Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SET MICROPUNCT 4F SS MAK401E

Facility

$12.50

Hospital Charge Code	270655023S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

SET MICROPUNCT 4F SS MAK401E

Facility

$12.50

Hospital Charge Code	270655023
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$6.25
Rate for Payer: Aetna Commercial	$4.75
Rate for Payer: Aetna Medicare Advantage	$3.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.19
Rate for Payer: Cigna Commercial	$6.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.75
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.88
Rate for Payer: UnitedHealthcare Commercial	$2.50
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

SET MICROPUNCT 4F SS MAK401E

Facility

$12.50

Hospital Charge Code	270655023N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$6.25
Rate for Payer: Aetna Commercial	$4.75
Rate for Payer: Aetna Medicare Advantage	$3.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.19
Rate for Payer: Cigna Commercial	$6.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.75
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.88
Rate for Payer: UnitedHealthcare Commercial	$2.50
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

SET MICROPUNCT 4F SS MAK401E

Facility

$12.50

Hospital Charge Code	270655023N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

SET MICROPUNCT 4F SS MAK401E

Facility

$12.50

Hospital Charge Code	270655023
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

SET MICROPUNCT 4F SS MAK401E

Facility

$12.50

Hospital Charge Code	270655023S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$6.25
Rate for Payer: Aetna Commercial	$4.75
Rate for Payer: Aetna Medicare Advantage	$3.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.19
Rate for Payer: Cigna Commercial	$6.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.75
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.88
Rate for Payer: UnitedHealthcare Commercial	$2.50
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

SET MINI-INFUSER BARD OB

Facility

$13.65

Hospital Charge Code	270600490
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$5.19
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.09
Rate for Payer: Oxford Commercial	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$2.73
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

SET MINI-INFUSER BARD OB

Facility

$13.65

Hospital Charge Code	270600490
Hospital Revenue Code	272
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

SET MINI-INFUSOR BARD

Facility

$8.00

Hospital Charge Code	1801117
Hospital Revenue Code	272
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

SET MINI-INFUSOR BARD

Facility

$8.00

Hospital Charge Code	1801117
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$1.60
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SET NEEDLE 25x6 SPINAL 181031

Facility

$60.60

Hospital Charge Code	270636102
Hospital Revenue Code	272
Min. Negotiated Rate	$9.09
Max. Negotiated Rate	$9.09
Rate for Payer: Qualcare PPO/HMO/WC	$9.09

SET NEEDLE 25x6 SPINAL 181031

Facility

$60.60

Hospital Charge Code	270636102
Hospital Revenue Code	272
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$30.30
Rate for Payer: Aetna Commercial	$23.03
Rate for Payer: Aetna Medicare Advantage	$18.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.45
Rate for Payer: Cigna Commercial	$30.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.18
Rate for Payer: Oxford Commercial	$12.12
Rate for Payer: Qualcare PPO/HMO/WC	$9.09
Rate for Payer: UnitedHealthcare Commercial	$12.12
Rate for Payer: UnitedHealthcare Community & State	$1.46
Rate for Payer: Wellpoint Medicaid Managed Care	$1.61

SET NEPHROSTOMY PIGTAIL 080008

Facility

$674.65

Hospital Charge Code	270632772
Hospital Revenue Code	272
Min. Negotiated Rate	$101.20
Max. Negotiated Rate	$101.20
Rate for Payer: Qualcare PPO/HMO/WC	$101.20

SET NEPHROSTOMY PIGTAIL 080008

Facility

$674.65

Hospital Charge Code	270632772
Hospital Revenue Code	272
Min. Negotiated Rate	$16.26
Max. Negotiated Rate	$337.32
Rate for Payer: Aetna Commercial	$256.37
Rate for Payer: Aetna Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.04
Rate for Payer: Cigna Commercial	$337.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.40
Rate for Payer: Oxford Commercial	$134.93
Rate for Payer: Qualcare PPO/HMO/WC	$101.20
Rate for Payer: UnitedHealthcare Commercial	$134.93
Rate for Payer: UnitedHealthcare Community & State	$16.26
Rate for Payer: Wellpoint Medicaid Managed Care	$17.88

SET NIGHT DRAINAGE

Facility

$1,685.65

Hospital Charge Code	270303175
Hospital Revenue Code	272
Min. Negotiated Rate	$252.85
Max. Negotiated Rate	$252.85
Rate for Payer: Qualcare PPO/HMO/WC	$252.85

SET NIGHT DRAINAGE

Facility

$1,685.65

Hospital Charge Code	270303175
Hospital Revenue Code	272
Min. Negotiated Rate	$40.62
Max. Negotiated Rate	$842.83
Rate for Payer: Aetna Commercial	$640.55
Rate for Payer: Aetna Medicare Advantage	$505.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$429.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$429.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$429.84
Rate for Payer: Cigna Commercial	$842.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$505.69
Rate for Payer: Oxford Commercial	$337.13
Rate for Payer: Qualcare PPO/HMO/WC	$252.85
Rate for Payer: UnitedHealthcare Commercial	$337.13
Rate for Payer: UnitedHealthcare Community & State	$40.62
Rate for Payer: Wellpoint Medicaid Managed Care	$44.67

SET PECUTANEOUS PIGTAIL NEPHRO

Facility

$707.20

Hospital Charge Code	270666870
Hospital Revenue Code	272
Min. Negotiated Rate	$106.08
Max. Negotiated Rate	$106.08
Rate for Payer: Qualcare PPO/HMO/WC	$106.08

SET PECUTANEOUS PIGTAIL NEPHRO

Facility

$707.20

Hospital Charge Code	270666870
Hospital Revenue Code	272
Min. Negotiated Rate	$17.04
Max. Negotiated Rate	$353.60
Rate for Payer: Aetna Commercial	$268.74
Rate for Payer: Aetna Medicare Advantage	$212.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$180.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$180.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$180.34
Rate for Payer: Cigna Commercial	$353.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.16
Rate for Payer: Oxford Commercial	$141.44
Rate for Payer: Qualcare PPO/HMO/WC	$106.08
Rate for Payer: UnitedHealthcare Commercial	$141.44
Rate for Payer: UnitedHealthcare Community & State	$17.04
Rate for Payer: Wellpoint Medicaid Managed Care	$18.74

SET PERCUTANEOUS MALECOT

Facility

$715.00

Hospital Charge Code	270331380
Hospital Revenue Code	278
Min. Negotiated Rate	$17.23
Max. Negotiated Rate	$357.50
Rate for Payer: Aetna Commercial	$271.70
Rate for Payer: Aetna Medicare Advantage	$214.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.32
Rate for Payer: Cigna Commercial	$357.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$107.25
Rate for Payer: UnitedHealthcare Community & State	$17.23
Rate for Payer: Wellpoint Medicaid Managed Care	$18.95

SET PERCUTANEOUS MALECOT

Facility

$715.00

Hospital Charge Code	270331380
Hospital Revenue Code	278
Min. Negotiated Rate	$107.25
Max. Negotiated Rate	$173.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.03
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$107.25

SET PICK CHONDRO

Facility

$10,735.00

Hospital Charge Code	270688808
Hospital Revenue Code	272
Min. Negotiated Rate	$1,610.25
Max. Negotiated Rate	$1,610.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,610.25

SET PICK CHONDRO

Facility

$10,735.00

Hospital Charge Code	270688808
Hospital Revenue Code	272
Min. Negotiated Rate	$258.71
Max. Negotiated Rate	$5,367.50
Rate for Payer: Aetna Commercial	$4,079.30
Rate for Payer: Aetna Medicare Advantage	$3,220.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,737.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,737.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,737.43
Rate for Payer: Cigna Commercial	$5,367.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,220.50
Rate for Payer: Oxford Commercial	$2,147.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,610.25
Rate for Payer: UnitedHealthcare Commercial	$2,147.00
Rate for Payer: UnitedHealthcare Community & State	$258.71
Rate for Payer: Wellpoint Medicaid Managed Care	$284.48

SET PLEUX DRAINAGE LINE 507225

Facility

$79.45

Hospital Charge Code	270635259
Hospital Revenue Code	272
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$39.73
Rate for Payer: Aetna Commercial	$30.19
Rate for Payer: Aetna Medicare Advantage	$23.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.26
Rate for Payer: Cigna Commercial	$39.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.84
Rate for Payer: Oxford Commercial	$15.89
Rate for Payer: Qualcare PPO/HMO/WC	$11.92
Rate for Payer: UnitedHealthcare Commercial	$15.89
Rate for Payer: UnitedHealthcare Community & State	$1.91
Rate for Payer: Wellpoint Medicaid Managed Care	$2.11

SET PLEUX DRAINAGE LINE 507225

Facility

$79.45

Hospital Charge Code	270635259
Hospital Revenue Code	272
Min. Negotiated Rate	$11.92
Max. Negotiated Rate	$11.92
Rate for Payer: Qualcare PPO/HMO/WC	$11.92

SET PROCESNG ANGEL ANGELKIT110

Facility

$1,170.00

Hospital Charge Code	270639730
Hospital Revenue Code	272
Min. Negotiated Rate	$175.50
Max. Negotiated Rate	$175.50
Rate for Payer: Qualcare PPO/HMO/WC	$175.50

Know your out-of-pocket cost for care.

All Charges