Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SET ATX HARVEST 8/9 AR1980-08S

Facility

$3,250.45

Hospital Charge Code	270622882
Hospital Revenue Code	272
Min. Negotiated Rate	$78.34
Max. Negotiated Rate	$1,625.22
Rate for Payer: Aetna Commercial	$1,235.17
Rate for Payer: Aetna Medicare Advantage	$975.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.86
Rate for Payer: Cigna Commercial	$1,625.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$975.13
Rate for Payer: Oxford Commercial	$650.09
Rate for Payer: Qualcare PPO/HMO/WC	$487.57
Rate for Payer: UnitedHealthcare Commercial	$650.09
Rate for Payer: UnitedHealthcare Community & State	$78.34
Rate for Payer: Wellpoint Medicaid Managed Care	$86.14

SET ATX HARVEST 8/9 AR1980-08S

Facility

$3,250.45

Hospital Charge Code	270622882
Hospital Revenue Code	272
Min. Negotiated Rate	$487.57
Max. Negotiated Rate	$487.57
Rate for Payer: Qualcare PPO/HMO/WC	$487.57

SET AUTOSYRINGE HI-FLO 2N3349

Facility

$16.85

Hospital Charge Code	270600581
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

SET AUTOSYRINGE HI-FLO 2N3349

Facility

$16.85

Hospital Charge Code	270600581
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$6.40
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.05
Rate for Payer: Oxford Commercial	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$3.37
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

SET AUTOSYRINGE HIGH FL OM8521

Facility

$16.85

Hospital Charge Code	270600877
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

SET AUTOSYRINGE HIGH FL OM8521

Facility

$16.85

Hospital Charge Code	270600877
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$6.40
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.05
Rate for Payer: Oxford Commercial	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$3.37
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

SET CATH***

Facility

$30.00

Hospital Charge Code	8002784
Hospital Revenue Code	279
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

SET CATH***

Facility

$30.00

Hospital Charge Code	8002784
Hospital Revenue Code	279
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$15.00
Rate for Payer: Aetna Commercial	$11.40
Rate for Payer: Aetna Medicare Advantage	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.65
Rate for Payer: Cigna Commercial	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.00
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$6.00
Rate for Payer: UnitedHealthcare Community & State	$0.72
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

SET CATH ARROW CS-01700 ******

Facility

$248.00

Hospital Charge Code	1608199
Hospital Revenue Code	272
Min. Negotiated Rate	$37.20
Max. Negotiated Rate	$37.20
Rate for Payer: Qualcare PPO/HMO/WC	$37.20

SET CATH ARROW CS-01700 ******

Facility

$248.00

Hospital Charge Code	1608199
Hospital Revenue Code	272
Min. Negotiated Rate	$5.98
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$94.24
Rate for Payer: Aetna Medicare Advantage	$74.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.24
Rate for Payer: Cigna Commercial	$124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.40
Rate for Payer: Oxford Commercial	$49.60
Rate for Payer: Qualcare PPO/HMO/WC	$37.20
Rate for Payer: UnitedHealthcare Commercial	$49.60
Rate for Payer: UnitedHealthcare Community & State	$5.98
Rate for Payer: Wellpoint Medicaid Managed Care	$6.57

SET CATH CHOLANGIO C1002

Facility

$340.00

Hospital Charge Code	270627916
Hospital Revenue Code	272
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

SET CATH CHOLANGIO C1002

Facility

$340.00

Hospital Charge Code	270627916
Hospital Revenue Code	272
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$129.20
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.00
Rate for Payer: Oxford Commercial	$68.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Commercial	$68.00
Rate for Payer: UnitedHealthcare Community & State	$8.19
Rate for Payer: Wellpoint Medicaid Managed Care	$9.01

SET CATH RADIAL ART FEP 22G

Facility

$46.61

Hospital Charge Code	270606560
Hospital Revenue Code	272
Min. Negotiated Rate	$6.99
Max. Negotiated Rate	$6.99
Rate for Payer: Qualcare PPO/HMO/WC	$6.99

SET CATH RADIAL ART FEP 22G

Facility

$46.61

Hospital Charge Code	270606560
Hospital Revenue Code	272
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$23.30
Rate for Payer: Aetna Commercial	$17.71
Rate for Payer: Aetna Medicare Advantage	$13.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.89
Rate for Payer: Cigna Commercial	$23.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.98
Rate for Payer: Oxford Commercial	$9.32
Rate for Payer: Qualcare PPO/HMO/WC	$6.99
Rate for Payer: UnitedHealthcare Commercial	$9.32
Rate for Payer: UnitedHealthcare Community & State	$1.12
Rate for Payer: Wellpoint Medicaid Managed Care	$1.24

SET CATH STAMEY PERC SUPRA

Facility

$216.00

Hospital Charge Code	270684724
Hospital Revenue Code	272
Min. Negotiated Rate	$5.21
Max. Negotiated Rate	$108.00
Rate for Payer: Aetna Commercial	$82.08
Rate for Payer: Aetna Medicare Advantage	$64.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.08
Rate for Payer: Cigna Commercial	$108.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.80
Rate for Payer: Oxford Commercial	$43.20
Rate for Payer: Qualcare PPO/HMO/WC	$32.40
Rate for Payer: UnitedHealthcare Commercial	$43.20
Rate for Payer: UnitedHealthcare Community & State	$5.21
Rate for Payer: Wellpoint Medicaid Managed Care	$5.72

SET CATH STAMEY PERC SUPRA

Facility

$216.00

Hospital Charge Code	270684724
Hospital Revenue Code	272
Min. Negotiated Rate	$32.40
Max. Negotiated Rate	$32.40
Rate for Payer: Qualcare PPO/HMO/WC	$32.40

SET CHOLANGIO W/BALLOON CATH

Facility

$577.50

Hospital Charge Code	270605529
Hospital Revenue Code	272
Min. Negotiated Rate	$13.92
Max. Negotiated Rate	$288.75
Rate for Payer: Aetna Commercial	$219.45
Rate for Payer: Aetna Medicare Advantage	$173.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.26
Rate for Payer: Cigna Commercial	$288.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.25
Rate for Payer: Oxford Commercial	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$86.62
Rate for Payer: UnitedHealthcare Commercial	$115.50
Rate for Payer: UnitedHealthcare Community & State	$13.92
Rate for Payer: Wellpoint Medicaid Managed Care	$15.30

SET CHOLANGIO W/BALLOON CATH

Facility

$577.50

Hospital Charge Code	270605529
Hospital Revenue Code	272
Min. Negotiated Rate	$86.62
Max. Negotiated Rate	$86.62
Rate for Payer: Qualcare PPO/HMO/WC	$86.62

SET CK LIVER BX 19G LABS-200

Facility

$2,124.00

Hospital Charge Code	270626547
Hospital Revenue Code	272
Min. Negotiated Rate	$51.19
Max. Negotiated Rate	$1,062.00
Rate for Payer: Aetna Commercial	$807.12
Rate for Payer: Aetna Medicare Advantage	$637.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.62
Rate for Payer: Cigna Commercial	$1,062.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$637.20
Rate for Payer: Oxford Commercial	$424.80
Rate for Payer: Qualcare PPO/HMO/WC	$318.60
Rate for Payer: UnitedHealthcare Commercial	$424.80
Rate for Payer: UnitedHealthcare Community & State	$51.19
Rate for Payer: Wellpoint Medicaid Managed Care	$56.29

SET CK LIVER BX 19G LABS-200

Facility

$2,124.00

Hospital Charge Code	270626547
Hospital Revenue Code	272
Min. Negotiated Rate	$318.60
Max. Negotiated Rate	$318.60
Rate for Payer: Qualcare PPO/HMO/WC	$318.60

SET COLLECTION SYNEVAC 610

Facility

$26.75

Hospital Charge Code	270612228
Hospital Revenue Code	272
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$13.38
Rate for Payer: Aetna Commercial	$10.16
Rate for Payer: Aetna Medicare Advantage	$8.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.82
Rate for Payer: Cigna Commercial	$13.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.03
Rate for Payer: Oxford Commercial	$5.35
Rate for Payer: Qualcare PPO/HMO/WC	$4.01
Rate for Payer: UnitedHealthcare Commercial	$5.35
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

SET COLLECTION SYNEVAC 610

Facility

$26.75

Hospital Charge Code	270612228
Hospital Revenue Code	272
Min. Negotiated Rate	$4.01
Max. Negotiated Rate	$4.01
Rate for Payer: Qualcare PPO/HMO/WC	$4.01

SET CONNECTION ACCEL TUBING

Facility

$9.80

Hospital Charge Code	270703866
Hospital Revenue Code	279
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$4.90
Rate for Payer: Aetna Commercial	$3.72
Rate for Payer: Aetna Medicare Advantage	$2.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.50
Rate for Payer: Cigna Commercial	$4.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.94
Rate for Payer: Oxford Commercial	$1.96
Rate for Payer: Qualcare PPO/HMO/WC	$1.47
Rate for Payer: UnitedHealthcare Commercial	$1.96
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

SET CONNECTION ACCEL TUBING

Facility

$9.80

Hospital Charge Code	270703866
Hospital Revenue Code	279
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$1.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.47

SET COUDE 30 CC **********

Facility

$84.00

Hospital Charge Code	8002776
Hospital Revenue Code	279
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

Know your out-of-pocket cost for care.

All Charges