Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HUMIDIFIER BUBBLE

Facility

$40.00

Hospital Charge Code	270639795
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.00
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

HUMIDIFIER HYGROSCOPIC

Facility

$84.00

Hospital Charge Code	270600875
Hospital Revenue Code	272
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

HUMIDIFIER HYGROSCOPIC

Facility

$84.00

Hospital Charge Code	270600875
Hospital Revenue Code	272
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$31.92
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.20
Rate for Payer: Oxford Commercial	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$16.80
Rate for Payer: UnitedHealthcare Community & State	$2.02
Rate for Payer: Wellpoint Medicaid Managed Care	$2.23

HUMIDIFIER OXYGEN 500 ML

Facility

$6.96

Hospital Charge Code	270625161
Hospital Revenue Code	270
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.48
Rate for Payer: Aetna Commercial	$2.64
Rate for Payer: Aetna Medicare Advantage	$2.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.77
Rate for Payer: Cigna Commercial	$3.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.09
Rate for Payer: Oxford Commercial	$1.39
Rate for Payer: Qualcare PPO/HMO/WC	$1.04
Rate for Payer: UnitedHealthcare Commercial	$1.39
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

HUMIDIFIER OXYGEN 500 ML

Facility

$6.96

Hospital Charge Code	270625161
Hospital Revenue Code	270
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$1.04
Rate for Payer: Qualcare PPO/HMO/WC	$1.04

HUMIDIFIER OXYGEN STERILE H20

Facility

$5.50

Hospital Charge Code	270369531
Hospital Revenue Code	270
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$0.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.83

HUMIDIFIER OXYGEN STERILE H20

Facility

$5.50

Hospital Charge Code	270369531
Hospital Revenue Code	270
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.75
Rate for Payer: Aetna Commercial	$2.09
Rate for Payer: Aetna Medicare Advantage	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.40
Rate for Payer: Cigna Commercial	$2.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.65
Rate for Payer: Oxford Commercial	$1.10
Rate for Payer: Qualcare PPO/HMO/WC	$0.83
Rate for Payer: UnitedHealthcare Commercial	$1.10
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

HUMIDIFIER RM

Facility

$141.65

Hospital Charge Code	8000895
Hospital Revenue Code	270
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$70.83
Rate for Payer: Aetna Commercial	$53.83
Rate for Payer: Aetna Medicare Advantage	$42.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.12
Rate for Payer: Cigna Commercial	$70.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.49
Rate for Payer: Oxford Commercial	$28.33
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$28.33
Rate for Payer: UnitedHealthcare Community & State	$3.41
Rate for Payer: Wellpoint Medicaid Managed Care	$3.75

HUMIDIFIER RM

Facility

$141.65

Hospital Charge Code	8000895
Hospital Revenue Code	270
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

HUMIDIFIER TYPE 1 HYDROSCOPIC

Facility

$15.30

Hospital Charge Code	270633734
Hospital Revenue Code	270
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$2.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.29

HUMIDIFIER TYPE 1 HYDROSCOPIC

Facility

$15.30

Hospital Charge Code	270633734
Hospital Revenue Code	270
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$7.65
Rate for Payer: Aetna Commercial	$5.81
Rate for Payer: Aetna Medicare Advantage	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.90
Rate for Payer: Cigna Commercial	$7.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.59
Rate for Payer: Oxford Commercial	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$2.29
Rate for Payer: UnitedHealthcare Commercial	$3.06
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

HUMIDIF OXYG 500ml L.FRE M0352

Facility

$7.50

Hospital Charge Code	270639700
Hospital Revenue Code	270
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.75
Rate for Payer: Aetna Commercial	$2.85
Rate for Payer: Aetna Medicare Advantage	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.91
Rate for Payer: Cigna Commercial	$3.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.25
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.12
Rate for Payer: UnitedHealthcare Commercial	$1.50
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

HUMIDIF OXYG 500ml L.FRE M0352

Facility

$7.50

Hospital Charge Code	270639700
Hospital Revenue Code	270
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$1.12
Rate for Payer: Qualcare PPO/HMO/WC	$1.12

HUM METAPHYS CMNTLS 135A 7 DEG

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686874
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

HUM METAPHYS CMNTLS 135A 7 DEG

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686874
Hospital Revenue Code	278
Min. Negotiated Rate	$96.40
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$880.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$96.40
Rate for Payer: Wellpoint Medicaid Managed Care	$106.00

HUM STEM TA6V 12 CEMENTLESS

Facility

$15,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270692129
Hospital Revenue Code	278
Min. Negotiated Rate	$2,325.00
Max. Negotiated Rate	$3,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,751.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,410.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.00

HUM STEM TA6V 12 CEMENTLESS

Facility

$15,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270692129
Hospital Revenue Code	278
Min. Negotiated Rate	$373.55
Max. Negotiated Rate	$7,750.00
Rate for Payer: Aetna Commercial	$5,890.00
Rate for Payer: Aetna Medicare Advantage	$4,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,952.50
Rate for Payer: Cigna Commercial	$7,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,751.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,410.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.00
Rate for Payer: UnitedHealthcare Community & State	$373.55
Rate for Payer: Wellpoint Medicaid Managed Care	$410.75

HUM SYSTEM T2 PROX 08X260MM

Facility

$13,075.00

Hospital Charge Code	270648814
Hospital Revenue Code	278
Min. Negotiated Rate	$315.11
Max. Negotiated Rate	$6,537.50
Rate for Payer: Aetna Commercial	$4,968.50
Rate for Payer: Aetna Medicare Advantage	$3,922.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,334.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,334.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,615.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,334.12
Rate for Payer: Cigna Commercial	$6,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,164.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,876.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.25
Rate for Payer: UnitedHealthcare Community & State	$315.11
Rate for Payer: Wellpoint Medicaid Managed Care	$346.49

HUM SYSTEM T2 PROX 08X260MM

Facility

$13,075.00

Hospital Charge Code	270648814
Hospital Revenue Code	278
Min. Negotiated Rate	$1,961.25
Max. Negotiated Rate	$3,164.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,615.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,164.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,876.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.25

HUMULIN 70/30/100U/1ML

Facility

$39.00

Hospital Charge Code	60633099
Hospital Revenue Code	250
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$19.50
Rate for Payer: Aetna Commercial	$14.82
Rate for Payer: Aetna Medicare Advantage	$11.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.95
Rate for Payer: Cigna Commercial	$19.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$5.85
Rate for Payer: UnitedHealthcare Commercial	$7.80
Rate for Payer: UnitedHealthcare Community & State	$0.94
Rate for Payer: Wellpoint Medicaid Managed Care	$1.03

HUMULIN 70/30/100U/1ML

Facility

$39.00

Hospital Charge Code	60633099
Hospital Revenue Code	250
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$5.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.85

HUMULIN L INSULIN

Facility

$41.00

Hospital Charge Code	60634522
Hospital Revenue Code	250
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$20.50
Rate for Payer: Aetna Commercial	$15.58
Rate for Payer: Aetna Medicare Advantage	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.46
Rate for Payer: Cigna Commercial	$20.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.30
Rate for Payer: Oxford Commercial	$8.20
Rate for Payer: Qualcare PPO/HMO/WC	$6.15
Rate for Payer: UnitedHealthcare Commercial	$8.20
Rate for Payer: UnitedHealthcare Community & State	$0.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1.09

HUMULIN L INSULIN

Facility

$41.00

Hospital Charge Code	60634522
Hospital Revenue Code	250
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$6.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.15

HUMULIN N/100U/1ML

Facility

$39.00

Hospital Charge Code	60633096
Hospital Revenue Code	250
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$19.50
Rate for Payer: Aetna Commercial	$14.82
Rate for Payer: Aetna Medicare Advantage	$11.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.95
Rate for Payer: Cigna Commercial	$19.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$5.85
Rate for Payer: UnitedHealthcare Commercial	$7.80
Rate for Payer: UnitedHealthcare Community & State	$0.94
Rate for Payer: Wellpoint Medicaid Managed Care	$1.03

HUMULIN N/100U/1ML

Facility

$39.00

Hospital Charge Code	60633096
Hospital Revenue Code	250
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$5.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.85

Know your out-of-pocket cost for care.

All Charges