Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT, EC10 ML ACCESSORY

Facility

$2,265.90

Hospital Charge Code	270658603
Hospital Revenue Code	272
Min. Negotiated Rate	$54.61
Max. Negotiated Rate	$1,132.95
Rate for Payer: Aetna Commercial	$861.04
Rate for Payer: Aetna Medicare Advantage	$679.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$577.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$577.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$577.80
Rate for Payer: Cigna Commercial	$1,132.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$679.77
Rate for Payer: Oxford Commercial	$453.18
Rate for Payer: Qualcare PPO/HMO/WC	$339.88
Rate for Payer: UnitedHealthcare Commercial	$453.18
Rate for Payer: UnitedHealthcare Community & State	$54.61
Rate for Payer: Wellpoint Medicaid Managed Care	$60.05

KIT, EC10 ML ACCESSORY

Facility

$2,265.90

Hospital Charge Code	270658603
Hospital Revenue Code	272
Min. Negotiated Rate	$339.88
Max. Negotiated Rate	$339.88
Rate for Payer: Qualcare PPO/HMO/WC	$339.88

KIT ENDO CTR DISPOS 4MM BASIC

Facility

$3,750.00

Hospital Charge Code	270693667
Hospital Revenue Code	272
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.00
Rate for Payer: Oxford Commercial	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Commercial	$750.00
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

KIT ENDO CTR DISPOS 4MM BASIC

Facility

$3,750.00

Hospital Charge Code	270693667
Hospital Revenue Code	272
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$562.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

KIT ENDOGATOR IRRIG TUBING

Facility

$120.00

Hospital Charge Code	270677282
Hospital Revenue Code	272
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$45.60
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.00
Rate for Payer: Oxford Commercial	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$24.00
Rate for Payer: UnitedHealthcare Community & State	$2.89
Rate for Payer: Wellpoint Medicaid Managed Care	$3.18

KIT ENDOGATOR IRRIG TUBING

Facility

$120.00

Hospital Charge Code	270677282
Hospital Revenue Code	272
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

KIT ENDOSCOPY BEDSIDE

Facility

$16.90

Hospital Charge Code	270676645
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.45
Rate for Payer: Aetna Commercial	$6.42
Rate for Payer: Aetna Medicare Advantage	$5.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.31
Rate for Payer: Cigna Commercial	$8.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.07
Rate for Payer: Oxford Commercial	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$2.54
Rate for Payer: UnitedHealthcare Commercial	$3.38
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

KIT ENDOSCOPY BEDSIDE

Facility

$16.90

Hospital Charge Code	270676645
Hospital Revenue Code	272
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$2.54
Rate for Payer: Qualcare PPO/HMO/WC	$2.54

KIT ENDOSCOPY KIT BASIC

Facility

$250.00

Hospital Charge Code	270700164
Hospital Revenue Code	273
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

KIT ENDOSCOPY KIT BASIC

Facility

$250.00

Hospital Charge Code	270700164
Hospital Revenue Code	273
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

KIT ENEMA CLEANSING

Facility

$6.33

Hospital Charge Code	270649625
Hospital Revenue Code	270
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$3.17
Rate for Payer: Aetna Commercial	$2.41
Rate for Payer: Aetna Medicare Advantage	$1.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.61
Rate for Payer: Cigna Commercial	$3.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.90
Rate for Payer: Oxford Commercial	$1.27
Rate for Payer: Qualcare PPO/HMO/WC	$0.95
Rate for Payer: UnitedHealthcare Commercial	$1.27
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

KIT ENEMA CLEANSING

Facility

$6.33

Hospital Charge Code	270649625
Hospital Revenue Code	270
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$0.95
Rate for Payer: Qualcare PPO/HMO/WC	$0.95

KIT ENTRY MEDI-TECH******

Facility

$374.00

Hospital Charge Code	1605815
Hospital Revenue Code	272
Min. Negotiated Rate	$9.01
Max. Negotiated Rate	$187.00
Rate for Payer: Aetna Commercial	$142.12
Rate for Payer: Aetna Medicare Advantage	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.37
Rate for Payer: Cigna Commercial	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.20
Rate for Payer: Oxford Commercial	$74.80
Rate for Payer: Qualcare PPO/HMO/WC	$56.10
Rate for Payer: UnitedHealthcare Commercial	$74.80
Rate for Payer: UnitedHealthcare Community & State	$9.01
Rate for Payer: Wellpoint Medicaid Managed Care	$9.91

KIT ENTRY MEDI-TECH******

Facility

$374.00

Hospital Charge Code	1605815
Hospital Revenue Code	272
Min. Negotiated Rate	$56.10
Max. Negotiated Rate	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$56.10

KIT ENTRY VENA CAVA 12F 50-350

Facility

$912.85

Hospital Charge Code	270601157
Hospital Revenue Code	272
Min. Negotiated Rate	$22.00
Max. Negotiated Rate	$456.43
Rate for Payer: Aetna Commercial	$346.88
Rate for Payer: Aetna Medicare Advantage	$273.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.78
Rate for Payer: Cigna Commercial	$456.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.86
Rate for Payer: Oxford Commercial	$182.57
Rate for Payer: Qualcare PPO/HMO/WC	$136.93
Rate for Payer: UnitedHealthcare Commercial	$182.57
Rate for Payer: UnitedHealthcare Community & State	$22.00
Rate for Payer: Wellpoint Medicaid Managed Care	$24.19

KIT ENTRY VENA CAVA 12F 50-350

Facility

$912.85

Hospital Charge Code	270601157
Hospital Revenue Code	272
Min. Negotiated Rate	$136.93
Max. Negotiated Rate	$136.93
Rate for Payer: Qualcare PPO/HMO/WC	$136.93

KIT ENTRY VENA CAVA 12F 50350*

Facility

$160.00

Hospital Charge Code	1607191
Hospital Revenue Code	272
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

KIT ENTRY VENA CAVA 12F 50350*

Facility

$160.00

Hospital Charge Code	1607191
Hospital Revenue Code	272
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$60.80
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.00
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$32.00
Rate for Payer: UnitedHealthcare Community & State	$3.86
Rate for Payer: Wellpoint Medicaid Managed Care	$4.24

KIT ENTRY VENA CAVA 12FR

Facility

$665.00

Hospital Charge Code	270605533
Hospital Revenue Code	272
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.50
Rate for Payer: Oxford Commercial	$133.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Commercial	$133.00
Rate for Payer: UnitedHealthcare Community & State	$16.03
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

KIT ENTRY VENA CAVA 12FR

Facility

$665.00

Hospital Charge Code	270605533
Hospital Revenue Code	272
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$99.75
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

KIT EPISTAXIS BALLOON CATH

Facility

$457.50

Hospital Charge Code	270677766
Hospital Revenue Code	272
Min. Negotiated Rate	$11.03
Max. Negotiated Rate	$228.75
Rate for Payer: Aetna Commercial	$173.85
Rate for Payer: Aetna Medicare Advantage	$137.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.66
Rate for Payer: Cigna Commercial	$228.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.25
Rate for Payer: Oxford Commercial	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$68.62
Rate for Payer: UnitedHealthcare Commercial	$91.50
Rate for Payer: UnitedHealthcare Community & State	$11.03
Rate for Payer: Wellpoint Medicaid Managed Care	$12.12

KIT EPISTAXIS BALLOON CATH

Facility

$457.50

Hospital Charge Code	270677766
Hospital Revenue Code	272
Min. Negotiated Rate	$68.62
Max. Negotiated Rate	$68.62
Rate for Payer: Qualcare PPO/HMO/WC	$68.62

KIT EPISTAXIS BALLOON CATH****

Facility

$115.00

Hospital Charge Code	8004301
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$57.50
Rate for Payer: Aetna Commercial	$43.70
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.50
Rate for Payer: Oxford Commercial	$23.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Commercial	$23.00
Rate for Payer: UnitedHealthcare Community & State	$2.77
Rate for Payer: Wellpoint Medicaid Managed Care	$3.05

KIT EPISTAXIS BALLOON CATH****

Facility

$115.00

Hospital Charge Code	8004301
Hospital Revenue Code	272
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

KIT EXTENSION

Facility

$3,475.00

Hospital Charge Code	270663407
Hospital Revenue Code	278
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$840.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$764.50
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

Know your out-of-pocket cost for care.

All Charges