Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MASK O2 PEDIATRIC 3 IN1

Facility

$278.65

Hospital Charge Code	270653961
Hospital Revenue Code	270
Min. Negotiated Rate	$41.80
Max. Negotiated Rate	$41.80
Rate for Payer: Qualcare PPO/HMO/WC	$41.80

MASK O2 PEDIATRIC 3 IN1

Facility

$278.65

Hospital Charge Code	270653961
Hospital Revenue Code	270
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$139.32
Rate for Payer: Aetna Commercial	$105.89
Rate for Payer: Aetna Medicare Advantage	$83.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.06
Rate for Payer: Cigna Commercial	$139.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.59
Rate for Payer: Oxford Commercial	$55.73
Rate for Payer: Qualcare PPO/HMO/WC	$41.80
Rate for Payer: UnitedHealthcare Commercial	$55.73
Rate for Payer: UnitedHealthcare Community & State	$6.72
Rate for Payer: Wellpoint Medicaid Managed Care	$7.38

MASK OPTICHAMBER MD HS81111

Facility

$26.35

Hospital Charge Code	270635278
Hospital Revenue Code	272
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$13.18
Rate for Payer: Aetna Commercial	$10.01
Rate for Payer: Aetna Medicare Advantage	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.72
Rate for Payer: Cigna Commercial	$13.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.91
Rate for Payer: Oxford Commercial	$5.27
Rate for Payer: Qualcare PPO/HMO/WC	$3.95
Rate for Payer: UnitedHealthcare Commercial	$5.27
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

MASK OPTICHAMBER MD HS81111

Facility

$26.35

Hospital Charge Code	270635278
Hospital Revenue Code	272
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$3.95
Rate for Payer: Qualcare PPO/HMO/WC	$3.95

MASK OPTICHAMBER SM HS81211

Facility

$26.85

Hospital Charge Code	270635277
Hospital Revenue Code	272
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$13.43
Rate for Payer: Aetna Commercial	$10.20
Rate for Payer: Aetna Medicare Advantage	$8.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.85
Rate for Payer: Cigna Commercial	$13.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.05
Rate for Payer: Oxford Commercial	$5.37
Rate for Payer: Qualcare PPO/HMO/WC	$4.03
Rate for Payer: UnitedHealthcare Commercial	$5.37
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

MASK OPTICHAMBER SM HS81211

Facility

$26.85

Hospital Charge Code	270635277
Hospital Revenue Code	272
Min. Negotiated Rate	$4.03
Max. Negotiated Rate	$4.03
Rate for Payer: Qualcare PPO/HMO/WC	$4.03

MASK OXYGEN MED CONCENTRATION

Facility

$13.65

Hospital Charge Code	270611535
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$5.19
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.09
Rate for Payer: Oxford Commercial	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$2.73
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

MASK OXYGEN MED CONCENTRATION

Facility

$13.65

Hospital Charge Code	270611535
Hospital Revenue Code	272
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

MASK OXYGEN MED CONCENTRATION

Facility

$2.32

Hospital Charge Code	270616791
Hospital Revenue Code	272
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.16
Rate for Payer: Aetna Commercial	$0.88
Rate for Payer: Aetna Medicare Advantage	$0.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.59
Rate for Payer: Cigna Commercial	$1.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.70
Rate for Payer: Oxford Commercial	$0.46
Rate for Payer: Qualcare PPO/HMO/WC	$0.35
Rate for Payer: UnitedHealthcare Commercial	$0.46
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

MASK OXYGEN MED CONCENTRATION

Facility

$2.32

Hospital Charge Code	270616791
Hospital Revenue Code	272
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.35
Rate for Payer: Qualcare PPO/HMO/WC	$0.35

MASK OXYGEN NON-REBREATHER

Facility

$11.55

Hospital Charge Code	270654268
Hospital Revenue Code	270
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$1.73
Rate for Payer: Qualcare PPO/HMO/WC	$1.73

MASK OXYGEN NON-REBREATHER

Facility

$11.55

Hospital Charge Code	270654268
Hospital Revenue Code	270
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$5.78
Rate for Payer: Aetna Commercial	$4.39
Rate for Payer: Aetna Medicare Advantage	$3.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.95
Rate for Payer: Cigna Commercial	$5.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.46
Rate for Payer: Oxford Commercial	$2.31
Rate for Payer: Qualcare PPO/HMO/WC	$1.73
Rate for Payer: UnitedHealthcare Commercial	$2.31
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.31

MASK PEDI AERSL ELEPHNT 001276

Facility

$6.25

Hospital Charge Code	270638579
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$3.12
Rate for Payer: Aetna Commercial	$2.38
Rate for Payer: Aetna Medicare Advantage	$1.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.59
Rate for Payer: Cigna Commercial	$3.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.88
Rate for Payer: Oxford Commercial	$1.25
Rate for Payer: Qualcare PPO/HMO/WC	$0.94
Rate for Payer: UnitedHealthcare Commercial	$1.25
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

MASK PEDI AERSL ELEPHNT 001276

Facility

$6.25

Hospital Charge Code	270638579
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$0.94
Rate for Payer: Qualcare PPO/HMO/WC	$0.94

MASK PEDIATRIC AEROSOL

Facility

$2.41

Hospital Charge Code	270613881
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.36
Rate for Payer: Qualcare PPO/HMO/WC	$0.36

MASK PEDIATRIC AEROSOL

Facility

$2.41

Hospital Charge Code	270613881
Hospital Revenue Code	272
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.21
Rate for Payer: Aetna Commercial	$0.92
Rate for Payer: Aetna Medicare Advantage	$0.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.61
Rate for Payer: Cigna Commercial	$1.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.72
Rate for Payer: Oxford Commercial	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.36
Rate for Payer: UnitedHealthcare Commercial	$0.48
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

MASK PEDIATRIC DRAGON

Facility

$170.90

Hospital Charge Code	270630009
Hospital Revenue Code	270
Min. Negotiated Rate	$25.64
Max. Negotiated Rate	$25.64
Rate for Payer: Qualcare PPO/HMO/WC	$25.64

MASK PEDIATRIC DRAGON

Facility

$170.90

Hospital Charge Code	270630009
Hospital Revenue Code	270
Min. Negotiated Rate	$4.12
Max. Negotiated Rate	$85.45
Rate for Payer: Aetna Commercial	$64.94
Rate for Payer: Aetna Medicare Advantage	$51.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.58
Rate for Payer: Cigna Commercial	$85.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.27
Rate for Payer: Oxford Commercial	$34.18
Rate for Payer: Qualcare PPO/HMO/WC	$25.64
Rate for Payer: UnitedHealthcare Commercial	$34.18
Rate for Payer: UnitedHealthcare Community & State	$4.12
Rate for Payer: Wellpoint Medicaid Managed Care	$4.53

MASK PEDIATRIC NON-REBREATHER

Facility

$8.15

Hospital Charge Code	270622711
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$4.08
Rate for Payer: Aetna Commercial	$3.10
Rate for Payer: Aetna Medicare Advantage	$2.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.08
Rate for Payer: Cigna Commercial	$4.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.44
Rate for Payer: Oxford Commercial	$1.63
Rate for Payer: Qualcare PPO/HMO/WC	$1.22
Rate for Payer: UnitedHealthcare Commercial	$1.63
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

MASK PEDIATRIC NON-REBREATHER

Facility

$8.15

Hospital Charge Code	270622711
Hospital Revenue Code	272
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$1.22
Rate for Payer: Qualcare PPO/HMO/WC	$1.22

MASK PED MAN RES CHILD

Facility

$48.03

Hospital Charge Code	270669811
Hospital Revenue Code	270
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$24.02
Rate for Payer: Aetna Commercial	$18.25
Rate for Payer: Aetna Medicare Advantage	$14.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.25
Rate for Payer: Cigna Commercial	$24.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.41
Rate for Payer: Oxford Commercial	$9.61
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$9.61
Rate for Payer: UnitedHealthcare Community & State	$1.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

MASK PED MAN RES CHILD

Facility

$48.03

Hospital Charge Code	270669811
Hospital Revenue Code	270
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

MASK PERCENT O2 ADULT DISP

Facility

$250.30

Hospital Charge Code	270653960
Hospital Revenue Code	270
Min. Negotiated Rate	$37.55
Max. Negotiated Rate	$37.55
Rate for Payer: Qualcare PPO/HMO/WC	$37.55

MASK PERCENT O2 ADULT DISP

Facility

$250.30

Hospital Charge Code	270653960
Hospital Revenue Code	270
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.15
Rate for Payer: Aetna Commercial	$95.11
Rate for Payer: Aetna Medicare Advantage	$75.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.83
Rate for Payer: Cigna Commercial	$125.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.09
Rate for Payer: Oxford Commercial	$50.06
Rate for Payer: Qualcare PPO/HMO/WC	$37.55
Rate for Payer: UnitedHealthcare Commercial	$50.06
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.63

MASK PERFORMATRAK LARGE WITH

Facility

$156.29

Hospital Charge Code	270641430
Hospital Revenue Code	272
Min. Negotiated Rate	$3.77
Max. Negotiated Rate	$78.14
Rate for Payer: Aetna Commercial	$59.39
Rate for Payer: Aetna Medicare Advantage	$46.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.85
Rate for Payer: Cigna Commercial	$78.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.89
Rate for Payer: Oxford Commercial	$31.26
Rate for Payer: Qualcare PPO/HMO/WC	$23.44
Rate for Payer: UnitedHealthcare Commercial	$31.26
Rate for Payer: UnitedHealthcare Community & State	$3.77
Rate for Payer: Wellpoint Medicaid Managed Care	$4.14

Know your out-of-pocket cost for care.

All Charges