Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRAPE LAP CHOLE 89225

Facility

$140.00

Hospital Charge Code	270609215
Hospital Revenue Code	272
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$70.00
Rate for Payer: Aetna Commercial	$53.20
Rate for Payer: Aetna Medicare Advantage	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.70
Rate for Payer: Cigna Commercial	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.00
Rate for Payer: Oxford Commercial	$28.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00
Rate for Payer: UnitedHealthcare Commercial	$28.00
Rate for Payer: UnitedHealthcare Community & State	$3.37
Rate for Payer: Wellpoint Medicaid Managed Care	$3.71

DRAPE LAP PELVI 89222

Facility

$69.65

Hospital Charge Code	270620009
Hospital Revenue Code	272
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$34.83
Rate for Payer: Aetna Commercial	$26.47
Rate for Payer: Aetna Medicare Advantage	$20.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.76
Rate for Payer: Cigna Commercial	$34.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.89
Rate for Payer: Oxford Commercial	$13.93
Rate for Payer: Qualcare PPO/HMO/WC	$10.45
Rate for Payer: UnitedHealthcare Commercial	$13.93
Rate for Payer: UnitedHealthcare Community & State	$1.68
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

DRAPE LAP PELVI 89222

Facility

$69.65

Hospital Charge Code	270620009
Hospital Revenue Code	272
Min. Negotiated Rate	$10.45
Max. Negotiated Rate	$10.45
Rate for Payer: Qualcare PPO/HMO/WC	$10.45

DRAPE LASER ARM 21-12050

Facility

$124.85

Hospital Charge Code	270600244
Hospital Revenue Code	272
Min. Negotiated Rate	$18.73
Max. Negotiated Rate	$18.73
Rate for Payer: Qualcare PPO/HMO/WC	$18.73

DRAPE LASER ARM 21-12050

Facility

$124.85

Hospital Charge Code	270600244
Hospital Revenue Code	272
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.42
Rate for Payer: Aetna Commercial	$47.44
Rate for Payer: Aetna Medicare Advantage	$37.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.84
Rate for Payer: Cigna Commercial	$62.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.45
Rate for Payer: Oxford Commercial	$24.97
Rate for Payer: Qualcare PPO/HMO/WC	$18.73
Rate for Payer: UnitedHealthcare Commercial	$24.97
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

DRAPE LEGGINGS 8420

Facility

$11.48

Hospital Charge Code	270649148
Hospital Revenue Code	272
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$1.72
Rate for Payer: Qualcare PPO/HMO/WC	$1.72

DRAPE LEGGINGS 8420

Facility

$11.48

Hospital Charge Code	270649148
Hospital Revenue Code	272
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$5.74
Rate for Payer: Aetna Commercial	$4.36
Rate for Payer: Aetna Medicare Advantage	$3.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.93
Rate for Payer: Cigna Commercial	$5.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.44
Rate for Payer: Oxford Commercial	$2.30
Rate for Payer: Qualcare PPO/HMO/WC	$1.72
Rate for Payer: UnitedHealthcare Commercial	$2.30
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

DRAPE LG W/REVERSE FOLD 89122

Facility

$20.85

Hospital Charge Code	270609200
Hospital Revenue Code	272
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$3.13
Rate for Payer: Qualcare PPO/HMO/WC	$3.13

DRAPE LG W/REVERSE FOLD 89122

Facility

$20.85

Hospital Charge Code	270609200
Hospital Revenue Code	272
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$10.43
Rate for Payer: Aetna Commercial	$7.92
Rate for Payer: Aetna Medicare Advantage	$6.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.32
Rate for Payer: Cigna Commercial	$10.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.25
Rate for Payer: Oxford Commercial	$4.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.13
Rate for Payer: UnitedHealthcare Commercial	$4.17
Rate for Payer: UnitedHealthcare Community & State	$0.50
Rate for Payer: Wellpoint Medicaid Managed Care	$0.55

DRAPE LOWER EXTREMITY 89276

Facility

$54.45

Hospital Charge Code	270620422
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$27.23
Rate for Payer: Aetna Commercial	$20.69
Rate for Payer: Aetna Medicare Advantage	$16.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.88
Rate for Payer: Cigna Commercial	$27.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.34
Rate for Payer: Oxford Commercial	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$8.17
Rate for Payer: UnitedHealthcare Commercial	$10.89
Rate for Payer: UnitedHealthcare Community & State	$1.31
Rate for Payer: Wellpoint Medicaid Managed Care	$1.44

DRAPE LOWER EXTREMITY 89276

Facility

$54.45

Hospital Charge Code	270620422
Hospital Revenue Code	272
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$8.17

DRAPE MAGNETIC 30/CS

Facility

$20.65

Hospital Charge Code	270655944
Hospital Revenue Code	270
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$10.32
Rate for Payer: Aetna Commercial	$7.85
Rate for Payer: Aetna Medicare Advantage	$6.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.27
Rate for Payer: Cigna Commercial	$10.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.20
Rate for Payer: Oxford Commercial	$4.13
Rate for Payer: Qualcare PPO/HMO/WC	$3.10
Rate for Payer: UnitedHealthcare Commercial	$4.13
Rate for Payer: UnitedHealthcare Community & State	$0.50
Rate for Payer: Wellpoint Medicaid Managed Care	$0.55

DRAPE MAGNETIC 30/CS

Facility

$20.65

Hospital Charge Code	270655944
Hospital Revenue Code	270
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$3.10
Rate for Payer: Qualcare PPO/HMO/WC	$3.10

DRAPE MAGNETIC INST W/STAYS

Facility

$20.65

Hospital Charge Code	270651665
Hospital Revenue Code	272
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$10.32
Rate for Payer: Aetna Commercial	$7.85
Rate for Payer: Aetna Medicare Advantage	$6.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.27
Rate for Payer: Cigna Commercial	$10.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.20
Rate for Payer: Oxford Commercial	$4.13
Rate for Payer: Qualcare PPO/HMO/WC	$3.10
Rate for Payer: UnitedHealthcare Commercial	$4.13
Rate for Payer: UnitedHealthcare Community & State	$0.50
Rate for Payer: Wellpoint Medicaid Managed Care	$0.55

DRAPE MAGNETIC INST W/STAYS

Facility

$20.65

Hospital Charge Code	270651665
Hospital Revenue Code	272
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$3.10
Rate for Payer: Qualcare PPO/HMO/WC	$3.10

DRAPE MAGNETIC SURGICAL PHRM**

Facility

$13.00

Hospital Charge Code	1601053
Hospital Revenue Code	272
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

DRAPE MAGNETIC SURGICAL PHRM**

Facility

$13.00

Hospital Charge Code	1601053
Hospital Revenue Code	272
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

DRAPE MCRSCPE ZEIS46x80 4862CL

Facility

$101.40

Hospital Charge Code	270641323
Hospital Revenue Code	272
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$50.70
Rate for Payer: Aetna Commercial	$38.53
Rate for Payer: Aetna Medicare Advantage	$30.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.86
Rate for Payer: Cigna Commercial	$50.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.42
Rate for Payer: Oxford Commercial	$20.28
Rate for Payer: Qualcare PPO/HMO/WC	$15.21
Rate for Payer: UnitedHealthcare Commercial	$20.28
Rate for Payer: UnitedHealthcare Community & State	$2.44
Rate for Payer: Wellpoint Medicaid Managed Care	$2.69

DRAPE MCRSCPE ZEIS46x80 4862CL

Facility

$101.40

Hospital Charge Code	270641323
Hospital Revenue Code	272
Min. Negotiated Rate	$15.21
Max. Negotiated Rate	$15.21
Rate for Payer: Qualcare PPO/HMO/WC	$15.21

DRAPE MICROSCOPE *****

Facility

$98.00

Hospital Charge Code	1600717
Hospital Revenue Code	272
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$14.70
Rate for Payer: Qualcare PPO/HMO/WC	$14.70

DRAPE MICROSCOPE *****

Facility

$98.00

Hospital Charge Code	1600717
Hospital Revenue Code	272
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$49.00
Rate for Payer: Aetna Commercial	$37.24
Rate for Payer: Aetna Medicare Advantage	$29.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.40
Rate for Payer: Oxford Commercial	$19.60
Rate for Payer: Qualcare PPO/HMO/WC	$14.70
Rate for Payer: UnitedHealthcare Commercial	$19.60
Rate for Payer: UnitedHealthcare Community & State	$2.36
Rate for Payer: Wellpoint Medicaid Managed Care	$2.60

DRAPE MICROSCOPE*******

Facility

$82.00

Hospital Charge Code	1608140
Hospital Revenue Code	272
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$41.00
Rate for Payer: Aetna Commercial	$31.16
Rate for Payer: Aetna Medicare Advantage	$24.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.91
Rate for Payer: Cigna Commercial	$41.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.60
Rate for Payer: Oxford Commercial	$16.40
Rate for Payer: Qualcare PPO/HMO/WC	$12.30
Rate for Payer: UnitedHealthcare Commercial	$16.40
Rate for Payer: UnitedHealthcare Community & State	$1.98
Rate for Payer: Wellpoint Medicaid Managed Care	$2.17

DRAPE MICROSCOPE*******

Facility

$82.00

Hospital Charge Code	1608140
Hospital Revenue Code	272
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$12.30
Rate for Payer: Qualcare PPO/HMO/WC	$12.30

DRAPE MICROSCOPE 41X64 M1071

Facility

$256.00

Hospital Charge Code	270601099
Hospital Revenue Code	272
Min. Negotiated Rate	$6.17
Max. Negotiated Rate	$128.00
Rate for Payer: Aetna Commercial	$97.28
Rate for Payer: Aetna Medicare Advantage	$76.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.28
Rate for Payer: Cigna Commercial	$128.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.80
Rate for Payer: Oxford Commercial	$51.20
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$51.20
Rate for Payer: UnitedHealthcare Community & State	$6.17
Rate for Payer: Wellpoint Medicaid Managed Care	$6.78

DRAPE MICROSCOPE 41X64 M1071

Facility

$256.00

Hospital Charge Code	270601099
Hospital Revenue Code	272
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

Know your out-of-pocket cost for care.

All Charges