Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MASK BIPAP LG NON-VENTED

Facility

$120.45

Hospital Charge Code	270655468
Hospital Revenue Code	270
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$60.23
Rate for Payer: Aetna Commercial	$45.77
Rate for Payer: Aetna Medicare Advantage	$36.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.71
Rate for Payer: Cigna Commercial	$60.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.13
Rate for Payer: Oxford Commercial	$24.09
Rate for Payer: Qualcare PPO/HMO/WC	$18.07
Rate for Payer: UnitedHealthcare Commercial	$24.09
Rate for Payer: UnitedHealthcare Community & State	$2.90
Rate for Payer: Wellpoint Medicaid Managed Care	$3.19

MASK BIPAP MED DISP HG 1012528

Facility

$275.00

Hospital Charge Code	270637977
Hospital Revenue Code	272
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

MASK BIPAP MED DISP HG 1012528

Facility

$275.00

Hospital Charge Code	270637977
Hospital Revenue Code	272
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.50
Rate for Payer: Oxford Commercial	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Commercial	$55.00
Rate for Payer: UnitedHealthcare Community & State	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$7.29

MASK BIPAP MED NON-VENTED

Facility

$108.14

Hospital Charge Code	270655466
Hospital Revenue Code	270
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$54.07
Rate for Payer: Aetna Commercial	$41.09
Rate for Payer: Aetna Medicare Advantage	$32.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.58
Rate for Payer: Cigna Commercial	$54.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.44
Rate for Payer: Oxford Commercial	$21.63
Rate for Payer: Qualcare PPO/HMO/WC	$16.22
Rate for Payer: UnitedHealthcare Commercial	$21.63
Rate for Payer: UnitedHealthcare Community & State	$2.61
Rate for Payer: Wellpoint Medicaid Managed Care	$2.87

MASK BIPAP MED NON-VENTED

Facility

$108.14

Hospital Charge Code	270655466
Hospital Revenue Code	270
Min. Negotiated Rate	$16.22
Max. Negotiated Rate	$16.22
Rate for Payer: Qualcare PPO/HMO/WC	$16.22

MASK BIPAP ME WIDE DISP

Facility

$153.65

Hospital Charge Code	270606855
Hospital Revenue Code	272
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$76.83
Rate for Payer: Aetna Commercial	$58.39
Rate for Payer: Aetna Medicare Advantage	$46.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.18
Rate for Payer: Cigna Commercial	$76.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.09
Rate for Payer: Oxford Commercial	$30.73
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Commercial	$30.73
Rate for Payer: UnitedHealthcare Community & State	$3.70
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

MASK BIPAP ME WIDE DISP

Facility

$153.65

Hospital Charge Code	270606855
Hospital Revenue Code	272
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$23.05
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

MASK BIPAP SM DISP HG 1012526

Facility

$275.00

Hospital Charge Code	270637976
Hospital Revenue Code	272
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$104.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.50
Rate for Payer: Oxford Commercial	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Commercial	$55.00
Rate for Payer: UnitedHealthcare Community & State	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$7.29

MASK BIPAP SM DISP HG 1012526

Facility

$275.00

Hospital Charge Code	270637976
Hospital Revenue Code	272
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

MASK BIPAP SM NON-VENTED

Facility

$108.14

Hospital Charge Code	270655465
Hospital Revenue Code	270
Min. Negotiated Rate	$16.22
Max. Negotiated Rate	$16.22
Rate for Payer: Qualcare PPO/HMO/WC	$16.22

MASK BIPAP SM NON-VENTED

Facility

$108.14

Hospital Charge Code	270655465
Hospital Revenue Code	270
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$54.07
Rate for Payer: Aetna Commercial	$41.09
Rate for Payer: Aetna Medicare Advantage	$32.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.58
Rate for Payer: Cigna Commercial	$54.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.44
Rate for Payer: Oxford Commercial	$21.63
Rate for Payer: Qualcare PPO/HMO/WC	$16.22
Rate for Payer: UnitedHealthcare Commercial	$21.63
Rate for Payer: UnitedHealthcare Community & State	$2.61
Rate for Payer: Wellpoint Medicaid Managed Care	$2.87

MASK COMFORT FLAP SMALL

Facility

$5.00

Hospital Charge Code	270657829
Hospital Revenue Code	272
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

MASK COMFORT FLAP SMALL

Facility

$5.00

Hospital Charge Code	270657829
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

MASK COMFORT FULL LARGE

Facility

$75.00

Hospital Charge Code	270657875
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

MASK COMFORT FULL LARGE

Facility

$75.00

Hospital Charge Code	270657875
Hospital Revenue Code	272
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

MASK COMFORT FULL MEDIUM

Facility

$75.00

Hospital Charge Code	270657874
Hospital Revenue Code	272
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

MASK COMFORT FULL MEDIUM

Facility

$75.00

Hospital Charge Code	270657874
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

MASK COMFORT FULL SMALL

Facility

$75.00

Hospital Charge Code	270657873
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

MASK COMFORT FULL SMALL

Facility

$75.00

Hospital Charge Code	270657873
Hospital Revenue Code	272
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

MASK COMFORT GEL LARGE

Facility

$45.00

Hospital Charge Code	270657814
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

MASK COMFORT GEL LARGE

Facility

$45.00

Hospital Charge Code	270657814
Hospital Revenue Code	278
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

MASK COMFORT GEL MED

Facility

$45.00

Hospital Charge Code	270657813
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.50
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Commercial	$9.00
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

MASK COMFORT GEL MED

Facility

$45.00

Hospital Charge Code	270657813
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

MASK COMFORT GEL PETITE

Facility

$45.00

Hospital Charge Code	270657871
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

MASK COMFORT GEL PETITE

Facility

$45.00

Hospital Charge Code	270657871
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.50
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Commercial	$9.00
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

Know your out-of-pocket cost for care.

All Charges