Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NUTRIT REASSES EACH 15 MINUTES

Facility

$90.00

Service Code	HCPCS 97803
Hospital Charge Code	9200042
Hospital Revenue Code	942
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

NUTRIT REASSES EACH 15 MINUTES

Facility

$90.00

Service Code	HCPCS 97803
Hospital Charge Code	9900002
Hospital Revenue Code	942
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

NUTRIT REASSES EACH 15 MINUTES

Facility

$90.00

Service Code	HCPCS 97803
Hospital Charge Code	9900002
Hospital Revenue Code	942
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$1,202.00
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) NJ Health	$34.85
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: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$1,202.00
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

NUTRIT REASSES EACH 15 MINUTES

Facility

$90.00

Service Code	HCPCS 97803
Hospital Charge Code	9200042
Hospital Revenue Code	942
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$1,202.00
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) NJ Health	$34.85
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: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$1,202.00
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

NUTRIVENT

Facility

$28.00

Hospital Charge Code	60634854
Hospital Revenue Code	250
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$10.64
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.40
Rate for Payer: Oxford Commercial	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

NUTRIVENT

Facility

$28.00

Hospital Charge Code	60634854
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

NUT SALVATION

Facility

$115.00

Hospital Charge Code	270684461
Hospital Revenue Code	272
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

NUT SALVATION

Facility

$115.00

Hospital Charge Code	270684461
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$57.50
Rate for Payer: Aetna Commercial	$43.70
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.50
Rate for Payer: Oxford Commercial	$23.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Commercial	$23.00
Rate for Payer: UnitedHealthcare Community & State	$2.77
Rate for Payer: Wellpoint Medicaid Managed Care	$3.05

NUTS ORTHO BONE

Facility

$208.15

Hospital Charge Code	270691903
Hospital Revenue Code	272
Min. Negotiated Rate	$31.22
Max. Negotiated Rate	$31.22
Rate for Payer: Qualcare PPO/HMO/WC	$31.22

NUTS ORTHO BONE

Facility

$208.15

Hospital Charge Code	270691903
Hospital Revenue Code	272
Min. Negotiated Rate	$5.02
Max. Negotiated Rate	$104.08
Rate for Payer: Aetna Commercial	$79.10
Rate for Payer: Aetna Medicare Advantage	$62.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.08
Rate for Payer: Cigna Commercial	$104.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.45
Rate for Payer: Oxford Commercial	$41.63
Rate for Payer: Qualcare PPO/HMO/WC	$31.22
Rate for Payer: UnitedHealthcare Commercial	$41.63
Rate for Payer: UnitedHealthcare Community & State	$5.02
Rate for Payer: Wellpoint Medicaid Managed Care	$5.52

NUT SPEED

Facility

$704.50

Hospital Charge Code	270678088
Hospital Revenue Code	278
Min. Negotiated Rate	$105.67
Max. Negotiated Rate	$170.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.99
Rate for Payer: Qualcare PPO/HMO/WC	$105.67

NUT SPEED

Facility

$704.50

Hospital Charge Code	270678088
Hospital Revenue Code	278
Min. Negotiated Rate	$16.98
Max. Negotiated Rate	$352.25
Rate for Payer: Aetna Commercial	$267.71
Rate for Payer: Aetna Medicare Advantage	$211.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.65
Rate for Payer: Cigna Commercial	$352.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$154.99
Rate for Payer: Qualcare PPO/HMO/WC	$105.67
Rate for Payer: UnitedHealthcare Community & State	$16.98
Rate for Payer: Wellpoint Medicaid Managed Care	$18.67

NUT SYN SPRG SM EXT FIX 395-58

Facility

$128.00

Hospital Charge Code	270601806
Hospital Revenue Code	274
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$28.16
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

NUT SYN SPRG SM EXT FIX 395-58

Facility

$128.00

Hospital Charge Code	270601806
Hospital Revenue Code	274
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$64.00
Rate for Payer: Aetna Commercial	$48.64
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.98
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$28.16
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Community & State	$3.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

NUT/WASHER DPY SPHERICAL 10095

Facility

$430.45

Hospital Charge Code	270612442
Hospital Revenue Code	272
Min. Negotiated Rate	$64.57
Max. Negotiated Rate	$64.57
Rate for Payer: Qualcare PPO/HMO/WC	$64.57

NUT/WASHER DPY SPHERICAL 10095

Facility

$430.45

Hospital Charge Code	270612442
Hospital Revenue Code	272
Min. Negotiated Rate	$10.37
Max. Negotiated Rate	$215.22
Rate for Payer: Aetna Commercial	$163.57
Rate for Payer: Aetna Medicare Advantage	$129.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.76
Rate for Payer: Cigna Commercial	$215.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.13
Rate for Payer: Oxford Commercial	$86.09
Rate for Payer: Qualcare PPO/HMO/WC	$64.57
Rate for Payer: UnitedHealthcare Commercial	$86.09
Rate for Payer: UnitedHealthcare Community & State	$10.37
Rate for Payer: Wellpoint Medicaid Managed Care	$11.41

NUT WHITE F/FLASHPAK INSTAL

Facility

$20.00

Hospital Charge Code	270639737
Hospital Revenue Code	272
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$7.60
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.00
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$4.00
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

NUT WHITE F/FLASHPAK INSTAL

Facility

$20.00

Hospital Charge Code	270639737
Hospital Revenue Code	272
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

NV ENDOTRACHEAL TUBE 7MM EMG

Facility

$1,850.00

Hospital Charge Code	270694490
Hospital Revenue Code	272
Min. Negotiated Rate	$44.59
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$703.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$555.00
Rate for Payer: Oxford Commercial	$370.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Commercial	$370.00
Rate for Payer: UnitedHealthcare Community & State	$44.59
Rate for Payer: Wellpoint Medicaid Managed Care	$49.02

NV ENDOTRACHEAL TUBE 7MM EMG

Facility

$1,850.00

Hospital Charge Code	270694490
Hospital Revenue Code	272
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$277.50
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

NVM5 EMG ENDOTRACH TUBE 7MM

Facility

$1,850.00

Hospital Charge Code	270694492
Hospital Revenue Code	272
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$277.50
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

NVM5 EMG ENDOTRACH TUBE 7MM

Facility

$1,850.00

Hospital Charge Code	270694492
Hospital Revenue Code	272
Min. Negotiated Rate	$44.59
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$703.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$555.00
Rate for Payer: Oxford Commercial	$370.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Commercial	$370.00
Rate for Payer: UnitedHealthcare Community & State	$44.59
Rate for Payer: Wellpoint Medicaid Managed Care	$49.02

NVM5 NEEDLE MODULE MEP EMG

Facility

$5,500.00

Service Code	HCPCS A4649
Hospital Charge Code	270696790
Hospital Revenue Code	272
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,650.00
Rate for Payer: Oxford Commercial	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Commercial	$1,100.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

NVM5 NEEDLE MODULE MEP EMG

Facility

$5,500.00

Service Code	HCPCS A4649
Hospital Charge Code	270696790
Hospital Revenue Code	272
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

NXGN A/P WDG PRCT TIB PLT SZ 5

Facility

$13,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270686883
Hospital Revenue Code	278
Min. Negotiated Rate	$318.12
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$5,016.00
Rate for Payer: Aetna Medicare Advantage	$3,960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,366.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,366.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,640.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,366.00
Rate for Payer: Cigna Commercial	$6,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,194.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,980.00
Rate for Payer: UnitedHealthcare Community & State	$318.12
Rate for Payer: Wellpoint Medicaid Managed Care	$349.80

Know your out-of-pocket cost for care.

All Charges