Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CIRCUIT ANESTHESIA BREATHING

Facility

$15.25

Hospital Charge Code	270658116
Hospital Revenue Code	270
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$2.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.29

CIRCUIT ANESTHESIA BREATHING

Facility

$15.25

Hospital Charge Code	270658116
Hospital Revenue Code	270
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$7.62
Rate for Payer: Aetna Commercial	$5.79
Rate for Payer: Aetna Medicare Advantage	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.89
Rate for Payer: Cigna Commercial	$7.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.58
Rate for Payer: Oxford Commercial	$3.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.29
Rate for Payer: UnitedHealthcare Commercial	$3.05
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

CIRCUIT ANESTHESIA PEDS

Facility

$14.38

Hospital Charge Code	270649970
Hospital Revenue Code	272
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$7.19
Rate for Payer: Aetna Commercial	$5.46
Rate for Payer: Aetna Medicare Advantage	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.67
Rate for Payer: Cigna Commercial	$7.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.31
Rate for Payer: Oxford Commercial	$2.88
Rate for Payer: Qualcare PPO/HMO/WC	$2.16
Rate for Payer: UnitedHealthcare Commercial	$2.88
Rate for Payer: UnitedHealthcare Community & State	$0.35
Rate for Payer: Wellpoint Medicaid Managed Care	$0.38

CIRCUIT ANESTHESIA PEDS

Facility

$14.38

Hospital Charge Code	270649970
Hospital Revenue Code	272
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.16
Rate for Payer: Qualcare PPO/HMO/WC	$2.16

CIRCUIT ANESTHESIA XLG 8667

Facility

$43.25

Hospital Charge Code	270600870
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.62
Rate for Payer: Aetna Commercial	$16.43
Rate for Payer: Aetna Medicare Advantage	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.97
Rate for Payer: Oxford Commercial	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$8.65
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

CIRCUIT ANESTHESIA XLG 8667

Facility

$43.25

Hospital Charge Code	270600870
Hospital Revenue Code	272
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

CIRCUIT BREATHING COAXIAL

Facility

$38.59

Hospital Charge Code	270651820
Hospital Revenue Code	272
Min. Negotiated Rate	$5.79
Max. Negotiated Rate	$5.79
Rate for Payer: Qualcare PPO/HMO/WC	$5.79

CIRCUIT BREATHING COAXIAL

Facility

$38.59

Hospital Charge Code	270651820
Hospital Revenue Code	272
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$19.30
Rate for Payer: Aetna Commercial	$14.66
Rate for Payer: Aetna Medicare Advantage	$11.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.84
Rate for Payer: Cigna Commercial	$19.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.58
Rate for Payer: Oxford Commercial	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$5.79
Rate for Payer: UnitedHealthcare Commercial	$7.72
Rate for Payer: UnitedHealthcare Community & State	$0.93
Rate for Payer: Wellpoint Medicaid Managed Care	$1.02

CIRCUIT BREATHING DUAL HEATED

Facility

$135.63

Hospital Charge Code	270688978
Hospital Revenue Code	272
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$67.81
Rate for Payer: Aetna Commercial	$51.54
Rate for Payer: Aetna Medicare Advantage	$40.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.59
Rate for Payer: Cigna Commercial	$67.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.69
Rate for Payer: Oxford Commercial	$27.13
Rate for Payer: Qualcare PPO/HMO/WC	$20.34
Rate for Payer: UnitedHealthcare Commercial	$27.13
Rate for Payer: UnitedHealthcare Community & State	$3.27
Rate for Payer: Wellpoint Medicaid Managed Care	$3.59

CIRCUIT BREATHING DUAL HEATED

Facility

$135.63

Hospital Charge Code	270688978
Hospital Revenue Code	272
Min. Negotiated Rate	$20.34
Max. Negotiated Rate	$20.34
Rate for Payer: Qualcare PPO/HMO/WC	$20.34

CIRCUIT BREATHING SNG LIMB 72

Facility

$91.30

Hospital Charge Code	270669514
Hospital Revenue Code	272
Min. Negotiated Rate	$2.20
Max. Negotiated Rate	$45.65
Rate for Payer: Aetna Commercial	$34.69
Rate for Payer: Aetna Medicare Advantage	$27.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.28
Rate for Payer: Cigna Commercial	$45.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.39
Rate for Payer: Oxford Commercial	$18.26
Rate for Payer: Qualcare PPO/HMO/WC	$13.70
Rate for Payer: UnitedHealthcare Commercial	$18.26
Rate for Payer: UnitedHealthcare Community & State	$2.20
Rate for Payer: Wellpoint Medicaid Managed Care	$2.42

CIRCUIT BREATHING SNG LIMB 72

Facility

$91.30

Hospital Charge Code	270669514
Hospital Revenue Code	272
Min. Negotiated Rate	$13.70
Max. Negotiated Rate	$13.70
Rate for Payer: Qualcare PPO/HMO/WC	$13.70

CIRCUIT BREATH PED 1L BAG 5101

Facility

$71.25

Hospital Charge Code	270600873
Hospital Revenue Code	272
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$35.62
Rate for Payer: Aetna Commercial	$27.07
Rate for Payer: Aetna Medicare Advantage	$21.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.17
Rate for Payer: Cigna Commercial	$35.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.38
Rate for Payer: Oxford Commercial	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
Rate for Payer: UnitedHealthcare Commercial	$14.25
Rate for Payer: UnitedHealthcare Community & State	$1.72
Rate for Payer: Wellpoint Medicaid Managed Care	$1.89

CIRCUIT BREATH PED 1L BAG 5101

Facility

$71.25

Hospital Charge Code	270600873
Hospital Revenue Code	272
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$10.69
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

CIRCUIT DISP CPAP 72IN 21953

Facility

$32.50

Hospital Charge Code	270638052
Hospital Revenue Code	272
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$4.88
Rate for Payer: Qualcare PPO/HMO/WC	$4.88

CIRCUIT DISP CPAP 72IN 21953

Facility

$32.50

Hospital Charge Code	270638052
Hospital Revenue Code	272
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$16.25
Rate for Payer: Aetna Commercial	$12.35
Rate for Payer: Aetna Medicare Advantage	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.29
Rate for Payer: Cigna Commercial	$16.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.88
Rate for Payer: UnitedHealthcare Commercial	$6.50
Rate for Payer: UnitedHealthcare Community & State	$0.78
Rate for Payer: Wellpoint Medicaid Managed Care	$0.86

CIRCUIT DUAL 90 IN HME FILTER

Facility

$34.50

Hospital Charge Code	270689034
Hospital Revenue Code	272
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$17.25
Rate for Payer: Aetna Commercial	$13.11
Rate for Payer: Aetna Medicare Advantage	$10.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.80
Rate for Payer: Cigna Commercial	$17.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.35
Rate for Payer: Oxford Commercial	$6.90
Rate for Payer: Qualcare PPO/HMO/WC	$5.17
Rate for Payer: UnitedHealthcare Commercial	$6.90
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.91

CIRCUIT DUAL 90 IN HME FILTER

Facility

$34.50

Hospital Charge Code	270689034
Hospital Revenue Code	272
Min. Negotiated Rate	$5.17
Max. Negotiated Rate	$5.17
Rate for Payer: Qualcare PPO/HMO/WC	$5.17

CIRCUIT FLIGHT 60

Facility

$188.70

Hospital Charge Code	270691055
Hospital Revenue Code	270
Min. Negotiated Rate	$28.30
Max. Negotiated Rate	$28.30
Rate for Payer: Qualcare PPO/HMO/WC	$28.30

CIRCUIT FLIGHT 60

Facility

$188.70

Hospital Charge Code	270691055
Hospital Revenue Code	270
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$94.35
Rate for Payer: Aetna Commercial	$71.71
Rate for Payer: Aetna Medicare Advantage	$56.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.12
Rate for Payer: Cigna Commercial	$94.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.61
Rate for Payer: Oxford Commercial	$37.74
Rate for Payer: Qualcare PPO/HMO/WC	$28.30
Rate for Payer: UnitedHealthcare Commercial	$37.74
Rate for Payer: UnitedHealthcare Community & State	$4.55
Rate for Payer: Wellpoint Medicaid Managed Care	$5.00

CIRCUIT HEATED F/VENTILATOR

Facility

$96.07

Hospital Charge Code	270643694
Hospital Revenue Code	272
Min. Negotiated Rate	$14.41
Max. Negotiated Rate	$14.41
Rate for Payer: Qualcare PPO/HMO/WC	$14.41

CIRCUIT HEATED F/VENTILATOR

Facility

$96.07

Hospital Charge Code	270643694
Hospital Revenue Code	272
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$48.03
Rate for Payer: Aetna Commercial	$36.51
Rate for Payer: Aetna Medicare Advantage	$28.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.50
Rate for Payer: Cigna Commercial	$48.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.82
Rate for Payer: Oxford Commercial	$19.21
Rate for Payer: Qualcare PPO/HMO/WC	$14.41
Rate for Payer: UnitedHealthcare Commercial	$19.21
Rate for Payer: UnitedHealthcare Community & State	$2.32
Rate for Payer: Wellpoint Medicaid Managed Care	$2.55

CIRCUIT HEATED F/VENTILATOR

Facility

$76.85

Hospital Charge Code	700643694
Hospital Revenue Code	272
Min. Negotiated Rate	$11.53
Max. Negotiated Rate	$11.53
Rate for Payer: Qualcare PPO/HMO/WC	$11.53

CIRCUIT HEATED F/VENTILATOR

Facility

$76.85

Hospital Charge Code	700643694
Hospital Revenue Code	272
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$38.42
Rate for Payer: Aetna Commercial	$29.20
Rate for Payer: Aetna Medicare Advantage	$23.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.60
Rate for Payer: Cigna Commercial	$38.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.05
Rate for Payer: Oxford Commercial	$15.37
Rate for Payer: Qualcare PPO/HMO/WC	$11.53
Rate for Payer: UnitedHealthcare Commercial	$15.37
Rate for Payer: UnitedHealthcare Community & State	$1.85
Rate for Payer: Wellpoint Medicaid Managed Care	$2.04

CIRCUIT IPPB***

Facility

$110.00

Service Code	HCPCS 94650
Hospital Charge Code	9500018
Hospital Revenue Code	419
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.00
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

Know your out-of-pocket cost for care.

All Charges