Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DUPLEX SCAN HEMO COMP UNI

Facility

$656.27

Service Code	HCPCS 93986
Hospital Charge Code	404293986
Hospital Revenue Code	920
Min. Negotiated Rate	$98.44
Max. Negotiated Rate	$98.44
Rate for Payer: Qualcare PPO/HMO/WC	$98.44

DUPLOCATH 35 921-020

Facility

$292.85

Hospital Charge Code	270617193
Hospital Revenue Code	272
Min. Negotiated Rate	$43.93
Max. Negotiated Rate	$43.93
Rate for Payer: Qualcare PPO/HMO/WC	$43.93

DUPLOCATH 35 921-020

Facility

$292.85

Hospital Charge Code	270617193
Hospital Revenue Code	272
Min. Negotiated Rate	$7.06
Max. Negotiated Rate	$146.43
Rate for Payer: Aetna Commercial	$111.28
Rate for Payer: Aetna Medicare Advantage	$87.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.68
Rate for Payer: Cigna Commercial	$146.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.86
Rate for Payer: Oxford Commercial	$58.57
Rate for Payer: Qualcare PPO/HMO/WC	$43.93
Rate for Payer: UnitedHealthcare Commercial	$58.57
Rate for Payer: UnitedHealthcare Community & State	$7.06
Rate for Payer: Wellpoint Medicaid Managed Care	$7.76

DUPLOTIP APPLICATOR KIT

Facility

$295.88

Hospital Charge Code	270662416
Hospital Revenue Code	272
Min. Negotiated Rate	$44.38
Max. Negotiated Rate	$44.38
Rate for Payer: Qualcare PPO/HMO/WC	$44.38

DUPLOTIP APPLICATOR KIT

Facility

$295.88

Hospital Charge Code	270662416
Hospital Revenue Code	272
Min. Negotiated Rate	$7.13
Max. Negotiated Rate	$147.94
Rate for Payer: Aetna Commercial	$112.43
Rate for Payer: Aetna Medicare Advantage	$88.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.45
Rate for Payer: Cigna Commercial	$147.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.76
Rate for Payer: Oxford Commercial	$59.18
Rate for Payer: Qualcare PPO/HMO/WC	$44.38
Rate for Payer: UnitedHealthcare Commercial	$59.18
Rate for Payer: UnitedHealthcare Community & State	$7.13
Rate for Payer: Wellpoint Medicaid Managed Care	$7.84

DURA-CUF BLOOD PRESSURE CUFF

Facility

$248.00

Hospital Charge Code	270332075
Hospital Revenue Code	272
Min. Negotiated Rate	$5.98
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$94.24
Rate for Payer: Aetna Medicare Advantage	$74.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.24
Rate for Payer: Cigna Commercial	$124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.40
Rate for Payer: Oxford Commercial	$49.60
Rate for Payer: Qualcare PPO/HMO/WC	$37.20
Rate for Payer: UnitedHealthcare Commercial	$49.60
Rate for Payer: UnitedHealthcare Community & State	$5.98
Rate for Payer: Wellpoint Medicaid Managed Care	$6.57

DURA-CUF BLOOD PRESSURE CUFF

Facility

$248.00

Hospital Charge Code	270332075
Hospital Revenue Code	272
Min. Negotiated Rate	$37.20
Max. Negotiated Rate	$37.20
Rate for Payer: Qualcare PPO/HMO/WC	$37.20

DURAGEN 10 X 12.5

Facility

$6,030.00

Hospital Charge Code	270667240
Hospital Revenue Code	278
Min. Negotiated Rate	$904.50
Max. Negotiated Rate	$1,459.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,206.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,459.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,326.60
Rate for Payer: Qualcare PPO/HMO/WC	$904.50

DURAGEN 10 X 12.5

Facility

$6,030.00

Hospital Charge Code	270667240
Hospital Revenue Code	278
Min. Negotiated Rate	$145.32
Max. Negotiated Rate	$3,015.00
Rate for Payer: Aetna Commercial	$2,291.40
Rate for Payer: Aetna Medicare Advantage	$1,809.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,537.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,537.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,206.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,537.65
Rate for Payer: Cigna Commercial	$3,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,459.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,326.60
Rate for Payer: Qualcare PPO/HMO/WC	$904.50
Rate for Payer: UnitedHealthcare Community & State	$145.32
Rate for Payer: Wellpoint Medicaid Managed Care	$159.79

DURAGEN 4X5

Facility

$6,365.20

Hospital Charge Code	270660489
Hospital Revenue Code	278
Min. Negotiated Rate	$954.78
Max. Negotiated Rate	$1,540.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,273.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,540.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,400.34
Rate for Payer: Qualcare PPO/HMO/WC	$954.78

DURAGEN 4X5

Facility

$6,365.20

Hospital Charge Code	270660489
Hospital Revenue Code	278
Min. Negotiated Rate	$153.40
Max. Negotiated Rate	$3,182.60
Rate for Payer: Aetna Commercial	$2,418.78
Rate for Payer: Aetna Medicare Advantage	$1,909.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,623.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,623.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,273.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,623.13
Rate for Payer: Cigna Commercial	$3,182.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,540.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,400.34
Rate for Payer: Qualcare PPO/HMO/WC	$954.78
Rate for Payer: UnitedHealthcare Community & State	$153.40
Rate for Payer: Wellpoint Medicaid Managed Care	$168.68

DURAGEN+ (DURAL REGEN MATRIX)

Facility

$4,930.00

Service Code	HCPCS C1762
Hospital Charge Code	270703897
Hospital Revenue Code	278
Min. Negotiated Rate	$739.50
Max. Negotiated Rate	$1,193.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$986.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,193.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,084.60
Rate for Payer: Qualcare PPO/HMO/WC	$739.50

DURAGEN+ (DURAL REGEN MATRIX)

Facility

$4,930.00

Service Code	HCPCS C1762
Hospital Charge Code	270703897
Hospital Revenue Code	278
Min. Negotiated Rate	$118.81
Max. Negotiated Rate	$2,465.00
Rate for Payer: Aetna Commercial	$1,873.40
Rate for Payer: Aetna Medicare Advantage	$1,479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,257.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,257.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$986.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,257.15
Rate for Payer: Cigna Commercial	$2,465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,193.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,084.60
Rate for Payer: Qualcare PPO/HMO/WC	$739.50
Rate for Payer: UnitedHealthcare Community & State	$118.81
Rate for Payer: Wellpoint Medicaid Managed Care	$130.65

DURAGEN PLUS 1x1

Facility

$1,395.60

Service Code	HCPCS Q4100
Hospital Charge Code	270677374
Hospital Revenue Code	636
Min. Negotiated Rate	$33.63
Max. Negotiated Rate	$697.80
Rate for Payer: Aetna Commercial	$530.33
Rate for Payer: Aetna Medicare Advantage	$418.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.88
Rate for Payer: Cigna Commercial	$697.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.74
Rate for Payer: Qualcare PPO/HMO/WC	$209.34
Rate for Payer: UnitedHealthcare Community & State	$33.63
Rate for Payer: Wellpoint Medicaid Managed Care	$36.98

DURAGEN PLUS 1x1

Facility

$1,395.60

Service Code	HCPCS Q4100
Hospital Charge Code	270677374
Hospital Revenue Code	636
Min. Negotiated Rate	$209.34
Max. Negotiated Rate	$337.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.74
Rate for Payer: Qualcare PPO/HMO/WC	$209.34

DURAGEN PLUS 3 X3

Facility

$3,962.55

Service Code	HCPCS Q4100
Hospital Charge Code	270658933
Hospital Revenue Code	636
Min. Negotiated Rate	$95.50
Max. Negotiated Rate	$1,981.28
Rate for Payer: Aetna Commercial	$1,505.77
Rate for Payer: Aetna Medicare Advantage	$1,188.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,010.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,010.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,010.45
Rate for Payer: Cigna Commercial	$1,981.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$958.94
Rate for Payer: Qualcare PPO/HMO/WC	$594.38
Rate for Payer: UnitedHealthcare Community & State	$95.50
Rate for Payer: Wellpoint Medicaid Managed Care	$105.01

DURAGEN PLUS 3 X3

Facility

$3,962.55

Service Code	HCPCS Q4100
Hospital Charge Code	270658933
Hospital Revenue Code	636
Min. Negotiated Rate	$594.38
Max. Negotiated Rate	$958.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$958.94
Rate for Payer: Qualcare PPO/HMO/WC	$594.38

DURAGEN PLUS REGEN MATRIX 5X7

Facility

$8,399.95

Service Code	HCPCS C1889
Hospital Charge Code	270665182
Hospital Revenue Code	278
Min. Negotiated Rate	$1,259.99
Max. Negotiated Rate	$2,032.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,679.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,032.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,847.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,259.99

DURAGEN PLUS REGEN MATRIX 5X7

Facility

$8,399.95

Service Code	HCPCS C1889
Hospital Charge Code	270665182
Hospital Revenue Code	278
Min. Negotiated Rate	$202.44
Max. Negotiated Rate	$4,199.98
Rate for Payer: Aetna Commercial	$3,191.98
Rate for Payer: Aetna Medicare Advantage	$2,519.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,141.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,141.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,679.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,141.99
Rate for Payer: Cigna Commercial	$4,199.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,032.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,847.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,259.99
Rate for Payer: UnitedHealthcare Community & State	$202.44
Rate for Payer: Wellpoint Medicaid Managed Care	$222.60

DURAGESIC 25 MCG/HR DISC

Facility

$89.00

Hospital Charge Code	6008064
Hospital Revenue Code	252
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$13.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.35

DURAGESIC 25 MCG/HR DISC

Facility

$89.00

Hospital Charge Code	6008064
Hospital Revenue Code	252
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$44.50
Rate for Payer: Aetna Commercial	$33.82
Rate for Payer: Aetna Medicare Advantage	$26.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.70
Rate for Payer: Cigna Commercial	$44.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.70
Rate for Payer: Oxford Commercial	$17.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.35
Rate for Payer: UnitedHealthcare Commercial	$17.80
Rate for Payer: UnitedHealthcare Community & State	$2.14
Rate for Payer: Wellpoint Medicaid Managed Care	$2.36

DURAGESIC 50 MCG/HR DISC

Facility

$131.85

Hospital Charge Code	6008072
Hospital Revenue Code	252
Min. Negotiated Rate	$19.78
Max. Negotiated Rate	$19.78
Rate for Payer: Qualcare PPO/HMO/WC	$19.78

DURAGESIC 50 MCG/HR DISC

Facility

$131.85

Hospital Charge Code	6008072
Hospital Revenue Code	252
Min. Negotiated Rate	$3.18
Max. Negotiated Rate	$65.92
Rate for Payer: Aetna Commercial	$50.10
Rate for Payer: Aetna Medicare Advantage	$39.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.62
Rate for Payer: Cigna Commercial	$65.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.55
Rate for Payer: Oxford Commercial	$26.37
Rate for Payer: Qualcare PPO/HMO/WC	$19.78
Rate for Payer: UnitedHealthcare Commercial	$26.37
Rate for Payer: UnitedHealthcare Community & State	$3.18
Rate for Payer: Wellpoint Medicaid Managed Care	$3.49

DURAGESIC 75 MCG/HR DISC

Facility

$197.15

Hospital Charge Code	6008080
Hospital Revenue Code	252
Min. Negotiated Rate	$4.75
Max. Negotiated Rate	$98.58
Rate for Payer: Aetna Commercial	$74.92
Rate for Payer: Aetna Medicare Advantage	$59.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.27
Rate for Payer: Cigna Commercial	$98.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.15
Rate for Payer: Oxford Commercial	$39.43
Rate for Payer: Qualcare PPO/HMO/WC	$29.57
Rate for Payer: UnitedHealthcare Commercial	$39.43
Rate for Payer: UnitedHealthcare Community & State	$4.75
Rate for Payer: Wellpoint Medicaid Managed Care	$5.22

DURAGESIC 75 MCG/HR DISC

Facility

$197.15

Hospital Charge Code	6008080
Hospital Revenue Code	252
Min. Negotiated Rate	$29.57
Max. Negotiated Rate	$29.57
Rate for Payer: Qualcare PPO/HMO/WC	$29.57

Know your out-of-pocket cost for care.

All Charges