Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

DRESSING NASAL 8 CM

Facility

$1,475.00

Hospital Charge Code	270660192
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

DRESSING NASAL 8 CM

Facility

$1,475.00

Hospital Charge Code	270660192
Hospital Revenue Code	272
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.50
Rate for Payer: Oxford Commercial	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$295.00
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

DRESSING NASAL GOODMAN

Facility

$137.50

Hospital Charge Code	270628903
Hospital Revenue Code	271
Min. Negotiated Rate	$20.62
Max. Negotiated Rate	$20.62
Rate for Payer: Qualcare PPO/HMO/WC	$20.62

DRESSING NASAL GOODMAN

Facility

$109.50

Hospital Charge Code	270638903
Hospital Revenue Code	272
Min. Negotiated Rate	$2.64
Max. Negotiated Rate	$54.75
Rate for Payer: Aetna Commercial	$41.61
Rate for Payer: Aetna Medicare Advantage	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.92
Rate for Payer: Cigna Commercial	$54.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: Oxford Commercial	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$16.43
Rate for Payer: UnitedHealthcare Commercial	$21.90
Rate for Payer: UnitedHealthcare Community & State	$2.64
Rate for Payer: Wellpoint Medicaid Managed Care	$2.90

DRESSING NASAL GOODMAN

Facility

$109.50

Hospital Charge Code	270638903
Hospital Revenue Code	272
Min. Negotiated Rate	$16.43
Max. Negotiated Rate	$16.43
Rate for Payer: Qualcare PPO/HMO/WC	$16.43

DRESSING NASAL GOODMAN

Facility

$137.50

Hospital Charge Code	270628903
Hospital Revenue Code	271
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$68.75
Rate for Payer: Aetna Commercial	$52.25
Rate for Payer: Aetna Medicare Advantage	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.06
Rate for Payer: Cigna Commercial	$68.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.25
Rate for Payer: Oxford Commercial	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$20.62
Rate for Payer: UnitedHealthcare Commercial	$27.50
Rate for Payer: UnitedHealthcare Community & State	$3.31
Rate for Payer: Wellpoint Medicaid Managed Care	$3.64

DRESSING NASAL RIEMANN

Facility

$157.50

Hospital Charge Code	270628901
Hospital Revenue Code	272
Min. Negotiated Rate	$3.80
Max. Negotiated Rate	$78.75
Rate for Payer: Aetna Commercial	$59.85
Rate for Payer: Aetna Medicare Advantage	$47.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.16
Rate for Payer: Cigna Commercial	$78.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.25
Rate for Payer: Oxford Commercial	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$23.62
Rate for Payer: UnitedHealthcare Commercial	$31.50
Rate for Payer: UnitedHealthcare Community & State	$3.80
Rate for Payer: Wellpoint Medicaid Managed Care	$4.17

DRESSING NASAL RIEMANN

Facility

$157.50

Hospital Charge Code	270628901
Hospital Revenue Code	272
Min. Negotiated Rate	$23.62
Max. Negotiated Rate	$23.62
Rate for Payer: Qualcare PPO/HMO/WC	$23.62

DRESSING NON-ADHERING 3x8 KNE

Facility

$64.38

Hospital Charge Code	270649980
Hospital Revenue Code	272
Min. Negotiated Rate	$1.55
Max. Negotiated Rate	$32.19
Rate for Payer: Aetna Commercial	$24.46
Rate for Payer: Aetna Medicare Advantage	$19.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.42
Rate for Payer: Cigna Commercial	$32.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.31
Rate for Payer: Oxford Commercial	$12.88
Rate for Payer: Qualcare PPO/HMO/WC	$9.66
Rate for Payer: UnitedHealthcare Commercial	$12.88
Rate for Payer: UnitedHealthcare Community & State	$1.55
Rate for Payer: Wellpoint Medicaid Managed Care	$1.71

DRESSING NON-ADHERING 3x8 KNE

Facility

$64.38

Hospital Charge Code	270649980
Hospital Revenue Code	272
Min. Negotiated Rate	$9.66
Max. Negotiated Rate	$9.66
Rate for Payer: Qualcare PPO/HMO/WC	$9.66

DRESSING OPTIFOAM GENTLE 4x4

Facility

$14.01

Hospital Charge Code	270646071
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$7.00
Rate for Payer: Aetna Commercial	$5.32
Rate for Payer: Aetna Medicare Advantage	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.57
Rate for Payer: Cigna Commercial	$7.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.20
Rate for Payer: Oxford Commercial	$2.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$2.80
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

DRESSING OPTIFOAM GENTLE 4x4

Facility

$14.01

Hospital Charge Code	270646071
Hospital Revenue Code	272
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

DRESSING OPTIFOAM GENTLE 6x6

Facility

$23.02

Hospital Charge Code	270646072
Hospital Revenue Code	272
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

DRESSING OPTIFOAM GENTLE 6x6

Facility

$23.02

Hospital Charge Code	270646072
Hospital Revenue Code	272
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$11.51
Rate for Payer: Aetna Commercial	$8.75
Rate for Payer: Aetna Medicare Advantage	$6.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.91
Rate for Payer: Oxford Commercial	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$4.60
Rate for Payer: UnitedHealthcare Community & State	$0.55
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

DRESSING OPTIFOAM SACRUM 7x7

Facility

$29.60

Hospital Charge Code	270350281
Hospital Revenue Code	272
Min. Negotiated Rate	$4.44
Max. Negotiated Rate	$4.44
Rate for Payer: Qualcare PPO/HMO/WC	$4.44

DRESSING OPTIFOAM SACRUM 7x7

Facility

$29.60

Hospital Charge Code	270350281
Hospital Revenue Code	272
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$14.80
Rate for Payer: Aetna Commercial	$11.25
Rate for Payer: Aetna Medicare Advantage	$8.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.55
Rate for Payer: Cigna Commercial	$14.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: Oxford Commercial	$5.92
Rate for Payer: Qualcare PPO/HMO/WC	$4.44
Rate for Payer: UnitedHealthcare Commercial	$5.92
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.78

DRESSING OPTILOCK 5x5.5

Facility

$10.57

Hospital Charge Code	270646073
Hospital Revenue Code	272
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.29
Rate for Payer: Aetna Commercial	$4.02
Rate for Payer: Aetna Medicare Advantage	$3.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.70
Rate for Payer: Cigna Commercial	$5.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.17
Rate for Payer: Oxford Commercial	$2.11
Rate for Payer: Qualcare PPO/HMO/WC	$1.59
Rate for Payer: UnitedHealthcare Commercial	$2.11
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

DRESSING OPTILOCK 5x5.5

Facility

$10.57

Hospital Charge Code	270646073
Hospital Revenue Code	272
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$1.59
Rate for Payer: Qualcare PPO/HMO/WC	$1.59

DRESSING OPTILOCK 6.5x10

Facility

$33.25

Hospital Charge Code	270646074
Hospital Revenue Code	272
Min. Negotiated Rate	$4.99
Max. Negotiated Rate	$4.99
Rate for Payer: Qualcare PPO/HMO/WC	$4.99

DRESSING OPTILOCK 6.5x10

Facility

$33.25

Hospital Charge Code	270646074
Hospital Revenue Code	272
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$16.62
Rate for Payer: Aetna Commercial	$12.63
Rate for Payer: Aetna Medicare Advantage	$9.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.48
Rate for Payer: Cigna Commercial	$16.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.97
Rate for Payer: Oxford Commercial	$6.65
Rate for Payer: Qualcare PPO/HMO/WC	$4.99
Rate for Payer: UnitedHealthcare Commercial	$6.65
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.88

DRESSING PAD ABD 5x9 STERILE

Facility

$17.49

Hospital Charge Code	270350055
Hospital Revenue Code	272
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$8.74
Rate for Payer: Aetna Commercial	$6.65
Rate for Payer: Aetna Medicare Advantage	$5.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.46
Rate for Payer: Cigna Commercial	$8.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.25
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.62
Rate for Payer: UnitedHealthcare Commercial	$3.50
Rate for Payer: UnitedHealthcare Community & State	$0.42
Rate for Payer: Wellpoint Medicaid Managed Care	$0.46

DRESSING PAD ABD 5x9 STERILE

Facility

$17.49

Hospital Charge Code	270350055
Hospital Revenue Code	272
Min. Negotiated Rate	$2.62
Max. Negotiated Rate	$2.62
Rate for Payer: Qualcare PPO/HMO/WC	$2.62

DRESSING POLYMEM 4x4 FE5044

Facility

$14.94

Hospital Charge Code	270639037
Hospital Revenue Code	272
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 POLYMEM 4x4 FE5044

Facility

$14.94

Hospital Charge Code	270639037
Hospital Revenue Code	272
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$2.24
Rate for Payer: Qualcare PPO/HMO/WC	$2.24

Know your out-of-pocket cost for care.

All Charges