Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DISPOSABLE ACCESSORY KIT,3 ARM

Facility

$5,000.00

Hospital Charge Code	270664012
Hospital Revenue Code	272
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.00
Rate for Payer: Oxford Commercial	$1,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Commercial	$1,000.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

DISPOSABLE ACCESSORY KIT,4 ARM

Facility

$1,300.00

Hospital Charge Code	270664011
Hospital Revenue Code	272
Min. Negotiated Rate	$31.33
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$494.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.00
Rate for Payer: Oxford Commercial	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00
Rate for Payer: UnitedHealthcare Commercial	$260.00
Rate for Payer: UnitedHealthcare Community & State	$31.33
Rate for Payer: Wellpoint Medicaid Managed Care	$34.45

DISPOSABLE ACCESSORY KIT,4 ARM

Facility

$1,300.00

Hospital Charge Code	270664011
Hospital Revenue Code	272
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

DISPOSABLE ACTIVE CORD

Facility

$209.00

Hospital Charge Code	270332324
Hospital Revenue Code	272
Min. Negotiated Rate	$5.04
Max. Negotiated Rate	$104.50
Rate for Payer: Aetna Commercial	$79.42
Rate for Payer: Aetna Medicare Advantage	$62.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.30
Rate for Payer: Cigna Commercial	$104.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.70
Rate for Payer: Oxford Commercial	$41.80
Rate for Payer: Qualcare PPO/HMO/WC	$31.35
Rate for Payer: UnitedHealthcare Commercial	$41.80
Rate for Payer: UnitedHealthcare Community & State	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$5.54

DISPOSABLE ACTIVE CORD

Facility

$209.00

Hospital Charge Code	270332324
Hospital Revenue Code	272
Min. Negotiated Rate	$31.35
Max. Negotiated Rate	$31.35
Rate for Payer: Qualcare PPO/HMO/WC	$31.35

DISPOSABLE CLIP FIXING DEVICE

Facility

$385.00

Hospital Charge Code	270325605
Hospital Revenue Code	272
Min. Negotiated Rate	$9.28
Max. Negotiated Rate	$192.50
Rate for Payer: Aetna Commercial	$146.30
Rate for Payer: Aetna Medicare Advantage	$115.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.17
Rate for Payer: Cigna Commercial	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.50
Rate for Payer: Oxford Commercial	$77.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.75
Rate for Payer: UnitedHealthcare Commercial	$77.00
Rate for Payer: UnitedHealthcare Community & State	$9.28
Rate for Payer: Wellpoint Medicaid Managed Care	$10.20

DISPOSABLE CLIP FIXING DEVICE

Facility

$385.00

Hospital Charge Code	270325605
Hospital Revenue Code	272
Min. Negotiated Rate	$57.75
Max. Negotiated Rate	$57.75
Rate for Payer: Qualcare PPO/HMO/WC	$57.75

DISPOSABLE CRANIAL PERFORATOR

Facility

$860.00

Hospital Charge Code	270657297
Hospital Revenue Code	270
Min. Negotiated Rate	$20.73
Max. Negotiated Rate	$430.00
Rate for Payer: Aetna Commercial	$326.80
Rate for Payer: Aetna Medicare Advantage	$258.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.30
Rate for Payer: Cigna Commercial	$430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.00
Rate for Payer: Oxford Commercial	$172.00
Rate for Payer: Qualcare PPO/HMO/WC	$129.00
Rate for Payer: UnitedHealthcare Commercial	$172.00
Rate for Payer: UnitedHealthcare Community & State	$20.73
Rate for Payer: Wellpoint Medicaid Managed Care	$22.79

DISPOSABLE CRANIAL PERFORATOR

Facility

$860.00

Hospital Charge Code	270657297
Hospital Revenue Code	270
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$129.00
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

DISPOSABLE DIALATOR SET

Facility

$4,375.00

Hospital Charge Code	270694232
Hospital Revenue Code	272
Min. Negotiated Rate	$105.44
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,312.50
Rate for Payer: Oxford Commercial	$875.00
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Commercial	$875.00
Rate for Payer: UnitedHealthcare Community & State	$105.44
Rate for Payer: Wellpoint Medicaid Managed Care	$115.94

DISPOSABLE DIALATOR SET

Facility

$4,375.00

Hospital Charge Code	270694232
Hospital Revenue Code	272
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$656.25
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

DISPOSABLE DILATORS NIM STIM

Facility

$4,125.00

Hospital Charge Code	270692668
Hospital Revenue Code	272
Min. Negotiated Rate	$99.41
Max. Negotiated Rate	$2,062.50
Rate for Payer: Aetna Commercial	$1,567.50
Rate for Payer: Aetna Medicare Advantage	$1,237.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,051.88
Rate for Payer: Cigna Commercial	$2,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,237.50
Rate for Payer: Oxford Commercial	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$618.75
Rate for Payer: UnitedHealthcare Commercial	$825.00
Rate for Payer: UnitedHealthcare Community & State	$99.41
Rate for Payer: Wellpoint Medicaid Managed Care	$109.31

DISPOSABLE DILATORS NIM STIM

Facility

$4,125.00

Hospital Charge Code	270692668
Hospital Revenue Code	272
Min. Negotiated Rate	$618.75
Max. Negotiated Rate	$618.75
Rate for Payer: Qualcare PPO/HMO/WC	$618.75

DISPOSABLE DISSECTING HOOK

Facility

$580.00

Hospital Charge Code	270335521
Hospital Revenue Code	272
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$87.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.00

DISPOSABLE DISSECTING HOOK

Facility

$580.00

Hospital Charge Code	270335521
Hospital Revenue Code	272
Min. Negotiated Rate	$13.98
Max. Negotiated Rate	$290.00
Rate for Payer: Aetna Commercial	$220.40
Rate for Payer: Aetna Medicare Advantage	$174.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.90
Rate for Payer: Cigna Commercial	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.00
Rate for Payer: Oxford Commercial	$116.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.00
Rate for Payer: UnitedHealthcare Commercial	$116.00
Rate for Payer: UnitedHealthcare Community & State	$13.98
Rate for Payer: Wellpoint Medicaid Managed Care	$15.37

DISPOSABLE INNER CANNULA SZ.4

Facility

$44.00

Hospital Charge Code	270331692
Hospital Revenue Code	272
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

DISPOSABLE INNER CANNULA SZ.4

Facility

$44.00

Hospital Charge Code	270331692
Hospital Revenue Code	272
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.20
Rate for Payer: Oxford Commercial	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$8.80
Rate for Payer: UnitedHealthcare Community & State	$1.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

DISPOSABLE KIT, 11MM

Facility

$21.40

Hospital Charge Code	270665048
Hospital Revenue Code	270
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$3.21
Rate for Payer: Qualcare PPO/HMO/WC	$3.21

DISPOSABLE KIT, 11MM

Facility

$21.40

Hospital Charge Code	270665048
Hospital Revenue Code	270
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$10.70
Rate for Payer: Aetna Commercial	$8.13
Rate for Payer: Aetna Medicare Advantage	$6.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.46
Rate for Payer: Cigna Commercial	$10.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.42
Rate for Payer: Oxford Commercial	$4.28
Rate for Payer: Qualcare PPO/HMO/WC	$3.21
Rate for Payer: UnitedHealthcare Commercial	$4.28
Rate for Payer: UnitedHealthcare Community & State	$0.52
Rate for Payer: Wellpoint Medicaid Managed Care	$0.57

DISPOSABLE KIT,HIP

Facility

$1,000.00

Hospital Charge Code	270679624
Hospital Revenue Code	272
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

DISPOSABLE KIT,HIP

Facility

$1,000.00

Hospital Charge Code	270679624
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

DISPOSABLE KIT STERILE

Facility

$2,875.00

Hospital Charge Code	270680750
Hospital Revenue Code	272
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$431.25
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

DISPOSABLE KIT STERILE

Facility

$2,875.00

Hospital Charge Code	270680750
Hospital Revenue Code	272
Min. Negotiated Rate	$69.29
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$1,092.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$862.50
Rate for Payer: Oxford Commercial	$575.00
Rate for Payer: Qualcare PPO/HMO/WC	$431.25
Rate for Payer: UnitedHealthcare Commercial	$575.00
Rate for Payer: UnitedHealthcare Community & State	$69.29
Rate for Payer: Wellpoint Medicaid Managed Care	$76.19

DISPOSABLE LIGHT

Facility

$1,822.05

Hospital Charge Code	270701764
Hospital Revenue Code	279
Min. Negotiated Rate	$273.31
Max. Negotiated Rate	$273.31
Rate for Payer: Qualcare PPO/HMO/WC	$273.31

DISPOSABLE LIGHT

Facility

$1,822.05

Hospital Charge Code	270701764
Hospital Revenue Code	279
Min. Negotiated Rate	$43.91
Max. Negotiated Rate	$911.02
Rate for Payer: Aetna Commercial	$692.38
Rate for Payer: Aetna Medicare Advantage	$546.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$464.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$464.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$464.62
Rate for Payer: Cigna Commercial	$911.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.62
Rate for Payer: Oxford Commercial	$364.41
Rate for Payer: Qualcare PPO/HMO/WC	$273.31
Rate for Payer: UnitedHealthcare Commercial	$364.41
Rate for Payer: UnitedHealthcare Community & State	$43.91
Rate for Payer: Wellpoint Medicaid Managed Care	$48.28

Know your out-of-pocket cost for care.

All Charges