Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CARPAL TUNNEL KNIFE INTEGRA

Facility

$1,097.25

Hospital Charge Code	270690828
Hospital Revenue Code	272
Min. Negotiated Rate	$164.59
Max. Negotiated Rate	$164.59
Rate for Payer: Qualcare PPO/HMO/WC	$164.59

CARPAL TUNNEL TX IN LT

Facility

$2,401.70

Service Code	HCPCS 20526
Hospital Charge Code	16000793
Hospital Revenue Code	360
Min. Negotiated Rate	$57.88
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
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	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.51
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.25
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$57.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$63.65

CARPAL TUNNEL TX IN LT

Facility

$2,401.70

Service Code	HCPCS 20526
Hospital Charge Code	16000793
Hospital Revenue Code	360
Min. Negotiated Rate	$360.25
Max. Negotiated Rate	$360.25
Rate for Payer: Qualcare PPO/HMO/WC	$360.25

CARPECTOMY;ALL BONES PROXIMAL

Facility

$25,274.60

Service Code	HCPCS 25215
Hospital Charge Code	16000831
Hospital Revenue Code	360
Min. Negotiated Rate	$3,791.19
Max. Negotiated Rate	$3,791.19
Rate for Payer: Qualcare PPO/HMO/WC	$3,791.19

CARPECTOMY;ALL BONES PROXIMAL

Facility

$25,274.60

Service Code	HCPCS 25215
Hospital Charge Code	16000831
Hospital Revenue Code	360
Min. Negotiated Rate	$609.12
Max. Negotiated Rate	$100,622.27
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,582.38
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,791.19
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$609.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$100,622.27
Rate for Payer: Wellpoint Medicaid Managed Care	$98,649.28

CARPUJECT CARTRIDGE UNIT

Facility

$0.85

Hospital Charge Code	60629266
Hospital Revenue Code	270
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.13

CARPUJECT CARTRIDGE UNIT

Facility

$0.85

Hospital Charge Code	60629266
Hospital Revenue Code	270
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.43
Rate for Payer: Aetna Commercial	$0.32
Rate for Payer: Aetna Medicare Advantage	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.22
Rate for Payer: Cigna Commercial	$0.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$0.17
Rate for Payer: Qualcare PPO/HMO/WC	$0.13
Rate for Payer: UnitedHealthcare Commercial	$0.17
Rate for Payer: UnitedHealthcare Community & State	$0.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.02

CARRAFOAM 120ML TOP

Facility

$35.85

Hospital Charge Code	6017479
Hospital Revenue Code	250
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$17.93
Rate for Payer: Aetna Commercial	$13.62
Rate for Payer: Aetna Medicare Advantage	$10.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.14
Rate for Payer: Cigna Commercial	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.76
Rate for Payer: Oxford Commercial	$7.17
Rate for Payer: Qualcare PPO/HMO/WC	$5.38
Rate for Payer: UnitedHealthcare Commercial	$7.17
Rate for Payer: UnitedHealthcare Community & State	$0.86
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

CARRAFOAM 120ML TOP

Facility

$35.85

Hospital Charge Code	6017479
Hospital Revenue Code	250
Min. Negotiated Rate	$5.38
Max. Negotiated Rate	$5.38
Rate for Payer: Qualcare PPO/HMO/WC	$5.38

CARRASYN SPRAY GEL TOP 240 ML

Facility

$245.80

Hospital Charge Code	6017461
Hospital Revenue Code	250
Min. Negotiated Rate	$36.87
Max. Negotiated Rate	$36.87
Rate for Payer: Qualcare PPO/HMO/WC	$36.87

CARRASYN SPRAY GEL TOP 240 ML

Facility

$245.80

Hospital Charge Code	6017461
Hospital Revenue Code	250
Min. Negotiated Rate	$5.92
Max. Negotiated Rate	$122.90
Rate for Payer: Aetna Commercial	$93.40
Rate for Payer: Aetna Medicare Advantage	$73.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.68
Rate for Payer: Cigna Commercial	$122.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.74
Rate for Payer: Oxford Commercial	$49.16
Rate for Payer: Qualcare PPO/HMO/WC	$36.87
Rate for Payer: UnitedHealthcare Commercial	$49.16
Rate for Payer: UnitedHealthcare Community & State	$5.92
Rate for Payer: Wellpoint Medicaid Managed Care	$6.51

CARRIER SKIN GRAFT DERM 3.0X1

Facility

$170.45

Service Code	HCPCS C1762
Hospital Charge Code	270600395
Hospital Revenue Code	278
Min. Negotiated Rate	$4.11
Max. Negotiated Rate	$85.22
Rate for Payer: Aetna Commercial	$64.77
Rate for Payer: Aetna Medicare Advantage	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.46
Rate for Payer: Cigna Commercial	$85.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.57
Rate for Payer: UnitedHealthcare Community & State	$4.11
Rate for Payer: Wellpoint Medicaid Managed Care	$4.52

CARRIER SKIN GRAFT DERM 3.0X1

Facility

$170.45

Service Code	HCPCS C1762
Hospital Charge Code	270600395
Hospital Revenue Code	278
Min. Negotiated Rate	$25.57
Max. Negotiated Rate	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.57

CARRISYN SPRAY GEL******

Facility

$103.00

Hospital Charge Code	4800751
Hospital Revenue Code	333
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$6,852.00
Rate for Payer: Aetna Commercial	$39.14
Rate for Payer: Aetna Medicare Advantage	$30.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.27
Rate for Payer: Cigna Commercial	$51.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.90
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.45
Rate for Payer: UnitedHealthcare Commercial	$6,852.00
Rate for Payer: UnitedHealthcare Community & State	$2.48
Rate for Payer: Wellpoint Medicaid Managed Care	$2.73

CARRISYN SPRAY GEL******

Facility

$103.00

Hospital Charge Code	4800751
Hospital Revenue Code	333
Min. Negotiated Rate	$15.45
Max. Negotiated Rate	$15.45
Rate for Payer: Qualcare PPO/HMO/WC	$15.45

CARRY CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8984GP
Hospital Charge Code	84201126
Hospital Revenue Code	429
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

CARRY CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8984GO
Hospital Charge Code	84201144
Hospital Revenue Code	439
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

CARRY CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8984GO
Hospital Charge Code	84201144
Hospital Revenue Code	439
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

CARRY CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8984GP
Hospital Charge Code	84201126
Hospital Revenue Code	429
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

CARRY CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8984GP
Hospital Charge Code	84202030
Hospital Revenue Code	420
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

CARRY CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8984GP
Hospital Charge Code	84202030
Hospital Revenue Code	420
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

CARRY CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8984GO
Hospital Charge Code	74203099
Hospital Revenue Code	430
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

CARRY CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8984GO
Hospital Charge Code	9109136
Hospital Revenue Code	430
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

CARRY CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8984GO
Hospital Charge Code	74203099
Hospital Revenue Code	430
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

CARRY CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8984GO
Hospital Charge Code	9109136
Hospital Revenue Code	430
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

Know your out-of-pocket cost for care.

All Charges