Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PACK CELL SAVER 165CC COBE125

Facility

$494.45

Hospital Charge Code	270605811
Hospital Revenue Code	272
Min. Negotiated Rate	$74.17
Max. Negotiated Rate	$74.17
Rate for Payer: Qualcare PPO/HMO/WC	$74.17

PACK CELL SAVER 165CC COBE125

Facility

$494.45

Hospital Charge Code	270605811
Hospital Revenue Code	272
Min. Negotiated Rate	$11.92
Max. Negotiated Rate	$247.22
Rate for Payer: Aetna Commercial	$187.89
Rate for Payer: Aetna Medicare Advantage	$148.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.08
Rate for Payer: Cigna Commercial	$247.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.34
Rate for Payer: Oxford Commercial	$98.89
Rate for Payer: Qualcare PPO/HMO/WC	$74.17
Rate for Payer: UnitedHealthcare Commercial	$98.89
Rate for Payer: UnitedHealthcare Community & State	$11.92
Rate for Payer: Wellpoint Medicaid Managed Care	$13.10

PACK CELL SAVER 225CC HAE243

Facility

$342.50

Hospital Charge Code	270605802
Hospital Revenue Code	272
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$171.25
Rate for Payer: Aetna Commercial	$130.15
Rate for Payer: Aetna Medicare Advantage	$102.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.34
Rate for Payer: Cigna Commercial	$171.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.75
Rate for Payer: Oxford Commercial	$68.50
Rate for Payer: Qualcare PPO/HMO/WC	$51.38
Rate for Payer: UnitedHealthcare Commercial	$68.50
Rate for Payer: UnitedHealthcare Community & State	$8.25
Rate for Payer: Wellpoint Medicaid Managed Care	$9.08

PACK CELL SAVER 225CC HAE243

Facility

$342.50

Hospital Charge Code	270605802
Hospital Revenue Code	272
Min. Negotiated Rate	$51.38
Max. Negotiated Rate	$51.38
Rate for Payer: Qualcare PPO/HMO/WC	$51.38

PACK CELL SAVER 250CC COBE250

Facility

$494.45

Hospital Charge Code	270606139
Hospital Revenue Code	272
Min. Negotiated Rate	$11.92
Max. Negotiated Rate	$247.22
Rate for Payer: Aetna Commercial	$187.89
Rate for Payer: Aetna Medicare Advantage	$148.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.08
Rate for Payer: Cigna Commercial	$247.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.34
Rate for Payer: Oxford Commercial	$98.89
Rate for Payer: Qualcare PPO/HMO/WC	$74.17
Rate for Payer: UnitedHealthcare Commercial	$98.89
Rate for Payer: UnitedHealthcare Community & State	$11.92
Rate for Payer: Wellpoint Medicaid Managed Care	$13.10

PACK CELL SAVER 250CC COBE250

Facility

$494.45

Hospital Charge Code	270606139
Hospital Revenue Code	272
Min. Negotiated Rate	$74.17
Max. Negotiated Rate	$74.17
Rate for Payer: Qualcare PPO/HMO/WC	$74.17

PACK COLD

Facility

$5.65

Hospital Charge Code	270605298
Hospital Revenue Code	270
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$2.15
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.70
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

PACK COLD

Facility

$16.85

Hospital Charge Code	8200206
Hospital Revenue Code	271
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$6.40
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.05
Rate for Payer: Oxford Commercial	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$3.37
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

PACK COLD

Facility

$5.65

Hospital Charge Code	270605298
Hospital Revenue Code	270
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

PACK COLD

Facility

$16.85

Hospital Charge Code	8200206
Hospital Revenue Code	271
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

PACK CONVENIENCE PERC K791301

Facility

$5,704.00

Hospital Charge Code	270630128
Hospital Revenue Code	272
Min. Negotiated Rate	$137.47
Max. Negotiated Rate	$2,852.00
Rate for Payer: Aetna Commercial	$2,167.52
Rate for Payer: Aetna Medicare Advantage	$1,711.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,454.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,454.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,454.52
Rate for Payer: Cigna Commercial	$2,852.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,711.20
Rate for Payer: Oxford Commercial	$1,140.80
Rate for Payer: Qualcare PPO/HMO/WC	$855.60
Rate for Payer: UnitedHealthcare Commercial	$1,140.80
Rate for Payer: UnitedHealthcare Community & State	$137.47
Rate for Payer: Wellpoint Medicaid Managed Care	$151.16

PACK CONVENIENCE PERC K791301

Facility

$5,704.00

Hospital Charge Code	270630128
Hospital Revenue Code	272
Min. Negotiated Rate	$855.60
Max. Negotiated Rate	$855.60
Rate for Payer: Qualcare PPO/HMO/WC	$855.60

PACK CT DRAINAGE TRAY

Facility

$550.55

Hospital Charge Code	2709006568
Hospital Revenue Code	272
Min. Negotiated Rate	$82.58
Max. Negotiated Rate	$82.58
Rate for Payer: Qualcare PPO/HMO/WC	$82.58

PACK CT DRAINAGE TRAY

Facility

$550.55

Hospital Charge Code	2709006568
Hospital Revenue Code	272
Min. Negotiated Rate	$13.27
Max. Negotiated Rate	$275.27
Rate for Payer: Aetna Commercial	$209.21
Rate for Payer: Aetna Medicare Advantage	$165.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.39
Rate for Payer: Cigna Commercial	$275.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.16
Rate for Payer: Oxford Commercial	$110.11
Rate for Payer: Qualcare PPO/HMO/WC	$82.58
Rate for Payer: UnitedHealthcare Commercial	$110.11
Rate for Payer: UnitedHealthcare Community & State	$13.27
Rate for Payer: Wellpoint Medicaid Managed Care	$14.59

PACK CT DRAINAGE TRAY

Facility

$285.00

Hospital Charge Code	270653745R
Hospital Revenue Code	272
Min. Negotiated Rate	$6.87
Max. Negotiated Rate	$142.50
Rate for Payer: Aetna Commercial	$108.30
Rate for Payer: Aetna Medicare Advantage	$85.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.67
Rate for Payer: Cigna Commercial	$142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.50
Rate for Payer: Oxford Commercial	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.75
Rate for Payer: UnitedHealthcare Commercial	$57.00
Rate for Payer: UnitedHealthcare Community & State	$6.87
Rate for Payer: Wellpoint Medicaid Managed Care	$7.55

PACK CT DRAINAGE TRAY

Facility

$285.00

Hospital Charge Code	270653745R
Hospital Revenue Code	272
Min. Negotiated Rate	$42.75
Max. Negotiated Rate	$42.75
Rate for Payer: Qualcare PPO/HMO/WC	$42.75

PACK CT DRAINAGE TRAY

Facility

$285.00

Hospital Charge Code	270653745
Hospital Revenue Code	272
Min. Negotiated Rate	$6.87
Max. Negotiated Rate	$142.50
Rate for Payer: Aetna Commercial	$108.30
Rate for Payer: Aetna Medicare Advantage	$85.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.67
Rate for Payer: Cigna Commercial	$142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.50
Rate for Payer: Oxford Commercial	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.75
Rate for Payer: UnitedHealthcare Commercial	$57.00
Rate for Payer: UnitedHealthcare Community & State	$6.87
Rate for Payer: Wellpoint Medicaid Managed Care	$7.55

PACK CT DRAINAGE TRAY

Facility

$285.00

Hospital Charge Code	270653745
Hospital Revenue Code	272
Min. Negotiated Rate	$42.75
Max. Negotiated Rate	$42.75
Rate for Payer: Qualcare PPO/HMO/WC	$42.75

PACK CUSTOM ANGIO

Facility

$372.95

Hospital Charge Code	270677787
Hospital Revenue Code	272
Min. Negotiated Rate	$8.99
Max. Negotiated Rate	$186.47
Rate for Payer: Aetna Commercial	$141.72
Rate for Payer: Aetna Medicare Advantage	$111.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.10
Rate for Payer: Cigna Commercial	$186.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.89
Rate for Payer: Oxford Commercial	$74.59
Rate for Payer: Qualcare PPO/HMO/WC	$55.94
Rate for Payer: UnitedHealthcare Commercial	$74.59
Rate for Payer: UnitedHealthcare Community & State	$8.99
Rate for Payer: Wellpoint Medicaid Managed Care	$9.88

PACK CUSTOM ANGIO

Facility

$325.00

Hospital Charge Code	270677787N
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

PACK CUSTOM ANGIO

Facility

$372.95

Hospital Charge Code	270677787
Hospital Revenue Code	272
Min. Negotiated Rate	$55.94
Max. Negotiated Rate	$55.94
Rate for Payer: Qualcare PPO/HMO/WC	$55.94

PACK CUSTOM ANGIO

Facility

$372.95

Hospital Charge Code	270677787S
Hospital Revenue Code	272
Min. Negotiated Rate	$8.99
Max. Negotiated Rate	$186.47
Rate for Payer: Aetna Commercial	$141.72
Rate for Payer: Aetna Medicare Advantage	$111.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.10
Rate for Payer: Cigna Commercial	$186.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.89
Rate for Payer: Oxford Commercial	$74.59
Rate for Payer: Qualcare PPO/HMO/WC	$55.94
Rate for Payer: UnitedHealthcare Commercial	$74.59
Rate for Payer: UnitedHealthcare Community & State	$8.99
Rate for Payer: Wellpoint Medicaid Managed Care	$9.88

PACK CUSTOM ANGIO

Facility

$325.00

Hospital Charge Code	270677787N
Hospital Revenue Code	272
Min. Negotiated Rate	$7.83
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$123.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$65.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$65.00
Rate for Payer: UnitedHealthcare Community & State	$7.83
Rate for Payer: Wellpoint Medicaid Managed Care	$8.61

PACK CUSTOM ANGIO

Facility

$372.95

Hospital Charge Code	270677787S
Hospital Revenue Code	272
Min. Negotiated Rate	$55.94
Max. Negotiated Rate	$55.94
Rate for Payer: Qualcare PPO/HMO/WC	$55.94

PACK CUSTOM ARTHROSCOPY

Facility

$474.45

Hospital Charge Code	270600342
Hospital Revenue Code	272
Min. Negotiated Rate	$71.17
Max. Negotiated Rate	$71.17
Rate for Payer: Qualcare PPO/HMO/WC	$71.17

Know your out-of-pocket cost for care.

All Charges