Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ELECTRODE LARYNX STIM KIT

Facility

$400.00

Hospital Charge Code	270697495
Hospital Revenue Code	272
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.00
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$80.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

ELECTRODE LEEP BALL 3MM 900161

Facility

$110.10

Hospital Charge Code	270608103
Hospital Revenue Code	272
Min. Negotiated Rate	$16.52
Max. Negotiated Rate	$16.52
Rate for Payer: Qualcare PPO/HMO/WC	$16.52

ELECTRODE LEEP BALL 3MM 900161

Facility

$110.10

Hospital Charge Code	270608103
Hospital Revenue Code	272
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$55.05
Rate for Payer: Aetna Commercial	$41.84
Rate for Payer: Aetna Medicare Advantage	$33.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.08
Rate for Payer: Cigna Commercial	$55.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.03
Rate for Payer: Oxford Commercial	$22.02
Rate for Payer: Qualcare PPO/HMO/WC	$16.52
Rate for Payer: UnitedHealthcare Commercial	$22.02
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

ELECTRODE LEEP BALL 5MM 900163

Facility

$110.10

Hospital Charge Code	270608102
Hospital Revenue Code	272
Min. Negotiated Rate	$16.52
Max. Negotiated Rate	$16.52
Rate for Payer: Qualcare PPO/HMO/WC	$16.52

ELECTRODE LEEP BALL 5MM 900163

Facility

$110.10

Hospital Charge Code	270608102
Hospital Revenue Code	272
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$55.05
Rate for Payer: Aetna Commercial	$41.84
Rate for Payer: Aetna Medicare Advantage	$33.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.08
Rate for Payer: Cigna Commercial	$55.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.03
Rate for Payer: Oxford Commercial	$22.02
Rate for Payer: Qualcare PPO/HMO/WC	$16.52
Rate for Payer: UnitedHealthcare Commercial	$22.02
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

ELECTRODE LEEP/LLETZ LOOP

Facility

$68.75

Hospital Charge Code	270676782
Hospital Revenue Code	272
Min. Negotiated Rate	$10.31
Max. Negotiated Rate	$10.31
Rate for Payer: Qualcare PPO/HMO/WC	$10.31

ELECTRODE LEEP/LLETZ LOOP

Facility

$68.75

Hospital Charge Code	270676782
Hospital Revenue Code	272
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$34.38
Rate for Payer: Aetna Commercial	$26.12
Rate for Payer: Aetna Medicare Advantage	$20.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.53
Rate for Payer: Cigna Commercial	$34.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.62
Rate for Payer: Oxford Commercial	$13.75
Rate for Payer: Qualcare PPO/HMO/WC	$10.31
Rate for Payer: UnitedHealthcare Commercial	$13.75
Rate for Payer: UnitedHealthcare Community & State	$1.66
Rate for Payer: Wellpoint Medicaid Managed Care	$1.82

ELECTRODE LETZ LOOP SML YELLOW

Facility

$75.00

Hospital Charge Code	270658132
Hospital Revenue Code	270
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

ELECTRODE LETZ LOOP SML YELLOW

Facility

$75.00

Hospital Charge Code	270658132
Hospital Revenue Code	270
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

ELECTRODE LEVEEN COAC 3.0 2622

Facility

$4,340.00

Hospital Charge Code	270633817
Hospital Revenue Code	272
Min. Negotiated Rate	$104.59
Max. Negotiated Rate	$2,170.00
Rate for Payer: Aetna Commercial	$1,649.20
Rate for Payer: Aetna Medicare Advantage	$1,302.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,106.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,106.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,106.70
Rate for Payer: Cigna Commercial	$2,170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,302.00
Rate for Payer: Oxford Commercial	$868.00
Rate for Payer: Qualcare PPO/HMO/WC	$651.00
Rate for Payer: UnitedHealthcare Commercial	$868.00
Rate for Payer: UnitedHealthcare Community & State	$104.59
Rate for Payer: Wellpoint Medicaid Managed Care	$115.01

ELECTRODE LEVEEN COAC 3.0 2622

Facility

$4,340.00

Hospital Charge Code	270633817
Hospital Revenue Code	272
Min. Negotiated Rate	$651.00
Max. Negotiated Rate	$651.00
Rate for Payer: Qualcare PPO/HMO/WC	$651.00

ELECTRODE LEVEEN COACCESS 2.0

Facility

$4,975.00

Hospital Charge Code	270634088
Hospital Revenue Code	278
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$1,203.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,094.50
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

ELECTRODE LEVEEN COACCESS 2.0

Facility

$4,975.00

Hospital Charge Code	270634088
Hospital Revenue Code	278
Min. Negotiated Rate	$119.90
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,890.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,094.50
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Community & State	$119.90
Rate for Payer: Wellpoint Medicaid Managed Care	$131.84

ELECTRODE LEVEEN COACCESS 4.0

Facility

$10,175.00

Hospital Charge Code	270631815
Hospital Revenue Code	272
Min. Negotiated Rate	$245.22
Max. Negotiated Rate	$5,087.50
Rate for Payer: Aetna Commercial	$3,866.50
Rate for Payer: Aetna Medicare Advantage	$3,052.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,594.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,594.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,594.62
Rate for Payer: Cigna Commercial	$5,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,052.50
Rate for Payer: Oxford Commercial	$2,035.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,526.25
Rate for Payer: UnitedHealthcare Commercial	$2,035.00
Rate for Payer: UnitedHealthcare Community & State	$245.22
Rate for Payer: Wellpoint Medicaid Managed Care	$269.64

ELECTRODE LEVEEN COACCESS 4.0

Facility

$10,175.00

Hospital Charge Code	270631815
Hospital Revenue Code	272
Min. Negotiated Rate	$1,526.25
Max. Negotiated Rate	$1,526.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,526.25

ELECTRODE LEVEEN SUPERSLIM 3.0

Facility

$5,555.25

Hospital Charge Code	270636524
Hospital Revenue Code	272
Min. Negotiated Rate	$833.29
Max. Negotiated Rate	$833.29
Rate for Payer: Qualcare PPO/HMO/WC	$833.29

ELECTRODE LEVEEN SUPERSLIM 3.0

Facility

$5,555.25

Hospital Charge Code	270636524
Hospital Revenue Code	272
Min. Negotiated Rate	$133.88
Max. Negotiated Rate	$2,777.62
Rate for Payer: Aetna Commercial	$2,110.99
Rate for Payer: Aetna Medicare Advantage	$1,666.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,416.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,416.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,416.59
Rate for Payer: Cigna Commercial	$2,777.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,666.58
Rate for Payer: Oxford Commercial	$1,111.05
Rate for Payer: Qualcare PPO/HMO/WC	$833.29
Rate for Payer: UnitedHealthcare Commercial	$1,111.05
Rate for Payer: UnitedHealthcare Community & State	$133.88
Rate for Payer: Wellpoint Medicaid Managed Care	$147.21

ELECTRODE LEVEN COAC 3.5 26223

Facility

$6,975.00

Hospital Charge Code	270632723
Hospital Revenue Code	272
Min. Negotiated Rate	$168.10
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,650.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,092.50
Rate for Payer: Oxford Commercial	$1,395.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Commercial	$1,395.00
Rate for Payer: UnitedHealthcare Community & State	$168.10
Rate for Payer: Wellpoint Medicaid Managed Care	$184.84

ELECTRODE LEVEN COAC 3.5 26223

Facility

$6,975.00

Hospital Charge Code	270632723
Hospital Revenue Code	272
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,046.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

ELECTRODE L HOOK 36CM

Facility

$162.70

Hospital Charge Code	270692089
Hospital Revenue Code	272
Min. Negotiated Rate	$3.92
Max. Negotiated Rate	$81.35
Rate for Payer: Aetna Commercial	$61.83
Rate for Payer: Aetna Medicare Advantage	$48.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.49
Rate for Payer: Cigna Commercial	$81.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.81
Rate for Payer: Oxford Commercial	$32.54
Rate for Payer: Qualcare PPO/HMO/WC	$24.41
Rate for Payer: UnitedHealthcare Commercial	$32.54
Rate for Payer: UnitedHealthcare Community & State	$3.92
Rate for Payer: Wellpoint Medicaid Managed Care	$4.31

ELECTRODE L HOOK 36CM

Facility

$162.72

Hospital Charge Code	270691560
Hospital Revenue Code	272
Min. Negotiated Rate	$3.92
Max. Negotiated Rate	$81.36
Rate for Payer: Aetna Commercial	$61.83
Rate for Payer: Aetna Medicare Advantage	$48.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.49
Rate for Payer: Cigna Commercial	$81.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.82
Rate for Payer: Oxford Commercial	$32.54
Rate for Payer: Qualcare PPO/HMO/WC	$24.41
Rate for Payer: UnitedHealthcare Commercial	$32.54
Rate for Payer: UnitedHealthcare Community & State	$3.92
Rate for Payer: Wellpoint Medicaid Managed Care	$4.31

ELECTRODE L HOOK 36CM

Facility

$162.70

Hospital Charge Code	270692089
Hospital Revenue Code	272
Min. Negotiated Rate	$24.41
Max. Negotiated Rate	$24.41
Rate for Payer: Qualcare PPO/HMO/WC	$24.41

ELECTRODE L HOOK 36CM

Facility

$162.72

Hospital Charge Code	270691560
Hospital Revenue Code	272
Min. Negotiated Rate	$24.41
Max. Negotiated Rate	$24.41
Rate for Payer: Qualcare PPO/HMO/WC	$24.41

ELECTRODE L HOOK DISP ******

Facility

$78.00

Hospital Charge Code	1606318
Hospital Revenue Code	279
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$11.70
Rate for Payer: Qualcare PPO/HMO/WC	$11.70

ELECTRODE L HOOK DISP ******

Facility

$78.00

Hospital Charge Code	1606318
Hospital Revenue Code	279
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$39.00
Rate for Payer: Aetna Commercial	$29.64
Rate for Payer: Aetna Medicare Advantage	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.89
Rate for Payer: Cigna Commercial	$39.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$11.70
Rate for Payer: UnitedHealthcare Commercial	$15.60
Rate for Payer: UnitedHealthcare Community & State	$1.88
Rate for Payer: Wellpoint Medicaid Managed Care	$2.07

Know your out-of-pocket cost for care.

All Charges