Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SENSORCAINE 0.75% W/EPI/1

Facility

$28.00

Hospital Charge Code	60633870
Hospital Revenue Code	250
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$10.64
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.40
Rate for Payer: Oxford Commercial	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

SENSORCAINE MPF 0.75%10ML

Facility

$24.00

Hospital Charge Code	60635356
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$9.12
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.20
Rate for Payer: Oxford Commercial	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$4.80
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

SENSORCAINE MPF 0.75%10ML

Facility

$24.00

Hospital Charge Code	60635356
Hospital Revenue Code	250
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

SENSOR FINGER ADULT SPOT 20IN

Facility

$993.90

Hospital Charge Code	270666966
Hospital Revenue Code	270
Min. Negotiated Rate	$23.95
Max. Negotiated Rate	$496.95
Rate for Payer: Aetna Commercial	$377.68
Rate for Payer: Aetna Medicare Advantage	$298.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.44
Rate for Payer: Cigna Commercial	$496.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$298.17
Rate for Payer: Oxford Commercial	$198.78
Rate for Payer: Qualcare PPO/HMO/WC	$149.09
Rate for Payer: UnitedHealthcare Commercial	$198.78
Rate for Payer: UnitedHealthcare Community & State	$23.95
Rate for Payer: Wellpoint Medicaid Managed Care	$26.34

SENSOR FINGER ADULT SPOT 20IN

Facility

$993.90

Hospital Charge Code	270666966
Hospital Revenue Code	270
Min. Negotiated Rate	$149.09
Max. Negotiated Rate	$149.09
Rate for Payer: Qualcare PPO/HMO/WC	$149.09

SENSOR FLO-TRAC 1-60 152CM

Facility

$2,036.85

Hospital Charge Code	270663136
Hospital Revenue Code	278
Min. Negotiated Rate	$305.53
Max. Negotiated Rate	$492.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$407.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$492.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$448.11
Rate for Payer: Qualcare PPO/HMO/WC	$305.53

SENSOR FLO-TRAC 1-60 152CM

Facility

$2,036.85

Hospital Charge Code	270663136
Hospital Revenue Code	278
Min. Negotiated Rate	$49.09
Max. Negotiated Rate	$1,018.42
Rate for Payer: Aetna Commercial	$774.00
Rate for Payer: Aetna Medicare Advantage	$611.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$519.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$519.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$407.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$519.40
Rate for Payer: Cigna Commercial	$1,018.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$492.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$448.11
Rate for Payer: Qualcare PPO/HMO/WC	$305.53
Rate for Payer: UnitedHealthcare Community & State	$49.09
Rate for Payer: Wellpoint Medicaid Managed Care	$53.98

SENSOR FLOTRAC 84 MHD85

Facility

$325.00

Hospital Charge Code	270666465
Hospital Revenue Code	271
Min. Negotiated Rate	$7.83
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$123.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$65.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$65.00
Rate for Payer: UnitedHealthcare Community & State	$7.83
Rate for Payer: Wellpoint Medicaid Managed Care	$8.61

SENSOR FLOTRAC 84 MHD85

Facility

$325.00

Hospital Charge Code	270666465
Hospital Revenue Code	271
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

SENSOR LNCS ADULT SPO2

Facility

$74.10

Hospital Charge Code	270677745
Hospital Revenue Code	272
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$37.05
Rate for Payer: Aetna Commercial	$28.16
Rate for Payer: Aetna Medicare Advantage	$22.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.90
Rate for Payer: Cigna Commercial	$37.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.23
Rate for Payer: Oxford Commercial	$14.82
Rate for Payer: Qualcare PPO/HMO/WC	$11.12
Rate for Payer: UnitedHealthcare Commercial	$14.82
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.96

SENSOR LNCS ADULT SPO2

Facility

$74.10

Hospital Charge Code	270677745
Hospital Revenue Code	272
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$11.12
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SENSOR MASIMO FINGER ADULT

Facility

$86.75

Hospital Charge Code	270623651
Hospital Revenue Code	272
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$13.01
Rate for Payer: Qualcare PPO/HMO/WC	$13.01

SENSOR MASIMO FINGER ADULT

Facility

$86.75

Hospital Charge Code	270623651
Hospital Revenue Code	272
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$43.38
Rate for Payer: Aetna Commercial	$32.97
Rate for Payer: Aetna Medicare Advantage	$26.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.12
Rate for Payer: Cigna Commercial	$43.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.02
Rate for Payer: Oxford Commercial	$17.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.01
Rate for Payer: UnitedHealthcare Commercial	$17.35
Rate for Payer: UnitedHealthcare Community & State	$2.09
Rate for Payer: Wellpoint Medicaid Managed Care	$2.30

SENSOR NEONATEAL OXY TIP 116

Facility

$131.25

Hospital Charge Code	270600461
Hospital Revenue Code	272
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$19.69
Rate for Payer: Qualcare PPO/HMO/WC	$19.69

SENSOR NEONATEAL OXY TIP 116

Facility

$131.25

Hospital Charge Code	270600461
Hospital Revenue Code	272
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$65.62
Rate for Payer: Aetna Commercial	$49.88
Rate for Payer: Aetna Medicare Advantage	$39.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.47
Rate for Payer: Cigna Commercial	$65.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.38
Rate for Payer: Oxford Commercial	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$19.69
Rate for Payer: UnitedHealthcare Commercial	$26.25
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$3.48

SENSOR PULSE OX NEONATAL

Facility

$2,317.50

Hospital Charge Code	270665248
Hospital Revenue Code	270
Min. Negotiated Rate	$55.85
Max. Negotiated Rate	$1,158.75
Rate for Payer: Aetna Commercial	$880.65
Rate for Payer: Aetna Medicare Advantage	$695.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$590.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$590.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$590.96
Rate for Payer: Cigna Commercial	$1,158.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.25
Rate for Payer: Oxford Commercial	$463.50
Rate for Payer: Qualcare PPO/HMO/WC	$347.62
Rate for Payer: UnitedHealthcare Commercial	$463.50
Rate for Payer: UnitedHealthcare Community & State	$55.85
Rate for Payer: Wellpoint Medicaid Managed Care	$61.41

SENSOR PULSE OX NEONATAL

Facility

$2,317.50

Hospital Charge Code	270665248
Hospital Revenue Code	270
Min. Negotiated Rate	$347.62
Max. Negotiated Rate	$347.62
Rate for Payer: Qualcare PPO/HMO/WC	$347.62

SENSOR PULSE OX PREMATURE SOFT

Facility

$2,317.50

Hospital Charge Code	270665249
Hospital Revenue Code	270
Min. Negotiated Rate	$55.85
Max. Negotiated Rate	$1,158.75
Rate for Payer: Aetna Commercial	$880.65
Rate for Payer: Aetna Medicare Advantage	$695.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$590.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$590.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$590.96
Rate for Payer: Cigna Commercial	$1,158.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.25
Rate for Payer: Oxford Commercial	$463.50
Rate for Payer: Qualcare PPO/HMO/WC	$347.62
Rate for Payer: UnitedHealthcare Commercial	$463.50
Rate for Payer: UnitedHealthcare Community & State	$55.85
Rate for Payer: Wellpoint Medicaid Managed Care	$61.41

SENSOR PULSE OX PREMATURE SOFT

Facility

$2,317.50

Hospital Charge Code	270665249
Hospital Revenue Code	270
Min. Negotiated Rate	$347.62
Max. Negotiated Rate	$347.62
Rate for Payer: Qualcare PPO/HMO/WC	$347.62

SENSOR RESTORE

Facility

$98,750.00

Service Code	HCPCS C1820
Hospital Charge Code	270665901
Hospital Revenue Code	278
Min. Negotiated Rate	$2,379.88
Max. Negotiated Rate	$49,375.00
Rate for Payer: Aetna Commercial	$37,525.00
Rate for Payer: Aetna Medicare Advantage	$29,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,181.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,181.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,181.25
Rate for Payer: Cigna Commercial	$49,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23,897.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$21,725.00
Rate for Payer: Qualcare PPO/HMO/WC	$14,812.50
Rate for Payer: UnitedHealthcare Community & State	$2,379.88
Rate for Payer: Wellpoint Medicaid Managed Care	$2,616.88

SENSOR RESTORE

Facility

$98,750.00

Service Code	HCPCS C1820
Hospital Charge Code	270665901
Hospital Revenue Code	278
Min. Negotiated Rate	$14,812.50
Max. Negotiated Rate	$23,897.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23,897.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$21,725.00
Rate for Payer: Qualcare PPO/HMO/WC	$14,812.50

SENSOR SPO2 ADLT 060000004301

Facility

$74.10

Hospital Charge Code	270633546
Hospital Revenue Code	272
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$11.12
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SENSOR SPO2 ADLT 060000004301

Facility

$74.10

Hospital Charge Code	270633546
Hospital Revenue Code	272
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$37.05
Rate for Payer: Aetna Commercial	$28.16
Rate for Payer: Aetna Medicare Advantage	$22.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.90
Rate for Payer: Cigna Commercial	$37.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.23
Rate for Payer: Oxford Commercial	$14.82
Rate for Payer: Qualcare PPO/HMO/WC	$11.12
Rate for Payer: UnitedHealthcare Commercial	$14.82
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.96

SENSOR WIRE .035 X 150 MM

Facility

$319.50

Hospital Charge Code	270701464
Hospital Revenue Code	278
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$159.75
Rate for Payer: Aetna Commercial	$121.41
Rate for Payer: Aetna Medicare Advantage	$95.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.47
Rate for Payer: Cigna Commercial	$159.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.29
Rate for Payer: Qualcare PPO/HMO/WC	$47.92
Rate for Payer: UnitedHealthcare Community & State	$7.70
Rate for Payer: Wellpoint Medicaid Managed Care	$8.47

SENSOR WIRE .035 X 150 MM

Facility

$319.50

Hospital Charge Code	270701464
Hospital Revenue Code	278
Min. Negotiated Rate	$47.92
Max. Negotiated Rate	$77.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.29
Rate for Payer: Qualcare PPO/HMO/WC	$47.92

Know your out-of-pocket cost for care.

All Charges