Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRAPE SURGICAL STERI ISOLATION

Facility

$15.28

Hospital Charge Code	270643305
Hospital Revenue Code	270
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$7.64
Rate for Payer: Aetna Commercial	$5.81
Rate for Payer: Aetna Medicare Advantage	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.90
Rate for Payer: Cigna Commercial	$7.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.58
Rate for Payer: Oxford Commercial	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$2.29
Rate for Payer: UnitedHealthcare Commercial	$3.06
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

DRAPE SURGICAL STERI ISOLATION

Facility

$15.28

Hospital Charge Code	270643305
Hospital Revenue Code	270
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$2.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.29

DRAPE SWITCH

Facility

$333.35

Hospital Charge Code	270663970
Hospital Revenue Code	270
Min. Negotiated Rate	$50.00
Max. Negotiated Rate	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.00

DRAPE SWITCH

Facility

$333.35

Hospital Charge Code	270663970
Hospital Revenue Code	270
Min. Negotiated Rate	$8.03
Max. Negotiated Rate	$166.68
Rate for Payer: Aetna Commercial	$126.67
Rate for Payer: Aetna Medicare Advantage	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.00
Rate for Payer: Cigna Commercial	$166.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.00
Rate for Payer: Oxford Commercial	$66.67
Rate for Payer: Qualcare PPO/HMO/WC	$50.00
Rate for Payer: UnitedHealthcare Commercial	$66.67
Rate for Payer: UnitedHealthcare Community & State	$8.03
Rate for Payer: Wellpoint Medicaid Managed Care	$8.83

DRAPE THYROIDW/ARM COVER 89258

Facility

$80.85

Hospital Charge Code	270609217
Hospital Revenue Code	272
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$40.42
Rate for Payer: Aetna Commercial	$30.72
Rate for Payer: Aetna Medicare Advantage	$24.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.62
Rate for Payer: Cigna Commercial	$40.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.25
Rate for Payer: Oxford Commercial	$16.17
Rate for Payer: Qualcare PPO/HMO/WC	$12.13
Rate for Payer: UnitedHealthcare Commercial	$16.17
Rate for Payer: UnitedHealthcare Community & State	$1.95
Rate for Payer: Wellpoint Medicaid Managed Care	$2.14

DRAPE THYROIDW/ARM COVER 89258

Facility

$80.85

Hospital Charge Code	270609217
Hospital Revenue Code	272
Min. Negotiated Rate	$12.13
Max. Negotiated Rate	$12.13
Rate for Payer: Qualcare PPO/HMO/WC	$12.13

DRAPE TOP EMERALD SHEET

Facility

$301.75

Hospital Charge Code	270653728
Hospital Revenue Code	270
Min. Negotiated Rate	$45.26
Max. Negotiated Rate	$45.26
Rate for Payer: Qualcare PPO/HMO/WC	$45.26

DRAPE TOP EMERALD SHEET

Facility

$301.75

Hospital Charge Code	270653728
Hospital Revenue Code	270
Min. Negotiated Rate	$7.27
Max. Negotiated Rate	$150.88
Rate for Payer: Aetna Commercial	$114.67
Rate for Payer: Aetna Medicare Advantage	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.95
Rate for Payer: Cigna Commercial	$150.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.53
Rate for Payer: Oxford Commercial	$60.35
Rate for Payer: Qualcare PPO/HMO/WC	$45.26
Rate for Payer: UnitedHealthcare Commercial	$60.35
Rate for Payer: UnitedHealthcare Community & State	$7.27
Rate for Payer: Wellpoint Medicaid Managed Care	$8.00

DRAPE TOWEL

Facility

$3.13

Hospital Charge Code	270654109
Hospital Revenue Code	270
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$1.56
Rate for Payer: Aetna Commercial	$1.19
Rate for Payer: Aetna Medicare Advantage	$0.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.80
Rate for Payer: Cigna Commercial	$1.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.94
Rate for Payer: Oxford Commercial	$0.63
Rate for Payer: Qualcare PPO/HMO/WC	$0.47
Rate for Payer: UnitedHealthcare Commercial	$0.63
Rate for Payer: UnitedHealthcare Community & State	$0.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

DRAPE TOWEL

Facility

$3.13

Hospital Charge Code	270654109
Hospital Revenue Code	270
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$0.47
Rate for Payer: Qualcare PPO/HMO/WC	$0.47

DRAPE TUR *******

Facility

$140.00

Hospital Charge Code	1608413
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 TUR *******

Facility

$140.00

Hospital Charge Code	1608413
Hospital Revenue Code	272
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

DRAPE TUR DISP 1-0437

Facility

$184.00

Hospital Charge Code	270600180
Hospital Revenue Code	272
Min. Negotiated Rate	$27.60
Max. Negotiated Rate	$27.60
Rate for Payer: Qualcare PPO/HMO/WC	$27.60

DRAPE TUR DISP 1-0437

Facility

$184.00

Hospital Charge Code	270600180
Hospital Revenue Code	272
Min. Negotiated Rate	$4.43
Max. Negotiated Rate	$92.00
Rate for Payer: Aetna Commercial	$69.92
Rate for Payer: Aetna Medicare Advantage	$55.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.92
Rate for Payer: Cigna Commercial	$92.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.20
Rate for Payer: Oxford Commercial	$36.80
Rate for Payer: Qualcare PPO/HMO/WC	$27.60
Rate for Payer: UnitedHealthcare Commercial	$36.80
Rate for Payer: UnitedHealthcare Community & State	$4.43
Rate for Payer: Wellpoint Medicaid Managed Care	$4.88

DRAPE U DISP 8475

Facility

$57.65

Hospital Charge Code	270605945
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 U DISP 8475

Facility

$57.65

Hospital Charge Code	270605945
Hospital Revenue Code	272
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$8.65

DRAPE U DISP 89301

Facility

$89.65

Hospital Charge Code	270600338
Hospital Revenue Code	272
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$44.83
Rate for Payer: Aetna Commercial	$34.07
Rate for Payer: Aetna Medicare Advantage	$26.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.86
Rate for Payer: Cigna Commercial	$44.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.89
Rate for Payer: Oxford Commercial	$17.93
Rate for Payer: Qualcare PPO/HMO/WC	$13.45
Rate for Payer: UnitedHealthcare Commercial	$17.93
Rate for Payer: UnitedHealthcare Community & State	$2.16
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

DRAPE U DISP 89301

Facility

$89.65

Hospital Charge Code	270600338
Hospital Revenue Code	272
Min. Negotiated Rate	$13.45
Max. Negotiated Rate	$13.45
Rate for Payer: Qualcare PPO/HMO/WC	$13.45

DRAPE ULTRASOUND 76x76cm

Facility

$17.01

Hospital Charge Code	270638769
Hospital Revenue Code	270
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.51
Rate for Payer: Aetna Commercial	$6.46
Rate for Payer: Aetna Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.34
Rate for Payer: Cigna Commercial	$8.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.10
Rate for Payer: Oxford Commercial	$3.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$3.40
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

DRAPE ULTRASOUND 76x76cm

Facility

$17.01

Hospital Charge Code	270638769
Hospital Revenue Code	270
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

DRAPE UNDER BTTCKS HYDROFLX HD

Facility

$1,809.00

Hospital Charge Code	270662642
Hospital Revenue Code	270
Min. Negotiated Rate	$43.60
Max. Negotiated Rate	$904.50
Rate for Payer: Aetna Commercial	$687.42
Rate for Payer: Aetna Medicare Advantage	$542.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.30
Rate for Payer: Cigna Commercial	$904.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$542.70
Rate for Payer: Oxford Commercial	$361.80
Rate for Payer: Qualcare PPO/HMO/WC	$271.35
Rate for Payer: UnitedHealthcare Commercial	$361.80
Rate for Payer: UnitedHealthcare Community & State	$43.60
Rate for Payer: Wellpoint Medicaid Managed Care	$47.94

DRAPE UNDER BTTCKS HYDROFLX HD

Facility

$1,809.00

Hospital Charge Code	270662642
Hospital Revenue Code	270
Min. Negotiated Rate	$271.35
Max. Negotiated Rate	$271.35
Rate for Payer: Qualcare PPO/HMO/WC	$271.35

DRAPE UNDERBUTTOCK STER 89414

Facility

$71.25

Hospital Charge Code	270600161
Hospital Revenue Code	272
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$10.69
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

DRAPE UNDERBUTTOCK STER 89414

Facility

$71.25

Hospital Charge Code	270600161
Hospital Revenue Code	272
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$35.62
Rate for Payer: Aetna Commercial	$27.07
Rate for Payer: Aetna Medicare Advantage	$21.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.17
Rate for Payer: Cigna Commercial	$35.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.38
Rate for Payer: Oxford Commercial	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
Rate for Payer: UnitedHealthcare Commercial	$14.25
Rate for Payer: UnitedHealthcare Community & State	$1.72
Rate for Payer: Wellpoint Medicaid Managed Care	$1.89

DRAPE UNDER BUTTOCK W/POUCH

Facility

$20.26

Hospital Charge Code	270649150
Hospital Revenue Code	272
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$3.04
Rate for Payer: Qualcare PPO/HMO/WC	$3.04

Know your out-of-pocket cost for care.

All Charges