Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MONITOR BELT DISPOSABLE

Facility

$14.10

Hospital Charge Code	270664965
Hospital Revenue Code	270
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$7.05
Rate for Payer: Aetna Commercial	$5.36
Rate for Payer: Aetna Medicare Advantage	$4.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.60
Rate for Payer: Cigna Commercial	$7.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.23
Rate for Payer: Oxford Commercial	$2.82
Rate for Payer: Qualcare PPO/HMO/WC	$2.12
Rate for Payer: UnitedHealthcare Commercial	$2.82
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

MONITOR BELT DISPOSABLE

Facility

$14.10

Hospital Charge Code	270664965
Hospital Revenue Code	270
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$2.12
Rate for Payer: Qualcare PPO/HMO/WC	$2.12

MONITOR CARDIAC AF REVEAL LINQ

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270698999S
Hospital Revenue Code	278
Min. Negotiated Rate	$3,746.25
Max. Negotiated Rate	$6,043.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,494.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25

MONITOR CARDIAC AF REVEAL LINQ

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270698999S
Hospital Revenue Code	278
Min. Negotiated Rate	$601.90
Max. Negotiated Rate	$12,487.50
Rate for Payer: Aetna Commercial	$9,490.50
Rate for Payer: Aetna Medicare Advantage	$7,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,368.62
Rate for Payer: Cigna Commercial	$12,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,494.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25
Rate for Payer: UnitedHealthcare Community & State	$601.90
Rate for Payer: Wellpoint Medicaid Managed Care	$661.84

MONITOR CO2 LNG TERM ORAL/NASL

Facility

$87.04

Hospital Charge Code	270652786
Hospital Revenue Code	270
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$43.52
Rate for Payer: Aetna Commercial	$33.08
Rate for Payer: Aetna Medicare Advantage	$26.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.20
Rate for Payer: Cigna Commercial	$43.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.11
Rate for Payer: Oxford Commercial	$17.41
Rate for Payer: Qualcare PPO/HMO/WC	$13.06
Rate for Payer: UnitedHealthcare Commercial	$17.41
Rate for Payer: UnitedHealthcare Community & State	$2.10
Rate for Payer: Wellpoint Medicaid Managed Care	$2.31

MONITOR CO2 LNG TERM ORAL/NASL

Facility

$87.04

Hospital Charge Code	270652786
Hospital Revenue Code	270
Min. Negotiated Rate	$13.06
Max. Negotiated Rate	$13.06
Rate for Payer: Qualcare PPO/HMO/WC	$13.06

MONITORING KIT W/TRANSDUCER IN

Facility

$34.80

Hospital Charge Code	2706000322
Hospital Revenue Code	272
Min. Negotiated Rate	$5.22
Max. Negotiated Rate	$5.22
Rate for Payer: Qualcare PPO/HMO/WC	$5.22

MONITORING KIT W/TRANSDUCER IN

Facility

$34.80

Hospital Charge Code	2706000322
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$17.40
Rate for Payer: Aetna Commercial	$13.22
Rate for Payer: Aetna Medicare Advantage	$10.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.87
Rate for Payer: Cigna Commercial	$17.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.44
Rate for Payer: Oxford Commercial	$6.96
Rate for Payer: Qualcare PPO/HMO/WC	$5.22
Rate for Payer: UnitedHealthcare Commercial	$6.96
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.92

MONITORING PH-24 HOUR***

Facility

$447.60

Service Code	HCPCS 91033
Hospital Charge Code	2300820
Hospital Revenue Code	759
Min. Negotiated Rate	$67.14
Max. Negotiated Rate	$67.14
Rate for Payer: Qualcare PPO/HMO/WC	$67.14

MONITORING PH-24 HOUR***

Facility

$447.60

Service Code	HCPCS 91033
Hospital Charge Code	2300820
Hospital Revenue Code	759
Min. Negotiated Rate	$10.79
Max. Negotiated Rate	$223.80
Rate for Payer: Aetna Commercial	$170.09
Rate for Payer: Aetna Medicare Advantage	$134.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.14
Rate for Payer: Cigna Commercial	$223.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.28
Rate for Payer: Qualcare PPO/HMO/WC	$67.14
Rate for Payer: UnitedHealthcare Community & State	$10.79
Rate for Payer: Wellpoint Medicaid Managed Care	$11.86

MONITORING PH 24-HR******

Facility

$90.00

Service Code	HCPCS 91032
Hospital Charge Code	1001110
Hospital Revenue Code	759
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

MONITORING PH 24-HR******

Facility

$90.00

Service Code	HCPCS 91032
Hospital Charge Code	1001110
Hospital Revenue Code	759
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

MONITOR NEURO IN OR/15 MIN

Facility

$1,000.00

Service Code	HCPCS 95940
Hospital Charge Code	1610001
Hospital Revenue Code	920
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$2,301.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

MONITOR NEURO IN OR/15 MIN

Facility

$1,000.00

Service Code	HCPCS 95940
Hospital Charge Code	1610001
Hospital Revenue Code	920
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

MONITOR NEURO REMOTE ADDL HR

Facility

$1,250.00

Service Code	HCPCS 95941
Hospital Charge Code	1610003
Hospital Revenue Code	920
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$2,301.00
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

MONITOR NEURO REMOTE ADDL HR

Facility

$1,250.00

Service Code	HCPCS 95941
Hospital Charge Code	1610003
Hospital Revenue Code	920
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

MONITOR NEURO REMOTE PER HR

Facility

$1,250.00

Service Code	HCPCS 95941
Hospital Charge Code	1610002
Hospital Revenue Code	920
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$2,301.00
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

MONITOR NEURO REMOTE PER HR

Facility

$1,250.00

Service Code	HCPCS 95941
Hospital Charge Code	1610002
Hospital Revenue Code	920
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

MONITOR SPINAL DISC

Facility

$1,049.00

Hospital Charge Code	270646497
Hospital Revenue Code	270
Min. Negotiated Rate	$157.35
Max. Negotiated Rate	$157.35
Rate for Payer: Qualcare PPO/HMO/WC	$157.35

MONITOR SPINAL DISC

Facility

$1,049.00

Hospital Charge Code	270646497
Hospital Revenue Code	270
Min. Negotiated Rate	$25.28
Max. Negotiated Rate	$524.50
Rate for Payer: Aetna Commercial	$398.62
Rate for Payer: Aetna Medicare Advantage	$314.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.50
Rate for Payer: Cigna Commercial	$524.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.70
Rate for Payer: Oxford Commercial	$209.80
Rate for Payer: Qualcare PPO/HMO/WC	$157.35
Rate for Payer: UnitedHealthcare Commercial	$209.80
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$27.80

MONITOR TEMP CRYSTAL LCM-409

Facility

$550.00

Hospital Charge Code	270614339
Hospital Revenue Code	270
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

MONITOR TEMP CRYSTAL LCM-409

Facility

$550.00

Hospital Charge Code	270614339
Hospital Revenue Code	270
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.00
Rate for Payer: Oxford Commercial	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$110.00
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

MONITOR TEMP TRANSDERM 1150

Facility

$11.25

Hospital Charge Code	270070195
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

MONITOR TEMP TRANSDERM 1150

Facility

$11.25

Hospital Charge Code	270070195
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

MONOCLATE P 955UNITS

Facility

$2,800.00

Hospital Charge Code	60635592
Hospital Revenue Code	636
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$677.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.60
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

Know your out-of-pocket cost for care.

All Charges