Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PAD MATRIX TRI/LAYER 3x3.5CM

Facility

$787.50

Service Code	HCPCS Q4102
Hospital Charge Code	270675286
Hospital Revenue Code	278
Min. Negotiated Rate	$118.12
Max. Negotiated Rate	$190.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$173.25
Rate for Payer: Qualcare PPO/HMO/WC	$118.12

PAD MATRIX TRI/LAYER 3x3.5CM

Facility

$787.50

Service Code	HCPCS Q4102
Hospital Charge Code	270675286
Hospital Revenue Code	278
Min. Negotiated Rate	$18.98
Max. Negotiated Rate	$533.66
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$533.66
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$173.25
Rate for Payer: Qualcare PPO/HMO/WC	$118.12
Rate for Payer: UnitedHealthcare Community & State	$18.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$20.87

PAD MATRIX TRI/LAYER 3x7CM

Facility

$1,417.50

Hospital Charge Code	270681360
Hospital Revenue Code	272
Min. Negotiated Rate	$212.62
Max. Negotiated Rate	$212.62
Rate for Payer: Qualcare PPO/HMO/WC	$212.62

PAD MATRIX TRI/LAYER 3x7CM

Facility

$1,417.50

Hospital Charge Code	270681360
Hospital Revenue Code	272
Min. Negotiated Rate	$34.16
Max. Negotiated Rate	$708.75
Rate for Payer: Aetna Commercial	$538.65
Rate for Payer: Aetna Medicare Advantage	$425.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$361.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$361.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$361.46
Rate for Payer: Cigna Commercial	$708.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.25
Rate for Payer: Oxford Commercial	$283.50
Rate for Payer: Qualcare PPO/HMO/WC	$212.62
Rate for Payer: UnitedHealthcare Commercial	$283.50
Rate for Payer: UnitedHealthcare Community & State	$34.16
Rate for Payer: Wellpoint Medicaid Managed Care	$37.56

PAD MATRIX TRILYR 5x7CM

Facility

$1,606.20

Service Code	HCPCS Q4124
Hospital Charge Code	270675194
Hospital Revenue Code	278
Min. Negotiated Rate	$38.71
Max. Negotiated Rate	$533.66
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$321.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$533.66
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$388.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$353.36
Rate for Payer: Qualcare PPO/HMO/WC	$240.93
Rate for Payer: UnitedHealthcare Community & State	$38.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$42.56

PAD MATRIX TRILYR 5x7CM

Facility

$1,606.20

Service Code	HCPCS Q4124
Hospital Charge Code	270675194
Hospital Revenue Code	278
Min. Negotiated Rate	$240.93
Max. Negotiated Rate	$388.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$321.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$388.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$353.36
Rate for Payer: Qualcare PPO/HMO/WC	$240.93

PAD MATRIX TRILYR 5x7CM/SQCMJW

Facility

$45.43

Hospital Charge Code	270675194W
Hospital Revenue Code	636
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$22.71
Rate for Payer: Aetna Commercial	$17.26
Rate for Payer: Aetna Medicare Advantage	$13.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.58
Rate for Payer: Cigna Commercial	$22.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.99
Rate for Payer: Qualcare PPO/HMO/WC	$6.81
Rate for Payer: UnitedHealthcare Community & State	$1.09
Rate for Payer: Wellpoint Medicaid Managed Care	$1.20

PAD MATRIX TRILYR 5x7CM/SQCMJW

Facility

$45.43

Hospital Charge Code	270675194W
Hospital Revenue Code	636
Min. Negotiated Rate	$6.81
Max. Negotiated Rate	$10.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.99
Rate for Payer: Qualcare PPO/HMO/WC	$6.81

PAD MESSY MONITORING SPLIT W/

Facility

$29.65

Hospital Charge Code	270607683
Hospital Revenue Code	270
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$4.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.45

PAD MESSY MONITORING SPLIT W/

Facility

$29.65

Hospital Charge Code	270607683
Hospital Revenue Code	270
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$14.82
Rate for Payer: Aetna Commercial	$11.27
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.56
Rate for Payer: Cigna Commercial	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.89
Rate for Payer: Oxford Commercial	$5.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.45
Rate for Payer: UnitedHealthcare Commercial	$5.93
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

PAD MICROCINATE BODY STANDARD

Facility

$16.40

Hospital Charge Code	270675834
Hospital Revenue Code	272
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$2.46
Rate for Payer: Qualcare PPO/HMO/WC	$2.46

PAD MICROCINATE BODY STANDARD

Facility

$16.40

Hospital Charge Code	270675834
Hospital Revenue Code	272
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$8.20
Rate for Payer: Aetna Commercial	$6.23
Rate for Payer: Aetna Medicare Advantage	$4.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.18
Rate for Payer: Cigna Commercial	$8.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.92
Rate for Payer: Oxford Commercial	$3.28
Rate for Payer: Qualcare PPO/HMO/WC	$2.46
Rate for Payer: UnitedHealthcare Commercial	$3.28
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

PAD MICRO-TEMP

Facility

$23.75

Hospital Charge Code	270301311
Hospital Revenue Code	270
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.88
Rate for Payer: Aetna Commercial	$9.03
Rate for Payer: Aetna Medicare Advantage	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.06
Rate for Payer: Cigna Commercial	$11.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.12
Rate for Payer: Oxford Commercial	$4.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.56
Rate for Payer: UnitedHealthcare Commercial	$4.75
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.63

PAD MICRO-TEMP

Facility

$23.75

Hospital Charge Code	270301311
Hospital Revenue Code	270
Min. Negotiated Rate	$3.56
Max. Negotiated Rate	$3.56
Rate for Payer: Qualcare PPO/HMO/WC	$3.56

PAD MTRX TRILYR 3x3.5CM/SQCMJW

Facility

$75.00

Hospital Charge Code	270675286W
Hospital Revenue Code	636
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

PAD MTRX TRILYR 3x3.5CM/SQCMJW

Facility

$75.00

Hospital Charge Code	270675286W
Hospital Revenue Code	636
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$18.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

PAD NAIL POLISH REMOVER

Facility

$0.01

Hospital Charge Code	270649193
Hospital Revenue Code	270
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) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

PAD NAIL POLISH REMOVER

Facility

$0.01

Hospital Charge Code	270649193
Hospital Revenue Code	270
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

PAD NASAL GECKO LARGE

Facility

$74.75

Hospital Charge Code	270646855
Hospital Revenue Code	272
Min. Negotiated Rate	$11.21
Max. Negotiated Rate	$11.21
Rate for Payer: Qualcare PPO/HMO/WC	$11.21

PAD NASAL GECKO LARGE

Facility

$74.75

Hospital Charge Code	270646855
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$37.38
Rate for Payer: Aetna Commercial	$28.41
Rate for Payer: Aetna Medicare Advantage	$22.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.06
Rate for Payer: Cigna Commercial	$37.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.43
Rate for Payer: Oxford Commercial	$14.95
Rate for Payer: Qualcare PPO/HMO/WC	$11.21
Rate for Payer: UnitedHealthcare Commercial	$14.95
Rate for Payer: UnitedHealthcare Community & State	$1.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1.98

PAD NURSING

Facility

$0.36

Hospital Charge Code	270649195
Hospital Revenue Code	270
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.18
Rate for Payer: Aetna Commercial	$0.14
Rate for Payer: Aetna Medicare Advantage	$0.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.09
Rate for Payer: Cigna Commercial	$0.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.11
Rate for Payer: Oxford Commercial	$0.07
Rate for Payer: Qualcare PPO/HMO/WC	$0.05
Rate for Payer: UnitedHealthcare Commercial	$0.07
Rate for Payer: UnitedHealthcare Community & State	$0.01
Rate for Payer: Wellpoint Medicaid Managed Care	$0.01

PAD NURSING

Facility

$0.36

Hospital Charge Code	270649195
Hospital Revenue Code	270
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.05
Rate for Payer: Qualcare PPO/HMO/WC	$0.05

PAD NURSING BRA

Facility

$4.85

Hospital Charge Code	270130125
Hospital Revenue Code	272
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$0.73
Rate for Payer: Qualcare PPO/HMO/WC	$0.73

PAD NURSING BRA

Facility

$4.85

Hospital Charge Code	270130125
Hospital Revenue Code	272
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.42
Rate for Payer: Aetna Commercial	$1.84
Rate for Payer: Aetna Medicare Advantage	$1.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.24
Rate for Payer: Cigna Commercial	$2.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.73
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

PAD OB IND WRAP N/STER 11

Facility

$5.25

Hospital Charge Code	270651642
Hospital Revenue Code	270
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$0.79
Rate for Payer: Qualcare PPO/HMO/WC	$0.79

Know your out-of-pocket cost for care.

All Charges