Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLEURX DRAINAGE KIT

Facility

$372.44

Service Code	HCPCS C1729
Hospital Charge Code	270629873
Hospital Revenue Code	278
Min. Negotiated Rate	$55.87
Max. Negotiated Rate	$90.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$81.94
Rate for Payer: Qualcare PPO/HMO/WC	$55.87

PLEURX DRAINAGE KIT

Facility

$372.44

Service Code	HCPCS C1729
Hospital Charge Code	270629873
Hospital Revenue Code	278
Min. Negotiated Rate	$8.98
Max. Negotiated Rate	$186.22
Rate for Payer: Aetna Commercial	$141.53
Rate for Payer: Aetna Medicare Advantage	$111.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.97
Rate for Payer: Cigna Commercial	$186.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$81.94
Rate for Payer: Qualcare PPO/HMO/WC	$55.87
Rate for Payer: UnitedHealthcare Community & State	$8.98
Rate for Payer: Wellpoint Medicaid Managed Care	$9.87

PLEURX PERITONEAL KIT

Facility

$6,073.60

Hospital Charge Code	270657046
Hospital Revenue Code	272
Min. Negotiated Rate	$911.04
Max. Negotiated Rate	$911.04
Rate for Payer: Qualcare PPO/HMO/WC	$911.04

PLEURX PERITONEAL KIT

Facility

$6,073.60

Hospital Charge Code	270657046
Hospital Revenue Code	272
Min. Negotiated Rate	$146.37
Max. Negotiated Rate	$3,036.80
Rate for Payer: Aetna Commercial	$2,307.97
Rate for Payer: Aetna Medicare Advantage	$1,822.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,548.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,548.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,548.77
Rate for Payer: Cigna Commercial	$3,036.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,822.08
Rate for Payer: Oxford Commercial	$1,214.72
Rate for Payer: Qualcare PPO/HMO/WC	$911.04
Rate for Payer: UnitedHealthcare Commercial	$1,214.72
Rate for Payer: UnitedHealthcare Community & State	$146.37
Rate for Payer: Wellpoint Medicaid Managed Care	$160.95

PLEURX PLEURAL CATH. & PATI

Facility

$4,125.00

Hospital Charge Code	270666217
Hospital Revenue Code	278
Min. Negotiated Rate	$618.75
Max. Negotiated Rate	$998.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$618.75

PLEURX PLEURAL CATH. & PATI

Facility

$4,125.00

Hospital Charge Code	270666217
Hospital Revenue Code	278
Min. Negotiated Rate	$99.41
Max. Negotiated Rate	$2,062.50
Rate for Payer: Aetna Commercial	$1,567.50
Rate for Payer: Aetna Medicare Advantage	$1,237.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,051.88
Rate for Payer: Cigna Commercial	$2,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$618.75
Rate for Payer: UnitedHealthcare Community & State	$99.41
Rate for Payer: Wellpoint Medicaid Managed Care	$109.31

PLEURX PLEURL CATH KIT 507000B

Facility

$2,625.00

Hospital Charge Code	270643278
Hospital Revenue Code	278
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$577.50
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

PLEURX PLEURL CATH KIT 507000B

Facility

$2,625.00

Hospital Charge Code	270643278
Hospital Revenue Code	278
Min. Negotiated Rate	$63.26
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$577.50
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Community & State	$63.26
Rate for Payer: Wellpoint Medicaid Managed Care	$69.56

PLICAMYCIN INJ 2.5MG

Facility

$591.40

Hospital Charge Code	6000194
Hospital Revenue Code	636
Min. Negotiated Rate	$88.71
Max. Negotiated Rate	$143.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.12
Rate for Payer: Qualcare PPO/HMO/WC	$88.71

PLICAMYCIN INJ 2.5MG

Facility

$394.96

Hospital Charge Code	60627405
Hospital Revenue Code	636
Min. Negotiated Rate	$59.24
Max. Negotiated Rate	$95.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.58
Rate for Payer: Qualcare PPO/HMO/WC	$59.24

PLICAMYCIN INJ 2.5MG

Facility

$591.40

Hospital Charge Code	6000194
Hospital Revenue Code	636
Min. Negotiated Rate	$14.25
Max. Negotiated Rate	$295.70
Rate for Payer: Aetna Commercial	$224.73
Rate for Payer: Aetna Medicare Advantage	$177.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.81
Rate for Payer: Cigna Commercial	$295.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.12
Rate for Payer: Qualcare PPO/HMO/WC	$88.71
Rate for Payer: UnitedHealthcare Community & State	$14.25
Rate for Payer: Wellpoint Medicaid Managed Care	$15.67

PLICAMYCIN INJ 2.5MG

Facility

$394.96

Hospital Charge Code	60627405
Hospital Revenue Code	636
Min. Negotiated Rate	$9.52
Max. Negotiated Rate	$197.48
Rate for Payer: Aetna Commercial	$150.08
Rate for Payer: Aetna Medicare Advantage	$118.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.71
Rate for Payer: Cigna Commercial	$197.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.58
Rate for Payer: Qualcare PPO/HMO/WC	$59.24
Rate for Payer: UnitedHealthcare Community & State	$9.52
Rate for Payer: Wellpoint Medicaid Managed Care	$10.47

PLIERS BENDING 2.7/3.5MM PLATE

Facility

$6,550.80

Hospital Charge Code	270626577
Hospital Revenue Code	272
Min. Negotiated Rate	$157.87
Max. Negotiated Rate	$3,275.40
Rate for Payer: Aetna Commercial	$2,489.30
Rate for Payer: Aetna Medicare Advantage	$1,965.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,670.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,670.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,670.45
Rate for Payer: Cigna Commercial	$3,275.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,965.24
Rate for Payer: Oxford Commercial	$1,310.16
Rate for Payer: Qualcare PPO/HMO/WC	$982.62
Rate for Payer: UnitedHealthcare Commercial	$1,310.16
Rate for Payer: UnitedHealthcare Community & State	$157.87
Rate for Payer: Wellpoint Medicaid Managed Care	$173.60

PLIERS BENDING 2.7/3.5MM PLATE

Facility

$6,550.80

Hospital Charge Code	270626577
Hospital Revenue Code	272
Min. Negotiated Rate	$982.62
Max. Negotiated Rate	$982.62
Rate for Payer: Qualcare PPO/HMO/WC	$982.62

PLIERS BND 2.7/3.5MM RCN PLATE

Facility

$4,887.00

Hospital Charge Code	270676250
Hospital Revenue Code	272
Min. Negotiated Rate	$733.05
Max. Negotiated Rate	$733.05
Rate for Payer: Qualcare PPO/HMO/WC	$733.05

PLIERS BND 2.7/3.5MM RCN PLATE

Facility

$4,887.00

Hospital Charge Code	270676250
Hospital Revenue Code	272
Min. Negotiated Rate	$117.78
Max. Negotiated Rate	$2,443.50
Rate for Payer: Aetna Commercial	$1,857.06
Rate for Payer: Aetna Medicare Advantage	$1,466.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,246.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,246.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,246.18
Rate for Payer: Cigna Commercial	$2,443.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,466.10
Rate for Payer: Oxford Commercial	$977.40
Rate for Payer: Qualcare PPO/HMO/WC	$733.05
Rate for Payer: UnitedHealthcare Commercial	$977.40
Rate for Payer: UnitedHealthcare Community & State	$117.78
Rate for Payer: Wellpoint Medicaid Managed Care	$129.51

PLIERS WIRE BENDING 155mm

Facility

$2,178.45

Hospital Charge Code	270614778
Hospital Revenue Code	272
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$1,089.22
Rate for Payer: Aetna Commercial	$827.81
Rate for Payer: Aetna Medicare Advantage	$653.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$555.50
Rate for Payer: Cigna Commercial	$1,089.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.53
Rate for Payer: Oxford Commercial	$435.69
Rate for Payer: Qualcare PPO/HMO/WC	$326.77
Rate for Payer: UnitedHealthcare Commercial	$435.69
Rate for Payer: UnitedHealthcare Community & State	$52.50
Rate for Payer: Wellpoint Medicaid Managed Care	$57.73

PLIERS WIRE BENDING 155mm

Facility

$2,178.45

Hospital Charge Code	270614778
Hospital Revenue Code	272
Min. Negotiated Rate	$326.77
Max. Negotiated Rate	$326.77
Rate for Payer: Qualcare PPO/HMO/WC	$326.77

PLIER UNIVERAL BENDING

Facility

$1,995.55

Hospital Charge Code	270680934
Hospital Revenue Code	272
Min. Negotiated Rate	$48.09
Max. Negotiated Rate	$997.77
Rate for Payer: Aetna Commercial	$758.31
Rate for Payer: Aetna Medicare Advantage	$598.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$508.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$508.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$508.87
Rate for Payer: Cigna Commercial	$997.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.66
Rate for Payer: Oxford Commercial	$399.11
Rate for Payer: Qualcare PPO/HMO/WC	$299.33
Rate for Payer: UnitedHealthcare Commercial	$399.11
Rate for Payer: UnitedHealthcare Community & State	$48.09
Rate for Payer: Wellpoint Medicaid Managed Care	$52.88

PLIER UNIVERAL BENDING

Facility

$1,995.55

Hospital Charge Code	270680934
Hospital Revenue Code	272
Min. Negotiated Rate	$299.33
Max. Negotiated Rate	$299.33
Rate for Payer: Qualcare PPO/HMO/WC	$299.33

PLIF LIGHT

Facility

$3,260.00

Hospital Charge Code	270658005
Hospital Revenue Code	278
Min. Negotiated Rate	$78.57
Max. Negotiated Rate	$1,630.00
Rate for Payer: Aetna Commercial	$1,238.80
Rate for Payer: Aetna Medicare Advantage	$978.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$831.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$831.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$652.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$831.30
Rate for Payer: Cigna Commercial	$1,630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$788.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$717.20
Rate for Payer: Qualcare PPO/HMO/WC	$489.00
Rate for Payer: UnitedHealthcare Community & State	$78.57
Rate for Payer: Wellpoint Medicaid Managed Care	$86.39

PLIF LIGHT

Facility

$3,260.00

Hospital Charge Code	270658005
Hospital Revenue Code	278
Min. Negotiated Rate	$489.00
Max. Negotiated Rate	$788.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$652.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$788.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$717.20
Rate for Payer: Qualcare PPO/HMO/WC	$489.00

PLI KIT PRELUDE SNAP 7FR

Facility

$325.00

Hospital Charge Code	270701742
Hospital Revenue Code	440
Min. Negotiated Rate	$7.83
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$123.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$7.83
Rate for Payer: Wellpoint Medicaid Managed Care	$8.61

PLI KIT PRELUDE SNAP 7FR

Facility

$325.00

Hospital Charge Code	270701742
Hospital Revenue Code	440
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

PLI KIT SSL7 SAFESHEATH 9FR 2

Facility

$365.00

Hospital Charge Code	270690420
Hospital Revenue Code	272
Min. Negotiated Rate	$8.80
Max. Negotiated Rate	$182.50
Rate for Payer: Aetna Commercial	$138.70
Rate for Payer: Aetna Medicare Advantage	$109.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.08
Rate for Payer: Cigna Commercial	$182.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.50
Rate for Payer: Oxford Commercial	$73.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.75
Rate for Payer: UnitedHealthcare Commercial	$73.00
Rate for Payer: UnitedHealthcare Community & State	$8.80
Rate for Payer: Wellpoint Medicaid Managed Care	$9.67

Know your out-of-pocket cost for care.

All Charges