Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CAPS DEPUY 1770.91.060

Facility

$1,388.85

Hospital Charge Code	270629834
Hospital Revenue Code	272
Min. Negotiated Rate	$33.47
Max. Negotiated Rate	$694.42
Rate for Payer: Aetna Commercial	$527.76
Rate for Payer: Aetna Medicare Advantage	$416.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$354.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$354.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$354.16
Rate for Payer: Cigna Commercial	$694.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$416.65
Rate for Payer: Oxford Commercial	$277.77
Rate for Payer: Qualcare PPO/HMO/WC	$208.33
Rate for Payer: UnitedHealthcare Commercial	$277.77
Rate for Payer: UnitedHealthcare Community & State	$33.47
Rate for Payer: Wellpoint Medicaid Managed Care	$36.80

CAPS LOCKING LINEUM

Facility

$1,075.00

Service Code	HCPCS L8699
Hospital Charge Code	270693060
Hospital Revenue Code	278
Min. Negotiated Rate	$25.91
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.50
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$28.49

CAPS LOCKING LINEUM

Facility

$1,075.00

Service Code	HCPCS L8699
Hospital Charge Code	270693060
Hospital Revenue Code	278
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$236.50
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

CAPS SINGLE INNER SETSCREW

Facility

$1,775.00

Hospital Charge Code	270667360
Hospital Revenue Code	278
Min. Negotiated Rate	$42.78
Max. Negotiated Rate	$887.50
Rate for Payer: Aetna Commercial	$674.50
Rate for Payer: Aetna Medicare Advantage	$532.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.62
Rate for Payer: Cigna Commercial	$887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$390.50
Rate for Payer: Qualcare PPO/HMO/WC	$266.25
Rate for Payer: UnitedHealthcare Community & State	$42.78
Rate for Payer: Wellpoint Medicaid Managed Care	$47.04

CAPS SINGLE INNER SETSCREW

Facility

$1,775.00

Hospital Charge Code	270667360
Hospital Revenue Code	278
Min. Negotiated Rate	$266.25
Max. Negotiated Rate	$429.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$390.50
Rate for Payer: Qualcare PPO/HMO/WC	$266.25

CAP SUCTION

Facility

$222.45

Hospital Charge Code	270676863
Hospital Revenue Code	272
Min. Negotiated Rate	$5.36
Max. Negotiated Rate	$111.22
Rate for Payer: Aetna Commercial	$84.53
Rate for Payer: Aetna Medicare Advantage	$66.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.72
Rate for Payer: Cigna Commercial	$111.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.73
Rate for Payer: Oxford Commercial	$44.49
Rate for Payer: Qualcare PPO/HMO/WC	$33.37
Rate for Payer: UnitedHealthcare Commercial	$44.49
Rate for Payer: UnitedHealthcare Community & State	$5.36
Rate for Payer: Wellpoint Medicaid Managed Care	$5.89

CAP SUCTION

Facility

$222.45

Hospital Charge Code	270676863
Hospital Revenue Code	272
Min. Negotiated Rate	$33.37
Max. Negotiated Rate	$33.37
Rate for Payer: Qualcare PPO/HMO/WC	$33.37

CAPSUCTMY W RELS HIP FLEX MSCL

Facility

$1,457.75

Service Code	HCPCS 11402
Hospital Charge Code	16000704
Hospital Revenue Code	360
Min. Negotiated Rate	$218.66
Max. Negotiated Rate	$218.66
Rate for Payer: Qualcare PPO/HMO/WC	$218.66

CAPSUCTMY W RELS HIP FLEX MSCL

Facility

$1,457.75

Service Code	HCPCS 11402
Hospital Charge Code	16000704
Hospital Revenue Code	360
Min. Negotiated Rate	$35.13
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,036.77
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.32
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$218.66
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$35.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$38.63

CAPSULE FM G3

Facility

$3,175.00

Hospital Charge Code	270683733
Hospital Revenue Code	272
Min. Negotiated Rate	$76.52
Max. Negotiated Rate	$1,587.50
Rate for Payer: Aetna Commercial	$1,206.50
Rate for Payer: Aetna Medicare Advantage	$952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$809.62
Rate for Payer: Cigna Commercial	$1,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.50
Rate for Payer: Oxford Commercial	$635.00
Rate for Payer: Qualcare PPO/HMO/WC	$476.25
Rate for Payer: UnitedHealthcare Commercial	$635.00
Rate for Payer: UnitedHealthcare Community & State	$76.52
Rate for Payer: Wellpoint Medicaid Managed Care	$84.14

CAPSULE FM G3

Facility

$3,175.00

Hospital Charge Code	270683733
Hospital Revenue Code	272
Min. Negotiated Rate	$476.25
Max. Negotiated Rate	$476.25
Rate for Payer: Qualcare PPO/HMO/WC	$476.25

CAPSULE POLISHER

Facility

$52.00

Hospital Charge Code	270335190
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

CAPSULE POLISHER

Facility

$52.00

Hospital Charge Code	270335190
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

CAPSULOTOMY; IP JNT SGL EA JOI

Facility

$6,728.28

Service Code	HCPCS 28272
Hospital Charge Code	16000264
Hospital Revenue Code	360
Min. Negotiated Rate	$1,009.24
Max. Negotiated Rate	$1,009.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,009.24

CAPSULOTOMY; IP JNT SGL EA JOI

Facility

$6,728.28

Service Code	HCPCS 28272
Hospital Charge Code	16000264
Hospital Revenue Code	360
Min. Negotiated Rate	$162.15
Max. Negotiated Rate	$8,157.00
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,018.48
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,009.24
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$162.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$178.30

CAPSURE

Facility

$3,150.00

Hospital Charge Code	270685690
Hospital Revenue Code	272
Min. Negotiated Rate	$75.92
Max. Negotiated Rate	$1,575.00
Rate for Payer: Aetna Commercial	$1,197.00
Rate for Payer: Aetna Medicare Advantage	$945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$803.25
Rate for Payer: Cigna Commercial	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$945.00
Rate for Payer: Oxford Commercial	$630.00
Rate for Payer: Qualcare PPO/HMO/WC	$472.50
Rate for Payer: UnitedHealthcare Commercial	$630.00
Rate for Payer: UnitedHealthcare Community & State	$75.92
Rate for Payer: Wellpoint Medicaid Managed Care	$83.47

CAPSURE

Facility

$3,150.00

Hospital Charge Code	270685690
Hospital Revenue Code	272
Min. Negotiated Rate	$472.50
Max. Negotiated Rate	$472.50
Rate for Payer: Qualcare PPO/HMO/WC	$472.50

CAPSURE FIXATION SYSTEM

Facility

$2,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270686021
Hospital Revenue Code	278
Min. Negotiated Rate	$307.50
Max. Negotiated Rate	$496.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$496.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$451.00
Rate for Payer: Qualcare PPO/HMO/WC	$307.50

CAPSURE FIXATION SYSTEM

Facility

$2,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270686021
Hospital Revenue Code	278
Min. Negotiated Rate	$49.41
Max. Negotiated Rate	$1,025.00
Rate for Payer: Aetna Commercial	$779.00
Rate for Payer: Aetna Medicare Advantage	$615.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$522.75
Rate for Payer: Cigna Commercial	$1,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$496.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$451.00
Rate for Payer: Qualcare PPO/HMO/WC	$307.50
Rate for Payer: UnitedHealthcare Community & State	$49.41
Rate for Payer: Wellpoint Medicaid Managed Care	$54.33

CAP SURGEON BLUE 69196

Facility

$76.48

Hospital Charge Code	270060205C
Hospital Revenue Code	272
Min. Negotiated Rate	$11.47
Max. Negotiated Rate	$11.47
Rate for Payer: Qualcare PPO/HMO/WC	$11.47

CAP SURGEON BLUE 69196

Facility

$76.48

Hospital Charge Code	270060205C
Hospital Revenue Code	272
Min. Negotiated Rate	$1.84
Max. Negotiated Rate	$38.24
Rate for Payer: Aetna Commercial	$29.06
Rate for Payer: Aetna Medicare Advantage	$22.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.50
Rate for Payer: Cigna Commercial	$38.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.94
Rate for Payer: Oxford Commercial	$15.30
Rate for Payer: Qualcare PPO/HMO/WC	$11.47
Rate for Payer: UnitedHealthcare Commercial	$15.30
Rate for Payer: UnitedHealthcare Community & State	$1.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2.03

CAP SURGEON BLUE DISP

Facility

$0.23

Hospital Charge Code	270648968
Hospital Revenue Code	270
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.03
Rate for Payer: Qualcare PPO/HMO/WC	$0.03

CAP SURGEON BLUE DISP

Facility

$0.23

Hospital Charge Code	270648968
Hospital Revenue Code	270
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.12
Rate for Payer: Aetna Commercial	$0.09
Rate for Payer: Aetna Medicare Advantage	$0.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.06
Rate for Payer: Cigna Commercial	$0.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.07
Rate for Payer: Oxford Commercial	$0.05
Rate for Payer: Qualcare PPO/HMO/WC	$0.03
Rate for Payer: UnitedHealthcare Commercial	$0.05
Rate for Payer: UnitedHealthcare Community & State	$0.01
Rate for Payer: Wellpoint Medicaid Managed Care	$0.01

CAP SYN K WIRE PTCT 2.5 392.24

Facility

$11.25

Hospital Charge Code	270601819
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

CAP SYN K WIRE PTCT 2.5 392.24

Facility

$11.25

Hospital Charge Code	270601819
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

Know your out-of-pocket cost for care.

All Charges