Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRAINAGE PAROTID ABSCESS SIMPL

Facility

$7,090.00

Service Code	HCPCS 42300
Hospital Charge Code	5780215
Hospital Revenue Code	450
Min. Negotiated Rate	$1,063.50
Max. Negotiated Rate	$1,063.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,063.50

DRAINAGE PAROTID ABSCESS SIMPL

Facility

$7,090.00

Service Code	HCPCS 42300
Hospital Charge Code	5780215
Hospital Revenue Code	450
Min. Negotiated Rate	$98.39
Max. Negotiated Rate	$6,653.83
Rate for Payer: Aetna Commercial	$5,013.83
Rate for Payer: Aetna Medicare Advantage	$5,972.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,653.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,653.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,843.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,653.83
Rate for Payer: Cigna Commercial	$3,694.94
Rate for Payer: Cigna Medicare Advantage	$1,843.32
Rate for Payer: Clover Medicare Advantage	$1,751.15
Rate for Payer: EmblemHealth Commercial	$5,529.96
Rate for Payer: Humana Medicare Advantage	$1,898.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,843.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,127.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,063.50
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,843.32
Rate for Payer: Wellcare Medicare Advantage	$1,843.32
Rate for Payer: Wellpoint Medicaid Managed Care	$187.88

DRAINAGE POUCH CLAMP FOR

Facility

$20.00

Hospital Charge Code	270331645
Hospital Revenue Code	272
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$7.60
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.00
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$4.00
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

DRAINAGE POUCH CLAMP FOR

Facility

$20.00

Hospital Charge Code	270331645
Hospital Revenue Code	272
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

DRAINAGE SCROTUM ABSCESS

Facility

$8,041.95

Service Code	HCPCS 55100
Hospital Charge Code	5792280
Hospital Revenue Code	450
Min. Negotiated Rate	$81.31
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,412.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,206.29
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$213.11

DRAINAGE SCROTUM ABSCESS

Facility

$8,041.95

Service Code	HCPCS 55100
Hospital Charge Code	5792280
Hospital Revenue Code	450
Min. Negotiated Rate	$1,206.29
Max. Negotiated Rate	$1,206.29
Rate for Payer: Qualcare PPO/HMO/WC	$1,206.29

DRAINAGE SYSTEM BAGS 15/BX

Facility

$33.75

Hospital Charge Code	270658342
Hospital Revenue Code	272
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$16.88
Rate for Payer: Aetna Commercial	$12.82
Rate for Payer: Aetna Medicare Advantage	$10.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.61
Rate for Payer: Cigna Commercial	$16.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.12
Rate for Payer: Oxford Commercial	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$5.06
Rate for Payer: UnitedHealthcare Commercial	$6.75
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.89

DRAINAGE SYSTEM BAGS 15/BX

Facility

$33.75

Hospital Charge Code	270658342
Hospital Revenue Code	272
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$5.06
Rate for Payer: Qualcare PPO/HMO/WC	$5.06

DRAINAGE SYSTEM BAGS 15/BX

Facility

$33.75

Hospital Charge Code	2709001458
Hospital Revenue Code	272
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$5.06
Rate for Payer: Qualcare PPO/HMO/WC	$5.06

DRAINAGE SYSTEM BAGS 15/BX

Facility

$33.75

Hospital Charge Code	2709001458
Hospital Revenue Code	272
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$16.88
Rate for Payer: Aetna Commercial	$12.82
Rate for Payer: Aetna Medicare Advantage	$10.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.61
Rate for Payer: Cigna Commercial	$16.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.12
Rate for Payer: Oxford Commercial	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$5.06
Rate for Payer: UnitedHealthcare Commercial	$6.75
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.89

DRAINAGE SYSTEM CFS EXTERNA

Facility

$1,100.00

Service Code	HCPCS C1729
Hospital Charge Code	270667556
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$266.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

DRAINAGE SYSTEM CFS EXTERNA

Facility

$1,100.00

Service Code	HCPCS C1729
Hospital Charge Code	270667556
Hospital Revenue Code	278
Min. Negotiated Rate	$26.51
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$418.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Community & State	$26.51
Rate for Payer: Wellpoint Medicaid Managed Care	$29.15

DRAINAGE SYSTEM CSF

Facility

$925.00

Hospital Charge Code	270697050
Hospital Revenue Code	272
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$138.75
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

DRAINAGE SYSTEM CSF

Facility

$925.00

Hospital Charge Code	270697050
Hospital Revenue Code	272
Min. Negotiated Rate	$22.29
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$351.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.50
Rate for Payer: Oxford Commercial	$185.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.75
Rate for Payer: UnitedHealthcare Commercial	$185.00
Rate for Payer: UnitedHealthcare Community & State	$22.29
Rate for Payer: Wellpoint Medicaid Managed Care	$24.51

DRAINAGE SYSTEM EXTERNAL *****

Facility

$280.00

Hospital Charge Code	1608058
Hospital Revenue Code	251
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$106.40
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.00
Rate for Payer: Oxford Commercial	$56.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Commercial	$56.00
Rate for Payer: UnitedHealthcare Community & State	$6.75
Rate for Payer: Wellpoint Medicaid Managed Care	$7.42

DRAINAGE SYSTEM EXTERNAL *****

Facility

$280.00

Hospital Charge Code	1608058
Hospital Revenue Code	251
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

DRAINAGE TUBING 48 IN

Facility

$30.45

Hospital Charge Code	270681435O
Hospital Revenue Code	272
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$15.22
Rate for Payer: Aetna Commercial	$11.57
Rate for Payer: Aetna Medicare Advantage	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.76
Rate for Payer: Cigna Commercial	$15.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.13
Rate for Payer: Oxford Commercial	$6.09
Rate for Payer: Qualcare PPO/HMO/WC	$4.57
Rate for Payer: UnitedHealthcare Commercial	$6.09
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

DRAINAGE TUBING 48 IN

Facility

$30.45

Hospital Charge Code	270681435O
Hospital Revenue Code	272
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$4.57
Rate for Payer: Qualcare PPO/HMO/WC	$4.57

DRAINAGE TUBING 48 IN

Facility

$30.45

Hospital Charge Code	270681435
Hospital Revenue Code	272
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$4.57
Rate for Payer: Qualcare PPO/HMO/WC	$4.57

DRAINAGE TUBING 48 IN

Facility

$30.45

Hospital Charge Code	270681435
Hospital Revenue Code	272
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$15.22
Rate for Payer: Aetna Commercial	$11.57
Rate for Payer: Aetna Medicare Advantage	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.76
Rate for Payer: Cigna Commercial	$15.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.13
Rate for Payer: Oxford Commercial	$6.09
Rate for Payer: Qualcare PPO/HMO/WC	$4.57
Rate for Payer: UnitedHealthcare Commercial	$6.09
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

DRAINAGE WOUND DEVICE W/TRO

Facility

$1,430.00

Service Code	HCPCS C1729
Hospital Charge Code	270668012
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$346.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$314.60
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

DRAINAGE WOUND DEVICE W/TRO

Facility

$1,430.00

Service Code	HCPCS C1729
Hospital Charge Code	270668012
Hospital Revenue Code	278
Min. Negotiated Rate	$34.46
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Commercial	$543.40
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$314.60
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Community & State	$34.46
Rate for Payer: Wellpoint Medicaid Managed Care	$37.90

DRAIN ANGLED MALECOT 26FR

Facility

$230.00

Hospital Charge Code	270331378
Hospital Revenue Code	278
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$55.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$50.60
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

DRAIN ANGLED MALECOT 26FR

Facility

$230.00

Hospital Charge Code	270331378
Hospital Revenue Code	278
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$115.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.66
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$50.60
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.09

DRAIN BAG 96 LGTH 8MM ADAPTER

Facility

$40.25

Hospital Charge Code	270660057
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$20.12
Rate for Payer: Aetna Commercial	$15.29
Rate for Payer: Aetna Medicare Advantage	$12.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.26
Rate for Payer: Cigna Commercial	$20.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.07
Rate for Payer: Oxford Commercial	$8.05
Rate for Payer: Qualcare PPO/HMO/WC	$6.04
Rate for Payer: UnitedHealthcare Commercial	$8.05
Rate for Payer: UnitedHealthcare Community & State	$0.97
Rate for Payer: Wellpoint Medicaid Managed Care	$1.07

Know your out-of-pocket cost for care.

All Charges