Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PEGS DISTAL FEMORAL 183099

Facility

$1,045.00

Hospital Charge Code	270641309
Hospital Revenue Code	278
Min. Negotiated Rate	$156.75
Max. Negotiated Rate	$252.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$156.75

PEG SERIS A PAT STD 31

Facility

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690517
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

PEG SERIS A PAT STD 31

Facility

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690517
Hospital Revenue Code	278
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

PEGS GASTRODOME

Facility

$383.25

Hospital Charge Code	270603907
Hospital Revenue Code	270
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$191.62
Rate for Payer: Aetna Commercial	$145.63
Rate for Payer: Aetna Medicare Advantage	$114.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.73
Rate for Payer: Cigna Commercial	$191.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.97
Rate for Payer: Oxford Commercial	$76.65
Rate for Payer: Qualcare PPO/HMO/WC	$57.49
Rate for Payer: UnitedHealthcare Commercial	$76.65
Rate for Payer: UnitedHealthcare Community & State	$9.24
Rate for Payer: Wellpoint Medicaid Managed Care	$10.16

PEGS GASTRODOME

Facility

$383.25

Hospital Charge Code	270603907
Hospital Revenue Code	270
Min. Negotiated Rate	$57.49
Max. Negotiated Rate	$57.49
Rate for Payer: Qualcare PPO/HMO/WC	$57.49

PEG SHOULDER STAND 32.5 STP325

Facility

$238.15

Hospital Charge Code	270634958
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

PEG SHOULDER STAND 32.5 STP325

Facility

$238.15

Hospital Charge Code	270634958
Hospital Revenue Code	272
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$90.50
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.44
Rate for Payer: Oxford Commercial	$47.63
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$47.63
Rate for Payer: UnitedHealthcare Community & State	$5.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.31

PEG SHOULDER STAND 37.5 STP375

Facility

$238.15

Hospital Charge Code	270634960
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

PEG SHOULDER STAND 37.5 STP375

Facility

$238.15

Hospital Charge Code	270634960
Hospital Revenue Code	272
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$90.50
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.44
Rate for Payer: Oxford Commercial	$47.63
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$47.63
Rate for Payer: UnitedHealthcare Community & State	$5.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.31

PEG SHOULDER STANDARD 35 STP35

Facility

$238.15

Hospital Charge Code	270634959
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

PEG SHOULDER STANDARD 35 STP35

Facility

$238.15

Hospital Charge Code	270634959
Hospital Revenue Code	272
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$90.50
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.44
Rate for Payer: Oxford Commercial	$47.63
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$47.63
Rate for Payer: UnitedHealthcare Community & State	$5.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.31

PEG SHOULDER STANDARD 40 STP40

Facility

$238.15

Hospital Charge Code	270634961
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

PEG SHOULDER STANDARD 40 STP40

Facility

$238.15

Hospital Charge Code	270634961
Hospital Revenue Code	272
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$90.50
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.44
Rate for Payer: Oxford Commercial	$47.63
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$47.63
Rate for Payer: UnitedHealthcare Community & State	$5.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.31

PEG SHOULDER STANDARD 45 STP45

Facility

$238.15

Hospital Charge Code	270634962
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

PEG SHOULDER STANDARD 45 STP45

Facility

$238.15

Hospital Charge Code	270634962
Hospital Revenue Code	272
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$90.50
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.44
Rate for Payer: Oxford Commercial	$47.63
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$47.63
Rate for Payer: UnitedHealthcare Community & State	$5.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.31

PEG SHOUL STD 4.0X30.mSTP-30.0

Facility

$238.15

Hospital Charge Code	270636719
Hospital Revenue Code	272
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$90.50
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.44
Rate for Payer: Oxford Commercial	$47.63
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$47.63
Rate for Payer: UnitedHealthcare Community & State	$5.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.31

PEG SHOUL STD 4.0X30.mSTP-30.0

Facility

$238.15

Hospital Charge Code	270636719
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

PEG SHOUL STD 4.0X35.0mSTP35.0

Facility

$238.15

Hospital Charge Code	270636721
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

PEG SHOUL STD 4.0X35.0mSTP35.0

Facility

$238.15

Hospital Charge Code	270636721
Hospital Revenue Code	272
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$90.50
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.44
Rate for Payer: Oxford Commercial	$47.63
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$47.63
Rate for Payer: UnitedHealthcare Community & State	$5.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.31

PEG SHOUL STD 4.0X40.0mSTP40.0

Facility

$238.15

Hospital Charge Code	270636722
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

PEG SHOUL STD 4.0X40.0mSTP40.0

Facility

$238.15

Hospital Charge Code	270636722
Hospital Revenue Code	272
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$90.50
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.44
Rate for Payer: Oxford Commercial	$47.63
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$47.63
Rate for Payer: UnitedHealthcare Community & State	$5.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.31

PEG SHOUL STD 4.0X45.0mSTP45.0

Facility

$238.15

Hospital Charge Code	270636723
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

PEG SHOUL STD 4.0X45.0mSTP45.0

Facility

$238.15

Hospital Charge Code	270636723
Hospital Revenue Code	272
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$90.50
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.44
Rate for Payer: Oxford Commercial	$47.63
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$47.63
Rate for Payer: UnitedHealthcare Community & State	$5.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.31

PEG SMOOTH 2.0x16mm P-16

Facility

$347.25

Hospital Charge Code	270635658
Hospital Revenue Code	272
Min. Negotiated Rate	$52.09
Max. Negotiated Rate	$52.09
Rate for Payer: Qualcare PPO/HMO/WC	$52.09

PEG SMOOTH 2.0x16mm P-16

Facility

$347.25

Hospital Charge Code	270635658
Hospital Revenue Code	272
Min. Negotiated Rate	$8.37
Max. Negotiated Rate	$173.62
Rate for Payer: Aetna Commercial	$131.96
Rate for Payer: Aetna Medicare Advantage	$104.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.55
Rate for Payer: Cigna Commercial	$173.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.17
Rate for Payer: Oxford Commercial	$69.45
Rate for Payer: Qualcare PPO/HMO/WC	$52.09
Rate for Payer: UnitedHealthcare Commercial	$69.45
Rate for Payer: UnitedHealthcare Community & State	$8.37
Rate for Payer: Wellpoint Medicaid Managed Care	$9.20

Know your out-of-pocket cost for care.

All Charges