Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SET INTRODUCER CATH VSTICK 5F

Facility

$116.68

Hospital Charge Code	270676899S
Hospital Revenue Code	272
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$17.50
Rate for Payer: Qualcare PPO/HMO/WC	$17.50

SET IRRIGATION COLOSTOMY

Facility

$621.65

Hospital Charge Code	270303210
Hospital Revenue Code	272
Min. Negotiated Rate	$14.98
Max. Negotiated Rate	$310.82
Rate for Payer: Aetna Commercial	$236.23
Rate for Payer: Aetna Medicare Advantage	$186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.52
Rate for Payer: Cigna Commercial	$310.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.50
Rate for Payer: Oxford Commercial	$124.33
Rate for Payer: Qualcare PPO/HMO/WC	$93.25
Rate for Payer: UnitedHealthcare Commercial	$124.33
Rate for Payer: UnitedHealthcare Community & State	$14.98
Rate for Payer: Wellpoint Medicaid Managed Care	$16.47

SET IRRIGATION COLOSTOMY

Facility

$621.65

Hospital Charge Code	270303210
Hospital Revenue Code	272
Min. Negotiated Rate	$93.25
Max. Negotiated Rate	$93.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.25

SET IRRIGATION FLUID

Facility

$564.85

Hospital Charge Code	270605497
Hospital Revenue Code	270
Min. Negotiated Rate	$13.61
Max. Negotiated Rate	$282.43
Rate for Payer: Aetna Commercial	$214.64
Rate for Payer: Aetna Medicare Advantage	$169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.04
Rate for Payer: Cigna Commercial	$282.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.46
Rate for Payer: Oxford Commercial	$112.97
Rate for Payer: Qualcare PPO/HMO/WC	$84.73
Rate for Payer: UnitedHealthcare Commercial	$112.97
Rate for Payer: UnitedHealthcare Community & State	$13.61
Rate for Payer: Wellpoint Medicaid Managed Care	$14.97

SET IRRIGATION FLUID

Facility

$564.85

Hospital Charge Code	270605497
Hospital Revenue Code	270
Min. Negotiated Rate	$84.73
Max. Negotiated Rate	$84.73
Rate for Payer: Qualcare PPO/HMO/WC	$84.73

SET IRRIG TUB STRYK 260-901-52

Facility

$287.25

Hospital Charge Code	270615504
Hospital Revenue Code	272
Min. Negotiated Rate	$43.09
Max. Negotiated Rate	$43.09
Rate for Payer: Qualcare PPO/HMO/WC	$43.09

SET IRRIG TUB STRYK 260-901-52

Facility

$287.25

Hospital Charge Code	270615504
Hospital Revenue Code	272
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$143.62
Rate for Payer: Aetna Commercial	$109.16
Rate for Payer: Aetna Medicare Advantage	$86.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.25
Rate for Payer: Cigna Commercial	$143.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.17
Rate for Payer: Oxford Commercial	$57.45
Rate for Payer: Qualcare PPO/HMO/WC	$43.09
Rate for Payer: UnitedHealthcare Commercial	$57.45
Rate for Payer: UnitedHealthcare Community & State	$6.92
Rate for Payer: Wellpoint Medicaid Managed Care	$7.61

SET IV FLUID WARMING DISP D100

Facility

$321.25

Hospital Charge Code	270617276
Hospital Revenue Code	272
Min. Negotiated Rate	$48.19
Max. Negotiated Rate	$48.19
Rate for Payer: Qualcare PPO/HMO/WC	$48.19

SET IV FLUID WARMING DISP D100

Facility

$321.25

Hospital Charge Code	270617276
Hospital Revenue Code	272
Min. Negotiated Rate	$7.74
Max. Negotiated Rate	$160.62
Rate for Payer: Aetna Commercial	$122.08
Rate for Payer: Aetna Medicare Advantage	$96.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.92
Rate for Payer: Cigna Commercial	$160.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.38
Rate for Payer: Oxford Commercial	$64.25
Rate for Payer: Qualcare PPO/HMO/WC	$48.19
Rate for Payer: UnitedHealthcare Commercial	$64.25
Rate for Payer: UnitedHealthcare Community & State	$7.74
Rate for Payer: Wellpoint Medicaid Managed Care	$8.51

SET IV FLUID WARMING L-30

Facility

$99.25

Hospital Charge Code	270617134
Hospital Revenue Code	272
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$49.62
Rate for Payer: Aetna Commercial	$37.72
Rate for Payer: Aetna Medicare Advantage	$29.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.31
Rate for Payer: Cigna Commercial	$49.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.77
Rate for Payer: Oxford Commercial	$19.85
Rate for Payer: Qualcare PPO/HMO/WC	$14.89
Rate for Payer: UnitedHealthcare Commercial	$19.85
Rate for Payer: UnitedHealthcare Community & State	$2.39
Rate for Payer: Wellpoint Medicaid Managed Care	$2.63

SET IV FLUID WARMING L-30

Facility

$99.25

Hospital Charge Code	270617134
Hospital Revenue Code	272
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$14.89
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

SET JUGGERKNOT 1.4MM SHORT

Facility

$2,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270661171
Hospital Revenue Code	278
Min. Negotiated Rate	$48.80
Max. Negotiated Rate	$1,012.50
Rate for Payer: Aetna Commercial	$769.50
Rate for Payer: Aetna Medicare Advantage	$607.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$516.38
Rate for Payer: Cigna Commercial	$1,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$303.75
Rate for Payer: UnitedHealthcare Community & State	$48.80
Rate for Payer: Wellpoint Medicaid Managed Care	$53.66

SET JUGGERKNOT 1.4MM SHORT

Facility

$2,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270661171
Hospital Revenue Code	278
Min. Negotiated Rate	$303.75
Max. Negotiated Rate	$490.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$445.50
Rate for Payer: Qualcare PPO/HMO/WC	$303.75

SET JUGGERNOT SHRT DISP 912073

Facility

$1,930.00

Service Code	HCPCS C1713
Hospital Charge Code	270661170
Hospital Revenue Code	278
Min. Negotiated Rate	$46.51
Max. Negotiated Rate	$965.00
Rate for Payer: Aetna Commercial	$733.40
Rate for Payer: Aetna Medicare Advantage	$579.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.15
Rate for Payer: Cigna Commercial	$965.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$424.60
Rate for Payer: Qualcare PPO/HMO/WC	$289.50
Rate for Payer: UnitedHealthcare Community & State	$46.51
Rate for Payer: Wellpoint Medicaid Managed Care	$51.15

SET JUGGERNOT SHRT DISP 912073

Facility

$1,930.00

Service Code	HCPCS C1713
Hospital Charge Code	270661170
Hospital Revenue Code	278
Min. Negotiated Rate	$289.50
Max. Negotiated Rate	$467.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$424.60
Rate for Payer: Qualcare PPO/HMO/WC	$289.50

SET KANGAROO ENTERAL PU

Facility

$22.80

Hospital Charge Code	270301932
Hospital Revenue Code	270
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$3.42
Rate for Payer: Qualcare PPO/HMO/WC	$3.42

SET KANGAROO ENTERAL PU

Facility

$22.80

Hospital Charge Code	270301932
Hospital Revenue Code	270
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$11.40
Rate for Payer: Aetna Commercial	$8.66
Rate for Payer: Aetna Medicare Advantage	$6.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.81
Rate for Payer: Cigna Commercial	$11.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.84
Rate for Payer: Oxford Commercial	$4.56
Rate for Payer: Qualcare PPO/HMO/WC	$3.42
Rate for Payer: UnitedHealthcare Commercial	$4.56
Rate for Payer: UnitedHealthcare Community & State	$0.55
Rate for Payer: Wellpoint Medicaid Managed Care	$0.60

SET KANGAROO ENTERAL PUMP****

Facility

$33.00

Hospital Charge Code	8000796
Hospital Revenue Code	279
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

SET KANGAROO ENTERAL PUMP****

Facility

$33.00

Hospital Charge Code	8000796
Hospital Revenue Code	279
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$12.54
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.90
Rate for Payer: Oxford Commercial	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$6.60
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

SET LIPID INFUSION LPS-3017

Facility

$29.65

Hospital Charge Code	270622023
Hospital Revenue Code	272
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$4.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.45

SET LIPID INFUSION LPS-3017

Facility

$29.65

Hospital Charge Code	270622023
Hospital Revenue Code	272
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$14.82
Rate for Payer: Aetna Commercial	$11.27
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.56
Rate for Payer: Cigna Commercial	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.89
Rate for Payer: Oxford Commercial	$5.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.45
Rate for Payer: UnitedHealthcare Commercial	$5.93
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

SET LIVER TRANSJUGULAR ROSCH

Facility

$2,262.00

Hospital Charge Code	270686621
Hospital Revenue Code	272
Min. Negotiated Rate	$54.51
Max. Negotiated Rate	$1,131.00
Rate for Payer: Aetna Commercial	$859.56
Rate for Payer: Aetna Medicare Advantage	$678.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$576.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$576.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$576.81
Rate for Payer: Cigna Commercial	$1,131.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$678.60
Rate for Payer: Oxford Commercial	$452.40
Rate for Payer: Qualcare PPO/HMO/WC	$339.30
Rate for Payer: UnitedHealthcare Commercial	$452.40
Rate for Payer: UnitedHealthcare Community & State	$54.51
Rate for Payer: Wellpoint Medicaid Managed Care	$59.94

SET LIVER TRANSJUGULAR ROSCH

Facility

$2,262.00

Hospital Charge Code	270686621
Hospital Revenue Code	272
Min. Negotiated Rate	$339.30
Max. Negotiated Rate	$339.30
Rate for Payer: Qualcare PPO/HMO/WC	$339.30

SET MARX-COPE GASTROJEJUNOSTMY

Facility

$1,778.65

Hospital Charge Code	270642026
Hospital Revenue Code	278
Min. Negotiated Rate	$42.87
Max. Negotiated Rate	$889.33
Rate for Payer: Aetna Commercial	$675.89
Rate for Payer: Aetna Medicare Advantage	$533.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$453.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$453.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$453.56
Rate for Payer: Cigna Commercial	$889.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$430.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$391.30
Rate for Payer: Qualcare PPO/HMO/WC	$266.80
Rate for Payer: UnitedHealthcare Community & State	$42.87
Rate for Payer: Wellpoint Medicaid Managed Care	$47.13

SET MARX-COPE GASTROJEJUNOSTMY

Facility

$1,778.65

Hospital Charge Code	270642026
Hospital Revenue Code	278
Min. Negotiated Rate	$266.80
Max. Negotiated Rate	$430.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$430.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$391.30
Rate for Payer: Qualcare PPO/HMO/WC	$266.80

Know your out-of-pocket cost for care.

All Charges