Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

DRAIN BLAKE *****

Facility

$44.00

Hospital Charge Code	1810001
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

DRAIN BLAKE *****

Facility

$44.00

Hospital Charge Code	1810001
Hospital Revenue Code	272
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

DRAIN BLAKE 10FR ROUN H

Facility

$77.45

Hospital Charge Code	270600376
Hospital Revenue Code	272
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$38.73
Rate for Payer: Aetna Commercial	$29.43
Rate for Payer: Aetna Medicare Advantage	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.75
Rate for Payer: Cigna Commercial	$38.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.23
Rate for Payer: Oxford Commercial	$15.49
Rate for Payer: Qualcare PPO/HMO/WC	$11.62
Rate for Payer: UnitedHealthcare Commercial	$15.49
Rate for Payer: UnitedHealthcare Community & State	$1.87
Rate for Payer: Wellpoint Medicaid Managed Care	$2.05

DRAIN BLAKE 10FR ROUN H

Facility

$77.45

Hospital Charge Code	270600376
Hospital Revenue Code	272
Min. Negotiated Rate	$11.62
Max. Negotiated Rate	$11.62
Rate for Payer: Qualcare PPO/HMO/WC	$11.62

DRAIN BLAKE 19 FR

Facility

$123.11

Hospital Charge Code	270655051
Hospital Revenue Code	272
Min. Negotiated Rate	$18.47
Max. Negotiated Rate	$18.47
Rate for Payer: Qualcare PPO/HMO/WC	$18.47

DRAIN BLAKE 19 FR

Facility

$123.11

Hospital Charge Code	270655051
Hospital Revenue Code	272
Min. Negotiated Rate	$2.97
Max. Negotiated Rate	$61.55
Rate for Payer: Aetna Commercial	$46.78
Rate for Payer: Aetna Medicare Advantage	$36.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.39
Rate for Payer: Cigna Commercial	$61.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.93
Rate for Payer: Oxford Commercial	$24.62
Rate for Payer: Qualcare PPO/HMO/WC	$18.47
Rate for Payer: UnitedHealthcare Commercial	$24.62
Rate for Payer: UnitedHealthcare Community & State	$2.97
Rate for Payer: Wellpoint Medicaid Managed Care	$3.26

DRAIN BLAKE HUBLESS 19fr ROUND

Facility

$82.15

Hospital Charge Code	270646027
Hospital Revenue Code	270
Min. Negotiated Rate	$12.32
Max. Negotiated Rate	$12.32
Rate for Payer: Qualcare PPO/HMO/WC	$12.32

DRAIN BLAKE HUBLESS 19fr ROUND

Facility

$82.15

Hospital Charge Code	270646027
Hospital Revenue Code	270
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$41.08
Rate for Payer: Aetna Commercial	$31.22
Rate for Payer: Aetna Medicare Advantage	$24.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.95
Rate for Payer: Cigna Commercial	$41.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.64
Rate for Payer: Oxford Commercial	$16.43
Rate for Payer: Qualcare PPO/HMO/WC	$12.32
Rate for Payer: UnitedHealthcare Commercial	$16.43
Rate for Payer: UnitedHealthcare Community & State	$1.98
Rate for Payer: Wellpoint Medicaid Managed Care	$2.18

DRAIN BLAKE J VAC 19FR

Facility

$198.18

Hospital Charge Code	270650812
Hospital Revenue Code	272
Min. Negotiated Rate	$29.73
Max. Negotiated Rate	$29.73
Rate for Payer: Qualcare PPO/HMO/WC	$29.73

DRAIN BLAKE J VAC 19FR

Facility

$198.18

Hospital Charge Code	270650812
Hospital Revenue Code	272
Min. Negotiated Rate	$4.78
Max. Negotiated Rate	$99.09
Rate for Payer: Aetna Commercial	$75.31
Rate for Payer: Aetna Medicare Advantage	$59.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.54
Rate for Payer: Cigna Commercial	$99.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.45
Rate for Payer: Oxford Commercial	$39.64
Rate for Payer: Qualcare PPO/HMO/WC	$29.73
Rate for Payer: UnitedHealthcare Commercial	$39.64
Rate for Payer: UnitedHealthcare Community & State	$4.78
Rate for Payer: Wellpoint Medicaid Managed Care	$5.25

DRAIN BLAKE KIT

Facility

$95.18

Hospital Charge Code	270600245
Hospital Revenue Code	270
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$47.59
Rate for Payer: Aetna Commercial	$36.17
Rate for Payer: Aetna Medicare Advantage	$28.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.27
Rate for Payer: Cigna Commercial	$47.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.55
Rate for Payer: Oxford Commercial	$19.04
Rate for Payer: Qualcare PPO/HMO/WC	$14.28
Rate for Payer: UnitedHealthcare Commercial	$19.04
Rate for Payer: UnitedHealthcare Community & State	$2.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2.52

DRAIN BLAKE KIT

Facility

$95.18

Hospital Charge Code	270600245
Hospital Revenue Code	270
Min. Negotiated Rate	$14.28
Max. Negotiated Rate	$14.28
Rate for Payer: Qualcare PPO/HMO/WC	$14.28

DRAIN BL W/CATH INSERTION

Facility

$16,211.70

Service Code	HCPCS 51102
Hospital Charge Code	1600000475
Hospital Revenue Code	360
Min. Negotiated Rate	$390.70
Max. Negotiated Rate	$8,964.44
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
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	$8,964.44
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,863.51
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,431.76
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$390.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$429.61

DRAIN BL W/CATH INSERTION

Facility

$16,211.70

Service Code	HCPCS 51102
Hospital Charge Code	1600000475
Hospital Revenue Code	360
Min. Negotiated Rate	$2,431.76
Max. Negotiated Rate	$2,431.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,431.76

DRAIN CEREBRO SPINAL FLUID

Facility

$4,204.50

Service Code	HCPCS 62272
Hospital Charge Code	16000592
Hospital Revenue Code	360
Min. Negotiated Rate	$630.67
Max. Negotiated Rate	$630.67
Rate for Payer: Qualcare PPO/HMO/WC	$630.67

DRAIN CEREBRO SPINAL FLUID

Facility

$4,204.50

Service Code	HCPCS 62272
Hospital Charge Code	16000592
Hospital Revenue Code	360
Min. Negotiated Rate	$101.33
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,281.02
Rate for Payer: Aetna Medicare Advantage	$2,717.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,027.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$838.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,027.13
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: Cigna Medicare Advantage	$838.61
Rate for Payer: Clover Medicare Advantage	$796.68
Rate for Payer: EmblemHealth Commercial	$2,515.83
Rate for Payer: Humana Medicare Advantage	$863.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$838.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,261.35
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$630.67
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$101.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$111.42

DRAIN CHEST EXPRESS MOBILE MIN

Facility

$306.50

Hospital Charge Code	270677020
Hospital Revenue Code	272
Min. Negotiated Rate	$45.98
Max. Negotiated Rate	$45.98
Rate for Payer: Qualcare PPO/HMO/WC	$45.98

DRAIN CHEST EXPRESS MOBILE MIN

Facility

$306.50

Hospital Charge Code	270677020
Hospital Revenue Code	272
Min. Negotiated Rate	$7.39
Max. Negotiated Rate	$153.25
Rate for Payer: Aetna Commercial	$116.47
Rate for Payer: Aetna Medicare Advantage	$91.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.16
Rate for Payer: Cigna Commercial	$153.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.95
Rate for Payer: Oxford Commercial	$61.30
Rate for Payer: Qualcare PPO/HMO/WC	$45.98
Rate for Payer: UnitedHealthcare Commercial	$61.30
Rate for Payer: UnitedHealthcare Community & State	$7.39
Rate for Payer: Wellpoint Medicaid Managed Care	$8.12

DRAIN FEURESTEIN SPLIT

Facility

$111.25

Hospital Charge Code	270060720
Hospital Revenue Code	272
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$55.62
Rate for Payer: Aetna Commercial	$42.27
Rate for Payer: Aetna Medicare Advantage	$33.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.37
Rate for Payer: Cigna Commercial	$55.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.38
Rate for Payer: Oxford Commercial	$22.25
Rate for Payer: Qualcare PPO/HMO/WC	$16.69
Rate for Payer: UnitedHealthcare Commercial	$22.25
Rate for Payer: UnitedHealthcare Community & State	$2.68
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

DRAIN FEURESTEIN SPLIT

Facility

$111.25

Hospital Charge Code	270060720
Hospital Revenue Code	272
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$16.69
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

DRAIN FEURSTEIN SPLIT 140250

Facility

$52.65

Hospital Charge Code	270617095
Hospital Revenue Code	272
Min. Negotiated Rate	$7.90
Max. Negotiated Rate	$7.90
Rate for Payer: Qualcare PPO/HMO/WC	$7.90

DRAIN FEURSTEIN SPLIT 140250

Facility

$52.65

Hospital Charge Code	270617095
Hospital Revenue Code	272
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$26.32
Rate for Payer: Aetna Commercial	$20.01
Rate for Payer: Aetna Medicare Advantage	$15.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.43
Rate for Payer: Cigna Commercial	$26.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.79
Rate for Payer: Oxford Commercial	$10.53
Rate for Payer: Qualcare PPO/HMO/WC	$7.90
Rate for Payer: UnitedHealthcare Commercial	$10.53
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

DRAIN FINGER ABSC,COMPLICATED

Facility

$10,031.10

Service Code	HCPCS 26011
Hospital Charge Code	16000554
Hospital Revenue Code	360
Min. Negotiated Rate	$241.75
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	$862.00
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	$3,009.33
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,504.66
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$241.75
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	$265.82

DRAIN FINGER ABSC,COMPLICATED

Facility

$10,031.10

Service Code	HCPCS 26011
Hospital Charge Code	16000554
Hospital Revenue Code	360
Min. Negotiated Rate	$1,504.66
Max. Negotiated Rate	$1,504.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,504.66

Know your out-of-pocket cost for care.

All Charges