMOTH KNEE STM

Facility

$7,620.00

Service Code	HCPCS C1776
Hospital Charge Code	270684252
Hospital Revenue Code	278
Min. Negotiated Rate	$183.64
Max. Negotiated Rate	$3,810.00
Rate for Payer: Aetna Commercial	$2,895.60
Rate for Payer: Aetna Medicare Advantage	$2,286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,943.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,943.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,524.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,943.10
Rate for Payer: Cigna Commercial	$3,810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,844.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,676.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.00
Rate for Payer: UnitedHealthcare Community & State	$183.64
Rate for Payer: Wellpoint Medicaid Managed Care	$201.93

BMT SMOTH KNEE STM

Facility

$7,620.00

Service Code	HCPCS C1776
Hospital Charge Code	270684252
Hospital Revenue Code	278
Min. Negotiated Rate	$1,143.00
Max. Negotiated Rate	$1,844.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,524.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,844.04
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,676.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.00

BMW II ANGIOPLASTY WIRE

Facility

$375.00

Hospital Charge Code	2709006286
Hospital Revenue Code	272
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

BMW II ANGIOPLASTY WIRE

Facility

$375.00

Hospital Charge Code	2709006286
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

BN GFT OSTEOLINK STR 50X10X7MM

Facility

$13,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270699028
Hospital Revenue Code	278
Min. Negotiated Rate	$327.16
Max. Negotiated Rate	$6,787.50
Rate for Payer: Aetna Commercial	$5,158.50
Rate for Payer: Aetna Medicare Advantage	$4,072.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,461.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,461.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,715.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,461.62
Rate for Payer: Cigna Commercial	$6,787.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,285.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,986.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,036.25
Rate for Payer: UnitedHealthcare Community & State	$327.16
Rate for Payer: Wellpoint Medicaid Managed Care	$359.74

Know your out-of-pocket cost for care.

All Charges