Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PUNCT ASP - ABSC HEMAT CYST

Facility

$1,471.36

Service Code	HCPCS 10160
Hospital Charge Code	16000245
Hospital Revenue Code	360
Min. Negotiated Rate	$35.46
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.41
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$220.70
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$35.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1,037.98

PUNCT ASP - ABSC HEMAT CYST

Facility

$1,471.36

Service Code	HCPCS 10160
Hospital Charge Code	16000245
Hospital Revenue Code	360
Min. Negotiated Rate	$220.70
Max. Negotiated Rate	$220.70
Rate for Payer: Qualcare PPO/HMO/WC	$220.70

PUNCTURE CLOS EXIT DEVICE DISP

Facility

$231.00

Hospital Charge Code	270600260
Hospital Revenue Code	272
Min. Negotiated Rate	$5.57
Max. Negotiated Rate	$115.50
Rate for Payer: Aetna Commercial	$87.78
Rate for Payer: Aetna Medicare Advantage	$69.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.91
Rate for Payer: Cigna Commercial	$115.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.30
Rate for Payer: Oxford Commercial	$46.20
Rate for Payer: Qualcare PPO/HMO/WC	$34.65
Rate for Payer: UnitedHealthcare Commercial	$46.20
Rate for Payer: UnitedHealthcare Community & State	$5.57
Rate for Payer: Wellpoint Medicaid Managed Care	$6.12

PUNCTURE CLOS EXIT DEVICE DISP

Facility

$231.00

Hospital Charge Code	270600260
Hospital Revenue Code	272
Min. Negotiated Rate	$34.65
Max. Negotiated Rate	$34.65
Rate for Payer: Qualcare PPO/HMO/WC	$34.65

PURACOL+COL 4.25x4.5 MSC8644EP

Facility

$199.03

Hospital Charge Code	270640869
Hospital Revenue Code	272
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$99.52
Rate for Payer: Aetna Commercial	$75.63
Rate for Payer: Aetna Medicare Advantage	$59.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.75
Rate for Payer: Cigna Commercial	$99.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.71
Rate for Payer: Oxford Commercial	$39.81
Rate for Payer: Qualcare PPO/HMO/WC	$29.85
Rate for Payer: UnitedHealthcare Commercial	$39.81
Rate for Payer: UnitedHealthcare Community & State	$4.80
Rate for Payer: Wellpoint Medicaid Managed Care	$5.27

PURACOL+COL 4.25x4.5 MSC8644EP

Facility

$199.03

Hospital Charge Code	270640869
Hospital Revenue Code	272
Min. Negotiated Rate	$29.85
Max. Negotiated Rate	$29.85
Rate for Payer: Qualcare PPO/HMO/WC	$29.85

PURACOL + COLG 2x2 5 MSC8622EP

Facility

$32.35

Hospital Charge Code	270640868
Hospital Revenue Code	272
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$16.18
Rate for Payer: Aetna Commercial	$12.29
Rate for Payer: Aetna Medicare Advantage	$9.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.25
Rate for Payer: Cigna Commercial	$16.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.71
Rate for Payer: Oxford Commercial	$6.47
Rate for Payer: Qualcare PPO/HMO/WC	$4.85
Rate for Payer: UnitedHealthcare Commercial	$6.47
Rate for Payer: UnitedHealthcare Community & State	$0.78
Rate for Payer: Wellpoint Medicaid Managed Care	$0.86

PURACOL + COLG 2x2 5 MSC8622EP

Facility

$32.35

Hospital Charge Code	270640868
Hospital Revenue Code	272
Min. Negotiated Rate	$4.85
Max. Negotiated Rate	$4.85
Rate for Payer: Qualcare PPO/HMO/WC	$4.85

PURAPLY AM 6X9 CM

Facility

$13,500.00

Service Code	HCPCS Q4195
Hospital Charge Code	270676741
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,970.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

PURAPLY AM 6X9 CM

Facility

$13,500.00

Service Code	HCPCS Q4195
Hospital Charge Code	270676741
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$3,267.00
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$533.66
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,970.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: UnitedHealthcare Community & State	$325.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$357.75

PURAPLY AM 6X9 CM/PER SQCM JW

Facility

$560.00

Hospital Charge Code	270676741W
Hospital Revenue Code	636
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: Wellpoint Medicaid Managed Care	$14.84

PURAPLY AM 6X9 CM/PER SQCM JW

Facility

$560.00

Hospital Charge Code	270676741W
Hospital Revenue Code	636
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$135.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

PURAPLY AM 8X16CM(FULL SHEET)

Facility

$64,000.00

Service Code	HCPCS Q4196
Hospital Charge Code	270689671
Hospital Revenue Code	636
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$15,488.00
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$533.66
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,488.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,600.00
Rate for Payer: UnitedHealthcare Community & State	$1,542.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$1,696.00

PURAPLY AM 8X16CM(FULL SHEET)

Facility

$64,000.00

Service Code	HCPCS Q4196
Hospital Charge Code	270689671
Hospital Revenue Code	636
Min. Negotiated Rate	$9,600.00
Max. Negotiated Rate	$15,488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,488.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,600.00

PURAPLY AM PER SQ CM

Facility

$3,750.00

Service Code	HCPCS Q4196
Hospital Charge Code	270676737
Hospital Revenue Code	636
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

PURAPLY AM PER SQ CM

Facility

$651.25

Service Code	HCPCS Q4172
Hospital Charge Code	270676737P
Hospital Revenue Code	636
Min. Negotiated Rate	$15.70
Max. Negotiated Rate	$325.62
Rate for Payer: Aetna Commercial	$247.47
Rate for Payer: Aetna Medicare Advantage	$195.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.07
Rate for Payer: Cigna Commercial	$325.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.60
Rate for Payer: Qualcare PPO/HMO/WC	$97.69
Rate for Payer: UnitedHealthcare Community & State	$15.70
Rate for Payer: Wellpoint Medicaid Managed Care	$17.26

PURAPLY AM PER SQ CM

Facility

$651.25

Service Code	HCPCS Q4172
Hospital Charge Code	270676737P
Hospital Revenue Code	636
Min. Negotiated Rate	$97.69
Max. Negotiated Rate	$157.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.60
Rate for Payer: Qualcare PPO/HMO/WC	$97.69

PURAPLY AM PER SQ CM

Facility

$3,750.00

Service Code	HCPCS Q4196
Hospital Charge Code	270676737
Hospital Revenue Code	636
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$907.50
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$533.66
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

PURAPLY AM PER SQ CM JW

Facility

$651.25

Hospital Charge Code	270676737W
Hospital Revenue Code	636
Min. Negotiated Rate	$15.70
Max. Negotiated Rate	$325.62
Rate for Payer: Aetna Commercial	$247.47
Rate for Payer: Aetna Medicare Advantage	$195.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.07
Rate for Payer: Cigna Commercial	$325.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.60
Rate for Payer: Qualcare PPO/HMO/WC	$97.69
Rate for Payer: UnitedHealthcare Community & State	$15.70
Rate for Payer: Wellpoint Medicaid Managed Care	$17.26

PURAPLY AM PER SQ CM JW

Facility

$651.25

Service Code	HCPCS Q4172JW
Hospital Charge Code	270676737J
Hospital Revenue Code	636
Min. Negotiated Rate	$15.70
Max. Negotiated Rate	$325.62
Rate for Payer: Aetna Commercial	$247.47
Rate for Payer: Aetna Medicare Advantage	$195.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.07
Rate for Payer: Cigna Commercial	$325.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.60
Rate for Payer: Qualcare PPO/HMO/WC	$97.69
Rate for Payer: UnitedHealthcare Community & State	$15.70
Rate for Payer: Wellpoint Medicaid Managed Care	$17.26

PURAPLY AM PER SQ CM JW

Facility

$651.25

Service Code	HCPCS Q4172JW
Hospital Charge Code	270676737J
Hospital Revenue Code	636
Min. Negotiated Rate	$97.69
Max. Negotiated Rate	$157.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.60
Rate for Payer: Qualcare PPO/HMO/WC	$97.69

PURAPLY AM PER SQ CM JW

Facility

$651.25

Hospital Charge Code	270676737W
Hospital Revenue Code	636
Min. Negotiated Rate	$97.69
Max. Negotiated Rate	$157.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.60
Rate for Payer: Qualcare PPO/HMO/WC	$97.69

PURAPLY WOUND MATRIX 5CM X 5CM

Facility

$6,475.00

Service Code	HCPCS Q4195
Hospital Charge Code	270681826
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$1,566.95
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$533.66
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,424.50
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Community & State	$156.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$171.59

PURAPLY WOUND MATRIX 5CM X 5CM

Facility

$6,475.00

Service Code	HCPCS Q4195
Hospital Charge Code	270681826
Hospital Revenue Code	278
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$1,566.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,424.50
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

PURCHASE REQUEST

Facility

$117.45

Hospital Charge Code	270656347
Hospital Revenue Code	271
Min. Negotiated Rate	$17.62
Max. Negotiated Rate	$17.62
Rate for Payer: Qualcare PPO/HMO/WC	$17.62

Know your out-of-pocket cost for care.

All Charges