Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRAPE BAG VI ISOLATION

Facility

$93.65

Hospital Charge Code	270060795
Hospital Revenue Code	272
Min. Negotiated Rate	$14.05
Max. Negotiated Rate	$14.05
Rate for Payer: Qualcare PPO/HMO/WC	$14.05

DRAPE BARRIER CRANI/INC 0291

Facility

$368.85

Hospital Charge Code	270601773
Hospital Revenue Code	272
Min. Negotiated Rate	$8.89
Max. Negotiated Rate	$184.43
Rate for Payer: Aetna Commercial	$140.16
Rate for Payer: Aetna Medicare Advantage	$110.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.06
Rate for Payer: Cigna Commercial	$184.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.66
Rate for Payer: Oxford Commercial	$73.77
Rate for Payer: Qualcare PPO/HMO/WC	$55.33
Rate for Payer: UnitedHealthcare Commercial	$73.77
Rate for Payer: UnitedHealthcare Community & State	$8.89
Rate for Payer: Wellpoint Medicaid Managed Care	$9.77

DRAPE BARRIER CRANI/INC 0291

Facility

$368.85

Hospital Charge Code	270601773
Hospital Revenue Code	272
Min. Negotiated Rate	$55.33
Max. Negotiated Rate	$55.33
Rate for Payer: Qualcare PPO/HMO/WC	$55.33

DRAPE BRACHIAL XR K12701715

Facility

$180.00

Hospital Charge Code	270654308
Hospital Revenue Code	272
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$90.00
Rate for Payer: Aetna Commercial	$68.40
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.00
Rate for Payer: Oxford Commercial	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$36.00
Rate for Payer: UnitedHealthcare Community & State	$4.34
Rate for Payer: Wellpoint Medicaid Managed Care	$4.77

DRAPE BRACHIAL XR K12701715

Facility

$180.00

Hospital Charge Code	270654308
Hospital Revenue Code	272
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

DRAPE C-ARM ******

Facility

$37.00

Hospital Charge Code	1601194
Hospital Revenue Code	272
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$18.50
Rate for Payer: Aetna Commercial	$14.06
Rate for Payer: Aetna Medicare Advantage	$11.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.44
Rate for Payer: Cigna Commercial	$18.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.10
Rate for Payer: Oxford Commercial	$7.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.55
Rate for Payer: UnitedHealthcare Commercial	$7.40
Rate for Payer: UnitedHealthcare Community & State	$0.89
Rate for Payer: Wellpoint Medicaid Managed Care	$0.98

DRAPE C-ARM ******

Facility

$37.00

Hospital Charge Code	1601194
Hospital Revenue Code	272
Min. Negotiated Rate	$5.55
Max. Negotiated Rate	$5.55
Rate for Payer: Qualcare PPO/HMO/WC	$5.55

DRAPE C-ARM STER 22-22505H

Facility

$76.85

Hospital Charge Code	270060761
Hospital Revenue Code	272
Min. Negotiated Rate	$11.53
Max. Negotiated Rate	$11.53
Rate for Payer: Qualcare PPO/HMO/WC	$11.53

DRAPE C-ARM STER 22-22505H

Facility

$76.85

Hospital Charge Code	270060761
Hospital Revenue Code	272
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$38.42
Rate for Payer: Aetna Commercial	$29.20
Rate for Payer: Aetna Medicare Advantage	$23.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.60
Rate for Payer: Cigna Commercial	$38.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.05
Rate for Payer: Oxford Commercial	$15.37
Rate for Payer: Qualcare PPO/HMO/WC	$11.53
Rate for Payer: UnitedHealthcare Commercial	$15.37
Rate for Payer: UnitedHealthcare Community & State	$1.85
Rate for Payer: Wellpoint Medicaid Managed Care	$2.04

DRAPE C-ARM XR 17x70 2222505H

Facility

$38.25

Hospital Charge Code	270632188
Hospital Revenue Code	272
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$19.12
Rate for Payer: Aetna Commercial	$14.54
Rate for Payer: Aetna Medicare Advantage	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.75
Rate for Payer: Cigna Commercial	$19.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.47
Rate for Payer: Oxford Commercial	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$5.74
Rate for Payer: UnitedHealthcare Commercial	$7.65
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

DRAPE C-ARM XR 17x70 2222505H

Facility

$38.25

Hospital Charge Code	270632188
Hospital Revenue Code	272
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$5.74
Rate for Payer: Qualcare PPO/HMO/WC	$5.74

DRAPE CESAREAN IOBAN II 6697

Facility

$149.65

Hospital Charge Code	270622870
Hospital Revenue Code	272
Min. Negotiated Rate	$22.45
Max. Negotiated Rate	$22.45
Rate for Payer: Qualcare PPO/HMO/WC	$22.45

DRAPE CESAREAN IOBAN II 6697

Facility

$149.65

Hospital Charge Code	270622870
Hospital Revenue Code	272
Min. Negotiated Rate	$3.61
Max. Negotiated Rate	$74.83
Rate for Payer: Aetna Commercial	$56.87
Rate for Payer: Aetna Medicare Advantage	$44.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.16
Rate for Payer: Cigna Commercial	$74.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.90
Rate for Payer: Oxford Commercial	$29.93
Rate for Payer: Qualcare PPO/HMO/WC	$22.45
Rate for Payer: UnitedHealthcare Commercial	$29.93
Rate for Payer: UnitedHealthcare Community & State	$3.61
Rate for Payer: Wellpoint Medicaid Managed Care	$3.97

DRAPE CESAREAN IOBAN II 6697**

Facility

$318.00

Hospital Charge Code	270130031
Hospital Revenue Code	272
Min. Negotiated Rate	$47.70
Max. Negotiated Rate	$47.70
Rate for Payer: Qualcare PPO/HMO/WC	$47.70

DRAPE CESAREAN IOBAN II 6697**

Facility

$318.00

Hospital Charge Code	270130031
Hospital Revenue Code	272
Min. Negotiated Rate	$7.66
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$120.84
Rate for Payer: Aetna Medicare Advantage	$95.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.09
Rate for Payer: Cigna Commercial	$159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.40
Rate for Payer: Oxford Commercial	$63.60
Rate for Payer: Qualcare PPO/HMO/WC	$47.70
Rate for Payer: UnitedHealthcare Commercial	$63.60
Rate for Payer: UnitedHealthcare Community & State	$7.66
Rate for Payer: Wellpoint Medicaid Managed Care	$8.43

DRAPE CHEST 89277

Facility

$97.65

Hospital Charge Code	270609202
Hospital Revenue Code	272
Min. Negotiated Rate	$2.35
Max. Negotiated Rate	$48.83
Rate for Payer: Aetna Commercial	$37.11
Rate for Payer: Aetna Medicare Advantage	$29.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.90
Rate for Payer: Cigna Commercial	$48.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.30
Rate for Payer: Oxford Commercial	$19.53
Rate for Payer: Qualcare PPO/HMO/WC	$14.65
Rate for Payer: UnitedHealthcare Commercial	$19.53
Rate for Payer: UnitedHealthcare Community & State	$2.35
Rate for Payer: Wellpoint Medicaid Managed Care	$2.59

DRAPE CHEST 89277

Facility

$97.65

Hospital Charge Code	270609202
Hospital Revenue Code	272
Min. Negotiated Rate	$14.65
Max. Negotiated Rate	$14.65
Rate for Payer: Qualcare PPO/HMO/WC	$14.65

DRAPE CRANIOTOMY 89062

Facility

$226.45

Hospital Charge Code	270609209
Hospital Revenue Code	272
Min. Negotiated Rate	$5.46
Max. Negotiated Rate	$113.22
Rate for Payer: Aetna Commercial	$86.05
Rate for Payer: Aetna Medicare Advantage	$67.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.74
Rate for Payer: Cigna Commercial	$113.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.94
Rate for Payer: Oxford Commercial	$45.29
Rate for Payer: Qualcare PPO/HMO/WC	$33.97
Rate for Payer: UnitedHealthcare Commercial	$45.29
Rate for Payer: UnitedHealthcare Community & State	$5.46
Rate for Payer: Wellpoint Medicaid Managed Care	$6.00

DRAPE CRANIOTOMY 89062

Facility

$226.45

Hospital Charge Code	270609209
Hospital Revenue Code	272
Min. Negotiated Rate	$33.97
Max. Negotiated Rate	$33.97
Rate for Payer: Qualcare PPO/HMO/WC	$33.97

DRAPE ENT 89358

Facility

$44.85

Hospital Charge Code	270620011
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.43
Rate for Payer: Aetna Commercial	$17.04
Rate for Payer: Aetna Medicare Advantage	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.44
Rate for Payer: Cigna Commercial	$22.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.46
Rate for Payer: Oxford Commercial	$8.97
Rate for Payer: Qualcare PPO/HMO/WC	$6.73
Rate for Payer: UnitedHealthcare Commercial	$8.97
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

DRAPE ENT 89358

Facility

$44.85

Hospital Charge Code	270620011
Hospital Revenue Code	272
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$6.73
Rate for Payer: Qualcare PPO/HMO/WC	$6.73

DRAPE ENT MICROSCOPE

Facility

$40.79

Hospital Charge Code	270657784
Hospital Revenue Code	270
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$20.39
Rate for Payer: Aetna Commercial	$15.50
Rate for Payer: Aetna Medicare Advantage	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.40
Rate for Payer: Cigna Commercial	$20.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.24
Rate for Payer: Oxford Commercial	$8.16
Rate for Payer: Qualcare PPO/HMO/WC	$6.12
Rate for Payer: UnitedHealthcare Commercial	$8.16
Rate for Payer: UnitedHealthcare Community & State	$0.98
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

DRAPE ENT MICROSCOPE

Facility

$40.79

Hospital Charge Code	270657784
Hospital Revenue Code	270
Min. Negotiated Rate	$6.12
Max. Negotiated Rate	$6.12
Rate for Payer: Qualcare PPO/HMO/WC	$6.12

DRAPE FLUOROSCOPE 4509001012

Facility

$4.00

Hospital Charge Code	270630333
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

DRAPE FLUOROSCOPE 4509001012

Facility

$4.00

Hospital Charge Code	270630333
Hospital Revenue Code	272
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

Know your out-of-pocket cost for care.

All Charges