Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PACKING NASAL RHINOROCKET

Facility

$67.25

Hospital Charge Code	270600765
Hospital Revenue Code	272
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$10.09
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

PACKING NASAL RHINOROCKET

Facility

$67.25

Hospital Charge Code	270600765
Hospital Revenue Code	272
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$33.62
Rate for Payer: Aetna Commercial	$25.55
Rate for Payer: Aetna Medicare Advantage	$20.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$33.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.18
Rate for Payer: Oxford Commercial	$13.45
Rate for Payer: Qualcare PPO/HMO/WC	$10.09
Rate for Payer: UnitedHealthcare Commercial	$13.45
Rate for Payer: UnitedHealthcare Community & State	$1.62
Rate for Payer: Wellpoint Medicaid Managed Care	$1.78

PACKING NASAL RHINOROCKET****

Facility

$34.50

Hospital Charge Code	270300765
Hospital Revenue Code	272
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$17.25
Rate for Payer: Aetna Commercial	$13.11
Rate for Payer: Aetna Medicare Advantage	$10.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.80
Rate for Payer: Cigna Commercial	$17.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.35
Rate for Payer: Oxford Commercial	$6.90
Rate for Payer: Qualcare PPO/HMO/WC	$5.17
Rate for Payer: UnitedHealthcare Commercial	$6.90
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.91

PACKING NASAL RHINOROCKET****

Facility

$34.50

Hospital Charge Code	270300765
Hospital Revenue Code	272
Min. Negotiated Rate	$5.17
Max. Negotiated Rate	$5.17
Rate for Payer: Qualcare PPO/HMO/WC	$5.17

PACKING PLAIN 1

Facility

$10.88

Hospital Charge Code	270300940
Hospital Revenue Code	272
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$1.63
Rate for Payer: Qualcare PPO/HMO/WC	$1.63

PACKING PLAIN 1

Facility

$10.88

Hospital Charge Code	270300940
Hospital Revenue Code	272
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$5.44
Rate for Payer: Aetna Commercial	$4.13
Rate for Payer: Aetna Medicare Advantage	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.77
Rate for Payer: Cigna Commercial	$5.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.26
Rate for Payer: Oxford Commercial	$2.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.63
Rate for Payer: UnitedHealthcare Commercial	$2.18
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

PACKING PLAIN 1/2

Facility

$9.58

Hospital Charge Code	270300935
Hospital Revenue Code	272
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.44

PACKING PLAIN 1/2

Facility

$9.58

Hospital Charge Code	270300935
Hospital Revenue Code	272
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.79
Rate for Payer: Aetna Commercial	$3.64
Rate for Payer: Aetna Medicare Advantage	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.44
Rate for Payer: Cigna Commercial	$4.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.87
Rate for Payer: Oxford Commercial	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.44
Rate for Payer: UnitedHealthcare Commercial	$1.92
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

PACKING PLAIN 1/4

Facility

$9.61

Hospital Charge Code	270300930
Hospital Revenue Code	272
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.80
Rate for Payer: Aetna Commercial	$3.65
Rate for Payer: Aetna Medicare Advantage	$2.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.45
Rate for Payer: Cigna Commercial	$4.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.88
Rate for Payer: Oxford Commercial	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.44
Rate for Payer: UnitedHealthcare Commercial	$1.92
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

PACKING PLAIN 1/4

Facility

$9.61

Hospital Charge Code	270300930
Hospital Revenue Code	272
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.44

PACKING PROCEDURE

Facility

$100.00

Service Code	HCPCS 86972
Hospital Charge Code	3100062
Hospital Revenue Code	309
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

PACKING PROCEDURE

Facility

$100.00

Service Code	HCPCS 86972
Hospital Charge Code	3100062
Hospital Revenue Code	309
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$730.60
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$730.60
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

PACKING VAGINAL ************

Facility

$21.00

Hospital Charge Code	8002131
Hospital Revenue Code	279
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

PACKING VAGINAL ************

Facility

$21.00

Hospital Charge Code	8002131
Hospital Revenue Code	279
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$10.50
Rate for Payer: Aetna Commercial	$7.98
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.30
Rate for Payer: Oxford Commercial	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$4.20
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

PACKING VAGINAL STER

Facility

$20.00

Hospital Charge Code	270649185
Hospital Revenue Code	272
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

PACKING VAGINAL STER

Facility

$20.00

Hospital Charge Code	270649185
Hospital Revenue Code	272
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$7.60
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.00
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$4.00
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

PACKING VAGINAL STER 2

Facility

$10.10

Hospital Charge Code	270649186
Hospital Revenue Code	272
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$5.05
Rate for Payer: Aetna Commercial	$3.84
Rate for Payer: Aetna Medicare Advantage	$3.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.58
Rate for Payer: Cigna Commercial	$5.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.03
Rate for Payer: Oxford Commercial	$2.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.51
Rate for Payer: UnitedHealthcare Commercial	$2.02
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

PACKING VAGINAL STER 2

Facility

$10.10

Hospital Charge Code	270649186
Hospital Revenue Code	272
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$1.51
Rate for Payer: Qualcare PPO/HMO/WC	$1.51

PACKING VAGINAL XRAY DETECT

Facility

$27.80

Hospital Charge Code	270600233
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$13.90
Rate for Payer: Aetna Commercial	$10.56
Rate for Payer: Aetna Medicare Advantage	$8.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.09
Rate for Payer: Cigna Commercial	$13.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.34
Rate for Payer: Oxford Commercial	$5.56
Rate for Payer: Qualcare PPO/HMO/WC	$4.17
Rate for Payer: UnitedHealthcare Commercial	$5.56
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

PACKING VAGINAL XRAY DETECT

Facility

$27.80

Hospital Charge Code	270600233
Hospital Revenue Code	272
Min. Negotiated Rate	$4.17
Max. Negotiated Rate	$4.17
Rate for Payer: Qualcare PPO/HMO/WC	$4.17

PACK KIT ENDOSCOPIC STERILE

Facility

$141.14

Hospital Charge Code	270688552
Hospital Revenue Code	272
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$70.57
Rate for Payer: Aetna Commercial	$53.63
Rate for Payer: Aetna Medicare Advantage	$42.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.99
Rate for Payer: Cigna Commercial	$70.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.34
Rate for Payer: Oxford Commercial	$28.23
Rate for Payer: Qualcare PPO/HMO/WC	$21.17
Rate for Payer: UnitedHealthcare Commercial	$28.23
Rate for Payer: UnitedHealthcare Community & State	$3.40
Rate for Payer: Wellpoint Medicaid Managed Care	$3.74

PACK KIT ENDOSCOPIC STERILE

Facility

$141.14

Hospital Charge Code	270688552
Hospital Revenue Code	272
Min. Negotiated Rate	$21.17
Max. Negotiated Rate	$21.17
Rate for Payer: Qualcare PPO/HMO/WC	$21.17

PACK KIT LAPAROSCOPIC CHOLE 2

Facility

$173.05

Hospital Charge Code	270688555
Hospital Revenue Code	272
Min. Negotiated Rate	$25.96
Max. Negotiated Rate	$25.96
Rate for Payer: Qualcare PPO/HMO/WC	$25.96

PACK KIT LAPAROSCOPIC CHOLE 2

Facility

$173.05

Hospital Charge Code	270688555
Hospital Revenue Code	272
Min. Negotiated Rate	$4.17
Max. Negotiated Rate	$86.53
Rate for Payer: Aetna Commercial	$65.76
Rate for Payer: Aetna Medicare Advantage	$51.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.13
Rate for Payer: Cigna Commercial	$86.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.91
Rate for Payer: Oxford Commercial	$34.61
Rate for Payer: Qualcare PPO/HMO/WC	$25.96
Rate for Payer: UnitedHealthcare Commercial	$34.61
Rate for Payer: UnitedHealthcare Community & State	$4.17
Rate for Payer: Wellpoint Medicaid Managed Care	$4.59

PACK KIT LAPAROSCOPY CHOLE I

Facility

$191.99

Hospital Charge Code	270688554
Hospital Revenue Code	272
Min. Negotiated Rate	$28.80
Max. Negotiated Rate	$28.80
Rate for Payer: Qualcare PPO/HMO/WC	$28.80

Know your out-of-pocket cost for care.

All Charges