Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT PEEK ROOT REPAIR

Facility

$6,975.00

Hospital Charge Code	270688311
Hospital Revenue Code	272
Min. Negotiated Rate	$168.10
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,650.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,092.50
Rate for Payer: Oxford Commercial	$1,395.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Commercial	$1,395.00
Rate for Payer: UnitedHealthcare Community & State	$168.10
Rate for Payer: Wellpoint Medicaid Managed Care	$184.84

KIT PEEK ROOT REPAIR

Facility

$6,975.00

Hospital Charge Code	270688311
Hospital Revenue Code	272
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,046.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

KIT PEG 24FR SAFETY PUSH

Facility

$442.18

Hospital Charge Code	270676987
Hospital Revenue Code	278
Min. Negotiated Rate	$66.33
Max. Negotiated Rate	$107.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$97.28
Rate for Payer: Qualcare PPO/HMO/WC	$66.33

KIT PEG 24FR SAFETY PUSH

Facility

$442.18

Hospital Charge Code	270676987
Hospital Revenue Code	278
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$221.09
Rate for Payer: Aetna Commercial	$168.03
Rate for Payer: Aetna Medicare Advantage	$132.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.76
Rate for Payer: Cigna Commercial	$221.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$97.28
Rate for Payer: Qualcare PPO/HMO/WC	$66.33
Rate for Payer: UnitedHealthcare Community & State	$10.66
Rate for Payer: Wellpoint Medicaid Managed Care	$11.72

KIT PEG SAFETY 20FR PULL

Facility

$442.18

Hospital Charge Code	270647892
Hospital Revenue Code	272
Min. Negotiated Rate	$10.66
Max. Negotiated Rate	$221.09
Rate for Payer: Aetna Commercial	$168.03
Rate for Payer: Aetna Medicare Advantage	$132.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.76
Rate for Payer: Cigna Commercial	$221.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.65
Rate for Payer: Oxford Commercial	$88.44
Rate for Payer: Qualcare PPO/HMO/WC	$66.33
Rate for Payer: UnitedHealthcare Commercial	$88.44
Rate for Payer: UnitedHealthcare Community & State	$10.66
Rate for Payer: Wellpoint Medicaid Managed Care	$11.72

KIT PEG SAFETY 20FR PULL

Facility

$442.18

Hospital Charge Code	270647892
Hospital Revenue Code	272
Min. Negotiated Rate	$66.33
Max. Negotiated Rate	$66.33
Rate for Payer: Qualcare PPO/HMO/WC	$66.33

KIT PEG SAFETY 20FR PUSH 6647

Facility

$1,125.00

Hospital Charge Code	270647893
Hospital Revenue Code	272
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

KIT PEG SAFETY 20FR PUSH 6647

Facility

$1,125.00

Hospital Charge Code	270647893
Hospital Revenue Code	272
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Commercial	$225.00
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

KIT PEN & LABEL

Facility

$3.10

Hospital Charge Code	270636909C
Hospital Revenue Code	272
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.55
Rate for Payer: Aetna Commercial	$1.18
Rate for Payer: Aetna Medicare Advantage	$0.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.79
Rate for Payer: Cigna Commercial	$1.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.93
Rate for Payer: Oxford Commercial	$0.62
Rate for Payer: Qualcare PPO/HMO/WC	$0.47
Rate for Payer: UnitedHealthcare Commercial	$0.62
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

KIT PEN & LABEL

Facility

$3.10

Hospital Charge Code	270636909C
Hospital Revenue Code	272
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$0.47
Rate for Payer: Qualcare PPO/HMO/WC	$0.47

KIT PERC CATH INTRODUCER 12FR

Facility

$463.25

Hospital Charge Code	270601153
Hospital Revenue Code	272
Min. Negotiated Rate	$11.16
Max. Negotiated Rate	$231.62
Rate for Payer: Aetna Commercial	$176.03
Rate for Payer: Aetna Medicare Advantage	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.13
Rate for Payer: Cigna Commercial	$231.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.97
Rate for Payer: Oxford Commercial	$92.65
Rate for Payer: Qualcare PPO/HMO/WC	$69.49
Rate for Payer: UnitedHealthcare Commercial	$92.65
Rate for Payer: UnitedHealthcare Community & State	$11.16
Rate for Payer: Wellpoint Medicaid Managed Care	$12.28

KIT PERC CATH INTRODUCER 12FR

Facility

$463.25

Hospital Charge Code	270601153
Hospital Revenue Code	272
Min. Negotiated Rate	$69.49
Max. Negotiated Rate	$69.49
Rate for Payer: Qualcare PPO/HMO/WC	$69.49

KIT PERCUTANEOUS 3MM

Facility

$975.00

Hospital Charge Code	270672213
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

KIT PERCUTANEOUS 3MM

Facility

$975.00

Hospital Charge Code	270672213
Hospital Revenue Code	272
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$195.00
Rate for Payer: UnitedHealthcare Community & State	$23.50
Rate for Payer: Wellpoint Medicaid Managed Care	$25.84

KIT PERCUTANEOUS CAVITY DRAING

Facility

$651.50

Hospital Charge Code	270676124
Hospital Revenue Code	272
Min. Negotiated Rate	$15.70
Max. Negotiated Rate	$325.75
Rate for Payer: Aetna Commercial	$247.57
Rate for Payer: Aetna Medicare Advantage	$195.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.13
Rate for Payer: Cigna Commercial	$325.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.45
Rate for Payer: Oxford Commercial	$130.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.72
Rate for Payer: UnitedHealthcare Commercial	$130.30
Rate for Payer: UnitedHealthcare Community & State	$15.70
Rate for Payer: Wellpoint Medicaid Managed Care	$17.26

KIT PERCUTANEOUS CAVITY DRAING

Facility

$651.50

Hospital Charge Code	270676124
Hospital Revenue Code	272
Min. Negotiated Rate	$97.72
Max. Negotiated Rate	$97.72
Rate for Payer: Qualcare PPO/HMO/WC	$97.72

KIT PERIVAC PERICARDIOCENTISIS

Facility

$866.67

Service Code	HCPCS C1729
Hospital Charge Code	270645514C
Hospital Revenue Code	278
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$209.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$190.67
Rate for Payer: Qualcare PPO/HMO/WC	$130.00

KIT PERIVAC PERICARDIOCENTISIS

Facility

$766.67

Hospital Charge Code	270635912C
Hospital Revenue Code	278
Min. Negotiated Rate	$115.00
Max. Negotiated Rate	$185.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.67
Rate for Payer: Qualcare PPO/HMO/WC	$115.00

KIT PERIVAC PERICARDIOCENTISIS

Facility

$766.67

Hospital Charge Code	270635912C
Hospital Revenue Code	278
Min. Negotiated Rate	$18.48
Max. Negotiated Rate	$383.33
Rate for Payer: Aetna Commercial	$291.33
Rate for Payer: Aetna Medicare Advantage	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.50
Rate for Payer: Cigna Commercial	$383.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$168.67
Rate for Payer: Qualcare PPO/HMO/WC	$115.00
Rate for Payer: UnitedHealthcare Community & State	$18.48
Rate for Payer: Wellpoint Medicaid Managed Care	$20.32

KIT PERIVAC PERICARDIOCENTISIS

Facility

$866.67

Service Code	HCPCS C1729
Hospital Charge Code	270645514C
Hospital Revenue Code	278
Min. Negotiated Rate	$20.89
Max. Negotiated Rate	$433.33
Rate for Payer: Aetna Commercial	$329.33
Rate for Payer: Aetna Medicare Advantage	$260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.00
Rate for Payer: Cigna Commercial	$433.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$190.67
Rate for Payer: Qualcare PPO/HMO/WC	$130.00
Rate for Payer: UnitedHealthcare Community & State	$20.89
Rate for Payer: Wellpoint Medicaid Managed Care	$22.97

KIT PICC 4.5FRx40cm SINGLE

Facility

$525.00

Hospital Charge Code	270648052
Hospital Revenue Code	278
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

KIT PICC 4.5FRx40cm SINGLE

Facility

$525.00

Hospital Charge Code	270648052
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

KIT PICC 4.5FRx50cm SINGLE

Facility

$525.00

Hospital Charge Code	270648053
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

KIT PICC 4.5FRx50cm SINGLE

Facility

$525.00

Hospital Charge Code	270648053
Hospital Revenue Code	278
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$12.65
Rate for Payer: Wellpoint Medicaid Managed Care	$13.91

KIT PICC 5.5FRx40cm DOUBLE

Facility

$525.00

Hospital Charge Code	270648054
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

Know your out-of-pocket cost for care.

All Charges