Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT PICC 5.5FRx40cm DOUBLE

Facility

$525.00

Hospital Charge Code	270648054
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 5.5FRx50cm DOUBLE

Facility

$525.00

Hospital Charge Code	270648055
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 5.5FRx50cm DOUBLE

Facility

$525.00

Hospital Charge Code	270648055
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 PLATET CONC SEPAR 8000603A

Facility

$2,281.65

Hospital Charge Code	270632535
Hospital Revenue Code	272
Min. Negotiated Rate	$342.25
Max. Negotiated Rate	$342.25
Rate for Payer: Qualcare PPO/HMO/WC	$342.25

KIT PLATET CONC SEPAR 8000603A

Facility

$2,281.65

Hospital Charge Code	270632535
Hospital Revenue Code	272
Min. Negotiated Rate	$54.99
Max. Negotiated Rate	$1,140.83
Rate for Payer: Aetna Commercial	$867.03
Rate for Payer: Aetna Medicare Advantage	$684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$581.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$581.82
Rate for Payer: Cigna Commercial	$1,140.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$684.50
Rate for Payer: Oxford Commercial	$456.33
Rate for Payer: Qualcare PPO/HMO/WC	$342.25
Rate for Payer: UnitedHealthcare Commercial	$456.33
Rate for Payer: UnitedHealthcare Community & State	$54.99
Rate for Payer: Wellpoint Medicaid Managed Care	$60.46

KIT PLEURX DRAINAGE 507500

Facility

$285.00

Hospital Charge Code	270629873V
Hospital Revenue Code	272
Min. Negotiated Rate	$42.75
Max. Negotiated Rate	$42.75
Rate for Payer: Qualcare PPO/HMO/WC	$42.75

KIT PLEURX DRAINAGE 507500

Facility

$285.00

Hospital Charge Code	270629873V
Hospital Revenue Code	272
Min. Negotiated Rate	$6.87
Max. Negotiated Rate	$142.50
Rate for Payer: Aetna Commercial	$108.30
Rate for Payer: Aetna Medicare Advantage	$85.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.67
Rate for Payer: Cigna Commercial	$142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.50
Rate for Payer: Oxford Commercial	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.75
Rate for Payer: UnitedHealthcare Commercial	$57.00
Rate for Payer: UnitedHealthcare Community & State	$6.87
Rate for Payer: Wellpoint Medicaid Managed Care	$7.55

KIT PLEURX PLEURAL CATH 507000

Facility

$2,875.00

Service Code	HCPCS C1729
Hospital Charge Code	270629872
Hospital Revenue Code	278
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$695.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$632.50
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

KIT PLEURX PLEURAL CATH 507000

Facility

$763.25

Hospital Charge Code	27062972V
Hospital Revenue Code	278
Min. Negotiated Rate	$114.49
Max. Negotiated Rate	$184.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$167.91
Rate for Payer: Qualcare PPO/HMO/WC	$114.49

KIT PLEURX PLEURAL CATH 507000

Facility

$763.25

Hospital Charge Code	27062972V
Hospital Revenue Code	278
Min. Negotiated Rate	$18.39
Max. Negotiated Rate	$381.62
Rate for Payer: Aetna Commercial	$290.04
Rate for Payer: Aetna Medicare Advantage	$228.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$194.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$194.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$194.63
Rate for Payer: Cigna Commercial	$381.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$167.91
Rate for Payer: Qualcare PPO/HMO/WC	$114.49
Rate for Payer: UnitedHealthcare Community & State	$18.39
Rate for Payer: Wellpoint Medicaid Managed Care	$20.23

KIT PLEURX PLEURAL CATH 507000

Facility

$2,875.00

Service Code	HCPCS C1729
Hospital Charge Code	270629872
Hospital Revenue Code	278
Min. Negotiated Rate	$69.29
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$1,092.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$632.50
Rate for Payer: Qualcare PPO/HMO/WC	$431.25
Rate for Payer: UnitedHealthcare Community & State	$69.29
Rate for Payer: Wellpoint Medicaid Managed Care	$76.19

KIT PONSKY PULL PEG 000302

Facility

$436.85

Hospital Charge Code	270600922
Hospital Revenue Code	270
Min. Negotiated Rate	$10.53
Max. Negotiated Rate	$218.43
Rate for Payer: Aetna Commercial	$166.00
Rate for Payer: Aetna Medicare Advantage	$131.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.40
Rate for Payer: Cigna Commercial	$218.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.06
Rate for Payer: Oxford Commercial	$87.37
Rate for Payer: Qualcare PPO/HMO/WC	$65.53
Rate for Payer: UnitedHealthcare Commercial	$87.37
Rate for Payer: UnitedHealthcare Community & State	$10.53
Rate for Payer: Wellpoint Medicaid Managed Care	$11.58

KIT PONSKY PULL PEG 000302

Facility

$436.85

Hospital Charge Code	270600922
Hospital Revenue Code	270
Min. Negotiated Rate	$65.53
Max. Negotiated Rate	$65.53
Rate for Payer: Qualcare PPO/HMO/WC	$65.53

KIT PORTAL ENTRY

Facility

$1,627.55

Hospital Charge Code	270673921
Hospital Revenue Code	272
Min. Negotiated Rate	$244.13
Max. Negotiated Rate	$244.13
Rate for Payer: Qualcare PPO/HMO/WC	$244.13

KIT PORTAL ENTRY

Facility

$1,627.55

Hospital Charge Code	270673921
Hospital Revenue Code	272
Min. Negotiated Rate	$39.22
Max. Negotiated Rate	$813.77
Rate for Payer: Aetna Commercial	$618.47
Rate for Payer: Aetna Medicare Advantage	$488.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$415.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$415.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$415.03
Rate for Payer: Cigna Commercial	$813.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$488.26
Rate for Payer: Oxford Commercial	$325.51
Rate for Payer: Qualcare PPO/HMO/WC	$244.13
Rate for Payer: UnitedHealthcare Commercial	$325.51
Rate for Payer: UnitedHealthcare Community & State	$39.22
Rate for Payer: Wellpoint Medicaid Managed Care	$43.13

KIT POST OP NATURA ST 2 PIECE

Facility

$97.27

Hospital Charge Code	270648475
Hospital Revenue Code	271
Min. Negotiated Rate	$14.59
Max. Negotiated Rate	$14.59
Rate for Payer: Qualcare PPO/HMO/WC	$14.59

KIT POST OP NATURA ST 2 PIECE

Facility

$97.27

Hospital Charge Code	270648475
Hospital Revenue Code	271
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$48.63
Rate for Payer: Aetna Commercial	$36.96
Rate for Payer: Aetna Medicare Advantage	$29.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.80
Rate for Payer: Cigna Commercial	$48.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.18
Rate for Payer: Oxford Commercial	$19.45
Rate for Payer: Qualcare PPO/HMO/WC	$14.59
Rate for Payer: UnitedHealthcare Commercial	$19.45
Rate for Payer: UnitedHealthcare Community & State	$2.34
Rate for Payer: Wellpoint Medicaid Managed Care	$2.58

KIT POWER PULSE Y CONNECTOR

Facility

$170.00

Hospital Charge Code	270645569S
Hospital Revenue Code	272
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$85.00
Rate for Payer: Aetna Commercial	$64.60
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.00
Rate for Payer: Oxford Commercial	$34.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$34.00
Rate for Payer: UnitedHealthcare Community & State	$4.10
Rate for Payer: Wellpoint Medicaid Managed Care	$4.50

KIT POWER PULSE Y CONNECTOR

Facility

$535.00

Hospital Charge Code	270645569N
Hospital Revenue Code	272
Min. Negotiated Rate	$12.89
Max. Negotiated Rate	$267.50
Rate for Payer: Aetna Commercial	$203.30
Rate for Payer: Aetna Medicare Advantage	$160.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.43
Rate for Payer: Cigna Commercial	$267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.50
Rate for Payer: Oxford Commercial	$107.00
Rate for Payer: Qualcare PPO/HMO/WC	$80.25
Rate for Payer: UnitedHealthcare Commercial	$107.00
Rate for Payer: UnitedHealthcare Community & State	$12.89
Rate for Payer: Wellpoint Medicaid Managed Care	$14.18

KIT POWER PULSE Y CONNECTOR

Facility

$535.00

Hospital Charge Code	270645569N
Hospital Revenue Code	272
Min. Negotiated Rate	$80.25
Max. Negotiated Rate	$80.25
Rate for Payer: Qualcare PPO/HMO/WC	$80.25

KIT POWER PULSE Y CONNECTOR

Facility

$170.00

Hospital Charge Code	270645569S
Hospital Revenue Code	272
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

KIT POWER PULSE Y CONNECTOR

Facility

$170.00

Hospital Charge Code	270645569
Hospital Revenue Code	272
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$85.00
Rate for Payer: Aetna Commercial	$64.60
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.00
Rate for Payer: Oxford Commercial	$34.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$34.00
Rate for Payer: UnitedHealthcare Community & State	$4.10
Rate for Payer: Wellpoint Medicaid Managed Care	$4.50

KIT POWER PULSE Y CONNECTOR

Facility

$170.00

Hospital Charge Code	270645569
Hospital Revenue Code	272
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

KIT PRECISION CHARGING SYSTEM

Facility

$14,000.00

Service Code	HCPCS C1778
Hospital Charge Code	270701896
Hospital Revenue Code	278
Min. Negotiated Rate	$337.40
Max. Negotiated Rate	$7,000.00
Rate for Payer: Aetna Commercial	$5,320.00
Rate for Payer: Aetna Medicare Advantage	$4,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,570.00
Rate for Payer: Cigna Commercial	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,080.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00
Rate for Payer: UnitedHealthcare Community & State	$337.40
Rate for Payer: Wellpoint Medicaid Managed Care	$371.00

KIT PRECISION CHARGING SYSTEM

Facility

$14,000.00

Service Code	HCPCS C1778
Hospital Charge Code	270701896
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$3,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,080.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00

Know your out-of-pocket cost for care.

All Charges