Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PROBE RECTAL ADULT DISPOSABLES

Facility

$27.50

Hospital Charge Code	270665987
Hospital Revenue Code	270
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$13.75
Rate for Payer: Aetna Commercial	$10.45
Rate for Payer: Aetna Medicare Advantage	$8.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.01
Rate for Payer: Cigna Commercial	$13.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.25
Rate for Payer: Oxford Commercial	$5.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.12
Rate for Payer: UnitedHealthcare Commercial	$5.50
Rate for Payer: UnitedHealthcare Community & State	$0.66
Rate for Payer: Wellpoint Medicaid Managed Care	$0.73

PROBE RECTAL ADULT DISPOSABLES

Facility

$27.50

Hospital Charge Code	270665987
Hospital Revenue Code	270
Min. Negotiated Rate	$4.12
Max. Negotiated Rate	$4.12
Rate for Payer: Qualcare PPO/HMO/WC	$4.12

PROBE RECTAL PT ADULT REUSABLE

Facility

$315.00

Hospital Charge Code	270665986
Hospital Revenue Code	270
Min. Negotiated Rate	$7.59
Max. Negotiated Rate	$157.50
Rate for Payer: Aetna Commercial	$119.70
Rate for Payer: Aetna Medicare Advantage	$94.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.33
Rate for Payer: Cigna Commercial	$157.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.50
Rate for Payer: Oxford Commercial	$63.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.25
Rate for Payer: UnitedHealthcare Commercial	$63.00
Rate for Payer: UnitedHealthcare Community & State	$7.59
Rate for Payer: Wellpoint Medicaid Managed Care	$8.35

PROBE RECTAL PT ADULT REUSABLE

Facility

$315.00

Hospital Charge Code	270665986
Hospital Revenue Code	270
Min. Negotiated Rate	$47.25
Max. Negotiated Rate	$47.25
Rate for Payer: Qualcare PPO/HMO/WC	$47.25

PROBE RESUABLE ADAPTER

Facility

$107.50

Hospital Charge Code	270669533
Hospital Revenue Code	272
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$53.75
Rate for Payer: Aetna Commercial	$40.85
Rate for Payer: Aetna Medicare Advantage	$32.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.41
Rate for Payer: Cigna Commercial	$53.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.25
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.12
Rate for Payer: UnitedHealthcare Commercial	$21.50
Rate for Payer: UnitedHealthcare Community & State	$2.59
Rate for Payer: Wellpoint Medicaid Managed Care	$2.85

PROBE RESUABLE ADAPTER

Facility

$107.50

Hospital Charge Code	270669533
Hospital Revenue Code	272
Min. Negotiated Rate	$16.12
Max. Negotiated Rate	$16.12
Rate for Payer: Qualcare PPO/HMO/WC	$16.12

PROBE RF2 SERFAS AARDVARK

Facility

$828.75

Hospital Charge Code	270640815
Hospital Revenue Code	272
Min. Negotiated Rate	$19.97
Max. Negotiated Rate	$414.38
Rate for Payer: Aetna Commercial	$314.93
Rate for Payer: Aetna Medicare Advantage	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.33
Rate for Payer: Cigna Commercial	$414.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.62
Rate for Payer: Oxford Commercial	$165.75
Rate for Payer: Qualcare PPO/HMO/WC	$124.31
Rate for Payer: UnitedHealthcare Commercial	$165.75
Rate for Payer: UnitedHealthcare Community & State	$19.97
Rate for Payer: Wellpoint Medicaid Managed Care	$21.96

PROBE RF2 SERFAS AARDVARK

Facility

$828.75

Hospital Charge Code	270640815
Hospital Revenue Code	272
Min. Negotiated Rate	$124.31
Max. Negotiated Rate	$124.31
Rate for Payer: Qualcare PPO/HMO/WC	$124.31

PROBE RF2 SERFAS HOOK279650501

Facility

$828.75

Hospital Charge Code	270640814
Hospital Revenue Code	272
Min. Negotiated Rate	$124.31
Max. Negotiated Rate	$124.31
Rate for Payer: Qualcare PPO/HMO/WC	$124.31

PROBE RF2 SERFAS HOOK279650501

Facility

$828.75

Hospital Charge Code	270640814
Hospital Revenue Code	272
Min. Negotiated Rate	$19.97
Max. Negotiated Rate	$414.38
Rate for Payer: Aetna Commercial	$314.93
Rate for Payer: Aetna Medicare Advantage	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.33
Rate for Payer: Cigna Commercial	$414.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.62
Rate for Payer: Oxford Commercial	$165.75
Rate for Payer: Qualcare PPO/HMO/WC	$124.31
Rate for Payer: UnitedHealthcare Commercial	$165.75
Rate for Payer: UnitedHealthcare Community & State	$19.97
Rate for Payer: Wellpoint Medicaid Managed Care	$21.96

PROBE RF ABLATION DUAL 10MM

Facility

$21,075.00

Hospital Charge Code	270686421
Hospital Revenue Code	272
Min. Negotiated Rate	$507.91
Max. Negotiated Rate	$10,537.50
Rate for Payer: Aetna Commercial	$8,008.50
Rate for Payer: Aetna Medicare Advantage	$6,322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,374.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,374.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,374.12
Rate for Payer: Cigna Commercial	$10,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,322.50
Rate for Payer: Oxford Commercial	$4,215.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,161.25
Rate for Payer: UnitedHealthcare Commercial	$4,215.00
Rate for Payer: UnitedHealthcare Community & State	$507.91
Rate for Payer: Wellpoint Medicaid Managed Care	$558.49

PROBE RF ABLATION DUAL 10MM

Facility

$21,075.00

Hospital Charge Code	270686421O
Hospital Revenue Code	272
Min. Negotiated Rate	$3,161.25
Max. Negotiated Rate	$3,161.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,161.25

PROBE RF ABLATION DUAL 10MM

Facility

$21,075.00

Hospital Charge Code	270686421O
Hospital Revenue Code	272
Min. Negotiated Rate	$507.91
Max. Negotiated Rate	$10,537.50
Rate for Payer: Aetna Commercial	$8,008.50
Rate for Payer: Aetna Medicare Advantage	$6,322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,374.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,374.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,374.12
Rate for Payer: Cigna Commercial	$10,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,322.50
Rate for Payer: Oxford Commercial	$4,215.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,161.25
Rate for Payer: UnitedHealthcare Commercial	$4,215.00
Rate for Payer: UnitedHealthcare Community & State	$507.91
Rate for Payer: Wellpoint Medicaid Managed Care	$558.49

PROBE RF ABLATION DUAL 10MM

Facility

$21,075.00

Hospital Charge Code	270686421
Hospital Revenue Code	272
Min. Negotiated Rate	$3,161.25
Max. Negotiated Rate	$3,161.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,161.25

PROBE RF ABLATION SINGLE 7MM

Facility

$14,575.00

Hospital Charge Code	270683887O
Hospital Revenue Code	272
Min. Negotiated Rate	$351.26
Max. Negotiated Rate	$7,287.50
Rate for Payer: Aetna Commercial	$5,538.50
Rate for Payer: Aetna Medicare Advantage	$4,372.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,716.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,716.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,716.62
Rate for Payer: Cigna Commercial	$7,287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,372.50
Rate for Payer: Oxford Commercial	$2,915.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,186.25
Rate for Payer: UnitedHealthcare Commercial	$2,915.00
Rate for Payer: UnitedHealthcare Community & State	$351.26
Rate for Payer: Wellpoint Medicaid Managed Care	$386.24

PROBE RF ABLATION SINGLE 7MM

Facility

$14,575.00

Hospital Charge Code	270683887O
Hospital Revenue Code	272
Min. Negotiated Rate	$2,186.25
Max. Negotiated Rate	$2,186.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,186.25

PROBE RF ABLATION SINGLE 7MM

Facility

$14,575.00

Hospital Charge Code	270683887
Hospital Revenue Code	272
Min. Negotiated Rate	$351.26
Max. Negotiated Rate	$7,287.50
Rate for Payer: Aetna Commercial	$5,538.50
Rate for Payer: Aetna Medicare Advantage	$4,372.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,716.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,716.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,716.62
Rate for Payer: Cigna Commercial	$7,287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,372.50
Rate for Payer: Oxford Commercial	$2,915.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,186.25
Rate for Payer: UnitedHealthcare Commercial	$2,915.00
Rate for Payer: UnitedHealthcare Community & State	$351.26
Rate for Payer: Wellpoint Medicaid Managed Care	$386.24

PROBE RF ABLATION SINGLE 7MM

Facility

$14,575.00

Hospital Charge Code	270683887
Hospital Revenue Code	272
Min. Negotiated Rate	$2,186.25
Max. Negotiated Rate	$2,186.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,186.25

PROBE SAFEOP STIM. BALL TIP

Facility

$4,468.75

Hospital Charge Code	270698068
Hospital Revenue Code	272
Min. Negotiated Rate	$107.70
Max. Negotiated Rate	$2,234.38
Rate for Payer: Aetna Commercial	$1,698.12
Rate for Payer: Aetna Medicare Advantage	$1,340.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,139.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,139.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,139.53
Rate for Payer: Cigna Commercial	$2,234.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,340.62
Rate for Payer: Oxford Commercial	$893.75
Rate for Payer: Qualcare PPO/HMO/WC	$670.31
Rate for Payer: UnitedHealthcare Commercial	$893.75
Rate for Payer: UnitedHealthcare Community & State	$107.70
Rate for Payer: Wellpoint Medicaid Managed Care	$118.42

PROBE SAFEOP STIM. BALL TIP

Facility

$4,468.75

Hospital Charge Code	270698068
Hospital Revenue Code	272
Min. Negotiated Rate	$670.31
Max. Negotiated Rate	$670.31
Rate for Payer: Qualcare PPO/HMO/WC	$670.31

PROBE SERAFS 50-S SUPER

Facility

$640.60

Hospital Charge Code	270677430
Hospital Revenue Code	272
Min. Negotiated Rate	$15.44
Max. Negotiated Rate	$320.30
Rate for Payer: Aetna Commercial	$243.43
Rate for Payer: Aetna Medicare Advantage	$192.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.35
Rate for Payer: Cigna Commercial	$320.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.18
Rate for Payer: Oxford Commercial	$128.12
Rate for Payer: Qualcare PPO/HMO/WC	$96.09
Rate for Payer: UnitedHealthcare Commercial	$128.12
Rate for Payer: UnitedHealthcare Community & State	$15.44
Rate for Payer: Wellpoint Medicaid Managed Care	$16.98

PROBE SERAFS 50-S SUPER

Facility

$640.60

Hospital Charge Code	270677430
Hospital Revenue Code	272
Min. Negotiated Rate	$96.09
Max. Negotiated Rate	$96.09
Rate for Payer: Qualcare PPO/HMO/WC	$96.09

PROBE SERF 90-S SUPER279351300

Facility

$845.10

Hospital Charge Code	270641986
Hospital Revenue Code	272
Min. Negotiated Rate	$20.37
Max. Negotiated Rate	$422.55
Rate for Payer: Aetna Commercial	$321.14
Rate for Payer: Aetna Medicare Advantage	$253.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$215.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$215.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$215.50
Rate for Payer: Cigna Commercial	$422.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.53
Rate for Payer: Oxford Commercial	$169.02
Rate for Payer: Qualcare PPO/HMO/WC	$126.77
Rate for Payer: UnitedHealthcare Commercial	$169.02
Rate for Payer: UnitedHealthcare Community & State	$20.37
Rate for Payer: Wellpoint Medicaid Managed Care	$22.40

PROBE SERF 90-S SUPER279351300

Facility

$845.10

Hospital Charge Code	270641986
Hospital Revenue Code	272
Min. Negotiated Rate	$126.77
Max. Negotiated Rate	$126.77
Rate for Payer: Qualcare PPO/HMO/WC	$126.77

PROBE SERF 90 W/SUCT 278510500

Facility

$813.65

Hospital Charge Code	270629736
Hospital Revenue Code	272
Min. Negotiated Rate	$122.05
Max. Negotiated Rate	$122.05
Rate for Payer: Qualcare PPO/HMO/WC	$122.05

Know your out-of-pocket cost for care.

All Charges