Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BAL ATLA PTA 26x4x75cm AT75264

Facility

$2,975.00

Hospital Charge Code	270639796V
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$719.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$654.50
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

BAL ATLA PTA 26x4x75cm AT75264

Facility

$2,975.00

Hospital Charge Code	270639796V
Hospital Revenue Code	278
Min. Negotiated Rate	$71.70
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$1,130.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$654.50
Rate for Payer: Qualcare PPO/HMO/WC	$446.25
Rate for Payer: UnitedHealthcare Community & State	$71.70
Rate for Payer: Wellpoint Medicaid Managed Care	$78.84

BAL IAB 7.5F 25cc 068400047801

Facility

$4,150.00

Service Code	HCPCS C1725
Hospital Charge Code	270634434
Hospital Revenue Code	278
Min. Negotiated Rate	$100.02
Max. Negotiated Rate	$2,075.00
Rate for Payer: Aetna Commercial	$1,577.00
Rate for Payer: Aetna Medicare Advantage	$1,245.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,058.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,058.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$830.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,058.25
Rate for Payer: Cigna Commercial	$2,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,004.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$913.00
Rate for Payer: Qualcare PPO/HMO/WC	$622.50
Rate for Payer: UnitedHealthcare Community & State	$100.02
Rate for Payer: Wellpoint Medicaid Managed Care	$109.97

BAL IAB 7.5F 25cc 068400047801

Facility

$4,150.00

Service Code	HCPCS C1725
Hospital Charge Code	270634434
Hospital Revenue Code	278
Min. Negotiated Rate	$622.50
Max. Negotiated Rate	$1,004.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$830.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,004.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$913.00
Rate for Payer: Qualcare PPO/HMO/WC	$622.50

BAL IAB 7.5F 25CC 068400047801

Facility

$5,075.00

Hospital Charge Code	270634434C
Hospital Revenue Code	278
Min. Negotiated Rate	$122.31
Max. Negotiated Rate	$2,537.50
Rate for Payer: Aetna Commercial	$1,928.50
Rate for Payer: Aetna Medicare Advantage	$1,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,294.12
Rate for Payer: Cigna Commercial	$2,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,116.50
Rate for Payer: Qualcare PPO/HMO/WC	$761.25
Rate for Payer: UnitedHealthcare Community & State	$122.31
Rate for Payer: Wellpoint Medicaid Managed Care	$134.49

BAL IAB 7.5F 25CC 068400047801

Facility

$5,075.00

Hospital Charge Code	270634434C
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$1,228.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,116.50
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

BAL IAB 7.5F 40cc 068400048001

Facility

$4,402.60

Service Code	HCPCS C1725
Hospital Charge Code	270634432S
Hospital Revenue Code	278
Min. Negotiated Rate	$660.39
Max. Negotiated Rate	$1,065.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,065.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$968.57
Rate for Payer: Qualcare PPO/HMO/WC	$660.39

BAL IAB 7.5F 40cc 068400048001

Facility

$5,075.00

Service Code	HCPCS C1725
Hospital Charge Code	270634432N
Hospital Revenue Code	278
Min. Negotiated Rate	$122.31
Max. Negotiated Rate	$2,537.50
Rate for Payer: Aetna Commercial	$1,928.50
Rate for Payer: Aetna Medicare Advantage	$1,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,294.12
Rate for Payer: Cigna Commercial	$2,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,116.50
Rate for Payer: Qualcare PPO/HMO/WC	$761.25
Rate for Payer: UnitedHealthcare Community & State	$122.31
Rate for Payer: Wellpoint Medicaid Managed Care	$134.49

BAL IAB 7.5F 40cc 068400048001

Facility

$4,402.60

Service Code	HCPCS C1725
Hospital Charge Code	270634432
Hospital Revenue Code	278
Min. Negotiated Rate	$660.39
Max. Negotiated Rate	$1,065.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,065.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$968.57
Rate for Payer: Qualcare PPO/HMO/WC	$660.39

BAL IAB 7.5F 40cc 068400048001

Facility

$4,402.60

Service Code	HCPCS C1725
Hospital Charge Code	270634432S
Hospital Revenue Code	278
Min. Negotiated Rate	$106.10
Max. Negotiated Rate	$2,201.30
Rate for Payer: Aetna Commercial	$1,672.99
Rate for Payer: Aetna Medicare Advantage	$1,320.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,122.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,122.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,122.66
Rate for Payer: Cigna Commercial	$2,201.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,065.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$968.57
Rate for Payer: Qualcare PPO/HMO/WC	$660.39
Rate for Payer: UnitedHealthcare Community & State	$106.10
Rate for Payer: Wellpoint Medicaid Managed Care	$116.67

BAL IAB 7.5F 40cc 068400048001

Facility

$4,402.60

Service Code	HCPCS C1725
Hospital Charge Code	270634432
Hospital Revenue Code	278
Min. Negotiated Rate	$106.10
Max. Negotiated Rate	$2,201.30
Rate for Payer: Aetna Commercial	$1,672.99
Rate for Payer: Aetna Medicare Advantage	$1,320.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,122.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,122.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,122.66
Rate for Payer: Cigna Commercial	$2,201.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,065.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$968.57
Rate for Payer: Qualcare PPO/HMO/WC	$660.39
Rate for Payer: UnitedHealthcare Community & State	$106.10
Rate for Payer: Wellpoint Medicaid Managed Care	$116.67

BAL IAB 7.5F 40cc 068400048001

Facility

$5,075.00

Service Code	HCPCS C1725
Hospital Charge Code	270634432N
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$1,228.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,116.50
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

BAL IN OIL

Facility

$114.00

Hospital Charge Code	60634885
Hospital Revenue Code	250
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$17.10
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

BAL IN OIL

Facility

$114.00

Hospital Charge Code	60634885
Hospital Revenue Code	250
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$57.00
Rate for Payer: Aetna Commercial	$43.32
Rate for Payer: Aetna Medicare Advantage	$34.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.07
Rate for Payer: Cigna Commercial	$57.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.20
Rate for Payer: Oxford Commercial	$22.80
Rate for Payer: Qualcare PPO/HMO/WC	$17.10
Rate for Payer: UnitedHealthcare Commercial	$22.80
Rate for Payer: UnitedHealthcare Community & State	$2.75
Rate for Payer: Wellpoint Medicaid Managed Care	$3.02

BALLARD SUCTION KIT TRACH

Facility

$57.65

Hospital Charge Code	270600663
Hospital Revenue Code	272
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$28.82
Rate for Payer: Aetna Commercial	$21.91
Rate for Payer: Aetna Medicare Advantage	$17.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.70
Rate for Payer: Cigna Commercial	$28.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.30
Rate for Payer: Oxford Commercial	$11.53
Rate for Payer: Qualcare PPO/HMO/WC	$8.65
Rate for Payer: UnitedHealthcare Commercial	$11.53
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.53

BALLARD SUCTION KIT TRACH

Facility

$57.65

Hospital Charge Code	270600663
Hospital Revenue Code	272
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$8.65

BALL BUR 4.0MM 24B6ST

Facility

$161.00

Hospital Charge Code	270335572
Hospital Revenue Code	272
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$24.15
Rate for Payer: Qualcare PPO/HMO/WC	$24.15

BALL BUR 4.0MM 24B6ST

Facility

$161.00

Hospital Charge Code	270335572
Hospital Revenue Code	272
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$80.50
Rate for Payer: Aetna Commercial	$61.18
Rate for Payer: Aetna Medicare Advantage	$48.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.05
Rate for Payer: Cigna Commercial	$80.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.30
Rate for Payer: Oxford Commercial	$32.20
Rate for Payer: Qualcare PPO/HMO/WC	$24.15
Rate for Payer: UnitedHealthcare Commercial	$32.20
Rate for Payer: UnitedHealthcare Community & State	$3.88
Rate for Payer: Wellpoint Medicaid Managed Care	$4.27

BALL BUR 4.0MM 24B9ST

Facility

$152.00

Hospital Charge Code	270335573
Hospital Revenue Code	272
Min. Negotiated Rate	$3.66
Max. Negotiated Rate	$76.00
Rate for Payer: Aetna Commercial	$57.76
Rate for Payer: Aetna Medicare Advantage	$45.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.76
Rate for Payer: Cigna Commercial	$76.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.60
Rate for Payer: Oxford Commercial	$30.40
Rate for Payer: Qualcare PPO/HMO/WC	$22.80
Rate for Payer: UnitedHealthcare Commercial	$30.40
Rate for Payer: UnitedHealthcare Community & State	$3.66
Rate for Payer: Wellpoint Medicaid Managed Care	$4.03

BALL BUR 4.0MM 24B9ST

Facility

$152.00

Hospital Charge Code	270335573
Hospital Revenue Code	272
Min. Negotiated Rate	$22.80
Max. Negotiated Rate	$22.80
Rate for Payer: Qualcare PPO/HMO/WC	$22.80

BALL BURR, CRANIAL

Facility

$5,000.00

Hospital Charge Code	270690851
Hospital Revenue Code	272
Min. Negotiated Rate	$120.50
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.00
Rate for Payer: Oxford Commercial	$1,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Commercial	$1,000.00
Rate for Payer: UnitedHealthcare Community & State	$120.50
Rate for Payer: Wellpoint Medicaid Managed Care	$132.50

BALL BURR, CRANIAL

Facility

$5,000.00

Hospital Charge Code	270690851
Hospital Revenue Code	272
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

BALL BURR FLUTED 6MM

Facility

$390.00

Hospital Charge Code	270668483
Hospital Revenue Code	272
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BALL BURR FLUTED 6MM

Facility

$390.00

Hospital Charge Code	270668483
Hospital Revenue Code	272
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$78.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$78.00
Rate for Payer: UnitedHealthcare Community & State	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

BALL DIAMOND 5MM MEDNEXT

Facility

$731.50

Hospital Charge Code	270657269
Hospital Revenue Code	278
Min. Negotiated Rate	$109.72
Max. Negotiated Rate	$177.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$160.93
Rate for Payer: Qualcare PPO/HMO/WC	$109.72

Know your out-of-pocket cost for care.

All Charges