Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

COBAN MULTICOLOR 3 1583A

Facility

$22.45

Hospital Charge Code	270600367
Hospital Revenue Code	270
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

COBAN MULTICOLOR 3 1583A

Facility

$22.45

Hospital Charge Code	270600367
Hospital Revenue Code	270
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$8.53
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.74
Rate for Payer: Oxford Commercial	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$4.49
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

COBAN NEON UNSTER 1583N

Facility

$32.00

Hospital Charge Code	270600366
Hospital Revenue Code	270
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$6.40
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

COBAN NEON UNSTER 1583N

Facility

$32.00

Hospital Charge Code	270600366
Hospital Revenue Code	270
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

COBAN SELF ADHERE WRAP RAINBOW

Facility

$5.83

Hospital Charge Code	270657861
Hospital Revenue Code	270
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$0.87
Rate for Payer: Qualcare PPO/HMO/WC	$0.87

COBAN SELF ADHERE WRAP RAINBOW

Facility

$5.83

Hospital Charge Code	270657861
Hospital Revenue Code	270
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.92
Rate for Payer: Aetna Commercial	$2.22
Rate for Payer: Aetna Medicare Advantage	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.49
Rate for Payer: Cigna Commercial	$2.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.75
Rate for Payer: Oxford Commercial	$1.17
Rate for Payer: Qualcare PPO/HMO/WC	$0.87
Rate for Payer: UnitedHealthcare Commercial	$1.17
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

COBAN WRAP SELF ADEHERENT 1

Facility

$2.23

Hospital Charge Code	270651845
Hospital Revenue Code	270
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.33
Rate for Payer: Qualcare PPO/HMO/WC	$0.33

COBAN WRAP SELF ADEHERENT 1

Facility

$2.23

Hospital Charge Code	270651845
Hospital Revenue Code	270
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$1.11
Rate for Payer: Aetna Commercial	$0.85
Rate for Payer: Aetna Medicare Advantage	$0.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.57
Rate for Payer: Cigna Commercial	$1.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.67
Rate for Payer: Oxford Commercial	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.33
Rate for Payer: UnitedHealthcare Commercial	$0.45
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

COBLATION HALO WAND

Facility

$1,786.10

Hospital Charge Code	270698007
Hospital Revenue Code	272
Min. Negotiated Rate	$43.05
Max. Negotiated Rate	$893.05
Rate for Payer: Aetna Commercial	$678.72
Rate for Payer: Aetna Medicare Advantage	$535.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$455.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$455.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$455.46
Rate for Payer: Cigna Commercial	$893.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$535.83
Rate for Payer: Oxford Commercial	$357.22
Rate for Payer: Qualcare PPO/HMO/WC	$267.92
Rate for Payer: UnitedHealthcare Commercial	$357.22
Rate for Payer: UnitedHealthcare Community & State	$43.05
Rate for Payer: Wellpoint Medicaid Managed Care	$47.33

COBLATION HALO WAND

Facility

$1,786.10

Hospital Charge Code	270698007
Hospital Revenue Code	272
Min. Negotiated Rate	$267.92
Max. Negotiated Rate	$267.92
Rate for Payer: Qualcare PPO/HMO/WC	$267.92

COBLATOR II

Facility

$7,500.00

Hospital Charge Code	270655384
Hospital Revenue Code	270
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

COBLATOR II

Facility

$7,500.00

Hospital Charge Code	270655384
Hospital Revenue Code	270
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,250.00
Rate for Payer: Oxford Commercial	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Commercial	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$180.75
Rate for Payer: Wellpoint Medicaid Managed Care	$198.75

COBRA GLUIDE CATH 5FR 65cm C1

Facility

$1,266.25

Service Code	HCPCS C1887
Hospital Charge Code	270651872
Hospital Revenue Code	278
Min. Negotiated Rate	$30.52
Max. Negotiated Rate	$633.12
Rate for Payer: Aetna Commercial	$481.18
Rate for Payer: Aetna Medicare Advantage	$379.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$253.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.89
Rate for Payer: Cigna Commercial	$633.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$306.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$278.57
Rate for Payer: Qualcare PPO/HMO/WC	$189.94
Rate for Payer: UnitedHealthcare Community & State	$30.52
Rate for Payer: Wellpoint Medicaid Managed Care	$33.56

COBRA GLUIDE CATH 5FR 65cm C1

Facility

$1,266.25

Service Code	HCPCS C1887
Hospital Charge Code	270651872S
Hospital Revenue Code	278
Min. Negotiated Rate	$189.94
Max. Negotiated Rate	$306.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$253.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$306.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$278.57
Rate for Payer: Qualcare PPO/HMO/WC	$189.94

COBRA GLUIDE CATH 5FR 65cm C1

Facility

$1,266.25

Service Code	HCPCS C1887
Hospital Charge Code	270651872S
Hospital Revenue Code	278
Min. Negotiated Rate	$30.52
Max. Negotiated Rate	$633.12
Rate for Payer: Aetna Commercial	$481.18
Rate for Payer: Aetna Medicare Advantage	$379.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$253.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.89
Rate for Payer: Cigna Commercial	$633.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$306.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$278.57
Rate for Payer: Qualcare PPO/HMO/WC	$189.94
Rate for Payer: UnitedHealthcare Community & State	$30.52
Rate for Payer: Wellpoint Medicaid Managed Care	$33.56

COBRA GLUIDE CATH 5FR 65cm C1

Facility

$1,266.25

Service Code	HCPCS C1887
Hospital Charge Code	270651872
Hospital Revenue Code	278
Min. Negotiated Rate	$189.94
Max. Negotiated Rate	$306.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$253.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$306.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$278.57
Rate for Payer: Qualcare PPO/HMO/WC	$189.94

COBRA GLUIDE CATH 5FR 65cm C1

Facility

$71.50

Service Code	HCPCS C1887
Hospital Charge Code	270651872N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$35.75
Rate for Payer: Aetna Commercial	$27.17
Rate for Payer: Aetna Medicare Advantage	$21.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.23
Rate for Payer: Cigna Commercial	$35.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.73
Rate for Payer: Qualcare PPO/HMO/WC	$10.72
Rate for Payer: UnitedHealthcare Community & State	$1.72
Rate for Payer: Wellpoint Medicaid Managed Care	$1.89

COBRA GLUIDE CATH 5FR 65cm C1

Facility

$71.50

Service Code	HCPCS C1887
Hospital Charge Code	270651872N
Hospital Revenue Code	278
Min. Negotiated Rate	$10.72
Max. Negotiated Rate	$17.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.73
Rate for Payer: Qualcare PPO/HMO/WC	$10.72

COCAINE

Facility

$314.00

Service Code	HCPCS 80353
Hospital Charge Code	38472209
Hospital Revenue Code	301
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$157.00
Rate for Payer: Aetna Commercial	$119.32
Rate for Payer: Aetna Medicare Advantage	$94.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.07
Rate for Payer: Cigna Commercial	$157.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$8.32

COCAINE

Facility

$314.00

Service Code	HCPCS 80353
Hospital Charge Code	38472209
Hospital Revenue Code	301
Min. Negotiated Rate	$47.10
Max. Negotiated Rate	$47.10
Rate for Payer: Qualcare PPO/HMO/WC	$47.10

COCAINE 10%/4ML

Facility

$122.00

Hospital Charge Code	60632722
Hospital Revenue Code	250
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$61.00
Rate for Payer: Aetna Commercial	$46.36
Rate for Payer: Aetna Medicare Advantage	$36.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.11
Rate for Payer: Cigna Commercial	$61.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.60
Rate for Payer: Oxford Commercial	$24.40
Rate for Payer: Qualcare PPO/HMO/WC	$18.30
Rate for Payer: UnitedHealthcare Commercial	$24.40
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: Wellpoint Medicaid Managed Care	$3.23

COCAINE 10%/4ML

Facility

$122.00

Hospital Charge Code	60632722
Hospital Revenue Code	250
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$18.30
Rate for Payer: Qualcare PPO/HMO/WC	$18.30

COCAINE 4% TOP SOLN

Facility

$1,494.70

Service Code	NDC 527172873
Hospital Charge Code	6001333
Hospital Revenue Code	251
Min. Negotiated Rate	$224.21
Max. Negotiated Rate	$224.21
Rate for Payer: Qualcare PPO/HMO/WC	$224.21

COCAINE 4% TOP SOLN

Facility

$1,494.70

Service Code	NDC 527172873
Hospital Charge Code	6001333
Hospital Revenue Code	251
Min. Negotiated Rate	$36.02
Max. Negotiated Rate	$747.35
Rate for Payer: Aetna Commercial	$567.99
Rate for Payer: Aetna Medicare Advantage	$448.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$381.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$381.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$381.15
Rate for Payer: Cigna Commercial	$747.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.41
Rate for Payer: Oxford Commercial	$298.94
Rate for Payer: Qualcare PPO/HMO/WC	$224.21
Rate for Payer: UnitedHealthcare Commercial	$298.94
Rate for Payer: UnitedHealthcare Community & State	$36.02
Rate for Payer: Wellpoint Medicaid Managed Care	$39.61

COCAINE ABUSE AND DEPENDENCE

Facility

$8,926.77

Service Code	APR-DRG 7743
Min. Negotiated Rate	$8,751.74
Max. Negotiated Rate	$8,926.77
Rate for Payer: UnitedHealthcare Community & State	$8,751.74
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,926.77
Rate for Payer: Wellpoint Medicaid Managed Care	$8,751.74

Know your out-of-pocket cost for care.

All Charges