Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GRANULES CO2 ABSORBENT

Facility

$99.25

Hospital Charge Code	270600652
Hospital Revenue Code	270
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$14.89
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

GRANULES CO2 ABSORBENT

Facility

$99.25

Hospital Charge Code	270600652
Hospital Revenue Code	270
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$49.62
Rate for Payer: Aetna Commercial	$37.72
Rate for Payer: Aetna Medicare Advantage	$29.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.31
Rate for Payer: Cigna Commercial	$49.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.77
Rate for Payer: Oxford Commercial	$19.85
Rate for Payer: Qualcare PPO/HMO/WC	$14.89
Rate for Payer: UnitedHealthcare Commercial	$19.85
Rate for Payer: UnitedHealthcare Community & State	$2.39
Rate for Payer: Wellpoint Medicaid Managed Care	$2.63

GRANULEX/120ML

Facility

$95.00

Hospital Charge Code	60633056
Hospital Revenue Code	250
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$47.50
Rate for Payer: Aetna Commercial	$36.10
Rate for Payer: Aetna Medicare Advantage	$28.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.23
Rate for Payer: Cigna Commercial	$47.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.50
Rate for Payer: Oxford Commercial	$19.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.25
Rate for Payer: UnitedHealthcare Commercial	$19.00
Rate for Payer: UnitedHealthcare Community & State	$2.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2.52

GRANULEX/120ML

Facility

$95.00

Hospital Charge Code	60633056
Hospital Revenue Code	250
Min. Negotiated Rate	$14.25
Max. Negotiated Rate	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$14.25

GRANULEX/60ML

Facility

$71.00

Hospital Charge Code	60633055
Hospital Revenue Code	250
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

GRANULEX/60ML

Facility

$71.00

Hospital Charge Code	60633055
Hospital Revenue Code	250
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$35.50
Rate for Payer: Aetna Commercial	$26.98
Rate for Payer: Aetna Medicare Advantage	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.11
Rate for Payer: Cigna Commercial	$35.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.30
Rate for Payer: Oxford Commercial	$14.20
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$14.20
Rate for Payer: UnitedHealthcare Community & State	$1.71
Rate for Payer: Wellpoint Medicaid Managed Care	$1.88

GRANULEX SPRAY 2 OZ

Facility

$163.20

Hospital Charge Code	6007165
Hospital Revenue Code	250
Min. Negotiated Rate	$24.48
Max. Negotiated Rate	$24.48
Rate for Payer: Qualcare PPO/HMO/WC	$24.48

GRANULEX SPRAY 2 OZ

Facility

$163.20

Hospital Charge Code	6007165
Hospital Revenue Code	250
Min. Negotiated Rate	$3.93
Max. Negotiated Rate	$81.60
Rate for Payer: Aetna Commercial	$62.02
Rate for Payer: Aetna Medicare Advantage	$48.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.62
Rate for Payer: Cigna Commercial	$81.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.96
Rate for Payer: Oxford Commercial	$32.64
Rate for Payer: Qualcare PPO/HMO/WC	$24.48
Rate for Payer: UnitedHealthcare Commercial	$32.64
Rate for Payer: UnitedHealthcare Community & State	$3.93
Rate for Payer: Wellpoint Medicaid Managed Care	$4.32

GRANULOCYTE AB SCREEN

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3008349
Hospital Revenue Code	302
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

GRANULOCYTE AB SCREEN

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3008349
Hospital Revenue Code	302
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

GRANULOCYTE CONCENTRATE,APHERE

Facility

$4,978.60

Hospital Charge Code	3100567
Hospital Revenue Code	390
Min. Negotiated Rate	$119.98
Max. Negotiated Rate	$2,489.30
Rate for Payer: Aetna Commercial	$1,891.87
Rate for Payer: Aetna Medicare Advantage	$1,493.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,269.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,269.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,269.54
Rate for Payer: Cigna Commercial	$2,489.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,493.58
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$746.79
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$119.98
Rate for Payer: Wellpoint Medicaid Managed Care	$131.93

GRANULOCYTE CONCENTRATE,APHERE

Facility

$4,978.60

Hospital Charge Code	3100567
Hospital Revenue Code	390
Min. Negotiated Rate	$746.79
Max. Negotiated Rate	$746.79
Rate for Payer: Qualcare PPO/HMO/WC	$746.79

GRANULOCYTES PHERESIS EACH

Facility

$8,954.00

Service Code	HCPCS P9060
Hospital Charge Code	38477230
Hospital Revenue Code	390
Min. Negotiated Rate	$1,343.10
Max. Negotiated Rate	$1,343.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,343.10

GRANULOCYTES PHERESIS EACH

Facility

$8,954.00

Service Code	HCPCS P9060
Hospital Charge Code	38477230
Hospital Revenue Code	390
Min. Negotiated Rate	$58.82
Max. Negotiated Rate	$2,686.20
Rate for Payer: Aetna Commercial	$168.42
Rate for Payer: Aetna Medicare Advantage	$200.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.51
Rate for Payer: Cigna Commercial	$124.12
Rate for Payer: Cigna Medicare Advantage	$61.92
Rate for Payer: Clover Medicare Advantage	$58.82
Rate for Payer: EmblemHealth Commercial	$185.76
Rate for Payer: Humana Medicare Advantage	$63.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$61.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,686.20
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,343.10
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$215.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.92
Rate for Payer: Wellcare Medicare Advantage	$61.92
Rate for Payer: Wellpoint Medicaid Managed Care	$237.28

GRASPER 5mm 35cm LAPAROS C4130

Facility

$303.50

Hospital Charge Code	270642079
Hospital Revenue Code	272
Min. Negotiated Rate	$45.52
Max. Negotiated Rate	$45.52
Rate for Payer: Qualcare PPO/HMO/WC	$45.52

GRASPER 5mm 35cm LAPAROS C4130

Facility

$303.50

Hospital Charge Code	270642079
Hospital Revenue Code	272
Min. Negotiated Rate	$7.31
Max. Negotiated Rate	$151.75
Rate for Payer: Aetna Commercial	$115.33
Rate for Payer: Aetna Medicare Advantage	$91.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.39
Rate for Payer: Cigna Commercial	$151.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.05
Rate for Payer: Oxford Commercial	$60.70
Rate for Payer: Qualcare PPO/HMO/WC	$45.52
Rate for Payer: UnitedHealthcare Commercial	$60.70
Rate for Payer: UnitedHealthcare Community & State	$7.31
Rate for Payer: Wellpoint Medicaid Managed Care	$8.04

GRASPER DOUBLE FENESTRATED

Facility

$10,000.00

Hospital Charge Code	270664215
Hospital Revenue Code	270
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

GRASPER DOUBLE FENESTRATED

Facility

$10,000.00

Hospital Charge Code	270664215
Hospital Revenue Code	270
Min. Negotiated Rate	$241.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,000.00
Rate for Payer: Oxford Commercial	$2,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Commercial	$2,000.00
Rate for Payer: UnitedHealthcare Community & State	$241.00
Rate for Payer: Wellpoint Medicaid Managed Care	$265.00

GRASPER FLE 3 PRO 115CM

Facility

$1,689.65

Hospital Charge Code	270601117
Hospital Revenue Code	272
Min. Negotiated Rate	$253.45
Max. Negotiated Rate	$253.45
Rate for Payer: Qualcare PPO/HMO/WC	$253.45

GRASPER FLE 3 PRO 115CM

Facility

$1,689.65

Hospital Charge Code	270601117
Hospital Revenue Code	272
Min. Negotiated Rate	$40.72
Max. Negotiated Rate	$844.83
Rate for Payer: Aetna Commercial	$642.07
Rate for Payer: Aetna Medicare Advantage	$506.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$430.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$430.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$430.86
Rate for Payer: Cigna Commercial	$844.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$506.89
Rate for Payer: Oxford Commercial	$337.93
Rate for Payer: Qualcare PPO/HMO/WC	$253.45
Rate for Payer: UnitedHealthcare Commercial	$337.93
Rate for Payer: UnitedHealthcare Community & State	$40.72
Rate for Payer: Wellpoint Medicaid Managed Care	$44.78

GRASPER VM SLIDELOCK 5MM 22MM

Facility

$2,625.00

Hospital Charge Code	270666058
Hospital Revenue Code	270
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$393.75
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

GRASPER VM SLIDELOCK 5MM 22MM

Facility

$2,625.00

Hospital Charge Code	270666058
Hospital Revenue Code	270
Min. Negotiated Rate	$63.26
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$787.50
Rate for Payer: Oxford Commercial	$525.00
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Commercial	$525.00
Rate for Payer: UnitedHealthcare Community & State	$63.26
Rate for Payer: Wellpoint Medicaid Managed Care	$69.56

GRASPER W/RATCHET HANDLE 5MM

Facility

$296.20

Hospital Charge Code	270671541
Hospital Revenue Code	272
Min. Negotiated Rate	$44.43
Max. Negotiated Rate	$44.43
Rate for Payer: Qualcare PPO/HMO/WC	$44.43

GRASPER W/RATCHET HANDLE 5MM

Facility

$296.20

Hospital Charge Code	270671541
Hospital Revenue Code	272
Min. Negotiated Rate	$7.14
Max. Negotiated Rate	$148.10
Rate for Payer: Aetna Commercial	$112.56
Rate for Payer: Aetna Medicare Advantage	$88.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.53
Rate for Payer: Cigna Commercial	$148.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.86
Rate for Payer: Oxford Commercial	$59.24
Rate for Payer: Qualcare PPO/HMO/WC	$44.43
Rate for Payer: UnitedHealthcare Commercial	$59.24
Rate for Payer: UnitedHealthcare Community & State	$7.14
Rate for Payer: Wellpoint Medicaid Managed Care	$7.85

GRASP NDL OPEN LOOP DISP 10165

Facility

$270.00

Hospital Charge Code	270641145
Hospital Revenue Code	272
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.00
Rate for Payer: Oxford Commercial	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Commercial	$54.00
Rate for Payer: UnitedHealthcare Community & State	$6.51
Rate for Payer: Wellpoint Medicaid Managed Care	$7.16

Know your out-of-pocket cost for care.

All Charges