Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NUR T4

Facility

$47.00

Service Code	HCPCS 84437
Hospital Charge Code	73092035
Hospital Revenue Code	301
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$17.60
Rate for Payer: Aetna Medicare Advantage	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.35
Rate for Payer: Cigna Commercial	$23.50
Rate for Payer: Cigna Medicare Advantage	$6.47
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Medicare Advantage	$6.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

NUR T4

Facility

$47.00

Service Code	HCPCS 84437
Hospital Charge Code	73092035
Hospital Revenue Code	301
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$7.05
Rate for Payer: Qualcare PPO/HMO/WC	$7.05

NUR TSH

Facility

$629.00

Service Code	HCPCS 84443
Hospital Charge Code	73092040
Hospital Revenue Code	301
Min. Negotiated Rate	$13.44
Max. Negotiated Rate	$314.50
Rate for Payer: Aetna Commercial	$45.70
Rate for Payer: Aetna Medicare Advantage	$54.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.64
Rate for Payer: Cigna Commercial	$314.50
Rate for Payer: Cigna Medicare Advantage	$16.80
Rate for Payer: Clover Medicare Advantage	$15.96
Rate for Payer: EmblemHealth Commercial	$50.40
Rate for Payer: Humana Medicare Advantage	$17.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.80
Rate for Payer: Wellcare Medicare Advantage	$16.80
Rate for Payer: Wellpoint Medicaid Managed Care	$16.67

NUR TSH

Facility

$629.00

Service Code	HCPCS 84443
Hospital Charge Code	73092040
Hospital Revenue Code	301
Min. Negotiated Rate	$94.35
Max. Negotiated Rate	$94.35
Rate for Payer: Qualcare PPO/HMO/WC	$94.35

NUT

Facility

$19.10

Hospital Charge Code	270678083
Hospital Revenue Code	272
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$2.87
Rate for Payer: Qualcare PPO/HMO/WC	$2.87

NUT

Facility

$19.10

Hospital Charge Code	270678083
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.55
Rate for Payer: Aetna Commercial	$7.26
Rate for Payer: Aetna Medicare Advantage	$5.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.87
Rate for Payer: Cigna Commercial	$9.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.73
Rate for Payer: Oxford Commercial	$3.82
Rate for Payer: Qualcare PPO/HMO/WC	$2.87
Rate for Payer: UnitedHealthcare Commercial	$3.82
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

NUT 10 MM

Facility

$835.00

Hospital Charge Code	270684460
Hospital Revenue Code	272
Min. Negotiated Rate	$125.25
Max. Negotiated Rate	$125.25
Rate for Payer: Qualcare PPO/HMO/WC	$125.25

NUT 10 MM

Facility

$835.00

Hospital Charge Code	270684460
Hospital Revenue Code	272
Min. Negotiated Rate	$20.12
Max. Negotiated Rate	$417.50
Rate for Payer: Aetna Commercial	$317.30
Rate for Payer: Aetna Medicare Advantage	$250.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.93
Rate for Payer: Cigna Commercial	$417.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.50
Rate for Payer: Oxford Commercial	$167.00
Rate for Payer: Qualcare PPO/HMO/WC	$125.25
Rate for Payer: UnitedHealthcare Commercial	$167.00
Rate for Payer: UnitedHealthcare Community & State	$20.12
Rate for Payer: Wellpoint Medicaid Managed Care	$22.13

NUT BMT TI-LOCK 33-345472

Facility

$944.85

Hospital Charge Code	270618211
Hospital Revenue Code	272
Min. Negotiated Rate	$141.73
Max. Negotiated Rate	$141.73
Rate for Payer: Qualcare PPO/HMO/WC	$141.73

NUT BMT TI-LOCK 33-345472

Facility

$944.85

Hospital Charge Code	270618211
Hospital Revenue Code	272
Min. Negotiated Rate	$22.77
Max. Negotiated Rate	$472.43
Rate for Payer: Aetna Commercial	$359.04
Rate for Payer: Aetna Medicare Advantage	$283.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.94
Rate for Payer: Cigna Commercial	$472.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.45
Rate for Payer: Oxford Commercial	$188.97
Rate for Payer: Qualcare PPO/HMO/WC	$141.73
Rate for Payer: UnitedHealthcare Commercial	$188.97
Rate for Payer: UnitedHealthcare Community & State	$22.77
Rate for Payer: Wellpoint Medicaid Managed Care	$25.04

NUT BUTTRESS COMPRESSION

Facility

$3,229.65

Service Code	HCPCS A4649
Hospital Charge Code	270697682
Hospital Revenue Code	270
Min. Negotiated Rate	$484.45
Max. Negotiated Rate	$484.45
Rate for Payer: Qualcare PPO/HMO/WC	$484.45

NUT BUTTRESS COMPRESSION

Facility

$3,229.65

Service Code	HCPCS A4649
Hospital Charge Code	270697682
Hospital Revenue Code	270
Min. Negotiated Rate	$77.83
Max. Negotiated Rate	$1,614.83
Rate for Payer: Aetna Commercial	$1,227.27
Rate for Payer: Aetna Medicare Advantage	$968.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$823.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$823.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$823.56
Rate for Payer: Cigna Commercial	$1,614.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.89
Rate for Payer: Oxford Commercial	$645.93
Rate for Payer: Qualcare PPO/HMO/WC	$484.45
Rate for Payer: UnitedHealthcare Commercial	$645.93
Rate for Payer: UnitedHealthcare Community & State	$77.83
Rate for Payer: Wellpoint Medicaid Managed Care	$85.59

NUT DOMED 177091045

Facility

$446.45

Hospital Charge Code	270632113
Hospital Revenue Code	272
Min. Negotiated Rate	$66.97
Max. Negotiated Rate	$66.97
Rate for Payer: Qualcare PPO/HMO/WC	$66.97

NUT DOMED 177091045

Facility

$446.45

Hospital Charge Code	270632113
Hospital Revenue Code	272
Min. Negotiated Rate	$10.76
Max. Negotiated Rate	$223.22
Rate for Payer: Aetna Commercial	$169.65
Rate for Payer: Aetna Medicare Advantage	$133.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.84
Rate for Payer: Cigna Commercial	$223.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.94
Rate for Payer: Oxford Commercial	$89.29
Rate for Payer: Qualcare PPO/HMO/WC	$66.97
Rate for Payer: UnitedHealthcare Commercial	$89.29
Rate for Payer: UnitedHealthcare Community & State	$10.76
Rate for Payer: Wellpoint Medicaid Managed Care	$11.83

NUT OUTER MNTR H/H X-CONN

Facility

$785.00

Hospital Charge Code	270663779
Hospital Revenue Code	272
Min. Negotiated Rate	$18.92
Max. Negotiated Rate	$392.50
Rate for Payer: Aetna Commercial	$298.30
Rate for Payer: Aetna Medicare Advantage	$235.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.18
Rate for Payer: Cigna Commercial	$392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.50
Rate for Payer: Oxford Commercial	$157.00
Rate for Payer: Qualcare PPO/HMO/WC	$117.75
Rate for Payer: UnitedHealthcare Commercial	$157.00
Rate for Payer: UnitedHealthcare Community & State	$18.92
Rate for Payer: Wellpoint Medicaid Managed Care	$20.80

NUT OUTER MNTR H/H X-CONN

Facility

$785.00

Hospital Charge Code	270663779
Hospital Revenue Code	272
Min. Negotiated Rate	$117.75
Max. Negotiated Rate	$117.75
Rate for Payer: Qualcare PPO/HMO/WC	$117.75

NUTRADERM 30/480ML

Facility

$43.00

Hospital Charge Code	60633563
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

NUTRADERM 30/480ML

Facility

$43.00

Hospital Charge Code	60633563
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

NUTRADERM/480ML

Facility

$43.00

Hospital Charge Code	60633562
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

NUTRADERM/480ML

Facility

$43.00

Hospital Charge Code	60633562
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

NUTRAHEP FLAVOR PKT

Facility

$5.00

Hospital Charge Code	60635266
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

NUTRAHEP FLAVOR PKT

Facility

$5.00

Hospital Charge Code	60635266
Hospital Revenue Code	250
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

NU-TRAKE CRICOTHYROTOMY DEVICE

Facility

$850.00

Hospital Charge Code	270642799
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

NU-TRAKE CRICOTHYROTOMY DEVICE

Facility

$850.00

Hospital Charge Code	270642799
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.00
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$170.00
Rate for Payer: UnitedHealthcare Community & State	$20.48
Rate for Payer: Wellpoint Medicaid Managed Care	$22.52

NUTREN 1-5

Facility

$61.00

Hospital Charge Code	60634853
Hospital Revenue Code	250
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$23.18
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.30
Rate for Payer: Oxford Commercial	$12.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$12.20
Rate for Payer: UnitedHealthcare Community & State	$1.47
Rate for Payer: Wellpoint Medicaid Managed Care	$1.62

Know your out-of-pocket cost for care.

All Charges