Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PUMP BREAST ******

Facility

$23.00

Hospital Charge Code	8003071
Hospital Revenue Code	279
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

PUMP BREAST ******

Facility

$23.00

Hospital Charge Code	8003071
Hospital Revenue Code	279
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$8.74
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.90
Rate for Payer: Oxford Commercial	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$4.60
Rate for Payer: UnitedHealthcare Community & State	$0.55
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

PUMP BREAST *******

Facility

$32.00

Hospital Charge Code	1800283
Hospital Revenue Code	279
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

PUMP BREAST *******

Facility

$32.00

Hospital Charge Code	1800283
Hospital Revenue Code	279
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$6.40
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

PUMP BREAST *********

Facility

$40.00

Hospital Charge Code	1801133
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.00
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

PUMP BREAST *********

Facility

$40.00

Hospital Charge Code	1801133
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

PUMP BREAST****

Facility

$55.00

Hospital Charge Code	270130180
Hospital Revenue Code	272
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

PUMP BREAST****

Facility

$55.00

Hospital Charge Code	270130180
Hospital Revenue Code	272
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$20.90
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.50
Rate for Payer: Oxford Commercial	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$11.00
Rate for Payer: UnitedHealthcare Community & State	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$1.46

PUMP BREAST 107900

Facility

$40.85

Hospital Charge Code	270622863
Hospital Revenue Code	272
Min. Negotiated Rate	$6.13
Max. Negotiated Rate	$6.13
Rate for Payer: Qualcare PPO/HMO/WC	$6.13

PUMP BREAST 107900

Facility

$40.85

Hospital Charge Code	270622863
Hospital Revenue Code	272
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$20.43
Rate for Payer: Aetna Commercial	$15.52
Rate for Payer: Aetna Medicare Advantage	$12.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.42
Rate for Payer: Cigna Commercial	$20.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.26
Rate for Payer: Oxford Commercial	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$6.13
Rate for Payer: UnitedHealthcare Commercial	$8.17
Rate for Payer: UnitedHealthcare Community & State	$0.98
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

PUMP CASSETTE

Facility

$35.00

Service Code	HCPCS 99999
Hospital Charge Code	3400280
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$17.50
Rate for Payer: Aetna Commercial	$13.30
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.50
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$7.00
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

PUMP CASSETTE

Facility

$35.00

Service Code	HCPCS 99999
Hospital Charge Code	3400280
Hospital Revenue Code	272
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

PUMP CONTROL W INHIBZ 72404127

Facility

$17,990.00

Hospital Charge Code	270641448
Hospital Revenue Code	278
Min. Negotiated Rate	$433.56
Max. Negotiated Rate	$8,995.00
Rate for Payer: Aetna Commercial	$6,836.20
Rate for Payer: Aetna Medicare Advantage	$5,397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,587.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,587.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,587.45
Rate for Payer: Cigna Commercial	$8,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,353.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,957.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,698.50
Rate for Payer: UnitedHealthcare Community & State	$433.56
Rate for Payer: Wellpoint Medicaid Managed Care	$476.74

PUMP CONTROL W INHIBZ 72404127

Facility

$17,990.00

Hospital Charge Code	270641448
Hospital Revenue Code	278
Min. Negotiated Rate	$2,698.50
Max. Negotiated Rate	$4,353.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,598.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,353.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,957.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,698.50

PUMP DRAIN MATE

Facility

$2,591.25

Hospital Charge Code	270612103
Hospital Revenue Code	272
Min. Negotiated Rate	$388.69
Max. Negotiated Rate	$388.69
Rate for Payer: Qualcare PPO/HMO/WC	$388.69

PUMP DRAIN MATE

Facility

$2,591.25

Hospital Charge Code	270612103
Hospital Revenue Code	272
Min. Negotiated Rate	$62.45
Max. Negotiated Rate	$1,295.62
Rate for Payer: Aetna Commercial	$984.67
Rate for Payer: Aetna Medicare Advantage	$777.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$660.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$660.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$660.77
Rate for Payer: Cigna Commercial	$1,295.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$777.38
Rate for Payer: Oxford Commercial	$518.25
Rate for Payer: Qualcare PPO/HMO/WC	$388.69
Rate for Payer: UnitedHealthcare Commercial	$518.25
Rate for Payer: UnitedHealthcare Community & State	$62.45
Rate for Payer: Wellpoint Medicaid Managed Care	$68.67

PUMP FLO STEADY ARTHROSCOPY

Facility

$313.95

Hospital Charge Code	270654828
Hospital Revenue Code	272
Min. Negotiated Rate	$47.09
Max. Negotiated Rate	$47.09
Rate for Payer: Qualcare PPO/HMO/WC	$47.09

PUMP FLO STEADY ARTHROSCOPY

Facility

$313.95

Hospital Charge Code	270654828
Hospital Revenue Code	272
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$156.97
Rate for Payer: Aetna Commercial	$119.30
Rate for Payer: Aetna Medicare Advantage	$94.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.06
Rate for Payer: Cigna Commercial	$156.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.19
Rate for Payer: Oxford Commercial	$62.79
Rate for Payer: Qualcare PPO/HMO/WC	$47.09
Rate for Payer: UnitedHealthcare Commercial	$62.79
Rate for Payer: UnitedHealthcare Community & State	$7.57
Rate for Payer: Wellpoint Medicaid Managed Care	$8.32

PUMP GX 18 CM

Facility

$50,465.00

Service Code	HCPCS C1813
Hospital Charge Code	270684782
Hospital Revenue Code	278
Min. Negotiated Rate	$1,216.21
Max. Negotiated Rate	$25,232.50
Rate for Payer: Aetna Commercial	$19,176.70
Rate for Payer: Aetna Medicare Advantage	$15,139.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,868.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,868.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,093.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,868.58
Rate for Payer: Cigna Commercial	$25,232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,212.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11,102.30
Rate for Payer: Qualcare PPO/HMO/WC	$7,569.75
Rate for Payer: UnitedHealthcare Community & State	$1,216.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1,337.32

PUMP GX 18 CM

Facility

$50,465.00

Service Code	HCPCS C1813
Hospital Charge Code	270684782
Hospital Revenue Code	278
Min. Negotiated Rate	$7,569.75
Max. Negotiated Rate	$12,212.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,093.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,212.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11,102.30
Rate for Payer: Qualcare PPO/HMO/WC	$7,569.75

PUMP INFUSOR LV5

Facility

$231.34

Hospital Charge Code	270638219
Hospital Revenue Code	272
Min. Negotiated Rate	$5.58
Max. Negotiated Rate	$115.67
Rate for Payer: Aetna Commercial	$87.91
Rate for Payer: Aetna Medicare Advantage	$69.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.99
Rate for Payer: Cigna Commercial	$115.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.40
Rate for Payer: Oxford Commercial	$46.27
Rate for Payer: Qualcare PPO/HMO/WC	$34.70
Rate for Payer: UnitedHealthcare Commercial	$46.27
Rate for Payer: UnitedHealthcare Community & State	$5.58
Rate for Payer: Wellpoint Medicaid Managed Care	$6.13

PUMP INFUSOR LV5

Facility

$231.34

Hospital Charge Code	270638219
Hospital Revenue Code	272
Min. Negotiated Rate	$34.70
Max. Negotiated Rate	$34.70
Rate for Payer: Qualcare PPO/HMO/WC	$34.70

PUMPING SYS SINGLE ACTION

Facility

$368.11

Hospital Charge Code	270601211
Hospital Revenue Code	272
Min. Negotiated Rate	$55.22
Max. Negotiated Rate	$55.22
Rate for Payer: Qualcare PPO/HMO/WC	$55.22

PUMPING SYS SINGLE ACTION

Facility

$368.11

Hospital Charge Code	270601211
Hospital Revenue Code	272
Min. Negotiated Rate	$8.87
Max. Negotiated Rate	$184.06
Rate for Payer: Aetna Commercial	$139.88
Rate for Payer: Aetna Medicare Advantage	$110.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.87
Rate for Payer: Cigna Commercial	$184.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.43
Rate for Payer: Oxford Commercial	$73.62
Rate for Payer: Qualcare PPO/HMO/WC	$55.22
Rate for Payer: UnitedHealthcare Commercial	$73.62
Rate for Payer: UnitedHealthcare Community & State	$8.87
Rate for Payer: Wellpoint Medicaid Managed Care	$9.75

PUMPING SYST SGL ACTION*****

Facility

$190.00

Hospital Charge Code	1604727
Hospital Revenue Code	272
Min. Negotiated Rate	$4.58
Max. Negotiated Rate	$95.00
Rate for Payer: Aetna Commercial	$72.20
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.00
Rate for Payer: Oxford Commercial	$38.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$38.00
Rate for Payer: UnitedHealthcare Community & State	$4.58
Rate for Payer: Wellpoint Medicaid Managed Care	$5.04

Know your out-of-pocket cost for care.

All Charges