Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

KIT TROCAR CATH ********

Facility

$225.00

Hospital Charge Code	1603190
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

KIT TROCAR CATH ********

Facility

$225.00

Hospital Charge Code	1603190
Hospital Revenue Code	272
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.50
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$45.00
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

KIT TUMOR ABLATION STAR

Facility

$19,475.00

Hospital Charge Code	270670691
Hospital Revenue Code	272
Min. Negotiated Rate	$2,921.25
Max. Negotiated Rate	$2,921.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,921.25

KIT TUMOR ABLATION STAR

Facility

$19,475.00

Hospital Charge Code	270670691
Hospital Revenue Code	272
Min. Negotiated Rate	$469.35
Max. Negotiated Rate	$9,737.50
Rate for Payer: Aetna Commercial	$7,400.50
Rate for Payer: Aetna Medicare Advantage	$5,842.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,966.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,966.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,966.12
Rate for Payer: Cigna Commercial	$9,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,842.50
Rate for Payer: Oxford Commercial	$3,895.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,921.25
Rate for Payer: UnitedHealthcare Commercial	$3,895.00
Rate for Payer: UnitedHealthcare Community & State	$469.35
Rate for Payer: Wellpoint Medicaid Managed Care	$516.09

KIT ULTRA DRIVE IMPLANTATION

Facility

$8,450.00

Hospital Charge Code	270695353
Hospital Revenue Code	272
Min. Negotiated Rate	$203.65
Max. Negotiated Rate	$4,225.00
Rate for Payer: Aetna Commercial	$3,211.00
Rate for Payer: Aetna Medicare Advantage	$2,535.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,154.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,154.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,154.75
Rate for Payer: Cigna Commercial	$4,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,535.00
Rate for Payer: Oxford Commercial	$1,690.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,267.50
Rate for Payer: UnitedHealthcare Commercial	$1,690.00
Rate for Payer: UnitedHealthcare Community & State	$203.65
Rate for Payer: Wellpoint Medicaid Managed Care	$223.93

KIT ULTRA DRIVE IMPLANTATION

Facility

$8,450.00

Hospital Charge Code	270695353
Hospital Revenue Code	272
Min. Negotiated Rate	$1,267.50
Max. Negotiated Rate	$1,267.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,267.50

KIT ULTRA PRO II DSPSABLE REPL

Facility

$80.21

Hospital Charge Code	270663445
Hospital Revenue Code	272
Min. Negotiated Rate	$12.03
Max. Negotiated Rate	$12.03
Rate for Payer: Qualcare PPO/HMO/WC	$12.03

KIT ULTRA PRO II DSPSABLE REPL

Facility

$80.21

Hospital Charge Code	270663445
Hospital Revenue Code	272
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$40.10
Rate for Payer: Aetna Commercial	$30.48
Rate for Payer: Aetna Medicare Advantage	$24.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.45
Rate for Payer: Cigna Commercial	$40.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.06
Rate for Payer: Oxford Commercial	$16.04
Rate for Payer: Qualcare PPO/HMO/WC	$12.03
Rate for Payer: UnitedHealthcare Commercial	$16.04
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

KIT URINARY COLLECTION******

Facility

$194.00

Hospital Charge Code	8001034
Hospital Revenue Code	279
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$97.00
Rate for Payer: Aetna Commercial	$73.72
Rate for Payer: Aetna Medicare Advantage	$58.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.47
Rate for Payer: Cigna Commercial	$97.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.20
Rate for Payer: Oxford Commercial	$38.80
Rate for Payer: Qualcare PPO/HMO/WC	$29.10
Rate for Payer: UnitedHealthcare Commercial	$38.80
Rate for Payer: UnitedHealthcare Community & State	$4.68
Rate for Payer: Wellpoint Medicaid Managed Care	$5.14

KIT URINARY COLLECTION******

Facility

$194.00

Hospital Charge Code	8001034
Hospital Revenue Code	279
Min. Negotiated Rate	$29.10
Max. Negotiated Rate	$29.10
Rate for Payer: Qualcare PPO/HMO/WC	$29.10

KIT UROSTOMY 2-3/4 70MM POST

Facility

$14.62

Hospital Charge Code	270654222
Hospital Revenue Code	272
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$2.19
Rate for Payer: Qualcare PPO/HMO/WC	$2.19

KIT UROSTOMY 2-3/4 70MM POST

Facility

$14.62

Hospital Charge Code	270654222
Hospital Revenue Code	272
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$7.31
Rate for Payer: Aetna Commercial	$5.56
Rate for Payer: Aetna Medicare Advantage	$4.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.73
Rate for Payer: Cigna Commercial	$7.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.39
Rate for Payer: Oxford Commercial	$2.92
Rate for Payer: Qualcare PPO/HMO/WC	$2.19
Rate for Payer: UnitedHealthcare Commercial	$2.92
Rate for Payer: UnitedHealthcare Community & State	$0.35
Rate for Payer: Wellpoint Medicaid Managed Care	$0.39

KIT VASCEL MICRO-PORT 45-318

Facility

$1,649.65

Hospital Charge Code	270629788
Hospital Revenue Code	270
Min. Negotiated Rate	$39.76
Max. Negotiated Rate	$824.83
Rate for Payer: Aetna Commercial	$626.87
Rate for Payer: Aetna Medicare Advantage	$494.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.66
Rate for Payer: Cigna Commercial	$824.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$494.89
Rate for Payer: Oxford Commercial	$329.93
Rate for Payer: Qualcare PPO/HMO/WC	$247.45
Rate for Payer: UnitedHealthcare Commercial	$329.93
Rate for Payer: UnitedHealthcare Community & State	$39.76
Rate for Payer: Wellpoint Medicaid Managed Care	$43.72

KIT VASCEL MICRO-PORT 45-318

Facility

$2,681.15

Hospital Charge Code	270629788V
Hospital Revenue Code	270
Min. Negotiated Rate	$402.17
Max. Negotiated Rate	$402.17
Rate for Payer: Qualcare PPO/HMO/WC	$402.17

KIT VASCEL MICRO-PORT 45-318

Facility

$1,649.65

Hospital Charge Code	270629788
Hospital Revenue Code	270
Min. Negotiated Rate	$247.45
Max. Negotiated Rate	$247.45
Rate for Payer: Qualcare PPO/HMO/WC	$247.45

KIT VASCEL MICRO-PORT 45-318

Facility

$2,681.15

Hospital Charge Code	270629788V
Hospital Revenue Code	270
Min. Negotiated Rate	$64.62
Max. Negotiated Rate	$1,340.58
Rate for Payer: Aetna Commercial	$1,018.84
Rate for Payer: Aetna Medicare Advantage	$804.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$683.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$683.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$683.69
Rate for Payer: Cigna Commercial	$1,340.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.35
Rate for Payer: Oxford Commercial	$536.23
Rate for Payer: Qualcare PPO/HMO/WC	$402.17
Rate for Payer: UnitedHealthcare Commercial	$536.23
Rate for Payer: UnitedHealthcare Community & State	$64.62
Rate for Payer: Wellpoint Medicaid Managed Care	$71.05

KIT VENTRICULOSTOMY

Facility

$1,530.00

Service Code	HCPCS C1729
Hospital Charge Code	270600327S
Hospital Revenue Code	278
Min. Negotiated Rate	$36.87
Max. Negotiated Rate	$765.00
Rate for Payer: Aetna Commercial	$581.40
Rate for Payer: Aetna Medicare Advantage	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$390.15
Rate for Payer: Cigna Commercial	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$336.60
Rate for Payer: Qualcare PPO/HMO/WC	$229.50
Rate for Payer: UnitedHealthcare Community & State	$36.87
Rate for Payer: Wellpoint Medicaid Managed Care	$40.55

KIT VENTRICULOSTOMY

Facility

$1,530.00

Service Code	HCPCS C1729
Hospital Charge Code	270600327S
Hospital Revenue Code	278
Min. Negotiated Rate	$229.50
Max. Negotiated Rate	$370.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$336.60
Rate for Payer: Qualcare PPO/HMO/WC	$229.50

KIT VENTRICULOSTOMY

Facility

$1,530.00

Hospital Charge Code	270600327
Hospital Revenue Code	278
Min. Negotiated Rate	$36.87
Max. Negotiated Rate	$765.00
Rate for Payer: Aetna Commercial	$581.40
Rate for Payer: Aetna Medicare Advantage	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$390.15
Rate for Payer: Cigna Commercial	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$336.60
Rate for Payer: Qualcare PPO/HMO/WC	$229.50
Rate for Payer: UnitedHealthcare Community & State	$36.87
Rate for Payer: Wellpoint Medicaid Managed Care	$40.55

KIT VENTRICULOSTOMY

Facility

$1,530.00

Hospital Charge Code	270600327
Hospital Revenue Code	278
Min. Negotiated Rate	$229.50
Max. Negotiated Rate	$370.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$336.60
Rate for Payer: Qualcare PPO/HMO/WC	$229.50

KIT VENTRICULOSTOMY *******

Facility

$280.00

Hospital Charge Code	1608066
Hospital Revenue Code	251
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$106.40
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.00
Rate for Payer: Oxford Commercial	$56.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Commercial	$56.00
Rate for Payer: UnitedHealthcare Community & State	$6.75
Rate for Payer: Wellpoint Medicaid Managed Care	$7.42

KIT VENTRICULOSTOMY *******

Facility

$280.00

Hospital Charge Code	1608066
Hospital Revenue Code	251
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

KIT VERTIFLEX SUPERION VIP

Facility

$1,500.00

Service Code	HCPCS A4649
Hospital Charge Code	270698878
Hospital Revenue Code	272
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$450.00
Rate for Payer: Oxford Commercial	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Commercial	$300.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

KIT VERTIFLEX SUPERION VIP

Facility

$1,500.00

Service Code	HCPCS A4649
Hospital Charge Code	270698878
Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

KIT VIZADISC HIP

Facility

$1,150.00

Hospital Charge Code	270668614
Hospital Revenue Code	272
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$172.50
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

Know your out-of-pocket cost for care.

All Charges