Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PROTAMINE SULF VL 50MG

Facility

$9.00

Hospital Charge Code	6013171
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

PROTECTIVE ANGIOCATHS ********

Facility

$6.00

Hospital Charge Code	8003527
Hospital Revenue Code	279
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

PROTECTIVE ANGIOCATHS ********

Facility

$6.00

Hospital Charge Code	8003527
Hospital Revenue Code	279
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

PROTECTOR ALEXIS WND PROTECTOR

Facility

$270.00

Hospital Charge Code	270688645
Hospital Revenue Code	272
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.00
Rate for Payer: Oxford Commercial	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Commercial	$54.00
Rate for Payer: UnitedHealthcare Community & State	$6.51
Rate for Payer: Wellpoint Medicaid Managed Care	$7.16

PROTECTOR ALEXIS WND PROTECTOR

Facility

$270.00

Hospital Charge Code	270688645
Hospital Revenue Code	272
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

PROTECTOR AXOGUARD 2X2MM

Facility

$9,950.00

Service Code	HCPCS C1763
Hospital Charge Code	270696878
Hospital Revenue Code	278
Min. Negotiated Rate	$1,492.50
Max. Negotiated Rate	$2,407.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,407.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,189.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,492.50

PROTECTOR AXOGUARD 2X2MM

Facility

$9,950.00

Service Code	HCPCS C1763
Hospital Charge Code	270696878
Hospital Revenue Code	278
Min. Negotiated Rate	$239.79
Max. Negotiated Rate	$4,975.00
Rate for Payer: Aetna Commercial	$3,781.00
Rate for Payer: Aetna Medicare Advantage	$2,985.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,537.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,537.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,537.25
Rate for Payer: Cigna Commercial	$4,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,407.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,189.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,492.50
Rate for Payer: UnitedHealthcare Community & State	$239.79
Rate for Payer: Wellpoint Medicaid Managed Care	$263.68

PROTECTOR AXOGUARD 5x40MM

Facility

$9,400.00

Service Code	HCPCS C1763
Hospital Charge Code	270667301
Hospital Revenue Code	278
Min. Negotiated Rate	$1,410.00
Max. Negotiated Rate	$2,274.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,274.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,068.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,410.00

PROTECTOR AXOGUARD 5x40MM

Facility

$9,400.00

Service Code	HCPCS C1763
Hospital Charge Code	270667301
Hospital Revenue Code	278
Min. Negotiated Rate	$226.54
Max. Negotiated Rate	$4,700.00
Rate for Payer: Aetna Commercial	$3,572.00
Rate for Payer: Aetna Medicare Advantage	$2,820.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,880.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,397.00
Rate for Payer: Cigna Commercial	$4,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,274.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,068.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,410.00
Rate for Payer: UnitedHealthcare Community & State	$226.54
Rate for Payer: Wellpoint Medicaid Managed Care	$249.10

PROTECTOR EYE OPTI-GARD

Facility

$33.00

Hospital Charge Code	270655049
Hospital Revenue Code	270
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

PROTECTOR EYE OPTI-GARD

Facility

$33.00

Hospital Charge Code	270655049
Hospital Revenue Code	270
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$12.54
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.90
Rate for Payer: Oxford Commercial	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$6.60
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

PROTECTOR EYE POSEY BILI

Facility

$7.72

Hospital Charge Code	270622843
Hospital Revenue Code	270
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

PROTECTOR EYE POSEY BILI

Facility

$13.65

Hospital Charge Code	270130175
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$5.19
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.09
Rate for Payer: Oxford Commercial	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$2.73
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

PROTECTOR EYE POSEY BILI

Facility

$13.65

Hospital Charge Code	270130175
Hospital Revenue Code	272
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

PROTECTOR EYE POSEY BILI

Facility

$7.72

Hospital Charge Code	270622843
Hospital Revenue Code	270
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.86
Rate for Payer: Aetna Commercial	$2.93
Rate for Payer: Aetna Medicare Advantage	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.97
Rate for Payer: Cigna Commercial	$3.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.32
Rate for Payer: Oxford Commercial	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$1.54
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

PROTECTOR FINGER COT 3

Facility

$6.07

Hospital Charge Code	270649487
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$3.04
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.55
Rate for Payer: Cigna Commercial	$3.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.82
Rate for Payer: Oxford Commercial	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.91
Rate for Payer: UnitedHealthcare Commercial	$1.21
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

PROTECTOR FINGER COT 3

Facility

$6.07

Hospital Charge Code	270649487
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.91

PROTECTOR GUIDEWIRE***

Facility

$345.00

Hospital Charge Code	2300770
Hospital Revenue Code	279
Min. Negotiated Rate	$51.75
Max. Negotiated Rate	$51.75
Rate for Payer: Qualcare PPO/HMO/WC	$51.75

PROTECTOR GUIDEWIRE***

Facility

$345.00

Hospital Charge Code	2300770
Hospital Revenue Code	279
Min. Negotiated Rate	$8.31
Max. Negotiated Rate	$172.50
Rate for Payer: Aetna Commercial	$131.10
Rate for Payer: Aetna Medicare Advantage	$103.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.97
Rate for Payer: Cigna Commercial	$172.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.50
Rate for Payer: Oxford Commercial	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.75
Rate for Payer: UnitedHealthcare Commercial	$69.00
Rate for Payer: UnitedHealthcare Community & State	$8.31
Rate for Payer: Wellpoint Medicaid Managed Care	$9.14

PROTECTOR GUIDEWIRE PLUS-480

Facility

$924.00

Hospital Charge Code	270601182
Hospital Revenue Code	272
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$462.00
Rate for Payer: Aetna Commercial	$351.12
Rate for Payer: Aetna Medicare Advantage	$277.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.62
Rate for Payer: Cigna Commercial	$462.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.20
Rate for Payer: Oxford Commercial	$184.80
Rate for Payer: Qualcare PPO/HMO/WC	$138.60
Rate for Payer: UnitedHealthcare Commercial	$184.80
Rate for Payer: UnitedHealthcare Community & State	$22.27
Rate for Payer: Wellpoint Medicaid Managed Care	$24.49

PROTECTOR GUIDEWIRE PLUS-480

Facility

$924.00

Hospital Charge Code	270601182
Hospital Revenue Code	272
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$138.60
Rate for Payer: Qualcare PPO/HMO/WC	$138.60

PROTECTOR HEEL/ELBOW LG

Facility

$20.42

Hospital Charge Code	270302855
Hospital Revenue Code	270
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$3.06

PROTECTOR HEEL/ELBOW LG

Facility

$20.42

Hospital Charge Code	270302855
Hospital Revenue Code	270
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$10.21
Rate for Payer: Aetna Commercial	$7.76
Rate for Payer: Aetna Medicare Advantage	$6.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.21
Rate for Payer: Cigna Commercial	$10.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.13
Rate for Payer: Oxford Commercial	$4.08
Rate for Payer: Qualcare PPO/HMO/WC	$3.06
Rate for Payer: UnitedHealthcare Commercial	$4.08
Rate for Payer: UnitedHealthcare Community & State	$0.49
Rate for Payer: Wellpoint Medicaid Managed Care	$0.54

PROTECTOR HEEL & ELBOW LG PR**

Facility

$27.00

Hospital Charge Code	8004368
Hospital Revenue Code	272
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

PROTECTOR HEEL & ELBOW LG PR**

Facility

$27.00

Hospital Charge Code	8004368
Hospital Revenue Code	272
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$10.26
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.10
Rate for Payer: Oxford Commercial	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$5.40
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.72

Know your out-of-pocket cost for care.

All Charges