Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

ACCESSORY COMPONENT KIT

Facility

$2,275.00

Hospital Charge Code	270645661
Hospital Revenue Code	270
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$341.25
Rate for Payer: Qualcare PPO/HMO/WC	$341.25

ACCESSORY COMPONENT KIT

Facility

$2,275.00

Hospital Charge Code	270645661
Hospital Revenue Code	270
Min. Negotiated Rate	$54.83
Max. Negotiated Rate	$1,137.50
Rate for Payer: Aetna Commercial	$864.50
Rate for Payer: Aetna Medicare Advantage	$682.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$580.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$580.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$580.12
Rate for Payer: Cigna Commercial	$1,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$682.50
Rate for Payer: Oxford Commercial	$455.00
Rate for Payer: Qualcare PPO/HMO/WC	$341.25
Rate for Payer: UnitedHealthcare Commercial	$455.00
Rate for Payer: UnitedHealthcare Community & State	$54.83
Rate for Payer: Wellpoint Medicaid Managed Care	$60.29

ACCESSORY KIT

Facility

$275.00

Hospital Charge Code	270682039
Hospital Revenue Code	272
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.50
Rate for Payer: Oxford Commercial	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Commercial	$55.00
Rate for Payer: UnitedHealthcare Community & State	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$7.29

ACCESSORY KIT

Facility

$275.00

Hospital Charge Code	270682039
Hospital Revenue Code	272
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

ACCESSORY KIT

Facility

$275.00

Hospital Charge Code	270682039N
Hospital Revenue Code	272
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.50
Rate for Payer: Oxford Commercial	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Commercial	$55.00
Rate for Payer: UnitedHealthcare Community & State	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$7.29

ACCESSORY KIT

Facility

$275.00

Hospital Charge Code	270682039N
Hospital Revenue Code	272
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

ACCESSORY TENACIO AMS700

Facility

$4,049.40

Hospital Charge Code	270702097
Hospital Revenue Code	272
Min. Negotiated Rate	$97.59
Max. Negotiated Rate	$2,024.70
Rate for Payer: Aetna Commercial	$1,538.77
Rate for Payer: Aetna Medicare Advantage	$1,214.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,032.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,032.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,032.60
Rate for Payer: Cigna Commercial	$2,024.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,214.82
Rate for Payer: Oxford Commercial	$809.88
Rate for Payer: Qualcare PPO/HMO/WC	$607.41
Rate for Payer: UnitedHealthcare Commercial	$809.88
Rate for Payer: UnitedHealthcare Community & State	$97.59
Rate for Payer: Wellpoint Medicaid Managed Care	$107.31

ACCESSORY TENACIO AMS700

Facility

$4,049.40

Hospital Charge Code	270702097
Hospital Revenue Code	272
Min. Negotiated Rate	$607.41
Max. Negotiated Rate	$607.41
Rate for Payer: Qualcare PPO/HMO/WC	$607.41

ACCESS PORT NEEDLE

Facility

$105.00

Hospital Charge Code	270338728
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.50
Rate for Payer: Oxford Commercial	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$21.00
Rate for Payer: UnitedHealthcare Community & State	$2.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

ACCESS PORT NEEDLE

Facility

$105.00

Hospital Charge Code	270338728
Hospital Revenue Code	272
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

ACCESS QUICK RELEASE DRL 15/64

Facility

$690.00

Hospital Charge Code	270690418
Hospital Revenue Code	272
Min. Negotiated Rate	$103.50
Max. Negotiated Rate	$103.50
Rate for Payer: Qualcare PPO/HMO/WC	$103.50

ACCESS QUICK RELEASE DRL 15/64

Facility

$690.00

Hospital Charge Code	270690418
Hospital Revenue Code	272
Min. Negotiated Rate	$16.63
Max. Negotiated Rate	$345.00
Rate for Payer: Aetna Commercial	$262.20
Rate for Payer: Aetna Medicare Advantage	$207.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.95
Rate for Payer: Cigna Commercial	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.00
Rate for Payer: Oxford Commercial	$138.00
Rate for Payer: Qualcare PPO/HMO/WC	$103.50
Rate for Payer: UnitedHealthcare Commercial	$138.00
Rate for Payer: UnitedHealthcare Community & State	$16.63
Rate for Payer: Wellpoint Medicaid Managed Care	$18.29

ACCLARENT AERA WITH VENT CAP

Facility

$2,010.00

Hospital Charge Code	270683379
Hospital Revenue Code	272
Min. Negotiated Rate	$301.50
Max. Negotiated Rate	$301.50
Rate for Payer: Qualcare PPO/HMO/WC	$301.50

ACCLARENT AERA WITH VENT CAP

Facility

$2,010.00

Hospital Charge Code	270683379
Hospital Revenue Code	272
Min. Negotiated Rate	$48.44
Max. Negotiated Rate	$1,005.00
Rate for Payer: Aetna Commercial	$763.80
Rate for Payer: Aetna Medicare Advantage	$603.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$512.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$512.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$512.55
Rate for Payer: Cigna Commercial	$1,005.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$603.00
Rate for Payer: Oxford Commercial	$402.00
Rate for Payer: Qualcare PPO/HMO/WC	$301.50
Rate for Payer: UnitedHealthcare Commercial	$402.00
Rate for Payer: UnitedHealthcare Community & State	$48.44
Rate for Payer: Wellpoint Medicaid Managed Care	$53.27

ACCLARENT SE INFLATION DEVICE

Facility

$447.30

Hospital Charge Code	270683378
Hospital Revenue Code	272
Min. Negotiated Rate	$10.78
Max. Negotiated Rate	$223.65
Rate for Payer: Aetna Commercial	$169.97
Rate for Payer: Aetna Medicare Advantage	$134.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.06
Rate for Payer: Cigna Commercial	$223.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.19
Rate for Payer: Oxford Commercial	$89.46
Rate for Payer: Qualcare PPO/HMO/WC	$67.09
Rate for Payer: UnitedHealthcare Commercial	$89.46
Rate for Payer: UnitedHealthcare Community & State	$10.78
Rate for Payer: Wellpoint Medicaid Managed Care	$11.85

ACCLARENT SE INFLATION DEVICE

Facility

$447.30

Hospital Charge Code	270683378
Hospital Revenue Code	272
Min. Negotiated Rate	$67.09
Max. Negotiated Rate	$67.09
Rate for Payer: Qualcare PPO/HMO/WC	$67.09

ACCO127CEMSTEMSZ5TPRV4037X145

Facility

$10,655.40

Service Code	HCPCS C1776
Hospital Charge Code	270691242
Hospital Revenue Code	278
Min. Negotiated Rate	$256.80
Max. Negotiated Rate	$5,327.70
Rate for Payer: Aetna Commercial	$4,049.05
Rate for Payer: Aetna Medicare Advantage	$3,196.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,717.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,717.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,131.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,717.13
Rate for Payer: Cigna Commercial	$5,327.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,578.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,344.19
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.31
Rate for Payer: UnitedHealthcare Community & State	$256.80
Rate for Payer: Wellpoint Medicaid Managed Care	$282.37

ACCO127CEMSTEMSZ5TPRV4037X145

Facility

$10,655.40

Service Code	HCPCS C1776
Hospital Charge Code	270691242
Hospital Revenue Code	278
Min. Negotiated Rate	$1,598.31
Max. Negotiated Rate	$2,578.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,131.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,578.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,344.19
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.31

ACCOLADE DISTAL SPACER SZ.SM

Facility

$930.00

Hospital Charge Code	270656474
Hospital Revenue Code	271
Min. Negotiated Rate	$22.41
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$353.40
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.00
Rate for Payer: Oxford Commercial	$186.00
Rate for Payer: Qualcare PPO/HMO/WC	$139.50
Rate for Payer: UnitedHealthcare Commercial	$186.00
Rate for Payer: UnitedHealthcare Community & State	$22.41
Rate for Payer: Wellpoint Medicaid Managed Care	$24.64

ACCOLADE DISTAL SPACER SZ.SM

Facility

$930.00

Hospital Charge Code	270656474
Hospital Revenue Code	271
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$139.50
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

ACCOLADE DIST SPACERMEDOD14MM

Facility

$460.85

Service Code	HCPCS C1713
Hospital Charge Code	270691244
Hospital Revenue Code	278
Min. Negotiated Rate	$69.13
Max. Negotiated Rate	$111.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$101.39
Rate for Payer: Qualcare PPO/HMO/WC	$69.13

ACCOLADE DIST SPACERMEDOD14MM

Facility

$460.85

Service Code	HCPCS C1713
Hospital Charge Code	270691244
Hospital Revenue Code	278
Min. Negotiated Rate	$11.11
Max. Negotiated Rate	$230.43
Rate for Payer: Aetna Commercial	$175.12
Rate for Payer: Aetna Medicare Advantage	$138.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.52
Rate for Payer: Cigna Commercial	$230.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$101.39
Rate for Payer: Qualcare PPO/HMO/WC	$69.13
Rate for Payer: UnitedHealthcare Community & State	$11.11
Rate for Payer: Wellpoint Medicaid Managed Care	$12.21

Accolade MRI DR

Facility

$51,500.00

Service Code	HCPCS C1785
Hospital Charge Code	270686184
Hospital Revenue Code	278
Min. Negotiated Rate	$7,725.00
Max. Negotiated Rate	$12,463.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,463.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11,330.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,725.00

Accolade MRI DR

Facility

$51,500.00

Service Code	HCPCS C1785
Hospital Charge Code	270686184
Hospital Revenue Code	278
Min. Negotiated Rate	$1,241.15
Max. Negotiated Rate	$25,750.00
Rate for Payer: Aetna Commercial	$19,570.00
Rate for Payer: Aetna Medicare Advantage	$15,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,132.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,132.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,132.50
Rate for Payer: Cigna Commercial	$25,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,463.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11,330.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,725.00
Rate for Payer: UnitedHealthcare Community & State	$1,241.15
Rate for Payer: Wellpoint Medicaid Managed Care	$1,364.75

Know your out-of-pocket cost for care.

All Charges