Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PASSER SUTURE STRAIGHT

Facility

$1,655.00

Hospital Charge Code	270613181
Hospital Revenue Code	272
Min. Negotiated Rate	$248.25
Max. Negotiated Rate	$248.25
Rate for Payer: Qualcare PPO/HMO/WC	$248.25

PASSPORT 8MM X 4

Facility

$160.00

Hospital Charge Code	270667982
Hospital Revenue Code	270
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$60.80
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.00
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$32.00
Rate for Payer: UnitedHealthcare Community & State	$3.86
Rate for Payer: Wellpoint Medicaid Managed Care	$4.24

PASSPORT 8MM X 4

Facility

$160.00

Hospital Charge Code	270667982
Hospital Revenue Code	270
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

PASSPORT BUTTON CANNULA

Facility

$160.00

Hospital Charge Code	270684275
Hospital Revenue Code	272
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

PASSPORT BUTTON CANNULA

Facility

$160.00

Hospital Charge Code	270684275
Hospital Revenue Code	272
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$60.80
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.00
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$32.00
Rate for Payer: UnitedHealthcare Community & State	$3.86
Rate for Payer: Wellpoint Medicaid Managed Care	$4.24

PASS ZIM WIRE 1.5 19MM 5091248

Facility

$328.85

Hospital Charge Code	270601269
Hospital Revenue Code	272
Min. Negotiated Rate	$49.33
Max. Negotiated Rate	$49.33
Rate for Payer: Qualcare PPO/HMO/WC	$49.33

PASS ZIM WIRE 1.5 19MM 5091248

Facility

$328.85

Hospital Charge Code	270601269
Hospital Revenue Code	272
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$164.43
Rate for Payer: Aetna Commercial	$124.96
Rate for Payer: Aetna Medicare Advantage	$98.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.86
Rate for Payer: Cigna Commercial	$164.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.66
Rate for Payer: Oxford Commercial	$65.77
Rate for Payer: Qualcare PPO/HMO/WC	$49.33
Rate for Payer: UnitedHealthcare Commercial	$65.77
Rate for Payer: UnitedHealthcare Community & State	$7.93
Rate for Payer: Wellpoint Medicaid Managed Care	$8.71

PASS ZIM WIRE 1.O 19MM 5091247

Facility

$1,396.00

Hospital Charge Code	270601028
Hospital Revenue Code	272
Min. Negotiated Rate	$33.64
Max. Negotiated Rate	$698.00
Rate for Payer: Aetna Commercial	$530.48
Rate for Payer: Aetna Medicare Advantage	$418.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.98
Rate for Payer: Cigna Commercial	$698.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$418.80
Rate for Payer: Oxford Commercial	$279.20
Rate for Payer: Qualcare PPO/HMO/WC	$209.40
Rate for Payer: UnitedHealthcare Commercial	$279.20
Rate for Payer: UnitedHealthcare Community & State	$33.64
Rate for Payer: Wellpoint Medicaid Managed Care	$36.99

PASS ZIM WIRE 1.O 19MM 5091247

Facility

$1,396.00

Hospital Charge Code	270601028
Hospital Revenue Code	272
Min. Negotiated Rate	$209.40
Max. Negotiated Rate	$209.40
Rate for Payer: Qualcare PPO/HMO/WC	$209.40

PASTE BMT ORTHBLAST 3CC 200003

Facility

$2,261.65

Hospital Charge Code	270619714
Hospital Revenue Code	278
Min. Negotiated Rate	$54.51
Max. Negotiated Rate	$1,130.83
Rate for Payer: Aetna Commercial	$859.43
Rate for Payer: Aetna Medicare Advantage	$678.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$576.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$576.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$452.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$576.72
Rate for Payer: Cigna Commercial	$1,130.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$547.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$497.56
Rate for Payer: Qualcare PPO/HMO/WC	$339.25
Rate for Payer: UnitedHealthcare Community & State	$54.51
Rate for Payer: Wellpoint Medicaid Managed Care	$59.93

PASTE BMT ORTHBLAST 3CC 200003

Facility

$2,261.65

Hospital Charge Code	270619714
Hospital Revenue Code	278
Min. Negotiated Rate	$339.25
Max. Negotiated Rate	$547.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$452.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$547.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$497.56
Rate for Payer: Qualcare PPO/HMO/WC	$339.25

PASTE OSTOMY STRIP

Facility

$4.02

Hospital Charge Code	270650471
Hospital Revenue Code	270
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PASTE OSTOMY STRIP

Facility

$4.02

Hospital Charge Code	270650471
Hospital Revenue Code	270
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.01
Rate for Payer: Aetna Commercial	$1.53
Rate for Payer: Aetna Medicare Advantage	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.03
Rate for Payer: Cigna Commercial	$2.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.21
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

PASTE POLYTEF INJ 7ML 22-7000

Facility

$3,180.85

Hospital Charge Code	270616154
Hospital Revenue Code	272
Min. Negotiated Rate	$76.66
Max. Negotiated Rate	$1,590.42
Rate for Payer: Aetna Commercial	$1,208.72
Rate for Payer: Aetna Medicare Advantage	$954.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$811.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$811.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$811.12
Rate for Payer: Cigna Commercial	$1,590.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$954.25
Rate for Payer: Oxford Commercial	$636.17
Rate for Payer: Qualcare PPO/HMO/WC	$477.13
Rate for Payer: UnitedHealthcare Commercial	$636.17
Rate for Payer: UnitedHealthcare Community & State	$76.66
Rate for Payer: Wellpoint Medicaid Managed Care	$84.29

PASTE POLYTEF INJ 7ML 22-7000

Facility

$3,180.85

Hospital Charge Code	270616154
Hospital Revenue Code	272
Min. Negotiated Rate	$477.13
Max. Negotiated Rate	$477.13
Rate for Payer: Qualcare PPO/HMO/WC	$477.13

PASTE PROTECTANT CALAZIME 4oz

Facility

$21.68

Hospital Charge Code	270650073
Hospital Revenue Code	270
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$10.84
Rate for Payer: Aetna Commercial	$8.24
Rate for Payer: Aetna Medicare Advantage	$6.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.53
Rate for Payer: Cigna Commercial	$10.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$4.34
Rate for Payer: Qualcare PPO/HMO/WC	$3.25
Rate for Payer: UnitedHealthcare Commercial	$4.34
Rate for Payer: UnitedHealthcare Community & State	$0.52
Rate for Payer: Wellpoint Medicaid Managed Care	$0.57

PASTE PROTECTANT CALAZIME 4oz

Facility

$21.68

Hospital Charge Code	270650073
Hospital Revenue Code	270
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$3.25
Rate for Payer: Qualcare PPO/HMO/WC	$3.25

PASTE REME CALAZ 4OZ MSC094544

Facility

$25.00

Hospital Charge Code	270640977W
Hospital Revenue Code	272
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

PASTE REME CALAZ 4OZ MSC094544

Facility

$21.75

Hospital Charge Code	270640977
Hospital Revenue Code	272
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$10.88
Rate for Payer: Aetna Commercial	$8.27
Rate for Payer: Aetna Medicare Advantage	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.55
Rate for Payer: Cigna Commercial	$10.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.53
Rate for Payer: Oxford Commercial	$4.35
Rate for Payer: Qualcare PPO/HMO/WC	$3.26
Rate for Payer: UnitedHealthcare Commercial	$4.35
Rate for Payer: UnitedHealthcare Community & State	$0.52
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

PASTE REME CALAZ 4OZ MSC094544

Facility

$21.75

Hospital Charge Code	270640977
Hospital Revenue Code	272
Min. Negotiated Rate	$3.26
Max. Negotiated Rate	$3.26
Rate for Payer: Qualcare PPO/HMO/WC	$3.26

PASTE REME CALAZ 4OZ MSC094544

Facility

$25.00

Hospital Charge Code	270640977W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

PASTE REMEDY CALAZIME MSC09454

Facility

$21.00

Hospital Charge Code	270302490
Hospital Revenue Code	270
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

PASTE REMEDY CALAZIME MSC09454

Facility

$21.00

Hospital Charge Code	270302490
Hospital Revenue Code	270
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

PASTE STOMAHESIVE

Facility

$54.45

Hospital Charge Code	270303176
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$27.23
Rate for Payer: Aetna Commercial	$20.69
Rate for Payer: Aetna Medicare Advantage	$16.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.88
Rate for Payer: Cigna Commercial	$27.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.34
Rate for Payer: Oxford Commercial	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$8.17
Rate for Payer: UnitedHealthcare Commercial	$10.89
Rate for Payer: UnitedHealthcare Community & State	$1.31
Rate for Payer: Wellpoint Medicaid Managed Care	$1.44

PASTE STOMAHESIVE

Facility

$54.45

Hospital Charge Code	270303176
Hospital Revenue Code	272
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$8.17

Know your out-of-pocket cost for care.

All Charges