Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRAPE MICROSCOPE DISP

Facility

$90.00

Hospital Charge Code	270658254
Hospital Revenue Code	270
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

DRAPE MICROSCOPE DISP

Facility

$90.00

Hospital Charge Code	270658254
Hospital Revenue Code	270
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.00
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

DRAPE MICROSCOPE URBAN M1071

Facility

$83.25

Hospital Charge Code	270601772
Hospital Revenue Code	272
Min. Negotiated Rate	$2.01
Max. Negotiated Rate	$41.62
Rate for Payer: Aetna Commercial	$31.64
Rate for Payer: Aetna Medicare Advantage	$24.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.23
Rate for Payer: Cigna Commercial	$41.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.98
Rate for Payer: Oxford Commercial	$16.65
Rate for Payer: Qualcare PPO/HMO/WC	$12.49
Rate for Payer: UnitedHealthcare Commercial	$16.65
Rate for Payer: UnitedHealthcare Community & State	$2.01
Rate for Payer: Wellpoint Medicaid Managed Care	$2.21

DRAPE MICROSCOPE URBAN M1071

Facility

$83.25

Hospital Charge Code	270601772
Hospital Revenue Code	272
Min. Negotiated Rate	$12.49
Max. Negotiated Rate	$12.49
Rate for Payer: Qualcare PPO/HMO/WC	$12.49

DRAPE NEURO IOBAN 6640

Facility

$57.65

Hospital Charge Code	270600326
Hospital Revenue Code	272
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$8.65

DRAPE NEURO IOBAN 6640

Facility

$57.65

Hospital Charge Code	270600326
Hospital Revenue Code	272
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$28.82
Rate for Payer: Aetna Commercial	$21.91
Rate for Payer: Aetna Medicare Advantage	$17.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.70
Rate for Payer: Cigna Commercial	$28.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.30
Rate for Payer: Oxford Commercial	$11.53
Rate for Payer: Qualcare PPO/HMO/WC	$8.65
Rate for Payer: UnitedHealthcare Commercial	$11.53
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.53

DRAPE NEUROLOGICAL W/XL POUCH

Facility

$97.62

Hospital Charge Code	270653749
Hospital Revenue Code	270
Min. Negotiated Rate	$14.64
Max. Negotiated Rate	$14.64
Rate for Payer: Qualcare PPO/HMO/WC	$14.64

DRAPE NEUROLOGICAL W/XL POUCH

Facility

$97.62

Hospital Charge Code	270653749
Hospital Revenue Code	270
Min. Negotiated Rate	$2.35
Max. Negotiated Rate	$48.81
Rate for Payer: Aetna Commercial	$37.10
Rate for Payer: Aetna Medicare Advantage	$29.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.89
Rate for Payer: Cigna Commercial	$48.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.29
Rate for Payer: Oxford Commercial	$19.52
Rate for Payer: Qualcare PPO/HMO/WC	$14.64
Rate for Payer: UnitedHealthcare Commercial	$19.52
Rate for Payer: UnitedHealthcare Community & State	$2.35
Rate for Payer: Wellpoint Medicaid Managed Care	$2.59

DRAPE OPHTHALMIC BASIC 89305

Facility

$37.65

Hospital Charge Code	270614336
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.82
Rate for Payer: Aetna Commercial	$14.31
Rate for Payer: Aetna Medicare Advantage	$11.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.60
Rate for Payer: Cigna Commercial	$18.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.29
Rate for Payer: Oxford Commercial	$7.53
Rate for Payer: Qualcare PPO/HMO/WC	$5.65
Rate for Payer: UnitedHealthcare Commercial	$7.53
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

DRAPE OPHTHALMIC BASIC 89305

Facility

$37.65

Hospital Charge Code	270614336
Hospital Revenue Code	272
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$5.65
Rate for Payer: Qualcare PPO/HMO/WC	$5.65

DRAPE OPMI STER XL 65mm LF

Facility

$536.60

Hospital Charge Code	270655870
Hospital Revenue Code	271
Min. Negotiated Rate	$12.93
Max. Negotiated Rate	$268.30
Rate for Payer: Aetna Commercial	$203.91
Rate for Payer: Aetna Medicare Advantage	$160.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.83
Rate for Payer: Cigna Commercial	$268.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.98
Rate for Payer: Oxford Commercial	$107.32
Rate for Payer: Qualcare PPO/HMO/WC	$80.49
Rate for Payer: UnitedHealthcare Commercial	$107.32
Rate for Payer: UnitedHealthcare Community & State	$12.93
Rate for Payer: Wellpoint Medicaid Managed Care	$14.22

DRAPE OPMI STER XL 65mm LF

Facility

$536.60

Hospital Charge Code	270655870
Hospital Revenue Code	271
Min. Negotiated Rate	$80.49
Max. Negotiated Rate	$80.49
Rate for Payer: Qualcare PPO/HMO/WC	$80.49

DRAPE ORTHOARTS HAND 89272

Facility

$194.45

Hospital Charge Code	270609211
Hospital Revenue Code	272
Min. Negotiated Rate	$4.69
Max. Negotiated Rate	$97.22
Rate for Payer: Aetna Commercial	$73.89
Rate for Payer: Aetna Medicare Advantage	$58.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.58
Rate for Payer: Cigna Commercial	$97.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.34
Rate for Payer: Oxford Commercial	$38.89
Rate for Payer: Qualcare PPO/HMO/WC	$29.17
Rate for Payer: UnitedHealthcare Commercial	$38.89
Rate for Payer: UnitedHealthcare Community & State	$4.69
Rate for Payer: Wellpoint Medicaid Managed Care	$5.15

DRAPE ORTHOARTS HAND 89272

Facility

$194.45

Hospital Charge Code	270609211
Hospital Revenue Code	272
Min. Negotiated Rate	$29.17
Max. Negotiated Rate	$29.17
Rate for Payer: Qualcare PPO/HMO/WC	$29.17

DRAPE ORTHO BAR 9381

Facility

$33.65

Hospital Charge Code	270620432
Hospital Revenue Code	279
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$16.82
Rate for Payer: Aetna Commercial	$12.79
Rate for Payer: Aetna Medicare Advantage	$10.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.58
Rate for Payer: Cigna Commercial	$16.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.10
Rate for Payer: Oxford Commercial	$6.73
Rate for Payer: Qualcare PPO/HMO/WC	$5.05
Rate for Payer: UnitedHealthcare Commercial	$6.73
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.89

DRAPE ORTHO BAR 9381

Facility

$33.65

Hospital Charge Code	270620432
Hospital Revenue Code	279
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$5.05
Rate for Payer: Qualcare PPO/HMO/WC	$5.05

DRAPE ORTHO SPLIT 89331

Facility

$24.85

Hospital Charge Code	270621255
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$9.44
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.46
Rate for Payer: Oxford Commercial	$4.97
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$4.97
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

DRAPE ORTHO SPLIT 89331

Facility

$24.85

Hospital Charge Code	270621255
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

DRAPE PEDIATRIC MAJOR OPTIMA

Facility

$22.10

Hospital Charge Code	270652032
Hospital Revenue Code	270
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$3.31
Rate for Payer: Qualcare PPO/HMO/WC	$3.31

DRAPE PEDIATRIC MAJOR OPTIMA

Facility

$22.10

Hospital Charge Code	270652032
Hospital Revenue Code	270
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$11.05
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.64
Rate for Payer: Cigna Commercial	$11.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.63
Rate for Payer: Oxford Commercial	$4.42
Rate for Payer: Qualcare PPO/HMO/WC	$3.31
Rate for Payer: UnitedHealthcare Commercial	$4.42
Rate for Payer: UnitedHealthcare Community & State	$0.53
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

DRAPE SHEET HALF 9358

Facility

$12.38

Hospital Charge Code	270649149
Hospital Revenue Code	270
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$6.19
Rate for Payer: Aetna Commercial	$4.70
Rate for Payer: Aetna Medicare Advantage	$3.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.16
Rate for Payer: Cigna Commercial	$6.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.71
Rate for Payer: Oxford Commercial	$2.48
Rate for Payer: Qualcare PPO/HMO/WC	$1.86
Rate for Payer: UnitedHealthcare Commercial	$2.48
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

DRAPE SHEET HALF 9358

Facility

$12.38

Hospital Charge Code	270649149
Hospital Revenue Code	270
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$1.86
Rate for Payer: Qualcare PPO/HMO/WC	$1.86

DRAPES OPMI 65m STERILE 306070

Facility

$69.50

Hospital Charge Code	270634097
Hospital Revenue Code	272
Min. Negotiated Rate	$1.67
Max. Negotiated Rate	$34.75
Rate for Payer: Aetna Commercial	$26.41
Rate for Payer: Aetna Medicare Advantage	$20.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.72
Rate for Payer: Cigna Commercial	$34.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.85
Rate for Payer: Oxford Commercial	$13.90
Rate for Payer: Qualcare PPO/HMO/WC	$10.43
Rate for Payer: UnitedHealthcare Commercial	$13.90
Rate for Payer: UnitedHealthcare Community & State	$1.67
Rate for Payer: Wellpoint Medicaid Managed Care	$1.84

DRAPES OPMI 65m STERILE 306070

Facility

$69.50

Hospital Charge Code	270634097
Hospital Revenue Code	272
Min. Negotiated Rate	$10.43
Max. Negotiated Rate	$10.43
Rate for Payer: Qualcare PPO/HMO/WC	$10.43

DRAPE SRGCL FMRL ANGRPHY 89711

Facility

$33.95

Hospital Charge Code	270648179C
Hospital Revenue Code	272
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$16.98
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$10.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.66
Rate for Payer: Cigna Commercial	$16.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.19
Rate for Payer: Oxford Commercial	$6.79
Rate for Payer: Qualcare PPO/HMO/WC	$5.09
Rate for Payer: UnitedHealthcare Commercial	$6.79
Rate for Payer: UnitedHealthcare Community & State	$0.82
Rate for Payer: Wellpoint Medicaid Managed Care	$0.90

Know your out-of-pocket cost for care.

All Charges