Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

AILERON TRX EXP IMP CORE SMALL

Facility

$15,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697660
Hospital Revenue Code	278
Min. Negotiated Rate	$361.50
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00
Rate for Payer: UnitedHealthcare Community & State	$361.50
Rate for Payer: Wellpoint Medicaid Managed Care	$397.50

AILERON TRX EXP IMP CORE SMALL

Facility

$15,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697660
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

AILERON TRX EXP IMP PLATE MED

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697664
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

AILERON TRX EXP IMP PLATE MED

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697664
Hospital Revenue Code	278
Min. Negotiated Rate	$241.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$241.00
Rate for Payer: Wellpoint Medicaid Managed Care	$265.00

AILERON TRX EXP IMP PLATESMALL

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697661
Hospital Revenue Code	278
Min. Negotiated Rate	$241.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$241.00
Rate for Payer: Wellpoint Medicaid Managed Care	$265.00

AILERON TRX EXP IMP PLATESMALL

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697661
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

AIR INJ. CANNULA 30G

Facility

$101.00

Hospital Charge Code	270332013
Hospital Revenue Code	272
Min. Negotiated Rate	$2.43
Max. Negotiated Rate	$50.50
Rate for Payer: Aetna Commercial	$38.38
Rate for Payer: Aetna Medicare Advantage	$30.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.75
Rate for Payer: Cigna Commercial	$50.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.30
Rate for Payer: Oxford Commercial	$20.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.15
Rate for Payer: UnitedHealthcare Commercial	$20.20
Rate for Payer: UnitedHealthcare Community & State	$2.43
Rate for Payer: Wellpoint Medicaid Managed Care	$2.68

AIR INJ. CANNULA 30G

Facility

$101.00

Hospital Charge Code	270332013
Hospital Revenue Code	272
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$15.15
Rate for Payer: Qualcare PPO/HMO/WC	$15.15

AIRPLANE SPT ************

Facility

$285.00

Hospital Charge Code	8001844
Hospital Revenue Code	279
Min. Negotiated Rate	$42.75
Max. Negotiated Rate	$42.75
Rate for Payer: Qualcare PPO/HMO/WC	$42.75

AIRPLANE SPT ************

Facility

$285.00

Hospital Charge Code	8001844
Hospital Revenue Code	279
Min. Negotiated Rate	$6.87
Max. Negotiated Rate	$142.50
Rate for Payer: Aetna Commercial	$108.30
Rate for Payer: Aetna Medicare Advantage	$85.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.67
Rate for Payer: Cigna Commercial	$142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.50
Rate for Payer: Oxford Commercial	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.75
Rate for Payer: UnitedHealthcare Commercial	$57.00
Rate for Payer: UnitedHealthcare Community & State	$6.87
Rate for Payer: Wellpoint Medicaid Managed Care	$7.55

AIR-RINGS ********

Facility

$33.00

Hospital Charge Code	8000028
Hospital Revenue Code	279
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$12.54
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.90
Rate for Payer: Oxford Commercial	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$6.60
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

AIR-RINGS ********

Facility

$33.00

Hospital Charge Code	8000028
Hospital Revenue Code	279
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

AIRSEAL 5MM ACCESS PORT

Facility

$990.52

Hospital Charge Code	270686723
Hospital Revenue Code	272
Min. Negotiated Rate	$23.87
Max. Negotiated Rate	$495.26
Rate for Payer: Aetna Commercial	$376.40
Rate for Payer: Aetna Medicare Advantage	$297.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.58
Rate for Payer: Cigna Commercial	$495.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$297.16
Rate for Payer: Oxford Commercial	$198.10
Rate for Payer: Qualcare PPO/HMO/WC	$148.58
Rate for Payer: UnitedHealthcare Commercial	$198.10
Rate for Payer: UnitedHealthcare Community & State	$23.87
Rate for Payer: Wellpoint Medicaid Managed Care	$26.25

AIRSEAL 5MM ACCESS PORT

Facility

$990.52

Hospital Charge Code	270686723
Hospital Revenue Code	272
Min. Negotiated Rate	$148.58
Max. Negotiated Rate	$148.58
Rate for Payer: Qualcare PPO/HMO/WC	$148.58

AIR WATER SUCTION AUX KIT

Facility

$1,400.00

Hospital Charge Code	270700165
Hospital Revenue Code	273
Min. Negotiated Rate	$33.74
Max. Negotiated Rate	$700.00
Rate for Payer: Aetna Commercial	$532.00
Rate for Payer: Aetna Medicare Advantage	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.00
Rate for Payer: Cigna Commercial	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00
Rate for Payer: UnitedHealthcare Community & State	$33.74
Rate for Payer: Wellpoint Medicaid Managed Care	$37.10

AIR WATER SUCTION AUX KIT

Facility

$1,400.00

Hospital Charge Code	270700165
Hospital Revenue Code	273
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

AIRWAY BERMAN SMALL CHILD

Facility

$7.11

Hospital Charge Code	270649783
Hospital Revenue Code	270
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.56
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.81
Rate for Payer: Cigna Commercial	$3.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.13
Rate for Payer: Oxford Commercial	$1.42
Rate for Payer: Qualcare PPO/HMO/WC	$1.07
Rate for Payer: UnitedHealthcare Commercial	$1.42
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

AIRWAY BERMAN SMALL CHILD

Facility

$7.11

Hospital Charge Code	270649783
Hospital Revenue Code	270
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$1.07
Rate for Payer: Qualcare PPO/HMO/WC	$1.07

AIRWAY NASAL *******

Facility

$45.00

Hospital Charge Code	8000010
Hospital Revenue Code	279
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.50
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Commercial	$9.00
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

AIRWAY NASAL *******

Facility

$45.00

Hospital Charge Code	8000010
Hospital Revenue Code	279
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

AIRWAY NASAL 30FR

Facility

$16.25

Hospital Charge Code	270638307
Hospital Revenue Code	270
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$8.12
Rate for Payer: Aetna Commercial	$6.17
Rate for Payer: Aetna Medicare Advantage	$4.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.14
Rate for Payer: Cigna Commercial	$8.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.88
Rate for Payer: Oxford Commercial	$3.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.44
Rate for Payer: UnitedHealthcare Commercial	$3.25
Rate for Payer: UnitedHealthcare Community & State	$0.39
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

AIRWAY NASAL 30FR

Facility

$16.25

Hospital Charge Code	270638307
Hospital Revenue Code	270
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$2.44
Rate for Payer: Qualcare PPO/HMO/WC	$2.44

AIRWAY NASAL PVC 20FR

Facility

$27.95

Hospital Charge Code	270676806
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$13.97
Rate for Payer: Aetna Commercial	$10.62
Rate for Payer: Aetna Medicare Advantage	$8.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.13
Rate for Payer: Cigna Commercial	$13.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.38
Rate for Payer: Oxford Commercial	$5.59
Rate for Payer: Qualcare PPO/HMO/WC	$4.19
Rate for Payer: UnitedHealthcare Commercial	$5.59
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

AIRWAY NASAL PVC 20FR

Facility

$27.95

Hospital Charge Code	270676806
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.19

AIRWAY NASAL PVC 22FR

Facility

$27.95

Hospital Charge Code	270676807
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.19

Know your out-of-pocket cost for care.

All Charges