Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SET EXT MINIBORE 12LX50 18937

Facility

$45.65

Hospital Charge Code	270633401
Hospital Revenue Code	272
Min. Negotiated Rate	$6.85
Max. Negotiated Rate	$6.85
Rate for Payer: Qualcare PPO/HMO/WC	$6.85

SET EXT MINIBORE 12LX50 18937

Facility

$45.65

Hospital Charge Code	270633401
Hospital Revenue Code	272
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$22.82
Rate for Payer: Aetna Commercial	$17.35
Rate for Payer: Aetna Medicare Advantage	$13.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.64
Rate for Payer: Cigna Commercial	$22.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.70
Rate for Payer: Oxford Commercial	$9.13
Rate for Payer: Qualcare PPO/HMO/WC	$6.85
Rate for Payer: UnitedHealthcare Commercial	$9.13
Rate for Payer: UnitedHealthcare Community & State	$1.10
Rate for Payer: Wellpoint Medicaid Managed Care	$1.21

SET FLAP REPAIR SINGLE SHOT

Facility

$1,625.00

Hospital Charge Code	270627256
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

SET FLAP REPAIR SINGLE SHOT

Facility

$1,625.00

Hospital Charge Code	270627256
Hospital Revenue Code	278
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$357.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

SET FLOSTE PUMP TUBE0350800006

Facility

$342.50

Hospital Charge Code	270640300
Hospital Revenue Code	272
Min. Negotiated Rate	$51.38
Max. Negotiated Rate	$51.38
Rate for Payer: Qualcare PPO/HMO/WC	$51.38

SET FLOSTE PUMP TUBE0350800006

Facility

$342.50

Hospital Charge Code	270640300
Hospital Revenue Code	272
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$171.25
Rate for Payer: Aetna Commercial	$130.15
Rate for Payer: Aetna Medicare Advantage	$102.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.34
Rate for Payer: Cigna Commercial	$171.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.75
Rate for Payer: Oxford Commercial	$68.50
Rate for Payer: Qualcare PPO/HMO/WC	$51.38
Rate for Payer: UnitedHealthcare Commercial	$68.50
Rate for Payer: UnitedHealthcare Community & State	$8.25
Rate for Payer: Wellpoint Medicaid Managed Care	$9.08

SET GBA WIRE GRFT TRFX AR1251S

Facility

$1,334.45

Hospital Charge Code	270614984
Hospital Revenue Code	272
Min. Negotiated Rate	$200.17
Max. Negotiated Rate	$200.17
Rate for Payer: Qualcare PPO/HMO/WC	$200.17

SET GBA WIRE GRFT TRFX AR1251S

Facility

$1,334.45

Hospital Charge Code	270614984
Hospital Revenue Code	272
Min. Negotiated Rate	$32.16
Max. Negotiated Rate	$667.23
Rate for Payer: Aetna Commercial	$507.09
Rate for Payer: Aetna Medicare Advantage	$400.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.28
Rate for Payer: Cigna Commercial	$667.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$400.33
Rate for Payer: Oxford Commercial	$266.89
Rate for Payer: Qualcare PPO/HMO/WC	$200.17
Rate for Payer: UnitedHealthcare Commercial	$266.89
Rate for Payer: UnitedHealthcare Community & State	$32.16
Rate for Payer: Wellpoint Medicaid Managed Care	$35.36

SET GBA WIRE GRFT TRFX AR1978

Facility

$414.45

Hospital Charge Code	270614982
Hospital Revenue Code	272
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$207.22
Rate for Payer: Aetna Commercial	$157.49
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.68
Rate for Payer: Cigna Commercial	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.33
Rate for Payer: Oxford Commercial	$82.89
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$82.89
Rate for Payer: UnitedHealthcare Community & State	$9.99
Rate for Payer: Wellpoint Medicaid Managed Care	$10.98

SET GBA WIRE GRFT TRFX AR1978

Facility

$414.45

Hospital Charge Code	270614982
Hospital Revenue Code	272
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

SET GRT TOE SIZR SWNSN 4933000

Facility

$2,356.00

Hospital Charge Code	270611662
Hospital Revenue Code	272
Min. Negotiated Rate	$56.78
Max. Negotiated Rate	$1,178.00
Rate for Payer: Aetna Commercial	$895.28
Rate for Payer: Aetna Medicare Advantage	$706.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$600.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$600.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$600.78
Rate for Payer: Cigna Commercial	$1,178.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$706.80
Rate for Payer: Oxford Commercial	$471.20
Rate for Payer: Qualcare PPO/HMO/WC	$353.40
Rate for Payer: UnitedHealthcare Commercial	$471.20
Rate for Payer: UnitedHealthcare Community & State	$56.78
Rate for Payer: Wellpoint Medicaid Managed Care	$62.43

SET GRT TOE SIZR SWNSN 4933000

Facility

$2,356.00

Hospital Charge Code	270611662
Hospital Revenue Code	272
Min. Negotiated Rate	$353.40
Max. Negotiated Rate	$353.40
Rate for Payer: Qualcare PPO/HMO/WC	$353.40

SET HYPERINFLATION 3L BAG

Facility

$41.25

Hospital Charge Code	270684594
Hospital Revenue Code	272
Min. Negotiated Rate	$6.19
Max. Negotiated Rate	$6.19
Rate for Payer: Qualcare PPO/HMO/WC	$6.19

SET HYPERINFLATION 3L BAG

Facility

$41.25

Hospital Charge Code	270684594
Hospital Revenue Code	272
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$20.62
Rate for Payer: Aetna Commercial	$15.68
Rate for Payer: Aetna Medicare Advantage	$12.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.52
Rate for Payer: Cigna Commercial	$20.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.38
Rate for Payer: Oxford Commercial	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$6.19
Rate for Payer: UnitedHealthcare Commercial	$8.25
Rate for Payer: UnitedHealthcare Community & State	$0.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1.09

SET HY THERMABLATR PROC 55015A

Facility

$3,224.00

Hospital Charge Code	270634096
Hospital Revenue Code	272
Min. Negotiated Rate	$483.60
Max. Negotiated Rate	$483.60
Rate for Payer: Qualcare PPO/HMO/WC	$483.60

SET HY THERMABLATR PROC 55015A

Facility

$3,224.00

Hospital Charge Code	270634096
Hospital Revenue Code	272
Min. Negotiated Rate	$77.70
Max. Negotiated Rate	$1,612.00
Rate for Payer: Aetna Commercial	$1,225.12
Rate for Payer: Aetna Medicare Advantage	$967.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$822.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$822.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$822.12
Rate for Payer: Cigna Commercial	$1,612.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$967.20
Rate for Payer: Oxford Commercial	$644.80
Rate for Payer: Qualcare PPO/HMO/WC	$483.60
Rate for Payer: UnitedHealthcare Commercial	$644.80
Rate for Payer: UnitedHealthcare Community & State	$77.70
Rate for Payer: Wellpoint Medicaid Managed Care	$85.44

SET,INFANT SUCTION

Facility

$16.00

Hospital Charge Code	270331481
Hospital Revenue Code	272
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$8.00
Rate for Payer: Aetna Commercial	$6.08
Rate for Payer: Aetna Medicare Advantage	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.08
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.80
Rate for Payer: Oxford Commercial	$3.20
Rate for Payer: Qualcare PPO/HMO/WC	$2.40
Rate for Payer: UnitedHealthcare Commercial	$3.20
Rate for Payer: UnitedHealthcare Community & State	$0.39
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

SET,INFANT SUCTION

Facility

$16.00

Hospital Charge Code	270331481
Hospital Revenue Code	272
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

SET INFILTRATION KLEIN S SPIKE

Facility

$75.00

Hospital Charge Code	270703802
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

SET INFILTRATION KLEIN S SPIKE

Facility

$75.00

Hospital Charge Code	270703802
Hospital Revenue Code	272
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$1.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

SET INFUS LIPID Y-SITE LPS3009

Facility

$44.00

Hospital Charge Code	270619304
Hospital Revenue Code	272
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

SET INFUS LIPID Y-SITE LPS3009

Facility

$44.00

Hospital Charge Code	270619304
Hospital Revenue Code	272
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.20
Rate for Payer: Oxford Commercial	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$8.80
Rate for Payer: UnitedHealthcare Community & State	$1.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

SET INTERMEDIARY TUBING 281142

Facility

$145.84

Hospital Charge Code	270643525
Hospital Revenue Code	272
Min. Negotiated Rate	$21.88
Max. Negotiated Rate	$21.88
Rate for Payer: Qualcare PPO/HMO/WC	$21.88

SET INTERMEDIARY TUBING 281142

Facility

$145.84

Hospital Charge Code	270643525
Hospital Revenue Code	272
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$72.92
Rate for Payer: Aetna Commercial	$55.42
Rate for Payer: Aetna Medicare Advantage	$43.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.19
Rate for Payer: Cigna Commercial	$72.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.75
Rate for Payer: Oxford Commercial	$29.17
Rate for Payer: Qualcare PPO/HMO/WC	$21.88
Rate for Payer: UnitedHealthcare Commercial	$29.17
Rate for Payer: UnitedHealthcare Community & State	$3.51
Rate for Payer: Wellpoint Medicaid Managed Care	$3.86

SET INTRODUCER CATH VSTICK 5F

Facility

$116.68

Hospital Charge Code	270676899S
Hospital Revenue Code	272
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$58.34
Rate for Payer: Aetna Commercial	$44.34
Rate for Payer: Aetna Medicare Advantage	$35.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.75
Rate for Payer: Cigna Commercial	$58.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.00
Rate for Payer: Oxford Commercial	$23.34
Rate for Payer: Qualcare PPO/HMO/WC	$17.50
Rate for Payer: UnitedHealthcare Commercial	$23.34
Rate for Payer: UnitedHealthcare Community & State	$2.81
Rate for Payer: Wellpoint Medicaid Managed Care	$3.09

Know your out-of-pocket cost for care.

All Charges