Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

COLD HEMAGGLUTINS

Facility

$55.00

Hospital Charge Code	39708012
Hospital Revenue Code	302
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

COLD KNIFE ROUND

Facility

$1,140.00

Hospital Charge Code	270684368
Hospital Revenue Code	272
Min. Negotiated Rate	$27.47
Max. Negotiated Rate	$570.00
Rate for Payer: Aetna Commercial	$433.20
Rate for Payer: Aetna Medicare Advantage	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.70
Rate for Payer: Cigna Commercial	$570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$342.00
Rate for Payer: Oxford Commercial	$228.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.00
Rate for Payer: UnitedHealthcare Commercial	$228.00
Rate for Payer: UnitedHealthcare Community & State	$27.47
Rate for Payer: Wellpoint Medicaid Managed Care	$30.21

COLD KNIFE ROUND

Facility

$1,140.00

Hospital Charge Code	270684368
Hospital Revenue Code	272
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$171.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

COLD KNIFE SACHSE STR

Facility

$1,140.00

Hospital Charge Code	270684366
Hospital Revenue Code	272
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$171.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

COLD KNIFE SACHSE STR

Facility

$1,140.00

Hospital Charge Code	270684366
Hospital Revenue Code	272
Min. Negotiated Rate	$27.47
Max. Negotiated Rate	$570.00
Rate for Payer: Aetna Commercial	$433.20
Rate for Payer: Aetna Medicare Advantage	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.70
Rate for Payer: Cigna Commercial	$570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$342.00
Rate for Payer: Oxford Commercial	$228.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.00
Rate for Payer: UnitedHealthcare Commercial	$228.00
Rate for Payer: UnitedHealthcare Community & State	$27.47
Rate for Payer: Wellpoint Medicaid Managed Care	$30.21

COLD PACK PERINEAL KWIK KOL

Facility

$3.02

Hospital Charge Code	270642518
Hospital Revenue Code	270
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

COLD PACK PERINEAL KWIK KOL

Facility

$3.02

Hospital Charge Code	270642518
Hospital Revenue Code	270
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.51
Rate for Payer: Aetna Commercial	$1.15
Rate for Payer: Aetna Medicare Advantage	$0.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.91
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

COLD THERAPY UNIT ICEMAN CLEAR

Facility

$725.00

Hospital Charge Code	270678392
Hospital Revenue Code	270
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$108.75
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

COLD THERAPY UNIT ICEMAN CLEAR

Facility

$725.00

Hospital Charge Code	270678392
Hospital Revenue Code	270
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.50
Rate for Payer: Oxford Commercial	$145.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Commercial	$145.00
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

COLECTMY P W RESECT/MUCOFISTLA

Facility

$28,649.20

Service Code	HCPCS 44141
Hospital Charge Code	1600000444
Hospital Revenue Code	360
Min. Negotiated Rate	$690.45
Max. Negotiated Rate	$14,324.60
Rate for Payer: Aetna Commercial	$10,886.70
Rate for Payer: Aetna Medicare Advantage	$8,594.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,305.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,305.55
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	$7,305.55
Rate for Payer: Cigna Commercial	$14,324.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,594.76
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,297.38
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$690.45
Rate for Payer: Wellpoint Medicaid Managed Care	$759.20

COLECTMY P W RESECT/MUCOFISTLA

Facility

$28,649.20

Service Code	HCPCS 44141
Hospital Charge Code	1600000444
Hospital Revenue Code	360
Min. Negotiated Rate	$4,297.38
Max. Negotiated Rate	$4,297.38
Rate for Payer: Qualcare PPO/HMO/WC	$4,297.38

COLECTMY P,W RESECT/MUCOFISTLA

Facility

$21,300.62

Service Code	HCPCS 44144
Hospital Charge Code	1600000849
Hospital Revenue Code	360
Min. Negotiated Rate	$513.34
Max. Negotiated Rate	$10,650.31
Rate for Payer: Aetna Commercial	$8,094.24
Rate for Payer: Aetna Medicare Advantage	$6,390.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,431.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,431.66
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	$5,431.66
Rate for Payer: Cigna Commercial	$10,650.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,390.19
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,195.09
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$513.34
Rate for Payer: Wellpoint Medicaid Managed Care	$564.47

COLECTMY P,W RESECT/MUCOFISTLA

Facility

$21,300.62

Service Code	HCPCS 44144
Hospital Charge Code	1600000849
Hospital Revenue Code	360
Min. Negotiated Rate	$3,195.09
Max. Negotiated Rate	$3,195.09
Rate for Payer: Qualcare PPO/HMO/WC	$3,195.09

COLECTOMY PARTIAL,W ANASTOMOSI

Facility

$14,894.10

Service Code	HCPCS 44140
Hospital Charge Code	16000642
Hospital Revenue Code	360
Min. Negotiated Rate	$2,234.11
Max. Negotiated Rate	$2,234.11
Rate for Payer: Qualcare PPO/HMO/WC	$2,234.11

COLECTOMY PARTIAL,W ANASTOMOSI

Facility

$14,894.10

Service Code	HCPCS 44140
Hospital Charge Code	16000642
Hospital Revenue Code	360
Min. Negotiated Rate	$358.95
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$5,659.76
Rate for Payer: Aetna Medicare Advantage	$4,468.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,798.00
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	$3,798.00
Rate for Payer: Cigna Commercial	$7,447.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,468.23
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,234.11
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$358.95
Rate for Payer: Wellpoint Medicaid Managed Care	$394.69

COLISTIMETHATE 150 MG REC

Facility

$381.90

Service Code	HCPCS J0770
Hospital Charge Code	60629961
Hospital Revenue Code	636
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$190.95
Rate for Payer: Aetna Commercial	$145.12
Rate for Payer: Aetna Medicare Advantage	$114.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.38
Rate for Payer: Cigna Commercial	$190.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.42
Rate for Payer: Qualcare PPO/HMO/WC	$57.28
Rate for Payer: UnitedHealthcare Community & State	$9.20
Rate for Payer: Wellpoint Medicaid Managed Care	$10.12

COLISTIMETHATE 150 MG REC

Facility

$381.90

Service Code	HCPCS J0770
Hospital Charge Code	60629961
Hospital Revenue Code	636
Min. Negotiated Rate	$57.28
Max. Negotiated Rate	$92.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.42
Rate for Payer: Qualcare PPO/HMO/WC	$57.28

COLISTIN INJ 150MG

Facility

$37.00

Hospital Charge Code	60635473
Hospital Revenue Code	636
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$18.50
Rate for Payer: Aetna Commercial	$14.06
Rate for Payer: Aetna Medicare Advantage	$11.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.44
Rate for Payer: Cigna Commercial	$18.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.95
Rate for Payer: Qualcare PPO/HMO/WC	$5.55
Rate for Payer: UnitedHealthcare Community & State	$0.89
Rate for Payer: Wellpoint Medicaid Managed Care	$0.98

COLISTIN INJ 150MG

Facility

$37.00

Hospital Charge Code	60635473
Hospital Revenue Code	636
Min. Negotiated Rate	$5.55
Max. Negotiated Rate	$8.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.95
Rate for Payer: Qualcare PPO/HMO/WC	$5.55

COLLAGEN ABSORB SPONGE 3X4

Facility

$379.55

Hospital Charge Code	6006365
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$189.78
Rate for Payer: Aetna Commercial	$144.23
Rate for Payer: Aetna Medicare Advantage	$113.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.79
Rate for Payer: Cigna Commercial	$189.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.86
Rate for Payer: Oxford Commercial	$75.91
Rate for Payer: Qualcare PPO/HMO/WC	$56.93
Rate for Payer: UnitedHealthcare Commercial	$75.91
Rate for Payer: UnitedHealthcare Community & State	$9.15
Rate for Payer: Wellpoint Medicaid Managed Care	$10.06

COLLAGEN ABSORB SPONGE 3X4

Facility

$379.55

Hospital Charge Code	6006365
Hospital Revenue Code	250
Min. Negotiated Rate	$56.93
Max. Negotiated Rate	$56.93
Rate for Payer: Qualcare PPO/HMO/WC	$56.93

COLLAGENASE 30GM

Facility

$367.95

Hospital Charge Code	60630082W
Hospital Revenue Code	250
Min. Negotiated Rate	$55.19
Max. Negotiated Rate	$55.19
Rate for Payer: Qualcare PPO/HMO/WC	$55.19

COLLAGENASE 30GM

Facility

$367.95

Hospital Charge Code	60630082W
Hospital Revenue Code	250
Min. Negotiated Rate	$8.87
Max. Negotiated Rate	$183.97
Rate for Payer: Aetna Commercial	$139.82
Rate for Payer: Aetna Medicare Advantage	$110.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.83
Rate for Payer: Cigna Commercial	$183.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.39
Rate for Payer: Oxford Commercial	$73.59
Rate for Payer: Qualcare PPO/HMO/WC	$55.19
Rate for Payer: UnitedHealthcare Commercial	$73.59
Rate for Payer: UnitedHealthcare Community & State	$8.87
Rate for Payer: Wellpoint Medicaid Managed Care	$9.75

COLLAGENASE OINT 15GM

Facility

$226.45

Hospital Charge Code	60628877
Hospital Revenue Code	250
Min. Negotiated Rate	$33.97
Max. Negotiated Rate	$33.97
Rate for Payer: Qualcare PPO/HMO/WC	$33.97

COLLAGENASE OINT 15GM

Facility

$226.45

Hospital Charge Code	60628877
Hospital Revenue Code	250
Min. Negotiated Rate	$5.46
Max. Negotiated Rate	$113.22
Rate for Payer: Aetna Commercial	$86.05
Rate for Payer: Aetna Medicare Advantage	$67.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.74
Rate for Payer: Cigna Commercial	$113.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.94
Rate for Payer: Oxford Commercial	$45.29
Rate for Payer: Qualcare PPO/HMO/WC	$33.97
Rate for Payer: UnitedHealthcare Commercial	$45.29
Rate for Payer: UnitedHealthcare Community & State	$5.46
Rate for Payer: Wellpoint Medicaid Managed Care	$6.00

Know your out-of-pocket cost for care.

All Charges