Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CANISTER SUCTION 2000cc W/TUBG

Facility

$7.79

Hospital Charge Code	270648962
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.90
Rate for Payer: Aetna Commercial	$2.96
Rate for Payer: Aetna Medicare Advantage	$2.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.99
Rate for Payer: Cigna Commercial	$3.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Oxford Commercial	$1.56
Rate for Payer: Qualcare PPO/HMO/WC	$1.17
Rate for Payer: UnitedHealthcare Commercial	$1.56
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

CANISTER SUCTION 2000cc W/TUBG

Facility

$7.79

Hospital Charge Code	270648962
Hospital Revenue Code	272
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$1.17
Rate for Payer: Qualcare PPO/HMO/WC	$1.17

CANISTER SUCTION 3000cc

Facility

$7.82

Hospital Charge Code	270648963
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.91
Rate for Payer: Aetna Commercial	$2.97
Rate for Payer: Aetna Medicare Advantage	$2.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.99
Rate for Payer: Cigna Commercial	$3.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.35
Rate for Payer: Oxford Commercial	$1.56
Rate for Payer: Qualcare PPO/HMO/WC	$1.17
Rate for Payer: UnitedHealthcare Commercial	$1.56
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

CANISTER SUCTION 3000cc

Facility

$7.82

Hospital Charge Code	270648963
Hospital Revenue Code	272
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$1.17
Rate for Payer: Qualcare PPO/HMO/WC	$1.17

CANISTER W/GEL M6275063-5

Facility

$189.00

Hospital Charge Code	270631132
Hospital Revenue Code	272
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$94.50
Rate for Payer: Aetna Commercial	$71.82
Rate for Payer: Aetna Medicare Advantage	$56.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.20
Rate for Payer: Cigna Commercial	$94.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.70
Rate for Payer: Oxford Commercial	$37.80
Rate for Payer: Qualcare PPO/HMO/WC	$28.35
Rate for Payer: UnitedHealthcare Commercial	$37.80
Rate for Payer: UnitedHealthcare Community & State	$4.55
Rate for Payer: Wellpoint Medicaid Managed Care	$5.01

CANISTER W/GEL M6275063-5

Facility

$189.00

Hospital Charge Code	270631132
Hospital Revenue Code	272
Min. Negotiated Rate	$28.35
Max. Negotiated Rate	$28.35
Rate for Payer: Qualcare PPO/HMO/WC	$28.35

CANN 15CM RF 22GA CURV 7210278

Facility

$1,750.00

Hospital Charge Code	270639692
Hospital Revenue Code	272
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$525.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

CANN 15CM RF 22GA CURV 7210278

Facility

$1,750.00

Hospital Charge Code	270639692
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

CANN 4.0MM AO FITTING SCREW

Facility

$1,865.00

Service Code	HCPCS C1713
Hospital Charge Code	270700428
Hospital Revenue Code	278
Min. Negotiated Rate	$44.95
Max. Negotiated Rate	$932.50
Rate for Payer: Aetna Commercial	$708.70
Rate for Payer: Aetna Medicare Advantage	$559.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$475.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$475.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$373.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$475.57
Rate for Payer: Cigna Commercial	$932.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$410.30
Rate for Payer: Qualcare PPO/HMO/WC	$279.75
Rate for Payer: UnitedHealthcare Community & State	$44.95
Rate for Payer: Wellpoint Medicaid Managed Care	$49.42

CANN 4.0MM AO FITTING SCREW

Facility

$1,865.00

Service Code	HCPCS C1713
Hospital Charge Code	270700428
Hospital Revenue Code	278
Min. Negotiated Rate	$279.75
Max. Negotiated Rate	$451.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$373.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$410.30
Rate for Payer: Qualcare PPO/HMO/WC	$279.75

CANNABINOIDS, URINE

Facility

$190.00

Service Code	HCPCS 80349
Hospital Charge Code	38472501
Hospital Revenue Code	301
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

CANNABINOIDS, URINE

Facility

$190.00

Service Code	HCPCS 80349
Hospital Charge Code	38472501
Hospital Revenue Code	301
Min. Negotiated Rate	$5.04
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$72.20
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$5.04

CANNABIN ,URINE,SCREEN

Facility

$190.45

Service Code	HCPCS 80349
Hospital Charge Code	3007614
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

CANNABIN ,URINE,SCREEN

Facility

$190.45

Service Code	HCPCS 80349
Hospital Charge Code	3007614
Hospital Revenue Code	301
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$72.37
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$5.05

CANN COUNTERSINK 4.5/5.5 QC

Facility

$2,585.00

Hospital Charge Code	270698608
Hospital Revenue Code	272
Min. Negotiated Rate	$62.30
Max. Negotiated Rate	$1,292.50
Rate for Payer: Aetna Commercial	$982.30
Rate for Payer: Aetna Medicare Advantage	$775.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$659.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$659.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$659.17
Rate for Payer: Cigna Commercial	$1,292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$775.50
Rate for Payer: Oxford Commercial	$517.00
Rate for Payer: Qualcare PPO/HMO/WC	$387.75
Rate for Payer: UnitedHealthcare Commercial	$517.00
Rate for Payer: UnitedHealthcare Community & State	$62.30
Rate for Payer: Wellpoint Medicaid Managed Care	$68.50

CANN COUNTERSINK 4.5/5.5 QC

Facility

$2,585.00

Hospital Charge Code	270698608
Hospital Revenue Code	272
Min. Negotiated Rate	$387.75
Max. Negotiated Rate	$387.75
Rate for Payer: Qualcare PPO/HMO/WC	$387.75

CANN DRILL 4.8X200MM

Facility

$1,800.00

Hospital Charge Code	270680500
Hospital Revenue Code	272
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$540.00
Rate for Payer: Oxford Commercial	$360.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Commercial	$360.00
Rate for Payer: UnitedHealthcare Community & State	$43.38
Rate for Payer: Wellpoint Medicaid Managed Care	$47.70

CANN DRILL 4.8X200MM

Facility

$1,800.00

Hospital Charge Code	270680500
Hospital Revenue Code	272
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$270.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

CANN DRILOCK 6.5

Facility

$140.65

Hospital Charge Code	270681377
Hospital Revenue Code	272
Min. Negotiated Rate	$3.39
Max. Negotiated Rate	$70.33
Rate for Payer: Aetna Commercial	$53.45
Rate for Payer: Aetna Medicare Advantage	$42.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.87
Rate for Payer: Cigna Commercial	$70.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.20
Rate for Payer: Oxford Commercial	$28.13
Rate for Payer: Qualcare PPO/HMO/WC	$21.10
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: UnitedHealthcare Community & State	$3.39
Rate for Payer: Wellpoint Medicaid Managed Care	$3.73

CANN DRILOCK 6.5

Facility

$140.65

Hospital Charge Code	270681377
Hospital Revenue Code	272
Min. Negotiated Rate	$21.10
Max. Negotiated Rate	$21.10
Rate for Payer: Qualcare PPO/HMO/WC	$21.10

CANN.DRILOK 6.5mm

Facility

$140.65

Hospital Charge Code	270680691
Hospital Revenue Code	272
Min. Negotiated Rate	$3.39
Max. Negotiated Rate	$70.33
Rate for Payer: Aetna Commercial	$53.45
Rate for Payer: Aetna Medicare Advantage	$42.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.87
Rate for Payer: Cigna Commercial	$70.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.20
Rate for Payer: Oxford Commercial	$28.13
Rate for Payer: Qualcare PPO/HMO/WC	$21.10
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: UnitedHealthcare Community & State	$3.39
Rate for Payer: Wellpoint Medicaid Managed Care	$3.73

CANN.DRILOK 6.5mm

Facility

$140.65

Hospital Charge Code	270680691
Hospital Revenue Code	272
Min. Negotiated Rate	$21.10
Max. Negotiated Rate	$21.10
Rate for Payer: Qualcare PPO/HMO/WC	$21.10

CANN.DRILOK 8mm

Facility

$140.65

Hospital Charge Code	270680692
Hospital Revenue Code	272
Min. Negotiated Rate	$3.39
Max. Negotiated Rate	$70.33
Rate for Payer: Aetna Commercial	$53.45
Rate for Payer: Aetna Medicare Advantage	$42.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.87
Rate for Payer: Cigna Commercial	$70.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.20
Rate for Payer: Oxford Commercial	$28.13
Rate for Payer: Qualcare PPO/HMO/WC	$21.10
Rate for Payer: UnitedHealthcare Commercial	$28.13
Rate for Payer: UnitedHealthcare Community & State	$3.39
Rate for Payer: Wellpoint Medicaid Managed Care	$3.73

CANN.DRILOK 8mm

Facility

$140.65

Hospital Charge Code	270680692
Hospital Revenue Code	272
Min. Negotiated Rate	$21.10
Max. Negotiated Rate	$21.10
Rate for Payer: Qualcare PPO/HMO/WC	$21.10

CANNISTER 150ML

Facility

$130.00

Hospital Charge Code	270684519
Hospital Revenue Code	272
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$19.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.50

Know your out-of-pocket cost for care.

All Charges