Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BAG WOUND DRNGE COLLECTION

Facility

$52.00

Hospital Charge Code	270300395
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

BAHA BP100 SOFT BLACK

Facility

$17,500.00

Hospital Charge Code	270657055
Hospital Revenue Code	278
Min. Negotiated Rate	$421.75
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$6,650.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Community & State	$421.75
Rate for Payer: Wellpoint Medicaid Managed Care	$463.75

BAHA BP100 SOFT BLACK

Facility

$17,500.00

Hospital Charge Code	270657055
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

BAL AMP DE 2.5x120AME025120152

Facility

$2,025.00

Hospital Charge Code	270636982V
Hospital Revenue Code	278
Min. Negotiated Rate	$48.80
Max. Negotiated Rate	$1,012.50
Rate for Payer: Aetna Commercial	$769.50
Rate for Payer: Aetna Medicare Advantage	$607.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$516.38
Rate for Payer: Cigna Commercial	$1,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$303.75
Rate for Payer: UnitedHealthcare Community & State	$48.80
Rate for Payer: Wellpoint Medicaid Managed Care	$53.66

BAL AMP DE 2.5x120AME025120152

Facility

$2,025.00

Hospital Charge Code	270636982V
Hospital Revenue Code	278
Min. Negotiated Rate	$303.75
Max. Negotiated Rate	$490.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$303.75

BAL AMP DE 2.5x80 AME025080152

Facility

$2,025.00

Hospital Charge Code	270636981V
Hospital Revenue Code	278
Min. Negotiated Rate	$48.80
Max. Negotiated Rate	$1,012.50
Rate for Payer: Aetna Commercial	$769.50
Rate for Payer: Aetna Medicare Advantage	$607.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$516.38
Rate for Payer: Cigna Commercial	$1,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$303.75
Rate for Payer: UnitedHealthcare Community & State	$48.80
Rate for Payer: Wellpoint Medicaid Managed Care	$53.66

BAL AMP DE 2.5x80 AME025080152

Facility

$2,025.00

Hospital Charge Code	270636981V
Hospital Revenue Code	278
Min. Negotiated Rate	$303.75
Max. Negotiated Rate	$490.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$303.75

BAL AMP DE 3.5x80 AME035080152

Facility

$2,025.00

Hospital Charge Code	270636985V
Hospital Revenue Code	278
Min. Negotiated Rate	$303.75
Max. Negotiated Rate	$490.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$303.75

BAL AMP DE 3.5x80 AME035080152

Facility

$2,025.00

Hospital Charge Code	270636985V
Hospital Revenue Code	278
Min. Negotiated Rate	$48.80
Max. Negotiated Rate	$1,012.50
Rate for Payer: Aetna Commercial	$769.50
Rate for Payer: Aetna Medicare Advantage	$607.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$516.38
Rate for Payer: Cigna Commercial	$1,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$303.75
Rate for Payer: UnitedHealthcare Community & State	$48.80
Rate for Payer: Wellpoint Medicaid Managed Care	$53.66

BAL AMP DEEP 2x40 AME020040152

Facility

$2,025.00

Hospital Charge Code	270636988V
Hospital Revenue Code	278
Min. Negotiated Rate	$303.75
Max. Negotiated Rate	$490.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$303.75

BAL AMP DEEP 2x40 AME020040152

Facility

$2,025.00

Hospital Charge Code	270636988V
Hospital Revenue Code	278
Min. Negotiated Rate	$48.80
Max. Negotiated Rate	$1,012.50
Rate for Payer: Aetna Commercial	$769.50
Rate for Payer: Aetna Medicare Advantage	$607.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$516.38
Rate for Payer: Cigna Commercial	$1,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$303.75
Rate for Payer: UnitedHealthcare Community & State	$48.80
Rate for Payer: Wellpoint Medicaid Managed Care	$53.66

BAL AMPHI DP 3x40 AME030040152

Facility

$2,025.00

Hospital Charge Code	270637203
Hospital Revenue Code	278
Min. Negotiated Rate	$48.80
Max. Negotiated Rate	$1,012.50
Rate for Payer: Aetna Commercial	$769.50
Rate for Payer: Aetna Medicare Advantage	$607.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$516.38
Rate for Payer: Cigna Commercial	$1,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$303.75
Rate for Payer: UnitedHealthcare Community & State	$48.80
Rate for Payer: Wellpoint Medicaid Managed Care	$53.66

BAL AMPHI DP 3x40 AME030040152

Facility

$2,025.00

Hospital Charge Code	270637203V
Hospital Revenue Code	278
Min. Negotiated Rate	$48.80
Max. Negotiated Rate	$1,012.50
Rate for Payer: Aetna Commercial	$769.50
Rate for Payer: Aetna Medicare Advantage	$607.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$516.38
Rate for Payer: Cigna Commercial	$1,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$303.75
Rate for Payer: UnitedHealthcare Community & State	$48.80
Rate for Payer: Wellpoint Medicaid Managed Care	$53.66

BAL AMPHI DP 3x40 AME030040152

Facility

$2,025.00

Hospital Charge Code	270637203
Hospital Revenue Code	278
Min. Negotiated Rate	$303.75
Max. Negotiated Rate	$490.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$303.75

BAL AMPHI DP 3x40 AME030040152

Facility

$2,025.00

Hospital Charge Code	270637203V
Hospital Revenue Code	278
Min. Negotiated Rate	$303.75
Max. Negotiated Rate	$490.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$303.75

BAL AMPHI DP 4x120AME040120152

Facility

$1,525.00

Service Code	HCPCS C1725
Hospital Charge Code	270636993
Hospital Revenue Code	278
Min. Negotiated Rate	$228.75
Max. Negotiated Rate	$369.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$335.50
Rate for Payer: Qualcare PPO/HMO/WC	$228.75

BAL AMPHI DP 4x120AME040120152

Facility

$1,525.00

Service Code	HCPCS C1725
Hospital Charge Code	270636993
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$762.50
Rate for Payer: Aetna Commercial	$579.50
Rate for Payer: Aetna Medicare Advantage	$457.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.88
Rate for Payer: Cigna Commercial	$762.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$335.50
Rate for Payer: Qualcare PPO/HMO/WC	$228.75
Rate for Payer: UnitedHealthcare Community & State	$36.75
Rate for Payer: Wellpoint Medicaid Managed Care	$40.41

BALANCED SALT OPHT SOL 500ML

Facility

$185.00

Hospital Charge Code	6000533
Hospital Revenue Code	251
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$92.50
Rate for Payer: Aetna Commercial	$70.30
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.50
Rate for Payer: Oxford Commercial	$37.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Commercial	$37.00
Rate for Payer: UnitedHealthcare Community & State	$4.46
Rate for Payer: Wellpoint Medicaid Managed Care	$4.90

BALANCED SALT OPHT SOL 500ML

Facility

$185.00

Hospital Charge Code	6000533
Hospital Revenue Code	251
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

BALANCED SALT SOLIOCARE 500ML

Facility

$459.00

Hospital Charge Code	270331114
Hospital Revenue Code	272
Min. Negotiated Rate	$11.06
Max. Negotiated Rate	$229.50
Rate for Payer: Aetna Commercial	$174.42
Rate for Payer: Aetna Medicare Advantage	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.05
Rate for Payer: Cigna Commercial	$229.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.70
Rate for Payer: Oxford Commercial	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$68.85
Rate for Payer: UnitedHealthcare Commercial	$91.80
Rate for Payer: UnitedHealthcare Community & State	$11.06
Rate for Payer: Wellpoint Medicaid Managed Care	$12.16

BALANCED SALT SOLIOCARE 500ML

Facility

$459.00

Hospital Charge Code	270331114
Hospital Revenue Code	272
Min. Negotiated Rate	$68.85
Max. Negotiated Rate	$68.85
Rate for Payer: Qualcare PPO/HMO/WC	$68.85

BALANCED SALT SOLUTION 3ML

Facility

$12.45

Hospital Charge Code	270650487
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$6.22
Rate for Payer: Aetna Commercial	$4.73
Rate for Payer: Aetna Medicare Advantage	$3.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.17
Rate for Payer: Cigna Commercial	$6.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.73
Rate for Payer: Oxford Commercial	$2.49
Rate for Payer: Qualcare PPO/HMO/WC	$1.87
Rate for Payer: UnitedHealthcare Commercial	$2.49
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

BALANCED SALT SOLUTION 3ML

Facility

$12.45

Hospital Charge Code	270650487
Hospital Revenue Code	272
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$1.87
Rate for Payer: Qualcare PPO/HMO/WC	$1.87

BALANCED SALT SOLUTION 500CC

Facility

$64.00

Hospital Charge Code	270331653
Hospital Revenue Code	272
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

BALANCED SALT SOLUTION 500CC

Facility

$64.00

Hospital Charge Code	270331653
Hospital Revenue Code	272
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$24.32
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.20
Rate for Payer: Oxford Commercial	$12.80
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$12.80
Rate for Payer: UnitedHealthcare Community & State	$1.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1.70

Know your out-of-pocket cost for care.

All Charges