Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ACCUSTICK II INTRODUCER SYSTEM

Facility

$336.70

Hospital Charge Code	2709001642
Hospital Revenue Code	272
Min. Negotiated Rate	$8.11
Max. Negotiated Rate	$168.35
Rate for Payer: Aetna Commercial	$127.95
Rate for Payer: Aetna Medicare Advantage	$101.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.86
Rate for Payer: Cigna Commercial	$168.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.01
Rate for Payer: Oxford Commercial	$67.34
Rate for Payer: Qualcare PPO/HMO/WC	$50.51
Rate for Payer: UnitedHealthcare Commercial	$67.34
Rate for Payer: UnitedHealthcare Community & State	$8.11
Rate for Payer: Wellpoint Medicaid Managed Care	$8.92

ACCUSTICK SYSTEM INTRODUCER II

Facility

$466.25

Service Code	HCPCS C1894
Hospital Charge Code	270664200
Hospital Revenue Code	278
Min. Negotiated Rate	$69.94
Max. Negotiated Rate	$112.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$102.58
Rate for Payer: Qualcare PPO/HMO/WC	$69.94

ACCUSTICK SYSTEM INTRODUCER II

Facility

$466.25

Service Code	HCPCS C1894
Hospital Charge Code	270664200
Hospital Revenue Code	278
Min. Negotiated Rate	$11.24
Max. Negotiated Rate	$233.12
Rate for Payer: Aetna Commercial	$177.18
Rate for Payer: Aetna Medicare Advantage	$139.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.89
Rate for Payer: Cigna Commercial	$233.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$102.58
Rate for Payer: Qualcare PPO/HMO/WC	$69.94
Rate for Payer: UnitedHealthcare Community & State	$11.24
Rate for Payer: Wellpoint Medicaid Managed Care	$12.36

ACCUTYPE IL28B

Facility

$1,499.85

Service Code	HCPCS 81400
Hospital Charge Code	39900025
Hospital Revenue Code	310
Min. Negotiated Rate	$224.98
Max. Negotiated Rate	$224.98
Rate for Payer: Qualcare PPO/HMO/WC	$224.98

ACCUTYPE IL28B

Facility

$1,499.85

Service Code	HCPCS 81400
Hospital Charge Code	39900025
Hospital Revenue Code	310
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$749.92
Rate for Payer: Aetna Commercial	$173.97
Rate for Payer: Aetna Medicare Advantage	$207.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$63.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.88
Rate for Payer: Cigna Commercial	$749.92
Rate for Payer: Cigna Medicare Advantage	$63.96
Rate for Payer: Clover Medicare Advantage	$60.76
Rate for Payer: EmblemHealth Commercial	$191.88
Rate for Payer: Humana Medicare Advantage	$65.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$63.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$449.95
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$224.98
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$51.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$63.96
Rate for Payer: Wellcare Medicare Advantage	$63.96
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

ACCUVISION 18MM

Facility

$2,735.00

Hospital Charge Code	270656640
Hospital Revenue Code	278
Min. Negotiated Rate	$65.91
Max. Negotiated Rate	$1,367.50
Rate for Payer: Aetna Commercial	$1,039.30
Rate for Payer: Aetna Medicare Advantage	$820.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$697.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$697.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$547.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$697.42
Rate for Payer: Cigna Commercial	$1,367.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$661.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$601.70
Rate for Payer: Qualcare PPO/HMO/WC	$410.25
Rate for Payer: UnitedHealthcare Community & State	$65.91
Rate for Payer: Wellpoint Medicaid Managed Care	$72.48

ACCUVISION 18MM

Facility

$2,735.00

Hospital Charge Code	270656640
Hospital Revenue Code	278
Min. Negotiated Rate	$410.25
Max. Negotiated Rate	$661.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$547.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$661.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$601.70
Rate for Payer: Qualcare PPO/HMO/WC	$410.25

ACCUVISION ILLUMINATED 25MM

Facility

$3,340.00

Hospital Charge Code	270656641
Hospital Revenue Code	278
Min. Negotiated Rate	$80.49
Max. Negotiated Rate	$1,670.00
Rate for Payer: Aetna Commercial	$1,269.20
Rate for Payer: Aetna Medicare Advantage	$1,002.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$851.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$851.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$668.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$851.70
Rate for Payer: Cigna Commercial	$1,670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$808.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$734.80
Rate for Payer: Qualcare PPO/HMO/WC	$501.00
Rate for Payer: UnitedHealthcare Community & State	$80.49
Rate for Payer: Wellpoint Medicaid Managed Care	$88.51

ACCUVISION ILLUMINATED 25MM

Facility

$3,340.00

Hospital Charge Code	270656641
Hospital Revenue Code	278
Min. Negotiated Rate	$501.00
Max. Negotiated Rate	$808.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$668.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$808.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$734.80
Rate for Payer: Qualcare PPO/HMO/WC	$501.00

ACCUZME OINT

Facility

$155.00

Hospital Charge Code	60635292
Hospital Revenue Code	250
Min. Negotiated Rate	$3.74
Max. Negotiated Rate	$77.50
Rate for Payer: Aetna Commercial	$58.90
Rate for Payer: Aetna Medicare Advantage	$46.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.52
Rate for Payer: Cigna Commercial	$77.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.50
Rate for Payer: Oxford Commercial	$31.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.25
Rate for Payer: UnitedHealthcare Commercial	$31.00
Rate for Payer: UnitedHealthcare Community & State	$3.74
Rate for Payer: Wellpoint Medicaid Managed Care	$4.11

ACCUZME OINT

Facility

$155.00

Hospital Charge Code	60635292
Hospital Revenue Code	250
Min. Negotiated Rate	$23.25
Max. Negotiated Rate	$23.25
Rate for Payer: Qualcare PPO/HMO/WC	$23.25

ACD FORMULA A 500ML INJ

Facility

$41.60

Hospital Charge Code	60628958
Hospital Revenue Code	250
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$20.80
Rate for Payer: Aetna Commercial	$15.81
Rate for Payer: Aetna Medicare Advantage	$12.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.61
Rate for Payer: Cigna Commercial	$20.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.48
Rate for Payer: Oxford Commercial	$8.32
Rate for Payer: Qualcare PPO/HMO/WC	$6.24
Rate for Payer: UnitedHealthcare Commercial	$8.32
Rate for Payer: UnitedHealthcare Community & State	$1.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1.10

ACD FORMULA A 500ML INJ

Facility

$41.60

Hospital Charge Code	60628958
Hospital Revenue Code	250
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$6.24
Rate for Payer: Qualcare PPO/HMO/WC	$6.24

ACDF SCREW 3.5X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705433
Hospital Revenue Code	278
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

ACDF SCREW 3.5X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705433
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

ACDF STANDALONE 14X12X7MM

Facility

$20,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270703787
Hospital Revenue Code	278
Min. Negotiated Rate	$497.67
Max. Negotiated Rate	$10,325.00
Rate for Payer: Aetna Commercial	$7,847.00
Rate for Payer: Aetna Medicare Advantage	$6,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,265.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,265.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,265.75
Rate for Payer: Cigna Commercial	$10,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,997.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,543.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,097.50
Rate for Payer: UnitedHealthcare Community & State	$497.67
Rate for Payer: Wellpoint Medicaid Managed Care	$547.23

ACDF STANDALONE 14X12X7MM

Facility

$20,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270703787
Hospital Revenue Code	278
Min. Negotiated Rate	$3,097.50
Max. Negotiated Rate	$4,997.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,997.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,543.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,097.50

ACDF STANDALONE 14X12X8MM

Facility

$20,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270703788
Hospital Revenue Code	278
Min. Negotiated Rate	$497.67
Max. Negotiated Rate	$10,325.00
Rate for Payer: Aetna Commercial	$7,847.00
Rate for Payer: Aetna Medicare Advantage	$6,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,265.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,265.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,265.75
Rate for Payer: Cigna Commercial	$10,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,997.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,543.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,097.50
Rate for Payer: UnitedHealthcare Community & State	$497.67
Rate for Payer: Wellpoint Medicaid Managed Care	$547.23

ACDF STANDALONE 14X12X8MM

Facility

$20,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270703788
Hospital Revenue Code	278
Min. Negotiated Rate	$3,097.50
Max. Negotiated Rate	$4,997.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,997.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,543.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,097.50

ACE 12A BLADE

Facility

$79.50

Hospital Charge Code	270664809
Hospital Revenue Code	270
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$11.93
Rate for Payer: Qualcare PPO/HMO/WC	$11.93

ACE 12A BLADE

Facility

$79.50

Hospital Charge Code	270664809
Hospital Revenue Code	270
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$39.75
Rate for Payer: Aetna Commercial	$30.21
Rate for Payer: Aetna Medicare Advantage	$23.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.27
Rate for Payer: Cigna Commercial	$39.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.85
Rate for Payer: Oxford Commercial	$15.90
Rate for Payer: Qualcare PPO/HMO/WC	$11.93
Rate for Payer: UnitedHealthcare Commercial	$15.90
Rate for Payer: UnitedHealthcare Community & State	$1.92
Rate for Payer: Wellpoint Medicaid Managed Care	$2.11

Ace64 Kit

Facility

$13,975.00

Hospital Charge Code	270682964S
Hospital Revenue Code	272
Min. Negotiated Rate	$336.80
Max. Negotiated Rate	$6,987.50
Rate for Payer: Aetna Commercial	$5,310.50
Rate for Payer: Aetna Medicare Advantage	$4,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,563.62
Rate for Payer: Cigna Commercial	$6,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,192.50
Rate for Payer: Oxford Commercial	$2,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25
Rate for Payer: UnitedHealthcare Commercial	$2,795.00
Rate for Payer: UnitedHealthcare Community & State	$336.80
Rate for Payer: Wellpoint Medicaid Managed Care	$370.34

Ace64 Kit

Facility

$13,975.00

Hospital Charge Code	270682964S
Hospital Revenue Code	272
Min. Negotiated Rate	$2,096.25
Max. Negotiated Rate	$2,096.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25

ACE 64 KIT

Facility

$13,975.00

Hospital Charge Code	270682964N
Hospital Revenue Code	272
Min. Negotiated Rate	$336.80
Max. Negotiated Rate	$6,987.50
Rate for Payer: Aetna Commercial	$5,310.50
Rate for Payer: Aetna Medicare Advantage	$4,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,563.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,563.62
Rate for Payer: Cigna Commercial	$6,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,192.50
Rate for Payer: Oxford Commercial	$2,795.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25
Rate for Payer: UnitedHealthcare Commercial	$2,795.00
Rate for Payer: UnitedHealthcare Community & State	$336.80
Rate for Payer: Wellpoint Medicaid Managed Care	$370.34

ACE 64 KIT

Facility

$13,975.00

Hospital Charge Code	270682964N
Hospital Revenue Code	272
Min. Negotiated Rate	$2,096.25
Max. Negotiated Rate	$2,096.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,096.25

Know your out-of-pocket cost for care.

All Charges