Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BAG BLOOD COLLECTION TERUMO

Facility

$43.25

Hospital Charge Code	270603461
Hospital Revenue Code	272
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

BAG BLOOD COLLECTION TERUMO

Facility

$43.25

Hospital Charge Code	270603461
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.62
Rate for Payer: Aetna Commercial	$16.43
Rate for Payer: Aetna Medicare Advantage	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.97
Rate for Payer: Oxford Commercial	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$8.65
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

BAG BONGORT MAXI****

Facility

$245.00

Hospital Charge Code	8001323
Hospital Revenue Code	279
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$36.75
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

BAG BONGORT MAXI****

Facility

$245.00

Hospital Charge Code	8001323
Hospital Revenue Code	279
Min. Negotiated Rate	$5.90
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.50
Rate for Payer: Oxford Commercial	$49.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Commercial	$49.00
Rate for Payer: UnitedHealthcare Community & State	$5.90
Rate for Payer: Wellpoint Medicaid Managed Care	$6.49

BAG BONGORT PEDS****

Facility

$165.00

Hospital Charge Code	8001307
Hospital Revenue Code	279
Min. Negotiated Rate	$24.75
Max. Negotiated Rate	$24.75
Rate for Payer: Qualcare PPO/HMO/WC	$24.75

BAG BONGORT PEDS****

Facility

$165.00

Hospital Charge Code	8001307
Hospital Revenue Code	279
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$82.50
Rate for Payer: Aetna Commercial	$62.70
Rate for Payer: Aetna Medicare Advantage	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.08
Rate for Payer: Cigna Commercial	$82.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.50
Rate for Payer: Oxford Commercial	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.75
Rate for Payer: UnitedHealthcare Commercial	$33.00
Rate for Payer: UnitedHealthcare Community & State	$3.98
Rate for Payer: Wellpoint Medicaid Managed Care	$4.37

BAG BONGORT REG

Facility

$104.00

Hospital Charge Code	8001299
Hospital Revenue Code	279
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

BAG BONGORT REG

Facility

$104.00

Hospital Charge Code	8001299
Hospital Revenue Code	279
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$52.00
Rate for Payer: Aetna Commercial	$39.52
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$20.80
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$20.80
Rate for Payer: UnitedHealthcare Community & State	$2.51
Rate for Payer: Wellpoint Medicaid Managed Care	$2.76

BAG BONGORT XLG***

Facility

$69.00

Hospital Charge Code	8001315
Hospital Revenue Code	279
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$34.50
Rate for Payer: Aetna Commercial	$26.22
Rate for Payer: Aetna Medicare Advantage	$20.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.59
Rate for Payer: Cigna Commercial	$34.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.70
Rate for Payer: Oxford Commercial	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.35
Rate for Payer: UnitedHealthcare Commercial	$13.80
Rate for Payer: UnitedHealthcare Community & State	$1.66
Rate for Payer: Wellpoint Medicaid Managed Care	$1.83

BAG BONGORT XLG***

Facility

$69.00

Hospital Charge Code	8001315
Hospital Revenue Code	279
Min. Negotiated Rate	$10.35
Max. Negotiated Rate	$10.35
Rate for Payer: Qualcare PPO/HMO/WC	$10.35

BAG BREATHING 3L L.F MODIFIED

Facility

$26.25

Hospital Charge Code	270645650
Hospital Revenue Code	270
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$3.94
Rate for Payer: Qualcare PPO/HMO/WC	$3.94

BAG BREATHING 3L L.F MODIFIED

Facility

$26.25

Hospital Charge Code	270645650
Hospital Revenue Code	270
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$13.12
Rate for Payer: Aetna Commercial	$9.97
Rate for Payer: Aetna Medicare Advantage	$7.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.69
Rate for Payer: Cigna Commercial	$13.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.88
Rate for Payer: Oxford Commercial	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$3.94
Rate for Payer: UnitedHealthcare Commercial	$5.25
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

BAG COLLECTION

Facility

$224.00

Hospital Charge Code	270600319
Hospital Revenue Code	272
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$112.00
Rate for Payer: Aetna Commercial	$85.12
Rate for Payer: Aetna Medicare Advantage	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.12
Rate for Payer: Cigna Commercial	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: Oxford Commercial	$44.80
Rate for Payer: Qualcare PPO/HMO/WC	$33.60
Rate for Payer: UnitedHealthcare Commercial	$44.80
Rate for Payer: UnitedHealthcare Community & State	$5.40
Rate for Payer: Wellpoint Medicaid Managed Care	$5.94

BAG COLLECTION

Facility

$224.00

Hospital Charge Code	270600319
Hospital Revenue Code	272
Min. Negotiated Rate	$33.60
Max. Negotiated Rate	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$33.60

BAG COLLECTION 1500ML 16100602

Facility

$297.65

Hospital Charge Code	270630300
Hospital Revenue Code	272
Min. Negotiated Rate	$7.17
Max. Negotiated Rate	$148.82
Rate for Payer: Aetna Commercial	$113.11
Rate for Payer: Aetna Medicare Advantage	$89.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.90
Rate for Payer: Cigna Commercial	$148.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.30
Rate for Payer: Oxford Commercial	$59.53
Rate for Payer: Qualcare PPO/HMO/WC	$44.65
Rate for Payer: UnitedHealthcare Commercial	$59.53
Rate for Payer: UnitedHealthcare Community & State	$7.17
Rate for Payer: Wellpoint Medicaid Managed Care	$7.89

BAG COLLECTION 1500ML 16100602

Facility

$297.65

Hospital Charge Code	270630300
Hospital Revenue Code	272
Min. Negotiated Rate	$44.65
Max. Negotiated Rate	$44.65
Rate for Payer: Qualcare PPO/HMO/WC	$44.65

BAG COLLECTION (NEURO) ****

Facility

$43.00

Hospital Charge Code	1608074
Hospital Revenue Code	251
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

BAG COLLECTION (NEURO) ****

Facility

$43.00

Hospital Charge Code	1608074
Hospital Revenue Code	251
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

BAG COLOST DANSEC 10MM 324-1

Facility

$47.25

Hospital Charge Code	270623677
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$23.62
Rate for Payer: Aetna Commercial	$17.95
Rate for Payer: Aetna Medicare Advantage	$14.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.05
Rate for Payer: Cigna Commercial	$23.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.18
Rate for Payer: Oxford Commercial	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$7.09
Rate for Payer: UnitedHealthcare Commercial	$9.45
Rate for Payer: UnitedHealthcare Community & State	$1.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

BAG COLOST DANSEC 10MM 324-1

Facility

$47.25

Hospital Charge Code	270623677
Hospital Revenue Code	272
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Qualcare PPO/HMO/WC	$7.09

BAG DECANTER

Facility

$546.25

Hospital Charge Code	270654842
Hospital Revenue Code	272
Min. Negotiated Rate	$81.94
Max. Negotiated Rate	$81.94
Rate for Payer: Qualcare PPO/HMO/WC	$81.94

BAG DECANTER

Facility

$546.25

Hospital Charge Code	270654842
Hospital Revenue Code	272
Min. Negotiated Rate	$13.16
Max. Negotiated Rate	$273.12
Rate for Payer: Aetna Commercial	$207.57
Rate for Payer: Aetna Medicare Advantage	$163.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.29
Rate for Payer: Cigna Commercial	$273.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.88
Rate for Payer: Oxford Commercial	$109.25
Rate for Payer: Qualcare PPO/HMO/WC	$81.94
Rate for Payer: UnitedHealthcare Commercial	$109.25
Rate for Payer: UnitedHealthcare Community & State	$13.16
Rate for Payer: Wellpoint Medicaid Managed Care	$14.48

BAG-DECANTER

Facility

$502.70

Hospital Charge Code	270653941
Hospital Revenue Code	272
Min. Negotiated Rate	$12.12
Max. Negotiated Rate	$251.35
Rate for Payer: Aetna Commercial	$191.03
Rate for Payer: Aetna Medicare Advantage	$150.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.19
Rate for Payer: Cigna Commercial	$251.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.81
Rate for Payer: Oxford Commercial	$100.54
Rate for Payer: Qualcare PPO/HMO/WC	$75.41
Rate for Payer: UnitedHealthcare Commercial	$100.54
Rate for Payer: UnitedHealthcare Community & State	$12.12
Rate for Payer: Wellpoint Medicaid Managed Care	$13.32

BAG-DECANTER

Facility

$502.70

Hospital Charge Code	270653941
Hospital Revenue Code	272
Min. Negotiated Rate	$75.41
Max. Negotiated Rate	$75.41
Rate for Payer: Qualcare PPO/HMO/WC	$75.41

BAG DRAINAGE ANTIFLUX 4000ml

Facility

$16.53

Service Code	HCPCS A4357
Hospital Charge Code	270649662
Hospital Revenue Code	272
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$8.27
Rate for Payer: Aetna Commercial	$6.28
Rate for Payer: Aetna Medicare Advantage	$4.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.22
Rate for Payer: Cigna Commercial	$8.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.96
Rate for Payer: Oxford Commercial	$3.31
Rate for Payer: Qualcare PPO/HMO/WC	$2.48
Rate for Payer: UnitedHealthcare Commercial	$3.31
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

Know your out-of-pocket cost for care.

All Charges