Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FILTER 40 MICRON

Facility

$131.25

Hospital Charge Code	270605804
Hospital Revenue Code	272
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$19.69
Rate for Payer: Qualcare PPO/HMO/WC	$19.69

FILTER 40 MICRON

Facility

$131.25

Hospital Charge Code	270605804
Hospital Revenue Code	272
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$65.62
Rate for Payer: Aetna Commercial	$49.88
Rate for Payer: Aetna Medicare Advantage	$39.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.47
Rate for Payer: Cigna Commercial	$65.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.38
Rate for Payer: Oxford Commercial	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$19.69
Rate for Payer: UnitedHealthcare Commercial	$26.25
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$3.48

FILTER 5-MICRON WSHNG MACHINE

Facility

$208.33

Hospital Charge Code	270606087
Hospital Revenue Code	271
Min. Negotiated Rate	$5.02
Max. Negotiated Rate	$104.17
Rate for Payer: Aetna Commercial	$79.17
Rate for Payer: Aetna Medicare Advantage	$62.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.12
Rate for Payer: Cigna Commercial	$104.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.50
Rate for Payer: Oxford Commercial	$41.67
Rate for Payer: Qualcare PPO/HMO/WC	$31.25
Rate for Payer: UnitedHealthcare Commercial	$41.67
Rate for Payer: UnitedHealthcare Community & State	$5.02
Rate for Payer: Wellpoint Medicaid Managed Care	$5.52

FILTER 5-MICRON WSHNG MACHINE

Facility

$208.33

Hospital Charge Code	270606087
Hospital Revenue Code	271
Min. Negotiated Rate	$31.25
Max. Negotiated Rate	$31.25
Rate for Payer: Qualcare PPO/HMO/WC	$31.25

FILTER ANA CUBE FOR BX41 MICRO

Facility

$5,063.50

Hospital Charge Code	270665724
Hospital Revenue Code	270
Min. Negotiated Rate	$759.52
Max. Negotiated Rate	$759.52
Rate for Payer: Qualcare PPO/HMO/WC	$759.52

FILTER ANA CUBE FOR BX41 MICRO

Facility

$5,063.50

Hospital Charge Code	270665724
Hospital Revenue Code	270
Min. Negotiated Rate	$122.03
Max. Negotiated Rate	$2,531.75
Rate for Payer: Aetna Commercial	$1,924.13
Rate for Payer: Aetna Medicare Advantage	$1,519.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,291.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,291.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,291.19
Rate for Payer: Cigna Commercial	$2,531.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.05
Rate for Payer: Oxford Commercial	$1,012.70
Rate for Payer: Qualcare PPO/HMO/WC	$759.52
Rate for Payer: UnitedHealthcare Commercial	$1,012.70
Rate for Payer: UnitedHealthcare Community & State	$122.03
Rate for Payer: Wellpoint Medicaid Managed Care	$134.18

FILTER ARTHROSC SPEC COLLECT**

Facility

$36.00

Hospital Charge Code	1603034
Hospital Revenue Code	279
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

FILTER ARTHROSC SPEC COLLECT**

Facility

$36.00

Hospital Charge Code	1603034
Hospital Revenue Code	279
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$18.00
Rate for Payer: Aetna Commercial	$13.68
Rate for Payer: Aetna Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.18
Rate for Payer: Cigna Commercial	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.80
Rate for Payer: Oxford Commercial	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$5.40
Rate for Payer: UnitedHealthcare Commercial	$7.20
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

FILTER ASSY PRECISION FLOW 02

Facility

$875.00

Hospital Charge Code	270680237
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

FILTER ASSY PRECISION FLOW 02

Facility

$875.00

Hospital Charge Code	270680237
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

FILTER BAC EXHALATION 40107930

Facility

$46.90

Hospital Charge Code	270633107
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$23.45
Rate for Payer: Aetna Commercial	$17.82
Rate for Payer: Aetna Medicare Advantage	$14.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.96
Rate for Payer: Cigna Commercial	$23.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.07
Rate for Payer: Oxford Commercial	$9.38
Rate for Payer: Qualcare PPO/HMO/WC	$7.04
Rate for Payer: UnitedHealthcare Commercial	$9.38
Rate for Payer: UnitedHealthcare Community & State	$1.13
Rate for Payer: Wellpoint Medicaid Managed Care	$1.24

FILTER BAC EXHALATION 40107930

Facility

$46.90

Hospital Charge Code	270633107
Hospital Revenue Code	272
Min. Negotiated Rate	$7.04
Max. Negotiated Rate	$7.04
Rate for Payer: Qualcare PPO/HMO/WC	$7.04

FILTER BACTERIA DISP

Facility

$11.25

Hospital Charge Code	270600629
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

FILTER BACTERIA DISP

Facility

$11.25

Hospital Charge Code	270600629
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

FILTER BACTERIA DISP***

Facility

$18.00

Hospital Charge Code	9501073
Hospital Revenue Code	279
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

FILTER BACTERIA DISP***

Facility

$18.00

Hospital Charge Code	9501073
Hospital Revenue Code	279
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

FILTER BAG TRANSFER BF40

Facility

$3,680.85

Hospital Charge Code	270610535
Hospital Revenue Code	272
Min. Negotiated Rate	$88.71
Max. Negotiated Rate	$1,840.42
Rate for Payer: Aetna Commercial	$1,398.72
Rate for Payer: Aetna Medicare Advantage	$1,104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$938.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$938.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$938.62
Rate for Payer: Cigna Commercial	$1,840.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,104.26
Rate for Payer: Oxford Commercial	$736.17
Rate for Payer: Qualcare PPO/HMO/WC	$552.13
Rate for Payer: UnitedHealthcare Commercial	$736.17
Rate for Payer: UnitedHealthcare Community & State	$88.71
Rate for Payer: Wellpoint Medicaid Managed Care	$97.54

FILTER BAG TRANSFER BF40

Facility

$3,680.85

Hospital Charge Code	270610535
Hospital Revenue Code	272
Min. Negotiated Rate	$552.13
Max. Negotiated Rate	$552.13
Rate for Payer: Qualcare PPO/HMO/WC	$552.13

FILTER BIRDSNEST G06451

Facility

$5,246.75

Hospital Charge Code	270635675
Hospital Revenue Code	272
Min. Negotiated Rate	$126.45
Max. Negotiated Rate	$2,623.38
Rate for Payer: Aetna Commercial	$1,993.77
Rate for Payer: Aetna Medicare Advantage	$1,574.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,337.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,337.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,337.92
Rate for Payer: Cigna Commercial	$2,623.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,574.03
Rate for Payer: Oxford Commercial	$1,049.35
Rate for Payer: Qualcare PPO/HMO/WC	$787.01
Rate for Payer: UnitedHealthcare Commercial	$1,049.35
Rate for Payer: UnitedHealthcare Community & State	$126.45
Rate for Payer: Wellpoint Medicaid Managed Care	$139.04

FILTER BIRDSNEST G06451

Facility

$5,246.75

Hospital Charge Code	270635675
Hospital Revenue Code	272
Min. Negotiated Rate	$787.01
Max. Negotiated Rate	$787.01
Rate for Payer: Qualcare PPO/HMO/WC	$787.01

FILTER CHARCOAL VAPOR

Facility

$192.65

Hospital Charge Code	270665981
Hospital Revenue Code	270
Min. Negotiated Rate	$28.90
Max. Negotiated Rate	$28.90
Rate for Payer: Qualcare PPO/HMO/WC	$28.90

FILTER CHARCOAL VAPOR

Facility

$192.65

Hospital Charge Code	270665981
Hospital Revenue Code	270
Min. Negotiated Rate	$4.64
Max. Negotiated Rate	$96.33
Rate for Payer: Aetna Commercial	$73.21
Rate for Payer: Aetna Medicare Advantage	$57.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.13
Rate for Payer: Cigna Commercial	$96.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.80
Rate for Payer: Oxford Commercial	$38.53
Rate for Payer: Qualcare PPO/HMO/WC	$28.90
Rate for Payer: UnitedHealthcare Commercial	$38.53
Rate for Payer: UnitedHealthcare Community & State	$4.64
Rate for Payer: Wellpoint Medicaid Managed Care	$5.11

FILTER (COMPONENTS) BLOOD BANK

Facility

$44.85

Hospital Charge Code	3109006
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.43
Rate for Payer: Aetna Commercial	$17.04
Rate for Payer: Aetna Medicare Advantage	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.44
Rate for Payer: Cigna Commercial	$22.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.46
Rate for Payer: Oxford Commercial	$8.97
Rate for Payer: Qualcare PPO/HMO/WC	$6.73
Rate for Payer: UnitedHealthcare Commercial	$8.97
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

FILTER (COMPONENTS) BLOOD BANK

Facility

$44.85

Hospital Charge Code	3109006
Hospital Revenue Code	272
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$6.73
Rate for Payer: Qualcare PPO/HMO/WC	$6.73

FILTER DAV ABRMSN SUMP DRN***

Facility

$47.00

Hospital Charge Code	8003980
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$23.50
Rate for Payer: Aetna Commercial	$17.86
Rate for Payer: Aetna Medicare Advantage	$14.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.98
Rate for Payer: Cigna Commercial	$23.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.10
Rate for Payer: Oxford Commercial	$9.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.05
Rate for Payer: UnitedHealthcare Commercial	$9.40
Rate for Payer: UnitedHealthcare Community & State	$1.13
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

Know your out-of-pocket cost for care.

All Charges