Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRESSG VIGILON 4X4 STER

Facility

$32.00

Hospital Charge Code	270350200
Hospital Revenue Code	272
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

DRESSG VIGILON 4X4 STER

Facility

$32.00

Hospital Charge Code	270350200
Hospital Revenue Code	272
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$6.40
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

DRESSG VIGILON WOUND 4X4******

Facility

$9.00

Hospital Charge Code	8002933
Hospital Revenue Code	279
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

DRESSG VIGILON WOUND 4X4******

Facility

$9.00

Hospital Charge Code	8002933
Hospital Revenue Code	279
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

DRESSG WATER STER 4X8

Facility

$13.65

Hospital Charge Code	270350015
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$5.19
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.09
Rate for Payer: Oxford Commercial	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$2.73
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

DRESSG WATER STER 4X8

Facility

$13.65

Hospital Charge Code	270350015
Hospital Revenue Code	272
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

DRESSG WET******

Facility

$285.00

Hospital Charge Code	8002172
Hospital Revenue Code	279
Min. Negotiated Rate	$42.75
Max. Negotiated Rate	$42.75
Rate for Payer: Qualcare PPO/HMO/WC	$42.75

DRESSG WET******

Facility

$285.00

Hospital Charge Code	8002172
Hospital Revenue Code	279
Min. Negotiated Rate	$6.87
Max. Negotiated Rate	$142.50
Rate for Payer: Aetna Commercial	$108.30
Rate for Payer: Aetna Medicare Advantage	$85.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.67
Rate for Payer: Cigna Commercial	$142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.50
Rate for Payer: Oxford Commercial	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.75
Rate for Payer: UnitedHealthcare Commercial	$57.00
Rate for Payer: UnitedHealthcare Community & State	$6.87
Rate for Payer: Wellpoint Medicaid Managed Care	$7.55

DRESSG WET SALINE *******

Facility

$15.00

Hospital Charge Code	8004483
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$3.00
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

DRESSG WET SALINE *******

Facility

$15.00

Hospital Charge Code	8004483
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

DRESSG WET WATER *******

Facility

$11.00

Hospital Charge Code	8004475
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.50
Rate for Payer: Aetna Commercial	$4.18
Rate for Payer: Aetna Medicare Advantage	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.81
Rate for Payer: Cigna Commercial	$5.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.30
Rate for Payer: Oxford Commercial	$2.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.65
Rate for Payer: UnitedHealthcare Commercial	$2.20
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

DRESSG WET WATER *******

Facility

$11.00

Hospital Charge Code	8004475
Hospital Revenue Code	272
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

DRESSIG ALLEVYN HEEL 66007630A

Facility

$41.09

Hospital Charge Code	270639038
Hospital Revenue Code	272
Min. Negotiated Rate	$6.16
Max. Negotiated Rate	$6.16
Rate for Payer: Qualcare PPO/HMO/WC	$6.16

DRESSIG ALLEVYN HEEL 66007630A

Facility

$41.09

Hospital Charge Code	270639038
Hospital Revenue Code	272
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$20.55
Rate for Payer: Aetna Commercial	$15.61
Rate for Payer: Aetna Medicare Advantage	$12.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.48
Rate for Payer: Cigna Commercial	$20.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.33
Rate for Payer: Oxford Commercial	$8.22
Rate for Payer: Qualcare PPO/HMO/WC	$6.16
Rate for Payer: UnitedHealthcare Commercial	$8.22
Rate for Payer: UnitedHealthcare Community & State	$0.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1.09

DRESSING 3X8 ADAPTIC 6113

Facility

$2.23

Hospital Charge Code	270649156
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.33
Rate for Payer: Qualcare PPO/HMO/WC	$0.33

DRESSING 3X8 ADAPTIC 6113

Facility

$2.23

Hospital Charge Code	270649156
Hospital Revenue Code	272
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$1.11
Rate for Payer: Aetna Commercial	$0.85
Rate for Payer: Aetna Medicare Advantage	$0.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.57
Rate for Payer: Cigna Commercial	$1.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.67
Rate for Payer: Oxford Commercial	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.33
Rate for Payer: UnitedHealthcare Commercial	$0.45
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

DRESSING ACTICOAT 7 2x2 20341

Facility

$30.86

Hospital Charge Code	270639046
Hospital Revenue Code	272
Min. Negotiated Rate	$4.63
Max. Negotiated Rate	$4.63
Rate for Payer: Qualcare PPO/HMO/WC	$4.63

DRESSING ACTICOAT 7 2x2 20341

Facility

$30.86

Hospital Charge Code	270639046
Hospital Revenue Code	272
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$15.43
Rate for Payer: Aetna Commercial	$11.73
Rate for Payer: Aetna Medicare Advantage	$9.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.87
Rate for Payer: Cigna Commercial	$15.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.26
Rate for Payer: Oxford Commercial	$6.17
Rate for Payer: Qualcare PPO/HMO/WC	$4.63
Rate for Payer: UnitedHealthcare Commercial	$6.17
Rate for Payer: UnitedHealthcare Community & State	$0.74
Rate for Payer: Wellpoint Medicaid Managed Care	$0.82

DRESSING ACTICOAT 7 4x5 SN2014

Facility

$95.83

Hospital Charge Code	270627497W
Hospital Revenue Code	272
Min. Negotiated Rate	$14.37
Max. Negotiated Rate	$14.37
Rate for Payer: Qualcare PPO/HMO/WC	$14.37

DRESSING ACTICOAT 7 4x5 SN2014

Facility

$95.83

Hospital Charge Code	270627497W
Hospital Revenue Code	272
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$47.91
Rate for Payer: Aetna Commercial	$36.42
Rate for Payer: Aetna Medicare Advantage	$28.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.44
Rate for Payer: Cigna Commercial	$47.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.75
Rate for Payer: Oxford Commercial	$19.17
Rate for Payer: Qualcare PPO/HMO/WC	$14.37
Rate for Payer: UnitedHealthcare Commercial	$19.17
Rate for Payer: UnitedHealthcare Community & State	$2.31
Rate for Payer: Wellpoint Medicaid Managed Care	$2.54

DRESSING ADAPTIC 3X3 2012

Facility

$23.90

Hospital Charge Code	270620473
Hospital Revenue Code	272
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$11.95
Rate for Payer: Aetna Commercial	$9.08
Rate for Payer: Aetna Medicare Advantage	$7.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.09
Rate for Payer: Cigna Commercial	$11.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.17
Rate for Payer: Oxford Commercial	$4.78
Rate for Payer: Qualcare PPO/HMO/WC	$3.58
Rate for Payer: UnitedHealthcare Commercial	$4.78
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.63

DRESSING ADAPTIC 3X3 2012

Facility

$23.90

Hospital Charge Code	270620473
Hospital Revenue Code	272
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$3.58
Rate for Payer: Qualcare PPO/HMO/WC	$3.58

DRESSING ADHESIVE SURG 4X8 STR

Facility

$14.94

Hospital Charge Code	270649154
Hospital Revenue Code	270
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.47
Rate for Payer: Aetna Commercial	$5.68
Rate for Payer: Aetna Medicare Advantage	$4.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.81
Rate for Payer: Cigna Commercial	$7.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.48
Rate for Payer: Oxford Commercial	$2.99
Rate for Payer: Qualcare PPO/HMO/WC	$2.24
Rate for Payer: UnitedHealthcare Commercial	$2.99
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

DRESSING ADHESIVE SURG 4X8 STR

Facility

$14.94

Hospital Charge Code	270649154
Hospital Revenue Code	270
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$2.24
Rate for Payer: Qualcare PPO/HMO/WC	$2.24

DRESSING AG AQUACEL 3.5X3.75

Facility

$101.44

Hospital Charge Code	270678573
Hospital Revenue Code	272
Min. Negotiated Rate	$15.22
Max. Negotiated Rate	$15.22
Rate for Payer: Qualcare PPO/HMO/WC	$15.22

Know your out-of-pocket cost for care.

All Charges