Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BAG KANGAROO****

Facility

$70.00

Hospital Charge Code	8000804
Hospital Revenue Code	279
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$35.00
Rate for Payer: Aetna Commercial	$26.60
Rate for Payer: Aetna Medicare Advantage	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.85
Rate for Payer: Cigna Commercial	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.00
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.50
Rate for Payer: UnitedHealthcare Commercial	$14.00
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

BAG LAPSAC 5 X 8

Facility

$243.10

Hospital Charge Code	270667480
Hospital Revenue Code	270
Min. Negotiated Rate	$5.86
Max. Negotiated Rate	$121.55
Rate for Payer: Aetna Commercial	$92.38
Rate for Payer: Aetna Medicare Advantage	$72.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.99
Rate for Payer: Cigna Commercial	$121.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.93
Rate for Payer: Oxford Commercial	$48.62
Rate for Payer: Qualcare PPO/HMO/WC	$36.47
Rate for Payer: UnitedHealthcare Commercial	$48.62
Rate for Payer: UnitedHealthcare Community & State	$5.86
Rate for Payer: Wellpoint Medicaid Managed Care	$6.44

BAG LAPSAC 5 X 8

Facility

$243.10

Hospital Charge Code	270667480
Hospital Revenue Code	270
Min. Negotiated Rate	$36.47
Max. Negotiated Rate	$36.47
Rate for Payer: Qualcare PPO/HMO/WC	$36.47

BAG LAPSAC 8 X 10

Facility

$242.10

Hospital Charge Code	270667481
Hospital Revenue Code	270
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$121.05
Rate for Payer: Aetna Commercial	$92.00
Rate for Payer: Aetna Medicare Advantage	$72.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.74
Rate for Payer: Cigna Commercial	$121.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.63
Rate for Payer: Oxford Commercial	$48.42
Rate for Payer: Qualcare PPO/HMO/WC	$36.31
Rate for Payer: UnitedHealthcare Commercial	$48.42
Rate for Payer: UnitedHealthcare Community & State	$5.83
Rate for Payer: Wellpoint Medicaid Managed Care	$6.42

BAG LAPSAC 8 X 10

Facility

$242.10

Hospital Charge Code	270667481
Hospital Revenue Code	270
Min. Negotiated Rate	$36.31
Max. Negotiated Rate	$36.31
Rate for Payer: Qualcare PPO/HMO/WC	$36.31

BAGLESS HD 6 US

Facility

$0.01

Hospital Charge Code	270703401
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

BAGLESS HD 6 US

Facility

$0.01

Hospital Charge Code	270703401
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

BAGLESS OC 5 US

Facility

$0.01

Hospital Charge Code	270703402
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

BAGLESS OC 5 US

Facility

$0.01

Hospital Charge Code	270703402
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

BAGLESS OC 6 US

Facility

$0.01

Hospital Charge Code	270703403
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

BAGLESS OC 6 US

Facility

$0.01

Hospital Charge Code	270703403
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

BAG LUB VIPERSLIDE 100ml VPRSL

Facility

$4,750.00

Hospital Charge Code	270642016
Hospital Revenue Code	272
Min. Negotiated Rate	$114.47
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,425.00
Rate for Payer: Oxford Commercial	$950.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Commercial	$950.00
Rate for Payer: UnitedHealthcare Community & State	$114.47
Rate for Payer: Wellpoint Medicaid Managed Care	$125.88

BAG LUB VIPERSLIDE 100ml VPRSL

Facility

$4,750.00

Hospital Charge Code	270642016
Hospital Revenue Code	272
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$712.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

BAG LUB VIPERSLIDE 100ML VPRSL

Facility

$400.00

Hospital Charge Code	270642016S
Hospital Revenue Code	272
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.00
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$80.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

BAG LUB VIPERSLIDE 100ML VPRSL

Facility

$400.00

Hospital Charge Code	270642016S
Hospital Revenue Code	272
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

BAG LUB VIPERSLIDE 100ML VPRSL

Facility

$400.00

Hospital Charge Code	270642016N
Hospital Revenue Code	272
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

BAG LUB VIPERSLIDE 100ML VPRSL

Facility

$400.00

Hospital Charge Code	270642016N
Hospital Revenue Code	272
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.00
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$80.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

BAG NON-LATEX BRTHNG 2 5062NL

Facility

$17.50

Hospital Charge Code	270608800
Hospital Revenue Code	272
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$8.75
Rate for Payer: Aetna Commercial	$6.65
Rate for Payer: Aetna Medicare Advantage	$5.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.46
Rate for Payer: Cigna Commercial	$8.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.25
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.62
Rate for Payer: UnitedHealthcare Commercial	$3.50
Rate for Payer: UnitedHealthcare Community & State	$0.42
Rate for Payer: Wellpoint Medicaid Managed Care	$0.46

BAG NON-LATEX BRTHNG 2 5062NL

Facility

$17.50

Hospital Charge Code	270608800
Hospital Revenue Code	272
Min. Negotiated Rate	$2.62
Max. Negotiated Rate	$2.62
Rate for Payer: Qualcare PPO/HMO/WC	$2.62

BAG PED STERILE******

Facility

$25.00

Hospital Charge Code	8001281
Hospital Revenue Code	279
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

BAG PED STERILE******

Facility

$25.00

Hospital Charge Code	8001281
Hospital Revenue Code	279
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

BAG PERSONAL BELONGING

Facility

$4.00

Hospital Charge Code	270300120
Hospital Revenue Code	270
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

BAG PERSONAL BELONGING

Facility

$0.53

Hospital Charge Code	270650305
Hospital Revenue Code	270
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.08
Rate for Payer: Qualcare PPO/HMO/WC	$0.08

BAG PERSONAL BELONGING

Facility

$0.53

Hospital Charge Code	270650305
Hospital Revenue Code	270
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.27
Rate for Payer: Aetna Commercial	$0.20
Rate for Payer: Aetna Medicare Advantage	$0.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.14
Rate for Payer: Cigna Commercial	$0.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.16
Rate for Payer: Oxford Commercial	$0.11
Rate for Payer: Qualcare PPO/HMO/WC	$0.08
Rate for Payer: UnitedHealthcare Commercial	$0.11
Rate for Payer: UnitedHealthcare Community & State	$0.01
Rate for Payer: Wellpoint Medicaid Managed Care	$0.01

BAG PERSONAL BELONGING

Facility

$4.00

Hospital Charge Code	270300120
Hospital Revenue Code	270
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

Know your out-of-pocket cost for care.

All Charges