Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

DRAPE STERI 36x36 1051

Facility

$32.62

Hospital Charge Code	270649151
Hospital Revenue Code	272
Min. Negotiated Rate	$4.89
Max. Negotiated Rate	$4.89
Rate for Payer: Qualcare PPO/HMO/WC	$4.89

DRAPE STERI 36x36 1051

Facility

$32.62

Hospital Charge Code	270649151
Hospital Revenue Code	272
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$16.31
Rate for Payer: Aetna Commercial	$12.40
Rate for Payer: Aetna Medicare Advantage	$9.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.32
Rate for Payer: Cigna Commercial	$16.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.79
Rate for Payer: Oxford Commercial	$6.52
Rate for Payer: Qualcare PPO/HMO/WC	$4.89
Rate for Payer: UnitedHealthcare Commercial	$6.52
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.86

DRAPE STERI EYE 1020

Facility

$29.65

Hospital Charge Code	270060770
Hospital Revenue Code	272
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$4.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.45

DRAPE STERI EYE 1020

Facility

$29.65

Hospital Charge Code	270060770
Hospital Revenue Code	272
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$14.82
Rate for Payer: Aetna Commercial	$11.27
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.56
Rate for Payer: Cigna Commercial	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.89
Rate for Payer: Oxford Commercial	$5.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.45
Rate for Payer: UnitedHealthcare Commercial	$5.93
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

DRAPE STERI EYE 1020

Facility

$7.57

Hospital Charge Code	270642907
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$1.14
Rate for Payer: Qualcare PPO/HMO/WC	$1.14

DRAPE STERI EYE 1020

Facility

$7.57

Hospital Charge Code	270642907
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.79
Rate for Payer: Aetna Commercial	$2.88
Rate for Payer: Aetna Medicare Advantage	$2.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.93
Rate for Payer: Cigna Commercial	$3.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.27
Rate for Payer: Oxford Commercial	$1.51
Rate for Payer: Qualcare PPO/HMO/WC	$1.14
Rate for Payer: UnitedHealthcare Commercial	$1.51
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

DRAPE STERI ISOLATION BAG

Facility

$15.73

Hospital Charge Code	270647759
Hospital Revenue Code	270
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$7.87
Rate for Payer: Aetna Commercial	$5.98
Rate for Payer: Aetna Medicare Advantage	$4.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.01
Rate for Payer: Cigna Commercial	$7.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.72
Rate for Payer: Oxford Commercial	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$2.36
Rate for Payer: UnitedHealthcare Commercial	$3.15
Rate for Payer: UnitedHealthcare Community & State	$0.38
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

DRAPE STERI ISOLATION BAG

Facility

$15.73

Hospital Charge Code	270647759
Hospital Revenue Code	270
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$2.36
Rate for Payer: Qualcare PPO/HMO/WC	$2.36

DRAPE STERI LARGE 1050

Facility

$52.00

Hospital Charge Code	270060780
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

DRAPE STERI LARGE 1050

Facility

$52.00

Hospital Charge Code	270060780
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

DRAPE STERI MEDIUM 1040

Facility

$10.25

Hospital Charge Code	270641460
Hospital Revenue Code	270
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.54

DRAPE STERI MEDIUM 1040

Facility

$10.25

Hospital Charge Code	270641460
Hospital Revenue Code	270
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.12
Rate for Payer: Aetna Commercial	$3.90
Rate for Payer: Aetna Medicare Advantage	$3.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.61
Rate for Payer: Cigna Commercial	$5.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.08
Rate for Payer: Oxford Commercial	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.54
Rate for Payer: UnitedHealthcare Commercial	$2.05
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

DRAPE STERI ORTHO 1010

Facility

$6.97

Hospital Charge Code	270600336
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.48
Rate for Payer: Aetna Commercial	$2.65
Rate for Payer: Aetna Medicare Advantage	$2.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.09
Rate for Payer: Oxford Commercial	$1.39
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.39
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

DRAPE STERI ORTHO 1010

Facility

$6.97

Hospital Charge Code	270600336
Hospital Revenue Code	272
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

DRAPE STERI SMALL 1040

Facility

$39.25

Hospital Charge Code	270060775
Hospital Revenue Code	272
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$5.89
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

DRAPE STERI SMALL 1040

Facility

$39.25

Hospital Charge Code	270060775
Hospital Revenue Code	272
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.62
Rate for Payer: Aetna Commercial	$14.91
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.78
Rate for Payer: Oxford Commercial	$7.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Commercial	$7.85
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

DRAPE STERI U 1015

Facility

$72.00

Hospital Charge Code	270613000
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$36.00
Rate for Payer: Aetna Commercial	$27.36
Rate for Payer: Aetna Medicare Advantage	$21.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.36
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.60
Rate for Payer: Oxford Commercial	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$14.40
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

DRAPE STERI U 1015

Facility

$72.00

Hospital Charge Code	270613000
Hospital Revenue Code	272
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

DRAPE STERI UROLOG 1071

Facility

$60.00

Hospital Charge Code	270060785
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.00
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

DRAPE STERI UROLOG 1071

Facility

$60.00

Hospital Charge Code	270060785
Hospital Revenue Code	272
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

DRAPE STERI UROLOGICAL

Facility

$22.09

Hospital Charge Code	270641462
Hospital Revenue Code	272
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$11.04
Rate for Payer: Aetna Commercial	$8.39
Rate for Payer: Aetna Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.63
Rate for Payer: Cigna Commercial	$11.04
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 STERI UROLOGICAL

Facility

$22.09

Hospital Charge Code	270641462
Hospital Revenue Code	272
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$3.31
Rate for Payer: Qualcare PPO/HMO/WC	$3.31

DRAPE SURGICAL STERI-DRAPE43-1

Facility

$21.63

Hospital Charge Code	270653208
Hospital Revenue Code	272
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$10.81
Rate for Payer: Aetna Commercial	$8.22
Rate for Payer: Aetna Medicare Advantage	$6.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.52
Rate for Payer: Cigna Commercial	$10.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.49
Rate for Payer: Oxford Commercial	$4.33
Rate for Payer: Qualcare PPO/HMO/WC	$3.24
Rate for Payer: UnitedHealthcare Commercial	$4.33
Rate for Payer: UnitedHealthcare Community & State	$0.52
Rate for Payer: Wellpoint Medicaid Managed Care	$0.57

DRAPE SURGICAL STERI-DRAPE43-1

Facility

$21.63

Hospital Charge Code	270653208
Hospital Revenue Code	272
Min. Negotiated Rate	$3.24
Max. Negotiated Rate	$3.24
Rate for Payer: Qualcare PPO/HMO/WC	$3.24

Know your out-of-pocket cost for care.

All Charges