Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FILTER DAV ABRMSN SUMP DRN***

Facility

$47.00

Hospital Charge Code	8003980
Hospital Revenue Code	272
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$7.05
Rate for Payer: Qualcare PPO/HMO/WC	$7.05

FILTER DC-1 RESP DISP

Facility

$24.00

Hospital Charge Code	270600653
Hospital Revenue Code	272
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$9.12
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.20
Rate for Payer: Oxford Commercial	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$4.80
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

FILTER DC-1 RESP DISP

Facility

$24.00

Hospital Charge Code	270600653
Hospital Revenue Code	272
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

FILTER DC-II DISPOSABLE

Facility

$12.99

Hospital Charge Code	270625375
Hospital Revenue Code	270
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

FILTER DC-II DISPOSABLE

Facility

$12.99

Hospital Charge Code	270625375
Hospital Revenue Code	270
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

FILTER DENALI IVC FEMORAL

Facility

$6,750.00

Service Code	HCPCS C1880
Hospital Charge Code	270646957S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

FILTER DENALI IVC FEMORAL

Facility

$6,500.00

Service Code	HCPCS C1880
Hospital Charge Code	270644009
Hospital Revenue Code	278
Min. Negotiated Rate	$156.65
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$2,470.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,430.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Community & State	$156.65
Rate for Payer: Wellpoint Medicaid Managed Care	$172.25

FILTER DENALI IVC FEMORAL

Facility

$6,750.00

Service Code	HCPCS C1880
Hospital Charge Code	270646957
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

FILTER DENALI IVC FEMORAL

Facility

$6,500.00

Service Code	HCPCS C1880
Hospital Charge Code	270644009
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,430.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

FILTER DENALI IVC FEMORAL

Facility

$6,750.00

Service Code	HCPCS C1880
Hospital Charge Code	270646957S
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

FILTER DENALI IVC FEMORAL

Facility

$6,750.00

Service Code	HCPCS C1880
Hospital Charge Code	270646957
Hospital Revenue Code	278
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,485.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

FILTER DISPOSABLE FOR MALDEHYD

Facility

$207.80

Hospital Charge Code	270665980
Hospital Revenue Code	270
Min. Negotiated Rate	$31.17
Max. Negotiated Rate	$31.17
Rate for Payer: Qualcare PPO/HMO/WC	$31.17

FILTER DISPOSABLE FOR MALDEHYD

Facility

$207.80

Hospital Charge Code	270665980
Hospital Revenue Code	270
Min. Negotiated Rate	$5.01
Max. Negotiated Rate	$103.90
Rate for Payer: Aetna Commercial	$78.96
Rate for Payer: Aetna Medicare Advantage	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.99
Rate for Payer: Cigna Commercial	$103.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.34
Rate for Payer: Oxford Commercial	$41.56
Rate for Payer: Qualcare PPO/HMO/WC	$31.17
Rate for Payer: UnitedHealthcare Commercial	$41.56
Rate for Payer: UnitedHealthcare Community & State	$5.01
Rate for Payer: Wellpoint Medicaid Managed Care	$5.51

FILTER FAE 48 LYL*****

Facility

$9.00

Hospital Charge Code	8002651
Hospital Revenue Code	279
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

FILTER FAE 48 LYL*****

Facility

$9.00

Hospital Charge Code	8002651
Hospital Revenue Code	279
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

FILTER FAN

Facility

$75.00

Hospital Charge Code	270665504
Hospital Revenue Code	300
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

FILTER FAN

Facility

$75.00

Hospital Charge Code	270665504
Hospital Revenue Code	300
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$124.00
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	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

FILTER FINAL****

Facility

$19.00

Hospital Charge Code	7000433
Hospital Revenue Code	279
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$2.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.85

FILTER FINAL****

Facility

$19.00

Hospital Charge Code	7000433
Hospital Revenue Code	279
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.50
Rate for Payer: Aetna Commercial	$7.22
Rate for Payer: Aetna Medicare Advantage	$5.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.84
Rate for Payer: Cigna Commercial	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.70
Rate for Payer: Oxford Commercial	$3.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.85
Rate for Payer: UnitedHealthcare Commercial	$3.80
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

FILTER FOR PCI GUS VAPOR CONTR

Facility

$1,480.00

Hospital Charge Code	270656301
Hospital Revenue Code	278
Min. Negotiated Rate	$222.00
Max. Negotiated Rate	$358.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$325.60
Rate for Payer: Qualcare PPO/HMO/WC	$222.00

FILTER FOR PCI GUS VAPOR CONTR

Facility

$1,480.00

Hospital Charge Code	270656301
Hospital Revenue Code	278
Min. Negotiated Rate	$35.67
Max. Negotiated Rate	$740.00
Rate for Payer: Aetna Commercial	$562.40
Rate for Payer: Aetna Medicare Advantage	$444.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$377.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$377.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$377.40
Rate for Payer: Cigna Commercial	$740.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$325.60
Rate for Payer: Qualcare PPO/HMO/WC	$222.00
Rate for Payer: UnitedHealthcare Community & State	$35.67
Rate for Payer: Wellpoint Medicaid Managed Care	$39.22

FILTER G2 EXPRESS RF400F

Facility

$7,475.00

Service Code	HCPCS C1880
Hospital Charge Code	270641168
Hospital Revenue Code	278
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Community & State	$180.15
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

FILTER G2 EXPRESS RF400F

Facility

$7,475.00

Service Code	HCPCS C1880
Hospital Charge Code	270641168
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,644.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

FILTER GREENFIELD FEMORAL

Facility

$4,994.50

Service Code	HCPCS C1880
Hospital Charge Code	270601124
Hospital Revenue Code	278
Min. Negotiated Rate	$120.37
Max. Negotiated Rate	$2,497.25
Rate for Payer: Aetna Commercial	$1,897.91
Rate for Payer: Aetna Medicare Advantage	$1,498.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,273.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,273.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,273.60
Rate for Payer: Cigna Commercial	$2,497.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,098.79
Rate for Payer: Qualcare PPO/HMO/WC	$749.17
Rate for Payer: UnitedHealthcare Community & State	$120.37
Rate for Payer: Wellpoint Medicaid Managed Care	$132.35

FILTER GREENFIELD FEMORAL

Facility

$4,994.50

Service Code	HCPCS C1880
Hospital Charge Code	270601124
Hospital Revenue Code	278
Min. Negotiated Rate	$749.17
Max. Negotiated Rate	$1,208.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,098.79
Rate for Payer: Qualcare PPO/HMO/WC	$749.17

Know your out-of-pocket cost for care.

All Charges