Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PUMP SET IMPELLA CP

Facility

$125,000.00

Hospital Charge Code	270681568
Hospital Revenue Code	278
Min. Negotiated Rate	$18,750.00
Max. Negotiated Rate	$30,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30,250.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$18,750.00

PUMP SET IMPELLA CP

Facility

$125,000.00

Hospital Charge Code	270681568S
Hospital Revenue Code	278
Min. Negotiated Rate	$3,012.50
Max. Negotiated Rate	$62,500.00
Rate for Payer: Aetna Commercial	$47,500.00
Rate for Payer: Aetna Medicare Advantage	$37,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,875.00
Rate for Payer: Cigna Commercial	$62,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30,250.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$18,750.00
Rate for Payer: UnitedHealthcare Community & State	$3,012.50
Rate for Payer: Wellpoint Medicaid Managed Care	$3,312.50

PUMP SET IMPELLA CP

Facility

$125,000.00

Hospital Charge Code	270681568
Hospital Revenue Code	278
Min. Negotiated Rate	$3,012.50
Max. Negotiated Rate	$62,500.00
Rate for Payer: Aetna Commercial	$47,500.00
Rate for Payer: Aetna Medicare Advantage	$37,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,875.00
Rate for Payer: Cigna Commercial	$62,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30,250.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$18,750.00
Rate for Payer: UnitedHealthcare Community & State	$3,012.50
Rate for Payer: Wellpoint Medicaid Managed Care	$3,312.50

PUMP SET IMPELLA CP

Facility

$125,000.00

Hospital Charge Code	270681568S
Hospital Revenue Code	278
Min. Negotiated Rate	$18,750.00
Max. Negotiated Rate	$30,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30,250.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$18,750.00

PUMP SOLUSET CLAVE

Facility

$40.91

Hospital Charge Code	270650216
Hospital Revenue Code	270
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$20.45
Rate for Payer: Aetna Commercial	$15.55
Rate for Payer: Aetna Medicare Advantage	$12.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.43
Rate for Payer: Cigna Commercial	$20.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.27
Rate for Payer: Oxford Commercial	$8.18
Rate for Payer: Qualcare PPO/HMO/WC	$6.14
Rate for Payer: UnitedHealthcare Commercial	$8.18
Rate for Payer: UnitedHealthcare Community & State	$0.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

PUMP SOLUSET CLAVE

Facility

$40.91

Hospital Charge Code	270650216
Hospital Revenue Code	270
Min. Negotiated Rate	$6.14
Max. Negotiated Rate	$6.14
Rate for Payer: Qualcare PPO/HMO/WC	$6.14

PUMP SUMP AMPRO DISP STERILE

Facility

$417.15

Hospital Charge Code	270644908
Hospital Revenue Code	272
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$208.57
Rate for Payer: Aetna Commercial	$158.52
Rate for Payer: Aetna Medicare Advantage	$125.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.37
Rate for Payer: Cigna Commercial	$208.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.14
Rate for Payer: Oxford Commercial	$83.43
Rate for Payer: Qualcare PPO/HMO/WC	$62.57
Rate for Payer: UnitedHealthcare Commercial	$83.43
Rate for Payer: UnitedHealthcare Community & State	$10.05
Rate for Payer: Wellpoint Medicaid Managed Care	$11.05

PUMP SUMP AMPRO DISP STERILE

Facility

$417.15

Hospital Charge Code	270644908
Hospital Revenue Code	272
Min. Negotiated Rate	$62.57
Max. Negotiated Rate	$62.57
Rate for Payer: Qualcare PPO/HMO/WC	$62.57

PUMP SUPPLIES-BAG/CASSETTE***

Facility

$300.00

Service Code	HCPCS 99999
Hospital Charge Code	3400272
Hospital Revenue Code	272
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

PUMP SUPPLIES-BAG/CASSETTE***

Facility

$300.00

Service Code	HCPCS 99999
Hospital Charge Code	3400272
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

PUMP SYNCHROMED II

Facility

$56,000.00

Service Code	HCPCS C1772
Hospital Charge Code	270660619
Hospital Revenue Code	278
Min. Negotiated Rate	$8,400.00
Max. Negotiated Rate	$13,552.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,552.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,400.00

PUMP SYNCHROMED II

Facility

$56,000.00

Service Code	HCPCS C1772
Hospital Charge Code	270660619
Hospital Revenue Code	278
Min. Negotiated Rate	$1,349.60
Max. Negotiated Rate	$28,000.00
Rate for Payer: Aetna Commercial	$21,280.00
Rate for Payer: Aetna Medicare Advantage	$16,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,280.00
Rate for Payer: Cigna Commercial	$28,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,552.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,400.00
Rate for Payer: UnitedHealthcare Community & State	$1,349.60
Rate for Payer: Wellpoint Medicaid Managed Care	$1,484.00

PUMP SYNCHROMED II 863740

Facility

$53,072.00

Hospital Charge Code	270633446
Hospital Revenue Code	278
Min. Negotiated Rate	$7,960.80
Max. Negotiated Rate	$12,843.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,614.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,843.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11,675.84
Rate for Payer: Qualcare PPO/HMO/WC	$7,960.80

PUMP SYNCHROMED II 863740

Facility

$53,072.00

Hospital Charge Code	270633446
Hospital Revenue Code	278
Min. Negotiated Rate	$1,279.04
Max. Negotiated Rate	$26,536.00
Rate for Payer: Aetna Commercial	$20,167.36
Rate for Payer: Aetna Medicare Advantage	$15,921.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,533.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,533.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,614.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,533.36
Rate for Payer: Cigna Commercial	$26,536.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,843.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11,675.84
Rate for Payer: Qualcare PPO/HMO/WC	$7,960.80
Rate for Payer: UnitedHealthcare Community & State	$1,279.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1,406.41

PUMP SYNCHROMED INFUS P

Facility

$41,425.00

Hospital Charge Code	270606846
Hospital Revenue Code	278
Min. Negotiated Rate	$6,213.75
Max. Negotiated Rate	$10,024.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,024.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,113.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,213.75

PUMP SYNCHROMED INFUS P

Facility

$41,425.00

Hospital Charge Code	270606846
Hospital Revenue Code	278
Min. Negotiated Rate	$998.34
Max. Negotiated Rate	$20,712.50
Rate for Payer: Aetna Commercial	$15,741.50
Rate for Payer: Aetna Medicare Advantage	$12,427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,563.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,563.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,563.38
Rate for Payer: Cigna Commercial	$20,712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,024.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,113.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,213.75
Rate for Payer: UnitedHealthcare Community & State	$998.34
Rate for Payer: Wellpoint Medicaid Managed Care	$1,097.76

PUMP SYSTM CLLCTION HYGIENIKIT

Facility

$578.45

Hospital Charge Code	270662660
Hospital Revenue Code	270
Min. Negotiated Rate	$86.77
Max. Negotiated Rate	$86.77
Rate for Payer: Qualcare PPO/HMO/WC	$86.77

PUMP SYSTM CLLCTION HYGIENIKIT

Facility

$578.45

Hospital Charge Code	270662660
Hospital Revenue Code	270
Min. Negotiated Rate	$13.94
Max. Negotiated Rate	$289.23
Rate for Payer: Aetna Commercial	$219.81
Rate for Payer: Aetna Medicare Advantage	$173.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.50
Rate for Payer: Cigna Commercial	$289.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.53
Rate for Payer: Oxford Commercial	$115.69
Rate for Payer: Qualcare PPO/HMO/WC	$86.77
Rate for Payer: UnitedHealthcare Commercial	$115.69
Rate for Payer: UnitedHealthcare Community & State	$13.94
Rate for Payer: Wellpoint Medicaid Managed Care	$15.33

PUMP TUBE SET ARTHROSCOPY

Facility

$287.70

Hospital Charge Code	270657504
Hospital Revenue Code	270
Min. Negotiated Rate	$43.16
Max. Negotiated Rate	$43.16
Rate for Payer: Qualcare PPO/HMO/WC	$43.16

PUMP TUBE SET ARTHROSCOPY

Facility

$287.70

Hospital Charge Code	270657504
Hospital Revenue Code	270
Min. Negotiated Rate	$6.93
Max. Negotiated Rate	$143.85
Rate for Payer: Aetna Commercial	$109.33
Rate for Payer: Aetna Medicare Advantage	$86.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.36
Rate for Payer: Cigna Commercial	$143.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.31
Rate for Payer: Oxford Commercial	$57.54
Rate for Payer: Qualcare PPO/HMO/WC	$43.16
Rate for Payer: UnitedHealthcare Commercial	$57.54
Rate for Payer: UnitedHealthcare Community & State	$6.93
Rate for Payer: Wellpoint Medicaid Managed Care	$7.62

PUMP TUBING

Facility

$26.00

Service Code	HCPCS 99999
Hospital Charge Code	3400298
Hospital Revenue Code	272
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$13.00
Rate for Payer: Aetna Commercial	$9.88
Rate for Payer: Aetna Medicare Advantage	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.63
Rate for Payer: Cigna Commercial	$13.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$5.20
Rate for Payer: Qualcare PPO/HMO/WC	$3.90
Rate for Payer: UnitedHealthcare Commercial	$5.20
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.69

PUMP TUBING

Facility

$26.00

Service Code	HCPCS 99999
Hospital Charge Code	3400298
Hospital Revenue Code	272
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.90

PUMP TUBING(CMG)

Facility

$63.00

Hospital Charge Code	270335626
Hospital Revenue Code	272
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

PUMP TUBING(CMG)

Facility

$63.00

Hospital Charge Code	270335626
Hospital Revenue Code	272
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna Commercial	$23.94
Rate for Payer: Aetna Medicare Advantage	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.07
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.90
Rate for Payer: Oxford Commercial	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$12.60
Rate for Payer: UnitedHealthcare Community & State	$1.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1.67

PUNCH BARRON CORNEA 8.75mm

Facility

$315.00

Hospital Charge Code	270667430
Hospital Revenue Code	272
Min. Negotiated Rate	$47.25
Max. Negotiated Rate	$47.25
Rate for Payer: Qualcare PPO/HMO/WC	$47.25

Know your out-of-pocket cost for care.

All Charges