Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CANNISTER 150ML

Facility

$130.00

Hospital Charge Code	270684519
Hospital Revenue Code	272
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$65.00
Rate for Payer: Aetna Commercial	$49.40
Rate for Payer: Aetna Medicare Advantage	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.15
Rate for Payer: Cigna Commercial	$65.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$26.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.50
Rate for Payer: UnitedHealthcare Commercial	$26.00
Rate for Payer: UnitedHealthcare Community & State	$3.13
Rate for Payer: Wellpoint Medicaid Managed Care	$3.44

CANNISTER GOMCO DISP SUCTION**

Facility

$15.00

Hospital Charge Code	8003006
Hospital Revenue Code	279
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$3.00
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

CANNISTER GOMCO DISP SUCTION**

Facility

$15.00

Hospital Charge Code	8003006
Hospital Revenue Code	279
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

CANNISTER PUMP SZ

Facility

$1,825.00

Hospital Charge Code	270688233
Hospital Revenue Code	272
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$273.75
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

CANNISTER PUMP SZ

Facility

$1,825.00

Hospital Charge Code	270688233
Hospital Revenue Code	272
Min. Negotiated Rate	$43.98
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$693.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$547.50
Rate for Payer: Oxford Commercial	$365.00
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Commercial	$365.00
Rate for Payer: UnitedHealthcare Community & State	$43.98
Rate for Payer: Wellpoint Medicaid Managed Care	$48.36

CANNISTER THIN WALL 1500CC

Facility

$24.00

Hospital Charge Code	270330966
Hospital Revenue Code	272
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$9.12
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.20
Rate for Payer: Oxford Commercial	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$4.80
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

CANNISTER THIN WALL 1500CC

Facility

$24.00

Hospital Charge Code	270330966
Hospital Revenue Code	272
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

CANNLA ADULT SFT TIP 7.85 0556

Facility

$3.00

Hospital Charge Code	270653963
Hospital Revenue Code	272
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

CANNLA ADULT SFT TIP 7.85 0556

Facility

$3.00

Hospital Charge Code	270653963
Hospital Revenue Code	272
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

CANN NAIL SYS NAIL 4X100MM

Facility

$18,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270705014
Hospital Revenue Code	278
Min. Negotiated Rate	$439.82
Max. Negotiated Rate	$9,125.00
Rate for Payer: Aetna Commercial	$6,935.00
Rate for Payer: Aetna Medicare Advantage	$5,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,653.75
Rate for Payer: Cigna Commercial	$9,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,015.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50
Rate for Payer: UnitedHealthcare Community & State	$439.82
Rate for Payer: Wellpoint Medicaid Managed Care	$483.62

CANN NAIL SYS NAIL 4X100MM

Facility

$18,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270705014
Hospital Revenue Code	278
Min. Negotiated Rate	$2,737.50
Max. Negotiated Rate	$4,416.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,015.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50

CANN PROFILE DRILL 4.0MM

Facility

$1,440.00

Hospital Charge Code	270686587
Hospital Revenue Code	272
Min. Negotiated Rate	$216.00
Max. Negotiated Rate	$216.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.00

CANN PROFILE DRILL 4.0MM

Facility

$1,440.00

Hospital Charge Code	270686587
Hospital Revenue Code	272
Min. Negotiated Rate	$34.70
Max. Negotiated Rate	$720.00
Rate for Payer: Aetna Commercial	$547.20
Rate for Payer: Aetna Medicare Advantage	$432.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$367.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$367.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$367.20
Rate for Payer: Cigna Commercial	$720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.00
Rate for Payer: Oxford Commercial	$288.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.00
Rate for Payer: UnitedHealthcare Commercial	$288.00
Rate for Payer: UnitedHealthcare Community & State	$34.70
Rate for Payer: Wellpoint Medicaid Managed Care	$38.16

CANN SCREW 6.5MM X 85MM X 40MM

Facility

$1,527.50

Service Code	HCPCS C1713
Hospital Charge Code	270688070
Hospital Revenue Code	278
Min. Negotiated Rate	$229.12
Max. Negotiated Rate	$369.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$336.05
Rate for Payer: Qualcare PPO/HMO/WC	$229.12

CANN SCREW 6.5MM X 85MM X 40MM

Facility

$1,527.50

Service Code	HCPCS C1713
Hospital Charge Code	270688070
Hospital Revenue Code	278
Min. Negotiated Rate	$36.81
Max. Negotiated Rate	$763.75
Rate for Payer: Aetna Commercial	$580.45
Rate for Payer: Aetna Medicare Advantage	$458.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$389.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$389.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$389.51
Rate for Payer: Cigna Commercial	$763.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$336.05
Rate for Payer: Qualcare PPO/HMO/WC	$229.12
Rate for Payer: UnitedHealthcare Community & State	$36.81
Rate for Payer: Wellpoint Medicaid Managed Care	$40.48

CANN SCREW 6.5MM X 90MM X 16MM

Facility

$1,527.50

Service Code	HCPCS C1713
Hospital Charge Code	270688069
Hospital Revenue Code	278
Min. Negotiated Rate	$36.81
Max. Negotiated Rate	$763.75
Rate for Payer: Aetna Commercial	$580.45
Rate for Payer: Aetna Medicare Advantage	$458.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$389.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$389.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$389.51
Rate for Payer: Cigna Commercial	$763.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$336.05
Rate for Payer: Qualcare PPO/HMO/WC	$229.12
Rate for Payer: UnitedHealthcare Community & State	$36.81
Rate for Payer: Wellpoint Medicaid Managed Care	$40.48

CANN SCREW 6.5MM X 90MM X 16MM

Facility

$1,527.50

Service Code	HCPCS C1713
Hospital Charge Code	270688069
Hospital Revenue Code	278
Min. Negotiated Rate	$229.12
Max. Negotiated Rate	$369.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$336.05
Rate for Payer: Qualcare PPO/HMO/WC	$229.12

CANN SCREW 6.5X70X40MM

Facility

$1,527.50

Service Code	HCPCS C1713
Hospital Charge Code	270684881
Hospital Revenue Code	278
Min. Negotiated Rate	$229.12
Max. Negotiated Rate	$369.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$336.05
Rate for Payer: Qualcare PPO/HMO/WC	$229.12

CANN SCREW 6.5X70X40MM

Facility

$1,527.50

Service Code	HCPCS C1713
Hospital Charge Code	270684881
Hospital Revenue Code	278
Min. Negotiated Rate	$36.81
Max. Negotiated Rate	$763.75
Rate for Payer: Aetna Commercial	$580.45
Rate for Payer: Aetna Medicare Advantage	$458.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$389.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$389.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$389.51
Rate for Payer: Cigna Commercial	$763.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$336.05
Rate for Payer: Qualcare PPO/HMO/WC	$229.12
Rate for Payer: UnitedHealthcare Community & State	$36.81
Rate for Payer: Wellpoint Medicaid Managed Care	$40.48

CANN SCREW 8.0MMX80MMX 14MM

Facility

$2,509.10

Service Code	HCPCS C1713
Hospital Charge Code	270704917
Hospital Revenue Code	278
Min. Negotiated Rate	$60.47
Max. Negotiated Rate	$1,254.55
Rate for Payer: Aetna Commercial	$953.46
Rate for Payer: Aetna Medicare Advantage	$752.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$639.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$639.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$639.82
Rate for Payer: Cigna Commercial	$1,254.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$607.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$552.00
Rate for Payer: Qualcare PPO/HMO/WC	$376.37
Rate for Payer: UnitedHealthcare Community & State	$60.47
Rate for Payer: Wellpoint Medicaid Managed Care	$66.49

CANN SCREW 8.0MMX80MMX 14MM

Facility

$2,509.10

Service Code	HCPCS C1713
Hospital Charge Code	270704917
Hospital Revenue Code	278
Min. Negotiated Rate	$376.37
Max. Negotiated Rate	$607.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$607.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$552.00
Rate for Payer: Qualcare PPO/HMO/WC	$376.37

CANN SCREW FULL THD 6.5X45MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270680498
Hospital Revenue Code	278
Min. Negotiated Rate	$53.02
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$836.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00
Rate for Payer: UnitedHealthcare Community & State	$53.02
Rate for Payer: Wellpoint Medicaid Managed Care	$58.30

CANN SCREW FULL THD 6.5X45MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270680498
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

CANN SCREW FULL THD 6.5X50MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270680497
Hospital Revenue Code	278
Min. Negotiated Rate	$53.02
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$836.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00
Rate for Payer: UnitedHealthcare Community & State	$53.02
Rate for Payer: Wellpoint Medicaid Managed Care	$58.30

CANN SCREW FULL THD 6.5X50MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270680497
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

Know your out-of-pocket cost for care.

All Charges