Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRESSING KIT PRO-1

Facility

$175.00

Hospital Charge Code	270647395
Hospital Revenue Code	271
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

DRESSING KIT PRO-1

Facility

$175.00

Hospital Charge Code	270647395
Hospital Revenue Code	271
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.50
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$35.00
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

DRESSING MAXORB EXT AG MSC9445

Facility

$39.40

Hospital Charge Code	270639867W
Hospital Revenue Code	272
Min. Negotiated Rate	$5.91
Max. Negotiated Rate	$5.91
Rate for Payer: Qualcare PPO/HMO/WC	$5.91

DRESSING MAXORB EXT AG MSC9445

Facility

$39.40

Hospital Charge Code	270639867W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.70
Rate for Payer: Aetna Commercial	$14.97
Rate for Payer: Aetna Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.05
Rate for Payer: Cigna Commercial	$19.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.82
Rate for Payer: Oxford Commercial	$7.88
Rate for Payer: Qualcare PPO/HMO/WC	$5.91
Rate for Payer: UnitedHealthcare Commercial	$7.88
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

DRESSING MEDIHONEY CA ALGI 2X2

Facility

$18.95

Hospital Charge Code	270666019
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.47
Rate for Payer: Aetna Commercial	$7.20
Rate for Payer: Aetna Medicare Advantage	$5.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.83
Rate for Payer: Cigna Commercial	$9.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.68
Rate for Payer: Oxford Commercial	$3.79
Rate for Payer: Qualcare PPO/HMO/WC	$2.84
Rate for Payer: UnitedHealthcare Commercial	$3.79
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

DRESSING MEDIHONEY CA ALGI 2X2

Facility

$18.95

Hospital Charge Code	270666019
Hospital Revenue Code	272
Min. Negotiated Rate	$2.84
Max. Negotiated Rate	$2.84
Rate for Payer: Qualcare PPO/HMO/WC	$2.84

DRESSING MEDIHONEY COLLIOD 2X2

Facility

$19.04

Hospital Charge Code	270669979
Hospital Revenue Code	272
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$2.86
Rate for Payer: Qualcare PPO/HMO/WC	$2.86

DRESSING MEDIHONEY COLLIOD 2X2

Facility

$19.04

Hospital Charge Code	270669979
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.52
Rate for Payer: Aetna Commercial	$7.24
Rate for Payer: Aetna Medicare Advantage	$5.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.86
Rate for Payer: Cigna Commercial	$9.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.71
Rate for Payer: Oxford Commercial	$3.81
Rate for Payer: Qualcare PPO/HMO/WC	$2.86
Rate for Payer: UnitedHealthcare Commercial	$3.81
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

DRESSING MEDIHONEY COLLOID 4X5

Facility

$43.27

Hospital Charge Code	270669978
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.64
Rate for Payer: Aetna Commercial	$16.44
Rate for Payer: Aetna Medicare Advantage	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.98
Rate for Payer: Oxford Commercial	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$8.65
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

DRESSING MEDIHONEY COLLOID 4X5

Facility

$43.27

Hospital Charge Code	270669978
Hospital Revenue Code	272
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

DRESSING MEDIHONEY GEL 0.5 OZ

Facility

$26.64

Hospital Charge Code	270666020
Hospital Revenue Code	250
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.00

DRESSING MEDIHONEY GEL 0.5 OZ

Facility

$26.64

Hospital Charge Code	270666020
Hospital Revenue Code	250
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$13.32
Rate for Payer: Aetna Commercial	$10.12
Rate for Payer: Aetna Medicare Advantage	$7.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.79
Rate for Payer: Cigna Commercial	$13.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.99
Rate for Payer: Oxford Commercial	$5.33
Rate for Payer: Qualcare PPO/HMO/WC	$4.00
Rate for Payer: UnitedHealthcare Commercial	$5.33
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

DRESSING MEPILEX BORDER 4INX4I

Facility

$15.00

Hospital Charge Code	270685348
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

DRESSING MEPILEX BORDER 4INX4I

Facility

$15.00

Hospital Charge Code	270685348
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

DRESSING MEPILEX BORDER 6INX6I

Facility

$67.01

Hospital Charge Code	270685349
Hospital Revenue Code	272
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

DRESSING MEPILEX BORDER 6INX6I

Facility

$67.01

Hospital Charge Code	270685349
Hospital Revenue Code	272
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$33.51
Rate for Payer: Aetna Commercial	$25.46
Rate for Payer: Aetna Medicare Advantage	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.09
Rate for Payer: Cigna Commercial	$33.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.10
Rate for Payer: Oxford Commercial	$13.40
Rate for Payer: Qualcare PPO/HMO/WC	$10.05
Rate for Payer: UnitedHealthcare Commercial	$13.40
Rate for Payer: UnitedHealthcare Community & State	$1.61
Rate for Payer: Wellpoint Medicaid Managed Care	$1.78

DRESSING MEPILEX HEEL 22 x23CM

Facility

$54.05

Hospital Charge Code	270685380
Hospital Revenue Code	272
Min. Negotiated Rate	$8.11
Max. Negotiated Rate	$8.11
Rate for Payer: Qualcare PPO/HMO/WC	$8.11

DRESSING MEPILEX HEEL 22 x23CM

Facility

$54.05

Hospital Charge Code	270685380
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$27.02
Rate for Payer: Aetna Commercial	$20.54
Rate for Payer: Aetna Medicare Advantage	$16.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.78
Rate for Payer: Cigna Commercial	$27.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.21
Rate for Payer: Oxford Commercial	$10.81
Rate for Payer: Qualcare PPO/HMO/WC	$8.11
Rate for Payer: UnitedHealthcare Commercial	$10.81
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

DRESSING MEPITEL ONE 2x3

Facility

$16.35

Hospital Charge Code	270677978
Hospital Revenue Code	272
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$2.45
Rate for Payer: Qualcare PPO/HMO/WC	$2.45

DRESSING MEPITEL ONE 2x3

Facility

$16.35

Hospital Charge Code	270677978
Hospital Revenue Code	272
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$8.18
Rate for Payer: Aetna Commercial	$6.21
Rate for Payer: Aetna Medicare Advantage	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.17
Rate for Payer: Cigna Commercial	$8.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.91
Rate for Payer: Oxford Commercial	$3.27
Rate for Payer: Qualcare PPO/HMO/WC	$2.45
Rate for Payer: UnitedHealthcare Commercial	$3.27
Rate for Payer: UnitedHealthcare Community & State	$0.39
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

DRESSING MEPLIEX XT 4x4IN

Facility

$17.41

Hospital Charge Code	270685406
Hospital Revenue Code	272
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$2.61
Rate for Payer: Qualcare PPO/HMO/WC	$2.61

DRESSING MEPLIEX XT 4x4IN

Facility

$17.41

Hospital Charge Code	270685406
Hospital Revenue Code	272
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$8.71
Rate for Payer: Aetna Commercial	$6.62
Rate for Payer: Aetna Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.44
Rate for Payer: Cigna Commercial	$8.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.22
Rate for Payer: Oxford Commercial	$3.48
Rate for Payer: Qualcare PPO/HMO/WC	$2.61
Rate for Payer: UnitedHealthcare Commercial	$3.48
Rate for Payer: UnitedHealthcare Community & State	$0.42
Rate for Payer: Wellpoint Medicaid Managed Care	$0.46

DRESSING MEXTRA 5 x 5 IN

Facility

$8.77

Hospital Charge Code	270685408
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.38
Rate for Payer: Aetna Commercial	$3.33
Rate for Payer: Aetna Medicare Advantage	$2.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.24
Rate for Payer: Cigna Commercial	$4.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.63
Rate for Payer: Oxford Commercial	$1.75
Rate for Payer: Qualcare PPO/HMO/WC	$1.32
Rate for Payer: UnitedHealthcare Commercial	$1.75
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

DRESSING MEXTRA 5 x 5 IN

Facility

$8.77

Hospital Charge Code	270685408
Hospital Revenue Code	272
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$1.32
Rate for Payer: Qualcare PPO/HMO/WC	$1.32

DRESSING MINI ISLAND TELFA 2X3

Facility

$2.00

Hospital Charge Code	270649163
Hospital Revenue Code	272
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.76
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.60
Rate for Payer: Oxford Commercial	$0.40
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$0.40
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

Know your out-of-pocket cost for care.

All Charges