Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRAIN FINGER ABSC:SIMPLE

Facility

$1,800.90

Service Code	HCPCS 26010
Hospital Charge Code	1600000446
Hospital Revenue Code	360
Min. Negotiated Rate	$270.13
Max. Negotiated Rate	$270.13
Rate for Payer: Qualcare PPO/HMO/WC	$270.13

DRAIN FINGER ABSC:SIMPLE

Facility

$1,800.90

Service Code	HCPCS 26010
Hospital Charge Code	1600000446
Hospital Revenue Code	360
Min. Negotiated Rate	$43.40
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
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	$860.41
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$540.27
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.13
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$43.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$47.72

DRAIN FLAT 7mm 3/4 PERF

Facility

$231.10

Hospital Charge Code	270655684
Hospital Revenue Code	271
Min. Negotiated Rate	$5.57
Max. Negotiated Rate	$115.55
Rate for Payer: Aetna Commercial	$87.82
Rate for Payer: Aetna Medicare Advantage	$69.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.93
Rate for Payer: Cigna Commercial	$115.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.33
Rate for Payer: Oxford Commercial	$46.22
Rate for Payer: Qualcare PPO/HMO/WC	$34.66
Rate for Payer: UnitedHealthcare Commercial	$46.22
Rate for Payer: UnitedHealthcare Community & State	$5.57
Rate for Payer: Wellpoint Medicaid Managed Care	$6.12

DRAIN FLAT 7mm 3/4 PERF

Facility

$231.10

Hospital Charge Code	270655684
Hospital Revenue Code	271
Min. Negotiated Rate	$34.66
Max. Negotiated Rate	$34.66
Rate for Payer: Qualcare PPO/HMO/WC	$34.66

DRAIN FLAT JACKSON PRATT 10MM

Facility

$30.69

Hospital Charge Code	270645145
Hospital Revenue Code	270
Min. Negotiated Rate	$4.60
Max. Negotiated Rate	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.60

DRAIN FLAT JACKSON PRATT 10MM

Facility

$30.69

Hospital Charge Code	270645145
Hospital Revenue Code	270
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$15.35
Rate for Payer: Aetna Commercial	$11.66
Rate for Payer: Aetna Medicare Advantage	$9.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.83
Rate for Payer: Cigna Commercial	$15.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.21
Rate for Payer: Oxford Commercial	$6.14
Rate for Payer: Qualcare PPO/HMO/WC	$4.60
Rate for Payer: UnitedHealthcare Commercial	$6.14
Rate for Payer: UnitedHealthcare Community & State	$0.74
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

DRAIN FLAT PERFOR 06200071360

Facility

$46.95

Hospital Charge Code	270635478
Hospital Revenue Code	272
Min. Negotiated Rate	$7.04
Max. Negotiated Rate	$7.04
Rate for Payer: Qualcare PPO/HMO/WC	$7.04

DRAIN FLAT PERFOR 06200071360

Facility

$46.95

Hospital Charge Code	270635478
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$23.48
Rate for Payer: Aetna Commercial	$17.84
Rate for Payer: Aetna Medicare Advantage	$14.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.97
Rate for Payer: Cigna Commercial	$23.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.09
Rate for Payer: Oxford Commercial	$9.39
Rate for Payer: Qualcare PPO/HMO/WC	$7.04
Rate for Payer: UnitedHealthcare Commercial	$9.39
Rate for Payer: UnitedHealthcare Community & State	$1.13
Rate for Payer: Wellpoint Medicaid Managed Care	$1.24

DRAIN FULLY PERFORATED 10MM

Facility

$725.00

Hospital Charge Code	270654982
Hospital Revenue Code	272
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$108.75
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

DRAIN FULLY PERFORATED 10MM

Facility

$725.00

Hospital Charge Code	270654982
Hospital Revenue Code	272
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.50
Rate for Payer: Oxford Commercial	$145.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Commercial	$145.00
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

DRAIN HEMOVAC W/NDL 400ML

Facility

$200.85

Hospital Charge Code	270060975
Hospital Revenue Code	272
Min. Negotiated Rate	$4.84
Max. Negotiated Rate	$100.42
Rate for Payer: Aetna Commercial	$76.32
Rate for Payer: Aetna Medicare Advantage	$60.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.22
Rate for Payer: Cigna Commercial	$100.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.26
Rate for Payer: Oxford Commercial	$40.17
Rate for Payer: Qualcare PPO/HMO/WC	$30.13
Rate for Payer: UnitedHealthcare Commercial	$40.17
Rate for Payer: UnitedHealthcare Community & State	$4.84
Rate for Payer: Wellpoint Medicaid Managed Care	$5.32

DRAIN HEMOVAC W/NDL 400ML

Facility

$200.85

Hospital Charge Code	270060975
Hospital Revenue Code	272
Min. Negotiated Rate	$30.13
Max. Negotiated Rate	$30.13
Rate for Payer: Qualcare PPO/HMO/WC	$30.13

DRAIN HEYER SCHUTE FLT SUCT***

Facility

$25.00

Hospital Charge Code	8002446
Hospital Revenue Code	279
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

DRAIN HEYER SCHUTE FLT SUCT***

Facility

$25.00

Hospital Charge Code	8002446
Hospital Revenue Code	279
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

DRAIN INCISION 24500000

Facility

$818.45

Hospital Charge Code	270611664
Hospital Revenue Code	272
Min. Negotiated Rate	$122.77
Max. Negotiated Rate	$122.77
Rate for Payer: Qualcare PPO/HMO/WC	$122.77

DRAIN INCISION 24500000

Facility

$818.45

Hospital Charge Code	270611664
Hospital Revenue Code	272
Min. Negotiated Rate	$19.72
Max. Negotiated Rate	$409.23
Rate for Payer: Aetna Commercial	$311.01
Rate for Payer: Aetna Medicare Advantage	$245.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.70
Rate for Payer: Cigna Commercial	$409.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.53
Rate for Payer: Oxford Commercial	$163.69
Rate for Payer: Qualcare PPO/HMO/WC	$122.77
Rate for Payer: UnitedHealthcare Commercial	$163.69
Rate for Payer: UnitedHealthcare Community & State	$19.72
Rate for Payer: Wellpoint Medicaid Managed Care	$21.69

DRAIN/INJECT-FINGER/TOE

Facility

$613.00

Service Code	HCPCS 20600
Hospital Charge Code	94186001
Hospital Revenue Code	761
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$1,316.35
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.90
Rate for Payer: Oxford Commercial	$122.60
Rate for Payer: Qualcare PPO/HMO/WC	$91.95
Rate for Payer: UnitedHealthcare Commercial	$122.60
Rate for Payer: UnitedHealthcare Community & State	$14.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$16.24

DRAIN/INJECT-FINGER/TOE

Facility

$613.00

Service Code	HCPCS 20600
Hospital Charge Code	94186001
Hospital Revenue Code	761
Min. Negotiated Rate	$91.95
Max. Negotiated Rate	$91.95
Rate for Payer: Qualcare PPO/HMO/WC	$91.95

DRAIN/INJECT-SHLDR HIP KN

Facility

$613.00

Service Code	HCPCS 20610
Hospital Charge Code	94186015
Hospital Revenue Code	761
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$1,316.35
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.90
Rate for Payer: Oxford Commercial	$122.60
Rate for Payer: Qualcare PPO/HMO/WC	$91.95
Rate for Payer: UnitedHealthcare Commercial	$122.60
Rate for Payer: UnitedHealthcare Community & State	$14.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$16.24

DRAIN/INJECT-SHLDR HIP KN

Facility

$613.00

Service Code	HCPCS 20610
Hospital Charge Code	94186015
Hospital Revenue Code	761
Min. Negotiated Rate	$91.95
Max. Negotiated Rate	$91.95
Rate for Payer: Qualcare PPO/HMO/WC	$91.95

DRAIN/INJECT-WRST ELBW AN

Facility

$613.00

Service Code	HCPCS 20605
Hospital Charge Code	94186010
Hospital Revenue Code	761
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$1,316.35
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.90
Rate for Payer: Oxford Commercial	$122.60
Rate for Payer: Qualcare PPO/HMO/WC	$91.95
Rate for Payer: UnitedHealthcare Commercial	$122.60
Rate for Payer: UnitedHealthcare Community & State	$14.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$16.24

DRAIN/INJECT-WRST ELBW AN

Facility

$613.00

Service Code	HCPCS 20605
Hospital Charge Code	94186010
Hospital Revenue Code	761
Min. Negotiated Rate	$91.95
Max. Negotiated Rate	$91.95
Rate for Payer: Qualcare PPO/HMO/WC	$91.95

DRAIN/INJ INTER JOINT/BURSA W/

Facility

$2,930.12

Service Code	HCPCS 20606
Hospital Charge Code	1600000714
Hospital Revenue Code	360
Min. Negotiated Rate	$70.62
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	$1,626.00
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	$879.04
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$439.52
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$70.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$77.65

DRAIN/INJ INTER JOINT/BURSA W/

Facility

$2,930.12

Service Code	HCPCS 20606
Hospital Charge Code	1600000714
Hospital Revenue Code	360
Min. Negotiated Rate	$439.52
Max. Negotiated Rate	$439.52
Rate for Payer: Qualcare PPO/HMO/WC	$439.52

DRAIN/INJ JOINT/BURSA

Facility

$1,630.99

Service Code	HCPCS 20605
Hospital Charge Code	1600000852
Hospital Revenue Code	360
Min. Negotiated Rate	$39.31
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
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	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$489.30
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$244.65
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$39.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$43.22

Know your out-of-pocket cost for care.

All Charges