Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NEEDLE BUTTERFLY 21G 3/4

Facility

$4.00

Hospital Charge Code	270041100
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NEEDLE BUTTERFLY 21G 3/4

Facility

$4.00

Hospital Charge Code	270041100
Hospital Revenue Code	272
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

NEEDLE BUTTERFLY 23G 3/4

Facility

$5.65

Hospital Charge Code	270041110
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$2.15
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.70
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

NEEDLE BUTTERFLY 23G 3/4

Facility

$5.65

Hospital Charge Code	270041110
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

NEEDLE BUTTERFLY 25G 3/8

Facility

$5.65

Hospital Charge Code	270041115
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

NEEDLE BUTTERFLY 25G 3/8

Facility

$5.65

Hospital Charge Code	270041115
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$2.15
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.70
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

NEEDLE BUTTERFLY SCALP VEIN

Facility

$3.80

Hospital Charge Code	270649498
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$0.57
Rate for Payer: Qualcare PPO/HMO/WC	$0.57

NEEDLE BUTTERFLY SCALP VEIN

Facility

$3.80

Hospital Charge Code	270649498
Hospital Revenue Code	272
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.90
Rate for Payer: Aetna Commercial	$1.44
Rate for Payer: Aetna Medicare Advantage	$1.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.97
Rate for Payer: Cigna Commercial	$1.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.14
Rate for Payer: Oxford Commercial	$0.76
Rate for Payer: Qualcare PPO/HMO/WC	$0.57
Rate for Payer: UnitedHealthcare Commercial	$0.76
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

NEEDLE BX 20GX11CM TEM ACT2011

Facility

$240.72

Hospital Charge Code	270662296R
Hospital Revenue Code	272
Min. Negotiated Rate	$36.11
Max. Negotiated Rate	$36.11
Rate for Payer: Qualcare PPO/HMO/WC	$36.11

NEEDLE BX 20GX11CM TEM ACT2011

Facility

$240.72

Hospital Charge Code	270662296R
Hospital Revenue Code	272
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$120.36
Rate for Payer: Aetna Commercial	$91.47
Rate for Payer: Aetna Medicare Advantage	$72.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.38
Rate for Payer: Cigna Commercial	$120.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.22
Rate for Payer: Oxford Commercial	$48.14
Rate for Payer: Qualcare PPO/HMO/WC	$36.11
Rate for Payer: UnitedHealthcare Commercial	$48.14
Rate for Payer: UnitedHealthcare Community & State	$5.80
Rate for Payer: Wellpoint Medicaid Managed Care	$6.38

NEEDLE BX 20GX11CM TEM ACT2011

Facility

$240.72

Hospital Charge Code	270662296
Hospital Revenue Code	272
Min. Negotiated Rate	$36.11
Max. Negotiated Rate	$36.11
Rate for Payer: Qualcare PPO/HMO/WC	$36.11

NEEDLE BX 20GX11CM TEM ACT2011

Facility

$240.72

Hospital Charge Code	270662296
Hospital Revenue Code	272
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$120.36
Rate for Payer: Aetna Commercial	$91.47
Rate for Payer: Aetna Medicare Advantage	$72.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.38
Rate for Payer: Cigna Commercial	$120.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.22
Rate for Payer: Oxford Commercial	$48.14
Rate for Payer: Qualcare PPO/HMO/WC	$36.11
Rate for Payer: UnitedHealthcare Commercial	$48.14
Rate for Payer: UnitedHealthcare Community & State	$5.80
Rate for Payer: Wellpoint Medicaid Managed Care	$6.38

NEEDLE BX 20GX15 TEMNO ACT2015

Facility

$268.86

Hospital Charge Code	270662294
Hospital Revenue Code	272
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$134.43
Rate for Payer: Aetna Commercial	$102.17
Rate for Payer: Aetna Medicare Advantage	$80.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.56
Rate for Payer: Cigna Commercial	$134.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.66
Rate for Payer: Oxford Commercial	$53.77
Rate for Payer: Qualcare PPO/HMO/WC	$40.33
Rate for Payer: UnitedHealthcare Commercial	$53.77
Rate for Payer: UnitedHealthcare Community & State	$6.48
Rate for Payer: Wellpoint Medicaid Managed Care	$7.12

NEEDLE BX 20GX15 TEMNO ACT2015

Facility

$268.86

Hospital Charge Code	270662294R
Hospital Revenue Code	272
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$134.43
Rate for Payer: Aetna Commercial	$102.17
Rate for Payer: Aetna Medicare Advantage	$80.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.56
Rate for Payer: Cigna Commercial	$134.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.66
Rate for Payer: Oxford Commercial	$53.77
Rate for Payer: Qualcare PPO/HMO/WC	$40.33
Rate for Payer: UnitedHealthcare Commercial	$53.77
Rate for Payer: UnitedHealthcare Community & State	$6.48
Rate for Payer: Wellpoint Medicaid Managed Care	$7.12

NEEDLE BX 20GX15 TEMNO ACT2015

Facility

$268.86

Hospital Charge Code	270662294R
Hospital Revenue Code	272
Min. Negotiated Rate	$40.33
Max. Negotiated Rate	$40.33
Rate for Payer: Qualcare PPO/HMO/WC	$40.33

NEEDLE BX 20GX15 TEMNO ACT2015

Facility

$268.86

Hospital Charge Code	270662294
Hospital Revenue Code	272
Min. Negotiated Rate	$40.33
Max. Negotiated Rate	$40.33
Rate for Payer: Qualcare PPO/HMO/WC	$40.33

NEEDLE BX HOMER BLN 20G 3CM

Facility

$160.00

Service Code	HCPCS A4648
Hospital Charge Code	270631351R
Hospital Revenue Code	278
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$60.80
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.20
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Community & State	$3.86
Rate for Payer: Wellpoint Medicaid Managed Care	$4.24

NEEDLE BX HOMER BLN 20G 3CM

Facility

$160.00

Service Code	HCPCS A4648
Hospital Charge Code	270631351R
Hospital Revenue Code	278
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$35.20
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

NEEDLE BX HOMER BLN 20G 5.0CM

Facility

$145.00

Service Code	HCPCS A4648
Hospital Charge Code	270607250R
Hospital Revenue Code	278
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$55.10
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Community & State	$3.49
Rate for Payer: Wellpoint Medicaid Managed Care	$3.84

NEEDLE BX HOMER BLN 20G 5.0CM

Facility

$145.00

Service Code	HCPCS A4648
Hospital Charge Code	270607250R
Hospital Revenue Code	278
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

NEEDLE BX HOMER BLN 20G 7.5CM

Facility

$145.00

Service Code	HCPCS A4648
Hospital Charge Code	270607251R
Hospital Revenue Code	278
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$55.10
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Community & State	$3.49
Rate for Payer: Wellpoint Medicaid Managed Care	$3.84

NEEDLE BX HOMER BLN 20G 7.5CM

Facility

$145.00

Service Code	HCPCS A4648
Hospital Charge Code	270607251R
Hospital Revenue Code	278
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$31.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

NEEDLE BX LIVER, PERCUTANEOUS

Facility

$4,202.30

Service Code	HCPCS 47000
Hospital Charge Code	1600000587
Hospital Revenue Code	360
Min. Negotiated Rate	$101.28
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,260.69
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$630.35
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$101.28
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$111.36

NEEDLE BX LIVER, PERCUTANEOUS

Facility

$4,202.30

Service Code	HCPCS 47000
Hospital Charge Code	1600000587
Hospital Revenue Code	360
Min. Negotiated Rate	$630.35
Max. Negotiated Rate	$630.35
Rate for Payer: Qualcare PPO/HMO/WC	$630.35

NEEDLE CANNULA STERILE 150MM

Facility

$250.00

Hospital Charge Code	270670842
Hospital Revenue Code	272
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

Know your out-of-pocket cost for care.

All Charges