Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRAIN OUTER EAR CANAL LESION

Facility

$3,005.56

Service Code	HCPCS 69020
Hospital Charge Code	16001045
Hospital Revenue Code	360
Min. Negotiated Rate	$72.43
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,036.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,036.77
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$901.67
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.83
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$72.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$79.65

DRAIN OVARY ABSCES PERCUT

Facility

$3,390.00

Service Code	HCPCS 58822
Hospital Charge Code	7411637
Hospital Revenue Code	361
Min. Negotiated Rate	$81.70
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$1,288.20
Rate for Payer: Aetna Medicare Advantage	$1,017.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.45
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	$864.45
Rate for Payer: Cigna Commercial	$1,695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,017.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$508.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$81.70
Rate for Payer: Wellpoint Medicaid Managed Care	$89.83

DRAIN OVARY ABSCES PERCUT

Facility

$3,390.00

Service Code	HCPCS 58822
Hospital Charge Code	7411637
Hospital Revenue Code	361
Min. Negotiated Rate	$508.50
Max. Negotiated Rate	$508.50
Rate for Payer: Qualcare PPO/HMO/WC	$508.50

DRAIN OVARY ABSCES PERCUT

Facility

$3,390.00

Service Code	HCPCS 58822
Hospital Charge Code	2690215
Hospital Revenue Code	361
Min. Negotiated Rate	$508.50
Max. Negotiated Rate	$508.50
Rate for Payer: Qualcare PPO/HMO/WC	$508.50

DRAIN OVARY ABSCES PERCUT

Facility

$3,390.00

Service Code	HCPCS 58822
Hospital Charge Code	2690215
Hospital Revenue Code	361
Min. Negotiated Rate	$81.70
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$1,288.20
Rate for Payer: Aetna Medicare Advantage	$1,017.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.45
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	$864.45
Rate for Payer: Cigna Commercial	$1,695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,017.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$508.50
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$81.70
Rate for Payer: Wellpoint Medicaid Managed Care	$89.83

DRAIN PENROSE 1/2x12

Facility

$3.85

Hospital Charge Code	270649921
Hospital Revenue Code	278
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.46
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

DRAIN PENROSE 1/2x12

Facility

$3.85

Hospital Charge Code	270649921
Hospital Revenue Code	278
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

DRAIN PENROSE 1/4 STERILE

Facility

$2.20

Hospital Charge Code	27061545
Hospital Revenue Code	270
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.33
Rate for Payer: Qualcare PPO/HMO/WC	$0.33

DRAIN PENROSE 1/4 STERILE

Facility

$2.20

Hospital Charge Code	27061545
Hospital Revenue Code	270
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$1.10
Rate for Payer: Aetna Commercial	$0.84
Rate for Payer: Aetna Medicare Advantage	$0.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.56
Rate for Payer: Cigna Commercial	$1.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.66
Rate for Payer: Oxford Commercial	$0.44
Rate for Payer: Qualcare PPO/HMO/WC	$0.33
Rate for Payer: UnitedHealthcare Commercial	$0.44
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

DRAIN PENROSE 5/8 STER

Facility

$11.25

Hospital Charge Code	270061431
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

DRAIN PENROSE 5/8 STER

Facility

$11.25

Hospital Charge Code	270061431
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

DRAIN PENROSE 5/8 STER *****

Facility

$3.00

Hospital Charge Code	8001240
Hospital Revenue Code	279
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

DRAIN PENROSE 5/8 STER *****

Facility

$3.00

Hospital Charge Code	8001240
Hospital Revenue Code	279
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

DRAIN PENROSE STER 1/4

Facility

$7.25

Hospital Charge Code	270061545
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

DRAIN PENROSE STER 1/4

Facility

$7.25

Hospital Charge Code	270061545
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.75
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.17
Rate for Payer: Oxford Commercial	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$1.45
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

DRAIN PENROSE STERILE 1

Facility

$2.20

Hospital Charge Code	270649670
Hospital Revenue Code	270
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.33
Rate for Payer: Qualcare PPO/HMO/WC	$0.33

DRAIN PENROSE STERILE 1

Facility

$2.20

Hospital Charge Code	270649670
Hospital Revenue Code	270
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$1.10
Rate for Payer: Aetna Commercial	$0.84
Rate for Payer: Aetna Medicare Advantage	$0.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.56
Rate for Payer: Cigna Commercial	$1.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.66
Rate for Payer: Oxford Commercial	$0.44
Rate for Payer: Qualcare PPO/HMO/WC	$0.33
Rate for Payer: UnitedHealthcare Commercial	$0.44
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

DRAIN PENROSE STERILE 1/2

Facility

$2.20

Hospital Charge Code	270649671
Hospital Revenue Code	270
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$1.10
Rate for Payer: Aetna Commercial	$0.84
Rate for Payer: Aetna Medicare Advantage	$0.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.56
Rate for Payer: Cigna Commercial	$1.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.66
Rate for Payer: Oxford Commercial	$0.44
Rate for Payer: Qualcare PPO/HMO/WC	$0.33
Rate for Payer: UnitedHealthcare Commercial	$0.44
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

DRAIN PENROSE STERILE 1/2

Facility

$2.20

Hospital Charge Code	270649671
Hospital Revenue Code	270
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.33
Rate for Payer: Qualcare PPO/HMO/WC	$0.33

DRAIN PETONEAL ABSCESS/CYST,OP

Facility

$19,658.35

Service Code	HCPCS 49020
Hospital Charge Code	16000591
Hospital Revenue Code	360
Min. Negotiated Rate	$2,948.75
Max. Negotiated Rate	$2,948.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,948.75

DRAIN PETONEAL ABSCESS/CYST,OP

Facility

$19,658.35

Service Code	HCPCS 49020
Hospital Charge Code	16000591
Hospital Revenue Code	360
Min. Negotiated Rate	$473.77
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$7,470.17
Rate for Payer: Aetna Medicare Advantage	$5,897.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,012.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,012.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,012.88
Rate for Payer: Cigna Commercial	$9,829.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,897.51
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,948.75
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$473.77
Rate for Payer: Wellpoint Medicaid Managed Care	$520.95

DRAIN PLEUREVAC SYS DOUBLE

Facility

$290.77

Service Code	HCPCS C1729
Hospital Charge Code	270652876
Hospital Revenue Code	278
Min. Negotiated Rate	$43.62
Max. Negotiated Rate	$70.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$63.97
Rate for Payer: Qualcare PPO/HMO/WC	$43.62

DRAIN PLEUREVAC SYS DOUBLE

Facility

$290.77

Service Code	HCPCS C1729
Hospital Charge Code	270652876
Hospital Revenue Code	278
Min. Negotiated Rate	$7.01
Max. Negotiated Rate	$145.38
Rate for Payer: Aetna Commercial	$110.49
Rate for Payer: Aetna Medicare Advantage	$87.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.15
Rate for Payer: Cigna Commercial	$145.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$63.97
Rate for Payer: Qualcare PPO/HMO/WC	$43.62
Rate for Payer: UnitedHealthcare Community & State	$7.01
Rate for Payer: Wellpoint Medicaid Managed Care	$7.71

DRAIN RETROPETONEAL ABSCES,OPN

Facility

$12,226.80

Service Code	HCPCS 49060
Hospital Charge Code	16000487
Hospital Revenue Code	360
Min. Negotiated Rate	$294.67
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$4,646.18
Rate for Payer: Aetna Medicare Advantage	$3,668.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,117.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,117.83
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	$3,117.83
Rate for Payer: Cigna Commercial	$6,113.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,668.04
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,834.02
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$294.67
Rate for Payer: Wellpoint Medicaid Managed Care	$324.01

DRAIN RETROPETONEAL ABSCES,OPN

Facility

$12,226.80

Service Code	HCPCS 49060
Hospital Charge Code	16000487
Hospital Revenue Code	360
Min. Negotiated Rate	$1,834.02
Max. Negotiated Rate	$1,834.02
Rate for Payer: Qualcare PPO/HMO/WC	$1,834.02

Know your out-of-pocket cost for care.

All Charges