Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT PREP SMALL DYND70288

Facility

$30.49

Hospital Charge Code	270632443
Hospital Revenue Code	270
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$15.24
Rate for Payer: Aetna Commercial	$11.59
Rate for Payer: Aetna Medicare Advantage	$9.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.77
Rate for Payer: Cigna Commercial	$15.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.15
Rate for Payer: Oxford Commercial	$6.10
Rate for Payer: Qualcare PPO/HMO/WC	$4.57
Rate for Payer: UnitedHealthcare Commercial	$6.10
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

KIT PREP SMALL DYND70288

Facility

$30.49

Hospital Charge Code	270632443
Hospital Revenue Code	270
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$4.57
Rate for Payer: Qualcare PPO/HMO/WC	$4.57

KIT PROBE ABLATION OSTEOCOOL

Facility

$21,075.00

Hospital Charge Code	270689767
Hospital Revenue Code	272
Min. Negotiated Rate	$507.91
Max. Negotiated Rate	$10,537.50
Rate for Payer: Aetna Commercial	$8,008.50
Rate for Payer: Aetna Medicare Advantage	$6,322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,374.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,374.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,374.12
Rate for Payer: Cigna Commercial	$10,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,322.50
Rate for Payer: Oxford Commercial	$4,215.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,161.25
Rate for Payer: UnitedHealthcare Commercial	$4,215.00
Rate for Payer: UnitedHealthcare Community & State	$507.91
Rate for Payer: Wellpoint Medicaid Managed Care	$558.49

KIT PROBE ABLATION OSTEOCOOL

Facility

$21,075.00

Hospital Charge Code	270689767
Hospital Revenue Code	272
Min. Negotiated Rate	$3,161.25
Max. Negotiated Rate	$3,161.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,161.25

KIT PROCEDURE PLEURIX

Facility

$295.00

Hospital Charge Code	270665608
Hospital Revenue Code	272
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$112.10
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.50
Rate for Payer: Oxford Commercial	$59.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.25
Rate for Payer: UnitedHealthcare Commercial	$59.00
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$7.82

KIT PROCEDURE PLEURIX

Facility

$295.00

Hospital Charge Code	270665608
Hospital Revenue Code	272
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$44.25
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

KIT PROGEL PLEURAL LEAK SEALNT

Facility

$4,625.00

Service Code	HCPCS C2615
Hospital Charge Code	270662136
Hospital Revenue Code	278
Min. Negotiated Rate	$693.75
Max. Negotiated Rate	$1,119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,017.50
Rate for Payer: Qualcare PPO/HMO/WC	$693.75

KIT PROGEL PLEURAL LEAK SEALNT

Facility

$4,625.00

Service Code	HCPCS C2615
Hospital Charge Code	270662136
Hospital Revenue Code	278
Min. Negotiated Rate	$111.46
Max. Negotiated Rate	$2,312.50
Rate for Payer: Aetna Commercial	$1,757.50
Rate for Payer: Aetna Medicare Advantage	$1,387.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,179.38
Rate for Payer: Cigna Commercial	$2,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,017.50
Rate for Payer: Qualcare PPO/HMO/WC	$693.75
Rate for Payer: UnitedHealthcare Community & State	$111.46
Rate for Payer: Wellpoint Medicaid Managed Care	$122.56

KIT PRO-NOX LARGE

Facility

$76.45

Hospital Charge Code	270679180
Hospital Revenue Code	272
Min. Negotiated Rate	$1.84
Max. Negotiated Rate	$38.23
Rate for Payer: Aetna Commercial	$29.05
Rate for Payer: Aetna Medicare Advantage	$22.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.49
Rate for Payer: Cigna Commercial	$38.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.93
Rate for Payer: Oxford Commercial	$15.29
Rate for Payer: Qualcare PPO/HMO/WC	$11.47
Rate for Payer: UnitedHealthcare Commercial	$15.29
Rate for Payer: UnitedHealthcare Community & State	$1.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2.03

KIT PRO-NOX LARGE

Facility

$76.45

Hospital Charge Code	270679180
Hospital Revenue Code	272
Min. Negotiated Rate	$11.47
Max. Negotiated Rate	$11.47
Rate for Payer: Qualcare PPO/HMO/WC	$11.47

KIT PRO-NOX MEDIUM

Facility

$76.45

Hospital Charge Code	270679179
Hospital Revenue Code	272
Min. Negotiated Rate	$1.84
Max. Negotiated Rate	$38.23
Rate for Payer: Aetna Commercial	$29.05
Rate for Payer: Aetna Medicare Advantage	$22.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.49
Rate for Payer: Cigna Commercial	$38.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.93
Rate for Payer: Oxford Commercial	$15.29
Rate for Payer: Qualcare PPO/HMO/WC	$11.47
Rate for Payer: UnitedHealthcare Commercial	$15.29
Rate for Payer: UnitedHealthcare Community & State	$1.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2.03

KIT PRO-NOX MEDIUM

Facility

$76.45

Hospital Charge Code	270679179
Hospital Revenue Code	272
Min. Negotiated Rate	$11.47
Max. Negotiated Rate	$11.47
Rate for Payer: Qualcare PPO/HMO/WC	$11.47

KIT PRO-NOX SMALL

Facility

$76.45

Hospital Charge Code	270679181
Hospital Revenue Code	272
Min. Negotiated Rate	$11.47
Max. Negotiated Rate	$11.47
Rate for Payer: Qualcare PPO/HMO/WC	$11.47

KIT PRO-NOX SMALL

Facility

$76.45

Hospital Charge Code	270679181
Hospital Revenue Code	272
Min. Negotiated Rate	$1.84
Max. Negotiated Rate	$38.23
Rate for Payer: Aetna Commercial	$29.05
Rate for Payer: Aetna Medicare Advantage	$22.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.49
Rate for Payer: Cigna Commercial	$38.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.93
Rate for Payer: Oxford Commercial	$15.29
Rate for Payer: Qualcare PPO/HMO/WC	$11.47
Rate for Payer: UnitedHealthcare Commercial	$15.29
Rate for Payer: UnitedHealthcare Community & State	$1.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2.03

KIT PTCA ADD ON 60023024

Facility

$168.00

Hospital Charge Code	270637058
Hospital Revenue Code	272
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$25.20
Rate for Payer: Qualcare PPO/HMO/WC	$25.20

KIT PTCA ADD ON 60023024

Facility

$168.00

Hospital Charge Code	270637058
Hospital Revenue Code	272
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$84.00
Rate for Payer: Aetna Commercial	$63.84
Rate for Payer: Aetna Medicare Advantage	$50.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.84
Rate for Payer: Cigna Commercial	$84.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.40
Rate for Payer: Oxford Commercial	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$25.20
Rate for Payer: UnitedHealthcare Commercial	$33.60
Rate for Payer: UnitedHealthcare Community & State	$4.05
Rate for Payer: Wellpoint Medicaid Managed Care	$4.45

KIT PTD 5FR 65CM

Facility

$4,293.35

Hospital Charge Code	270664876
Hospital Revenue Code	272
Min. Negotiated Rate	$103.47
Max. Negotiated Rate	$2,146.68
Rate for Payer: Aetna Commercial	$1,631.47
Rate for Payer: Aetna Medicare Advantage	$1,288.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,094.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,094.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,094.80
Rate for Payer: Cigna Commercial	$2,146.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,288.01
Rate for Payer: Oxford Commercial	$858.67
Rate for Payer: Qualcare PPO/HMO/WC	$644.00
Rate for Payer: UnitedHealthcare Commercial	$858.67
Rate for Payer: UnitedHealthcare Community & State	$103.47
Rate for Payer: Wellpoint Medicaid Managed Care	$113.77

KIT PTD 5FR 65CM

Facility

$4,293.35

Hospital Charge Code	270664876
Hospital Revenue Code	272
Min. Negotiated Rate	$644.00
Max. Negotiated Rate	$644.00
Rate for Payer: Qualcare PPO/HMO/WC	$644.00

KIT PT POSITIONER SCHLEIN

Facility

$379.25

Hospital Charge Code	270601200
Hospital Revenue Code	272
Min. Negotiated Rate	$56.89
Max. Negotiated Rate	$56.89
Rate for Payer: Qualcare PPO/HMO/WC	$56.89

KIT PT POSITIONER SCHLEIN

Facility

$379.25

Hospital Charge Code	270601200
Hospital Revenue Code	272
Min. Negotiated Rate	$9.14
Max. Negotiated Rate	$189.62
Rate for Payer: Aetna Commercial	$144.12
Rate for Payer: Aetna Medicare Advantage	$113.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.71
Rate for Payer: Cigna Commercial	$189.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.78
Rate for Payer: Oxford Commercial	$75.85
Rate for Payer: Qualcare PPO/HMO/WC	$56.89
Rate for Payer: UnitedHealthcare Commercial	$75.85
Rate for Payer: UnitedHealthcare Community & State	$9.14
Rate for Payer: Wellpoint Medicaid Managed Care	$10.05

KIT PT POSIT W/CHIN STRAP 5345

Facility

$167.45

Hospital Charge Code	270635030
Hospital Revenue Code	270
Min. Negotiated Rate	$25.12
Max. Negotiated Rate	$25.12
Rate for Payer: Qualcare PPO/HMO/WC	$25.12

KIT PT POSIT W/CHIN STRAP 5345

Facility

$167.45

Hospital Charge Code	270635030
Hospital Revenue Code	270
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$83.72
Rate for Payer: Aetna Commercial	$63.63
Rate for Payer: Aetna Medicare Advantage	$50.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.70
Rate for Payer: Cigna Commercial	$83.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.23
Rate for Payer: Oxford Commercial	$33.49
Rate for Payer: Qualcare PPO/HMO/WC	$25.12
Rate for Payer: UnitedHealthcare Commercial	$33.49
Rate for Payer: UnitedHealthcare Community & State	$4.04
Rate for Payer: Wellpoint Medicaid Managed Care	$4.44

KIT PUSHLOK 3.5MM

Facility

$875.00

Hospital Charge Code	270663912
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

KIT PUSHLOK 3.5MM

Facility

$875.00

Hospital Charge Code	270663912
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

KIT Q-IX SHOULDER 1.8MM

Facility

$2,500.00

Hospital Charge Code	270681092
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

Know your out-of-pocket cost for care.

All Charges