Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ABSTACK 5mm W/20 TACKS B000596

Facility

$2,392.25

Service Code	HCPCS C1713
Hospital Charge Code	270645859
Hospital Revenue Code	278
Min. Negotiated Rate	$57.65
Max. Negotiated Rate	$1,196.12
Rate for Payer: Aetna Commercial	$909.05
Rate for Payer: Aetna Medicare Advantage	$717.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$610.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$610.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$610.02
Rate for Payer: Cigna Commercial	$1,196.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$526.29
Rate for Payer: Qualcare PPO/HMO/WC	$358.84
Rate for Payer: UnitedHealthcare Community & State	$57.65
Rate for Payer: Wellpoint Medicaid Managed Care	$63.39

ABSTACK 5mm W/20 TACKS B000596

Facility

$2,392.25

Service Code	HCPCS C1713
Hospital Charge Code	270645859
Hospital Revenue Code	278
Min. Negotiated Rate	$358.84
Max. Negotiated Rate	$578.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$526.29
Rate for Payer: Qualcare PPO/HMO/WC	$358.84

AB TOXOPLASMA

Facility

$390.00

Service Code	HCPCS 86777
Hospital Charge Code	401386777
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

AB TOXOPLASMA

Facility

$390.00

Service Code	HCPCS 86777
Hospital Charge Code	401386777
Hospital Revenue Code	306
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$39.14
Rate for Payer: Aetna Medicare Advantage	$46.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.94
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.39
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Medicare Advantage	$14.39
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

AB TOXOPLASMA IGM

Facility

$390.00

Service Code	HCPCS 86778
Hospital Charge Code	401386778
Hospital Revenue Code	306
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$39.20
Rate for Payer: Aetna Medicare Advantage	$46.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.02
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.41
Rate for Payer: Clover Medicare Advantage	$13.69
Rate for Payer: EmblemHealth Commercial	$43.23
Rate for Payer: Humana Medicare Advantage	$14.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.41
Rate for Payer: Wellcare Medicare Advantage	$14.41
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

AB TOXOPLASMA IGM

Facility

$390.00

Service Code	HCPCS 86778
Hospital Charge Code	401386778
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ABUTMENT EP HEALING 2PCS TH254

Facility

$125.00

Hospital Charge Code	270620302
Hospital Revenue Code	272
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

ABUTMENT EP HEALING 2PCS TH254

Facility

$125.00

Hospital Charge Code	270620302
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

AB VIRUS,NON SPECIFIC

Facility

$218.00

Service Code	HCPCS 86790
Hospital Charge Code	38476269
Hospital Revenue Code	302
Min. Negotiated Rate	$32.70
Max. Negotiated Rate	$32.70
Rate for Payer: Qualcare PPO/HMO/WC	$32.70

AB VIRUS,NON SPECIFIC

Facility

$218.00

Service Code	HCPCS 86790
Hospital Charge Code	38476269
Hospital Revenue Code	302
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$459.20
Rate for Payer: Aetna Commercial	$35.03
Rate for Payer: Aetna Medicare Advantage	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$459.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.49
Rate for Payer: Cigna Commercial	$109.00
Rate for Payer: Cigna Medicare Advantage	$12.88
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Medicare Advantage	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$5.78

ACAPELLA PEDIATRIC BLUE

Facility

$205.49

Hospital Charge Code	270664899
Hospital Revenue Code	270
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$102.75
Rate for Payer: Aetna Commercial	$78.09
Rate for Payer: Aetna Medicare Advantage	$61.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.40
Rate for Payer: Cigna Commercial	$102.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.65
Rate for Payer: Oxford Commercial	$41.10
Rate for Payer: Qualcare PPO/HMO/WC	$30.82
Rate for Payer: UnitedHealthcare Commercial	$41.10
Rate for Payer: UnitedHealthcare Community & State	$4.95
Rate for Payer: Wellpoint Medicaid Managed Care	$5.45

ACAPELLA PEDIATRIC BLUE

Facility

$205.49

Hospital Charge Code	270664899
Hospital Revenue Code	270
Min. Negotiated Rate	$30.82
Max. Negotiated Rate	$30.82
Rate for Payer: Qualcare PPO/HMO/WC	$30.82

ACARBOSE

Facility

$8.51

Service Code	NDC 50419086148
Hospital Charge Code	6024202
Hospital Revenue Code	251
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.25
Rate for Payer: Aetna Commercial	$3.23
Rate for Payer: Aetna Medicare Advantage	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.17
Rate for Payer: Cigna Commercial	$4.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.55
Rate for Payer: Oxford Commercial	$1.70
Rate for Payer: Qualcare PPO/HMO/WC	$1.28
Rate for Payer: UnitedHealthcare Commercial	$1.70
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

ACARBOSE

Facility

$8.51

Service Code	NDC 50419086148
Hospital Charge Code	6024202
Hospital Revenue Code	251
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$1.28
Rate for Payer: Qualcare PPO/HMO/WC	$1.28

ACCELL CONNEXUS 5CC PUTTY

Facility

$5,500.00

Hospital Charge Code	270657197
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

ACCELL CONNEXUS 5CC PUTTY

Facility

$5,500.00

Hospital Charge Code	270657197
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

ACCELL DBM 100 021000010

Facility

$1,550.00

Hospital Charge Code	270638108
Hospital Revenue Code	272
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$232.50
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

ACCELL DBM 100 021000010

Facility

$1,550.00

Hospital Charge Code	270638108
Hospital Revenue Code	272
Min. Negotiated Rate	$37.35
Max. Negotiated Rate	$775.00
Rate for Payer: Aetna Commercial	$589.00
Rate for Payer: Aetna Medicare Advantage	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.25
Rate for Payer: Cigna Commercial	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$465.00
Rate for Payer: Oxford Commercial	$310.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.50
Rate for Payer: UnitedHealthcare Commercial	$310.00
Rate for Payer: UnitedHealthcare Community & State	$37.35
Rate for Payer: Wellpoint Medicaid Managed Care	$41.08

ACCESS DSC 5 F X 125CM

Facility

$6,750.00

Service Code	HCPCS C1887
Hospital Charge Code	270685192
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

ACCESS DSC 5 F X 125CM

Facility

$6,750.00

Service Code	HCPCS C1887
Hospital Charge Code	270685192
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

ACCESS NAVIEN DSC 6F X 115CM

Facility

$5,750.00

Service Code	HCPCS C1887
Hospital Charge Code	270685193
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$1,391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,265.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

ACCESS NAVIEN DSC 6F X 115CM

Facility

$5,750.00

Service Code	HCPCS C1887
Hospital Charge Code	270685193
Hospital Revenue Code	278
Min. Negotiated Rate	$138.57
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$2,185.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,265.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Community & State	$138.57
Rate for Payer: Wellpoint Medicaid Managed Care	$152.38

ACCESS NEEDLE 8Gx11CM

Facility

$1,375.00

Hospital Charge Code	270672820
Hospital Revenue Code	272
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$522.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$412.50
Rate for Payer: Oxford Commercial	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Commercial	$275.00
Rate for Payer: UnitedHealthcare Community & State	$33.14
Rate for Payer: Wellpoint Medicaid Managed Care	$36.44

ACCESS NEEDLE 8Gx11CM

Facility

$1,375.00

Hospital Charge Code	270672820
Hospital Revenue Code	272
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$206.25
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

ACCESSORY BLOOD PRESSURE KIT

Facility

$3,875.00

Hospital Charge Code	270656966
Hospital Revenue Code	272
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$581.25
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

Know your out-of-pocket cost for care.

All Charges