Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BURR TAPER FISS 2.1x45MM J-LAT

Facility

$381.50

Hospital Charge Code	270674609
Hospital Revenue Code	272
Min. Negotiated Rate	$57.23
Max. Negotiated Rate	$57.23
Rate for Payer: Qualcare PPO/HMO/WC	$57.23

BURR TAPER FISS 2.1x45MM J-LAT

Facility

$381.50

Hospital Charge Code	270674609
Hospital Revenue Code	272
Min. Negotiated Rate	$9.19
Max. Negotiated Rate	$190.75
Rate for Payer: Aetna Commercial	$144.97
Rate for Payer: Aetna Medicare Advantage	$114.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.28
Rate for Payer: Cigna Commercial	$190.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.45
Rate for Payer: Oxford Commercial	$76.30
Rate for Payer: Qualcare PPO/HMO/WC	$57.23
Rate for Payer: UnitedHealthcare Commercial	$76.30
Rate for Payer: UnitedHealthcare Community & State	$9.19
Rate for Payer: Wellpoint Medicaid Managed Care	$10.11

BURR TAPER FISS 2.1x45MM MQC

Facility

$381.50

Hospital Charge Code	270674561
Hospital Revenue Code	278
Min. Negotiated Rate	$9.19
Max. Negotiated Rate	$190.75
Rate for Payer: Aetna Commercial	$144.97
Rate for Payer: Aetna Medicare Advantage	$114.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.28
Rate for Payer: Cigna Commercial	$190.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$83.93
Rate for Payer: Qualcare PPO/HMO/WC	$57.23
Rate for Payer: UnitedHealthcare Community & State	$9.19
Rate for Payer: Wellpoint Medicaid Managed Care	$10.11

BURR TAPER FISS 2.1x45MM MQC

Facility

$381.50

Hospital Charge Code	270674561
Hospital Revenue Code	278
Min. Negotiated Rate	$57.23
Max. Negotiated Rate	$92.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$83.93
Rate for Payer: Qualcare PPO/HMO/WC	$57.23

BURR TAPER FISS 3.2x31MM J-LAT

Facility

$381.50

Hospital Charge Code	270674610
Hospital Revenue Code	272
Min. Negotiated Rate	$9.19
Max. Negotiated Rate	$190.75
Rate for Payer: Aetna Commercial	$144.97
Rate for Payer: Aetna Medicare Advantage	$114.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.28
Rate for Payer: Cigna Commercial	$190.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.45
Rate for Payer: Oxford Commercial	$76.30
Rate for Payer: Qualcare PPO/HMO/WC	$57.23
Rate for Payer: UnitedHealthcare Commercial	$76.30
Rate for Payer: UnitedHealthcare Community & State	$9.19
Rate for Payer: Wellpoint Medicaid Managed Care	$10.11

BURR TAPER FISS 3.2x31MM J-LAT

Facility

$381.50

Hospital Charge Code	270674610
Hospital Revenue Code	272
Min. Negotiated Rate	$57.23
Max. Negotiated Rate	$57.23
Rate for Payer: Qualcare PPO/HMO/WC	$57.23

BURR TAPER FISS 3.2x31MM MQC

Facility

$381.50

Hospital Charge Code	270674562
Hospital Revenue Code	272
Min. Negotiated Rate	$9.19
Max. Negotiated Rate	$190.75
Rate for Payer: Aetna Commercial	$144.97
Rate for Payer: Aetna Medicare Advantage	$114.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.28
Rate for Payer: Cigna Commercial	$190.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.45
Rate for Payer: Oxford Commercial	$76.30
Rate for Payer: Qualcare PPO/HMO/WC	$57.23
Rate for Payer: UnitedHealthcare Commercial	$76.30
Rate for Payer: UnitedHealthcare Community & State	$9.19
Rate for Payer: Wellpoint Medicaid Managed Care	$10.11

BURR TAPER FISS 3.2x31MM MQC

Facility

$381.50

Hospital Charge Code	270674562
Hospital Revenue Code	272
Min. Negotiated Rate	$57.23
Max. Negotiated Rate	$57.23
Rate for Payer: Qualcare PPO/HMO/WC	$57.23

BURR TAPER FISS 3.2x45MM J-LAT

Facility

$381.50

Hospital Charge Code	270674611
Hospital Revenue Code	272
Min. Negotiated Rate	$9.19
Max. Negotiated Rate	$190.75
Rate for Payer: Aetna Commercial	$144.97
Rate for Payer: Aetna Medicare Advantage	$114.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.28
Rate for Payer: Cigna Commercial	$190.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.45
Rate for Payer: Oxford Commercial	$76.30
Rate for Payer: Qualcare PPO/HMO/WC	$57.23
Rate for Payer: UnitedHealthcare Commercial	$76.30
Rate for Payer: UnitedHealthcare Community & State	$9.19
Rate for Payer: Wellpoint Medicaid Managed Care	$10.11

BURR TAPER FISS 3.2x45MM J-LAT

Facility

$381.50

Hospital Charge Code	270674611
Hospital Revenue Code	272
Min. Negotiated Rate	$57.23
Max. Negotiated Rate	$57.23
Rate for Payer: Qualcare PPO/HMO/WC	$57.23

BURR TAPER FISS 3.2x45MM MQC

Facility

$381.50

Hospital Charge Code	270674563
Hospital Revenue Code	272
Min. Negotiated Rate	$57.23
Max. Negotiated Rate	$57.23
Rate for Payer: Qualcare PPO/HMO/WC	$57.23

BURR TAPER FISS 3.2x45MM MQC

Facility

$381.50

Hospital Charge Code	270674563
Hospital Revenue Code	272
Min. Negotiated Rate	$9.19
Max. Negotiated Rate	$190.75
Rate for Payer: Aetna Commercial	$144.97
Rate for Payer: Aetna Medicare Advantage	$114.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.28
Rate for Payer: Cigna Commercial	$190.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.45
Rate for Payer: Oxford Commercial	$76.30
Rate for Payer: Qualcare PPO/HMO/WC	$57.23
Rate for Payer: UnitedHealthcare Commercial	$76.30
Rate for Payer: UnitedHealthcare Community & State	$9.19
Rate for Payer: Wellpoint Medicaid Managed Care	$10.11

BURR TAPER FISSURE L 1.6x4.5MM

Facility

$430.50

Hospital Charge Code	270674463
Hospital Revenue Code	272
Min. Negotiated Rate	$10.38
Max. Negotiated Rate	$215.25
Rate for Payer: Aetna Commercial	$163.59
Rate for Payer: Aetna Medicare Advantage	$129.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.78
Rate for Payer: Cigna Commercial	$215.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.15
Rate for Payer: Oxford Commercial	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.58
Rate for Payer: UnitedHealthcare Commercial	$86.10
Rate for Payer: UnitedHealthcare Community & State	$10.38
Rate for Payer: Wellpoint Medicaid Managed Care	$11.41

BURR TAPER FISSURE L 1.6x4.5MM

Facility

$430.50

Hospital Charge Code	270674463
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

BURR TAPER FISSURE L 2.3x5.2MM

Facility

$430.50

Hospital Charge Code	270674466
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

BURR TAPER FISSURE L 2.3x5.2MM

Facility

$430.50

Hospital Charge Code	270674466
Hospital Revenue Code	272
Min. Negotiated Rate	$10.38
Max. Negotiated Rate	$215.25
Rate for Payer: Aetna Commercial	$163.59
Rate for Payer: Aetna Medicare Advantage	$129.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.78
Rate for Payer: Cigna Commercial	$215.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.15
Rate for Payer: Oxford Commercial	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.58
Rate for Payer: UnitedHealthcare Commercial	$86.10
Rate for Payer: UnitedHealthcare Community & State	$10.38
Rate for Payer: Wellpoint Medicaid Managed Care	$11.41

BURR TAPER FISSURE L 2.6x6.8MM

Facility

$430.50

Hospital Charge Code	270674469
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

BURR TAPER FISSURE L 2.6x6.8MM

Facility

$430.50

Hospital Charge Code	270674469
Hospital Revenue Code	272
Min. Negotiated Rate	$10.38
Max. Negotiated Rate	$215.25
Rate for Payer: Aetna Commercial	$163.59
Rate for Payer: Aetna Medicare Advantage	$129.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.78
Rate for Payer: Cigna Commercial	$215.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.15
Rate for Payer: Oxford Commercial	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.58
Rate for Payer: UnitedHealthcare Commercial	$86.10
Rate for Payer: UnitedHealthcare Community & State	$10.38
Rate for Payer: Wellpoint Medicaid Managed Care	$11.41

BURR TAPER FISSURE M 1.6x4.5MM

Facility

$430.50

Hospital Charge Code	270674462
Hospital Revenue Code	272
Min. Negotiated Rate	$10.38
Max. Negotiated Rate	$215.25
Rate for Payer: Aetna Commercial	$163.59
Rate for Payer: Aetna Medicare Advantage	$129.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.78
Rate for Payer: Cigna Commercial	$215.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.15
Rate for Payer: Oxford Commercial	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.58
Rate for Payer: UnitedHealthcare Commercial	$86.10
Rate for Payer: UnitedHealthcare Community & State	$10.38
Rate for Payer: Wellpoint Medicaid Managed Care	$11.41

BURR TAPER FISSURE M 1.6x4.5MM

Facility

$430.50

Hospital Charge Code	270674462
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

BURR TAPER FISSURE M 2.3x5.2M

Facility

$430.50

Hospital Charge Code	270674465
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

BURR TAPER FISSURE M 2.3x5.2M

Facility

$430.50

Hospital Charge Code	270674465
Hospital Revenue Code	272
Min. Negotiated Rate	$10.38
Max. Negotiated Rate	$215.25
Rate for Payer: Aetna Commercial	$163.59
Rate for Payer: Aetna Medicare Advantage	$129.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.78
Rate for Payer: Cigna Commercial	$215.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.15
Rate for Payer: Oxford Commercial	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.58
Rate for Payer: UnitedHealthcare Commercial	$86.10
Rate for Payer: UnitedHealthcare Community & State	$10.38
Rate for Payer: Wellpoint Medicaid Managed Care	$11.41

BURR TAPER FISSURE M 2.6x6.8MM

Facility

$430.50

Hospital Charge Code	270674468
Hospital Revenue Code	272
Min. Negotiated Rate	$10.38
Max. Negotiated Rate	$215.25
Rate for Payer: Aetna Commercial	$163.59
Rate for Payer: Aetna Medicare Advantage	$129.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.78
Rate for Payer: Cigna Commercial	$215.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.15
Rate for Payer: Oxford Commercial	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.58
Rate for Payer: UnitedHealthcare Commercial	$86.10
Rate for Payer: UnitedHealthcare Community & State	$10.38
Rate for Payer: Wellpoint Medicaid Managed Care	$11.41

BURR TAPER FISSURE M 2.6x6.8MM

Facility

$430.50

Hospital Charge Code	270674468
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

BURR TAPER FISSURE S 1.6x4.5MM

Facility

$430.50

Hospital Charge Code	270674461
Hospital Revenue Code	272
Min. Negotiated Rate	$64.58
Max. Negotiated Rate	$64.58
Rate for Payer: Qualcare PPO/HMO/WC	$64.58

Know your out-of-pocket cost for care.

All Charges