Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FOLLOWER BOUGIE URETERAL 12FR

Facility

$947.90

Hospital Charge Code	270678182
Hospital Revenue Code	272
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$142.19
Rate for Payer: Qualcare PPO/HMO/WC	$142.19

FOLLOWER BOUGIE URETERAL 12FR

Facility

$947.90

Hospital Charge Code	270678182
Hospital Revenue Code	272
Min. Negotiated Rate	$22.84
Max. Negotiated Rate	$473.95
Rate for Payer: Aetna Commercial	$360.20
Rate for Payer: Aetna Medicare Advantage	$284.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.71
Rate for Payer: Cigna Commercial	$473.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.37
Rate for Payer: Oxford Commercial	$189.58
Rate for Payer: Qualcare PPO/HMO/WC	$142.19
Rate for Payer: UnitedHealthcare Commercial	$189.58
Rate for Payer: UnitedHealthcare Community & State	$22.84
Rate for Payer: Wellpoint Medicaid Managed Care	$25.12

FOLLOWER BOUGIE URETERAL 14FR

Facility

$947.90

Hospital Charge Code	270678187
Hospital Revenue Code	272
Min. Negotiated Rate	$22.84
Max. Negotiated Rate	$473.95
Rate for Payer: Aetna Commercial	$360.20
Rate for Payer: Aetna Medicare Advantage	$284.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.71
Rate for Payer: Cigna Commercial	$473.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.37
Rate for Payer: Oxford Commercial	$189.58
Rate for Payer: Qualcare PPO/HMO/WC	$142.19
Rate for Payer: UnitedHealthcare Commercial	$189.58
Rate for Payer: UnitedHealthcare Community & State	$22.84
Rate for Payer: Wellpoint Medicaid Managed Care	$25.12

FOLLOWER BOUGIE URETERAL 14FR

Facility

$947.90

Hospital Charge Code	270678187
Hospital Revenue Code	272
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$142.19
Rate for Payer: Qualcare PPO/HMO/WC	$142.19

FOLLOWER BOUGIE URETERAL 16FR

Facility

$947.90

Hospital Charge Code	270678183
Hospital Revenue Code	272
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$142.19
Rate for Payer: Qualcare PPO/HMO/WC	$142.19

FOLLOWER BOUGIE URETERAL 16FR

Facility

$947.90

Hospital Charge Code	270678183
Hospital Revenue Code	272
Min. Negotiated Rate	$22.84
Max. Negotiated Rate	$473.95
Rate for Payer: Aetna Commercial	$360.20
Rate for Payer: Aetna Medicare Advantage	$284.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.71
Rate for Payer: Cigna Commercial	$473.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.37
Rate for Payer: Oxford Commercial	$189.58
Rate for Payer: Qualcare PPO/HMO/WC	$142.19
Rate for Payer: UnitedHealthcare Commercial	$189.58
Rate for Payer: UnitedHealthcare Community & State	$22.84
Rate for Payer: Wellpoint Medicaid Managed Care	$25.12

FOLLOWER BOUGIE URETERAL 20FR

Facility

$947.90

Hospital Charge Code	270678184
Hospital Revenue Code	272
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$142.19
Rate for Payer: Qualcare PPO/HMO/WC	$142.19

FOLLOWER BOUGIE URETERAL 20FR

Facility

$947.90

Hospital Charge Code	270678184
Hospital Revenue Code	272
Min. Negotiated Rate	$22.84
Max. Negotiated Rate	$473.95
Rate for Payer: Aetna Commercial	$360.20
Rate for Payer: Aetna Medicare Advantage	$284.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.71
Rate for Payer: Cigna Commercial	$473.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.37
Rate for Payer: Oxford Commercial	$189.58
Rate for Payer: Qualcare PPO/HMO/WC	$142.19
Rate for Payer: UnitedHealthcare Commercial	$189.58
Rate for Payer: UnitedHealthcare Community & State	$22.84
Rate for Payer: Wellpoint Medicaid Managed Care	$25.12

FOLLOWER BOUGIE URETERAL 22FR

Facility

$947.90

Hospital Charge Code	270678185
Hospital Revenue Code	272
Min. Negotiated Rate	$22.84
Max. Negotiated Rate	$473.95
Rate for Payer: Aetna Commercial	$360.20
Rate for Payer: Aetna Medicare Advantage	$284.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.71
Rate for Payer: Cigna Commercial	$473.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.37
Rate for Payer: Oxford Commercial	$189.58
Rate for Payer: Qualcare PPO/HMO/WC	$142.19
Rate for Payer: UnitedHealthcare Commercial	$189.58
Rate for Payer: UnitedHealthcare Community & State	$22.84
Rate for Payer: Wellpoint Medicaid Managed Care	$25.12

FOLLOWER BOUGIE URETERAL 22FR

Facility

$947.90

Hospital Charge Code	270678185
Hospital Revenue Code	272
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$142.19
Rate for Payer: Qualcare PPO/HMO/WC	$142.19

FOLLOWER BOUGIE URETERAL 8FR

Facility

$947.90

Hospital Charge Code	270678180
Hospital Revenue Code	272
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$142.19
Rate for Payer: Qualcare PPO/HMO/WC	$142.19

FOLLOWER BOUGIE URETERAL 8FR

Facility

$947.90

Hospital Charge Code	270678180
Hospital Revenue Code	272
Min. Negotiated Rate	$22.84
Max. Negotiated Rate	$473.95
Rate for Payer: Aetna Commercial	$360.20
Rate for Payer: Aetna Medicare Advantage	$284.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.71
Rate for Payer: Cigna Commercial	$473.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.37
Rate for Payer: Oxford Commercial	$189.58
Rate for Payer: Qualcare PPO/HMO/WC	$142.19
Rate for Payer: UnitedHealthcare Commercial	$189.58
Rate for Payer: UnitedHealthcare Community & State	$22.84
Rate for Payer: Wellpoint Medicaid Managed Care	$25.12

FOLLOWER PHILLIPS 10FR

Facility

$716.00

Hospital Charge Code	270600282
Hospital Revenue Code	272
Min. Negotiated Rate	$17.26
Max. Negotiated Rate	$358.00
Rate for Payer: Aetna Commercial	$272.08
Rate for Payer: Aetna Medicare Advantage	$214.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.58
Rate for Payer: Cigna Commercial	$358.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.80
Rate for Payer: Oxford Commercial	$143.20
Rate for Payer: Qualcare PPO/HMO/WC	$107.40
Rate for Payer: UnitedHealthcare Commercial	$143.20
Rate for Payer: UnitedHealthcare Community & State	$17.26
Rate for Payer: Wellpoint Medicaid Managed Care	$18.97

FOLLOWER PHILLIPS 10FR

Facility

$716.00

Hospital Charge Code	270600282
Hospital Revenue Code	272
Min. Negotiated Rate	$107.40
Max. Negotiated Rate	$107.40
Rate for Payer: Qualcare PPO/HMO/WC	$107.40

FOLLOWER PHILLIPS 10FR

Facility

$249.80

Hospital Charge Code	270619882
Hospital Revenue Code	272
Min. Negotiated Rate	$37.47
Max. Negotiated Rate	$37.47
Rate for Payer: Qualcare PPO/HMO/WC	$37.47

FOLLOWER PHILLIPS 10FR

Facility

$249.80

Hospital Charge Code	270619882
Hospital Revenue Code	272
Min. Negotiated Rate	$6.02
Max. Negotiated Rate	$124.90
Rate for Payer: Aetna Commercial	$94.92
Rate for Payer: Aetna Medicare Advantage	$74.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.70
Rate for Payer: Cigna Commercial	$124.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.94
Rate for Payer: Oxford Commercial	$49.96
Rate for Payer: Qualcare PPO/HMO/WC	$37.47
Rate for Payer: UnitedHealthcare Commercial	$49.96
Rate for Payer: UnitedHealthcare Community & State	$6.02
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

FOLLOWER PHILLIPS 12FR

Facility

$249.80

Hospital Charge Code	270600148
Hospital Revenue Code	272
Min. Negotiated Rate	$6.02
Max. Negotiated Rate	$124.90
Rate for Payer: Aetna Commercial	$94.92
Rate for Payer: Aetna Medicare Advantage	$74.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.70
Rate for Payer: Cigna Commercial	$124.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.94
Rate for Payer: Oxford Commercial	$49.96
Rate for Payer: Qualcare PPO/HMO/WC	$37.47
Rate for Payer: UnitedHealthcare Commercial	$49.96
Rate for Payer: UnitedHealthcare Community & State	$6.02
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

FOLLOWER PHILLIPS 12FR

Facility

$621.65

Hospital Charge Code	270600279
Hospital Revenue Code	272
Min. Negotiated Rate	$93.25
Max. Negotiated Rate	$93.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.25

FOLLOWER PHILLIPS 12FR

Facility

$249.80

Hospital Charge Code	270600148
Hospital Revenue Code	272
Min. Negotiated Rate	$37.47
Max. Negotiated Rate	$37.47
Rate for Payer: Qualcare PPO/HMO/WC	$37.47

FOLLOWER PHILLIPS 12FR

Facility

$621.65

Hospital Charge Code	270600279
Hospital Revenue Code	272
Min. Negotiated Rate	$14.98
Max. Negotiated Rate	$310.82
Rate for Payer: Aetna Commercial	$236.23
Rate for Payer: Aetna Medicare Advantage	$186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.52
Rate for Payer: Cigna Commercial	$310.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.50
Rate for Payer: Oxford Commercial	$124.33
Rate for Payer: Qualcare PPO/HMO/WC	$93.25
Rate for Payer: UnitedHealthcare Commercial	$124.33
Rate for Payer: UnitedHealthcare Community & State	$14.98
Rate for Payer: Wellpoint Medicaid Managed Care	$16.47

FOLLOWER PHILLIPS 14FR

Facility

$249.80

Hospital Charge Code	270600284
Hospital Revenue Code	272
Min. Negotiated Rate	$6.02
Max. Negotiated Rate	$124.90
Rate for Payer: Aetna Commercial	$94.92
Rate for Payer: Aetna Medicare Advantage	$74.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.70
Rate for Payer: Cigna Commercial	$124.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.94
Rate for Payer: Oxford Commercial	$49.96
Rate for Payer: Qualcare PPO/HMO/WC	$37.47
Rate for Payer: UnitedHealthcare Commercial	$49.96
Rate for Payer: UnitedHealthcare Community & State	$6.02
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

FOLLOWER PHILLIPS 14FR

Facility

$249.80

Hospital Charge Code	270600284
Hospital Revenue Code	272
Min. Negotiated Rate	$37.47
Max. Negotiated Rate	$37.47
Rate for Payer: Qualcare PPO/HMO/WC	$37.47

FOLLOWER PHILLIPS 16FR

Facility

$252.20

Hospital Charge Code	270600150
Hospital Revenue Code	272
Min. Negotiated Rate	$37.83
Max. Negotiated Rate	$37.83
Rate for Payer: Qualcare PPO/HMO/WC	$37.83

FOLLOWER PHILLIPS 16FR

Facility

$252.20

Hospital Charge Code	270600150
Hospital Revenue Code	272
Min. Negotiated Rate	$6.08
Max. Negotiated Rate	$126.10
Rate for Payer: Aetna Commercial	$95.84
Rate for Payer: Aetna Medicare Advantage	$75.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.31
Rate for Payer: Cigna Commercial	$126.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.66
Rate for Payer: Oxford Commercial	$50.44
Rate for Payer: Qualcare PPO/HMO/WC	$37.83
Rate for Payer: UnitedHealthcare Commercial	$50.44
Rate for Payer: UnitedHealthcare Community & State	$6.08
Rate for Payer: Wellpoint Medicaid Managed Care	$6.68

FOLLOWER PHILLIPS 18FR

Facility

$252.20

Hospital Charge Code	270600285
Hospital Revenue Code	272
Min. Negotiated Rate	$37.83
Max. Negotiated Rate	$37.83
Rate for Payer: Qualcare PPO/HMO/WC	$37.83

Know your out-of-pocket cost for care.

All Charges