Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DERMABOND

Facility

$129.00

Hospital Charge Code	60635298
Hospital Revenue Code	250
Min. Negotiated Rate	$3.11
Max. Negotiated Rate	$64.50
Rate for Payer: Aetna Commercial	$49.02
Rate for Payer: Aetna Medicare Advantage	$38.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.90
Rate for Payer: Cigna Commercial	$64.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.70
Rate for Payer: Oxford Commercial	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$19.35
Rate for Payer: UnitedHealthcare Commercial	$25.80
Rate for Payer: UnitedHealthcare Community & State	$3.11
Rate for Payer: Wellpoint Medicaid Managed Care	$3.42

DERMABOND ADVANCE

Facility

$185.65

Hospital Charge Code	270653957
Hospital Revenue Code	272
Min. Negotiated Rate	$27.85
Max. Negotiated Rate	$27.85
Rate for Payer: Qualcare PPO/HMO/WC	$27.85

DERMABOND ADVANCE

Facility

$185.65

Hospital Charge Code	270653957
Hospital Revenue Code	272
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$92.83
Rate for Payer: Aetna Commercial	$70.55
Rate for Payer: Aetna Medicare Advantage	$55.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.34
Rate for Payer: Cigna Commercial	$92.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.70
Rate for Payer: Oxford Commercial	$37.13
Rate for Payer: Qualcare PPO/HMO/WC	$27.85
Rate for Payer: UnitedHealthcare Commercial	$37.13
Rate for Payer: UnitedHealthcare Community & State	$4.47
Rate for Payer: Wellpoint Medicaid Managed Care	$4.92

DERMABOND ADV SKIN ADHESIVE

Facility

$90.92

Hospital Charge Code	270653958
Hospital Revenue Code	272
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$45.46
Rate for Payer: Aetna Commercial	$34.55
Rate for Payer: Aetna Medicare Advantage	$27.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.18
Rate for Payer: Cigna Commercial	$45.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.28
Rate for Payer: Oxford Commercial	$18.18
Rate for Payer: Qualcare PPO/HMO/WC	$13.64
Rate for Payer: UnitedHealthcare Commercial	$18.18
Rate for Payer: UnitedHealthcare Community & State	$2.19
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

DERMABOND ADV SKIN ADHESIVE

Facility

$86.59

Hospital Charge Code	270618571
Hospital Revenue Code	272
Min. Negotiated Rate	$12.99
Max. Negotiated Rate	$12.99
Rate for Payer: Qualcare PPO/HMO/WC	$12.99

DERMABOND ADV SKIN ADHESIVE

Facility

$86.59

Hospital Charge Code	270618571
Hospital Revenue Code	272
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$43.30
Rate for Payer: Aetna Commercial	$32.90
Rate for Payer: Aetna Medicare Advantage	$25.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.08
Rate for Payer: Cigna Commercial	$43.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.98
Rate for Payer: Oxford Commercial	$17.32
Rate for Payer: Qualcare PPO/HMO/WC	$12.99
Rate for Payer: UnitedHealthcare Commercial	$17.32
Rate for Payer: UnitedHealthcare Community & State	$2.09
Rate for Payer: Wellpoint Medicaid Managed Care	$2.29

DERMABOND ADV SKIN ADHESIVE

Facility

$90.92

Hospital Charge Code	270653958
Hospital Revenue Code	272
Min. Negotiated Rate	$13.64
Max. Negotiated Rate	$13.64
Rate for Payer: Qualcare PPO/HMO/WC	$13.64

DERMABOND ADV SKIN ADHESIVE

Facility

$92.55

Hospital Charge Code	270618571N
Hospital Revenue Code	272
Min. Negotiated Rate	$13.88
Max. Negotiated Rate	$13.88
Rate for Payer: Qualcare PPO/HMO/WC	$13.88

DERMABOND ADV SKIN ADHESIVE

Facility

$92.55

Hospital Charge Code	270618571N
Hospital Revenue Code	272
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$46.27
Rate for Payer: Aetna Commercial	$35.17
Rate for Payer: Aetna Medicare Advantage	$27.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.60
Rate for Payer: Cigna Commercial	$46.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.77
Rate for Payer: Oxford Commercial	$18.51
Rate for Payer: Qualcare PPO/HMO/WC	$13.88
Rate for Payer: UnitedHealthcare Commercial	$18.51
Rate for Payer: UnitedHealthcare Community & State	$2.23
Rate for Payer: Wellpoint Medicaid Managed Care	$2.45

DERMABOND ADV SKIN ADHESIVE

Facility

$86.59

Hospital Charge Code	270618571S
Hospital Revenue Code	272
Min. Negotiated Rate	$12.99
Max. Negotiated Rate	$12.99
Rate for Payer: Qualcare PPO/HMO/WC	$12.99

DERMABOND ADV SKIN ADHESIVE

Facility

$86.59

Hospital Charge Code	270618571S
Hospital Revenue Code	272
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$43.30
Rate for Payer: Aetna Commercial	$32.90
Rate for Payer: Aetna Medicare Advantage	$25.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.08
Rate for Payer: Cigna Commercial	$43.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.98
Rate for Payer: Oxford Commercial	$17.32
Rate for Payer: Qualcare PPO/HMO/WC	$12.99
Rate for Payer: UnitedHealthcare Commercial	$17.32
Rate for Payer: UnitedHealthcare Community & State	$2.09
Rate for Payer: Wellpoint Medicaid Managed Care	$2.29

DERMABOND HVD MINI 12

Facility

$55.50

Hospital Charge Code	270677258
Hospital Revenue Code	272
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$8.32
Rate for Payer: Qualcare PPO/HMO/WC	$8.32

DERMABOND HVD MINI 12

Facility

$55.50

Hospital Charge Code	270677258
Hospital Revenue Code	272
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$27.75
Rate for Payer: Aetna Commercial	$21.09
Rate for Payer: Aetna Medicare Advantage	$16.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.15
Rate for Payer: Cigna Commercial	$27.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.65
Rate for Payer: Oxford Commercial	$11.10
Rate for Payer: Qualcare PPO/HMO/WC	$8.32
Rate for Payer: UnitedHealthcare Commercial	$11.10
Rate for Payer: UnitedHealthcare Community & State	$1.34
Rate for Payer: Wellpoint Medicaid Managed Care	$1.47

DERMABOND PRINEO Sys 22cm

Facility

$382.50

Hospital Charge Code	270674023
Hospital Revenue Code	272
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$191.25
Rate for Payer: Aetna Commercial	$145.35
Rate for Payer: Aetna Medicare Advantage	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.54
Rate for Payer: Cigna Commercial	$191.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.75
Rate for Payer: Oxford Commercial	$76.50
Rate for Payer: Qualcare PPO/HMO/WC	$57.38
Rate for Payer: UnitedHealthcare Commercial	$76.50
Rate for Payer: UnitedHealthcare Community & State	$9.22
Rate for Payer: Wellpoint Medicaid Managed Care	$10.14

DERMABOND PRINEO Sys 22cm

Facility

$382.50

Hospital Charge Code	270674023
Hospital Revenue Code	272
Min. Negotiated Rate	$57.38
Max. Negotiated Rate	$57.38
Rate for Payer: Qualcare PPO/HMO/WC	$57.38

DERMACARRIER 1.5 TO 1

Facility

$2,947.50

Hospital Charge Code	270664759
Hospital Revenue Code	270
Min. Negotiated Rate	$71.03
Max. Negotiated Rate	$1,473.75
Rate for Payer: Aetna Commercial	$1,120.05
Rate for Payer: Aetna Medicare Advantage	$884.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$751.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$751.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$751.61
Rate for Payer: Cigna Commercial	$1,473.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$884.25
Rate for Payer: Oxford Commercial	$589.50
Rate for Payer: Qualcare PPO/HMO/WC	$442.12
Rate for Payer: UnitedHealthcare Commercial	$589.50
Rate for Payer: UnitedHealthcare Community & State	$71.03
Rate for Payer: Wellpoint Medicaid Managed Care	$78.11

DERMACARRIER 1.5 TO 1

Facility

$2,947.50

Hospital Charge Code	270664759
Hospital Revenue Code	270
Min. Negotiated Rate	$442.12
Max. Negotiated Rate	$442.12
Rate for Payer: Qualcare PPO/HMO/WC	$442.12

DERMACARRIER II SKIN GRAFT

Facility

$171.00

Hospital Charge Code	270331680
Hospital Revenue Code	272
Min. Negotiated Rate	$4.12
Max. Negotiated Rate	$85.50
Rate for Payer: Aetna Commercial	$64.98
Rate for Payer: Aetna Medicare Advantage	$51.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.60
Rate for Payer: Cigna Commercial	$85.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.30
Rate for Payer: Oxford Commercial	$34.20
Rate for Payer: Qualcare PPO/HMO/WC	$25.65
Rate for Payer: UnitedHealthcare Commercial	$34.20
Rate for Payer: UnitedHealthcare Community & State	$4.12
Rate for Payer: Wellpoint Medicaid Managed Care	$4.53

DERMACARRIER II SKIN GRAFT

Facility

$171.00

Hospital Charge Code	270331680
Hospital Revenue Code	272
Min. Negotiated Rate	$25.65
Max. Negotiated Rate	$25.65
Rate for Payer: Qualcare PPO/HMO/WC	$25.65

DERMACARRIERS II SKIN GRAFT

Facility

$174.00

Hospital Charge Code	270600394
Hospital Revenue Code	272
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

DERMACARRIERS II SKIN GRAFT

Facility

$174.00

Hospital Charge Code	270600394
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$66.12
Rate for Payer: Aetna Medicare Advantage	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.20
Rate for Payer: Oxford Commercial	$34.80
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Commercial	$34.80
Rate for Payer: UnitedHealthcare Community & State	$4.19
Rate for Payer: Wellpoint Medicaid Managed Care	$4.61

DERMACARRIER SKIN GRAFT 3 TO 1

Facility

$174.00

Hospital Charge Code	270331700
Hospital Revenue Code	272
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

DERMACARRIER SKIN GRAFT 3 TO 1

Facility

$174.00

Hospital Charge Code	270331700
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$66.12
Rate for Payer: Aetna Medicare Advantage	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.20
Rate for Payer: Oxford Commercial	$34.80
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Commercial	$34.80
Rate for Payer: UnitedHealthcare Community & State	$4.19
Rate for Payer: Wellpoint Medicaid Managed Care	$4.61

DERMACELL 4X4 CM

Facility

$6,480.00

Hospital Charge Code	270657236
Hospital Revenue Code	636
Min. Negotiated Rate	$972.00
Max. Negotiated Rate	$1,568.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,568.16
Rate for Payer: Qualcare PPO/HMO/WC	$972.00

DERMACELL 4X4 CM

Facility

$6,480.00

Hospital Charge Code	270657236
Hospital Revenue Code	636
Min. Negotiated Rate	$156.17
Max. Negotiated Rate	$3,240.00
Rate for Payer: Aetna Commercial	$2,462.40
Rate for Payer: Aetna Medicare Advantage	$1,944.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,652.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,652.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,652.40
Rate for Payer: Cigna Commercial	$3,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,568.16
Rate for Payer: Qualcare PPO/HMO/WC	$972.00
Rate for Payer: UnitedHealthcare Community & State	$156.17
Rate for Payer: Wellpoint Medicaid Managed Care	$171.72

Know your out-of-pocket cost for care.

All Charges