Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SPIRAL ELECTRODE

Facility

$51.00

Hospital Charge Code	270331667
Hospital Revenue Code	272
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$25.50
Rate for Payer: Aetna Commercial	$19.38
Rate for Payer: Aetna Medicare Advantage	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.01
Rate for Payer: Cigna Commercial	$25.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.30
Rate for Payer: Oxford Commercial	$10.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$10.20
Rate for Payer: UnitedHealthcare Community & State	$1.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1.35

SPIRALOK 5.0MM O-C V&B

Facility

$1,850.00

Hospital Charge Code	270658636
Hospital Revenue Code	278
Min. Negotiated Rate	$44.59
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$703.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$407.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Community & State	$44.59
Rate for Payer: Wellpoint Medicaid Managed Care	$49.02

SPIRALOK 5.0MM O-C V&B

Facility

$1,850.00

Hospital Charge Code	270658636
Hospital Revenue Code	278
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$447.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$407.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

SPIRA V 19MM

Facility

$27,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704959
Hospital Revenue Code	278
Min. Negotiated Rate	$4,125.00
Max. Negotiated Rate	$6,655.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,655.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,125.00

SPIRA V 19MM

Facility

$27,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704959
Hospital Revenue Code	278
Min. Negotiated Rate	$662.75
Max. Negotiated Rate	$13,750.00
Rate for Payer: Aetna Commercial	$10,450.00
Rate for Payer: Aetna Medicare Advantage	$8,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,012.50
Rate for Payer: Cigna Commercial	$13,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,655.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,125.00
Rate for Payer: UnitedHealthcare Community & State	$662.75
Rate for Payer: Wellpoint Medicaid Managed Care	$728.75

SPIRO 12 X 16 1 1/4 IN

Facility

$285.00

Hospital Charge Code	270682982
Hospital Revenue Code	272
Min. Negotiated Rate	$6.87
Max. Negotiated Rate	$142.50
Rate for Payer: Aetna Commercial	$108.30
Rate for Payer: Aetna Medicare Advantage	$85.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.67
Rate for Payer: Cigna Commercial	$142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.50
Rate for Payer: Oxford Commercial	$57.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.75
Rate for Payer: UnitedHealthcare Commercial	$57.00
Rate for Payer: UnitedHealthcare Community & State	$6.87
Rate for Payer: Wellpoint Medicaid Managed Care	$7.55

SPIRO 12 X 16 1 1/4 IN

Facility

$285.00

Hospital Charge Code	270682982
Hospital Revenue Code	272
Min. Negotiated Rate	$42.75
Max. Negotiated Rate	$42.75
Rate for Payer: Qualcare PPO/HMO/WC	$42.75

SPIROMETER BELL DRY SEA

Facility

$2,681.65

Hospital Charge Code	270606088
Hospital Revenue Code	272
Min. Negotiated Rate	$64.63
Max. Negotiated Rate	$1,340.83
Rate for Payer: Aetna Commercial	$1,019.03
Rate for Payer: Aetna Medicare Advantage	$804.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$683.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$683.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$683.82
Rate for Payer: Cigna Commercial	$1,340.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.50
Rate for Payer: Oxford Commercial	$536.33
Rate for Payer: Qualcare PPO/HMO/WC	$402.25
Rate for Payer: UnitedHealthcare Commercial	$536.33
Rate for Payer: UnitedHealthcare Community & State	$64.63
Rate for Payer: Wellpoint Medicaid Managed Care	$71.06

SPIROMETER BELL DRY SEA

Facility

$2,681.65

Hospital Charge Code	270606088
Hospital Revenue Code	272
Min. Negotiated Rate	$402.25
Max. Negotiated Rate	$402.25
Rate for Payer: Qualcare PPO/HMO/WC	$402.25

SPIROMETER INCENTIVE

Facility

$37.65

Hospital Charge Code	270607014
Hospital Revenue Code	270
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.82
Rate for Payer: Aetna Commercial	$14.31
Rate for Payer: Aetna Medicare Advantage	$11.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.60
Rate for Payer: Cigna Commercial	$18.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.29
Rate for Payer: Oxford Commercial	$7.53
Rate for Payer: Qualcare PPO/HMO/WC	$5.65
Rate for Payer: UnitedHealthcare Commercial	$7.53
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

SPIROMETER INCENTIVE

Facility

$37.65

Hospital Charge Code	270607014
Hospital Revenue Code	270
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$5.65
Rate for Payer: Qualcare PPO/HMO/WC	$5.65

SPIROMETER INCENTIVE DEVICE

Facility

$32.00

Hospital Charge Code	270603159
Hospital Revenue Code	272
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$6.40
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

SPIROMETER INCENTIVE DEVICE

Facility

$32.00

Hospital Charge Code	270603159
Hospital Revenue Code	272
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

SPIROMETER INCENTIVE DEVICE***

Facility

$25.00

Hospital Charge Code	9501024
Hospital Revenue Code	279
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

SPIROMETER INCENTIVE DEVICE***

Facility

$25.00

Hospital Charge Code	9501024
Hospital Revenue Code	279
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

SPIROMETER INCENTIVE VOLUMETRC

Facility

$12.89

Hospital Charge Code	270200070
Hospital Revenue Code	270
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.93

SPIROMETER INCENTIVE VOLUMETRC

Facility

$12.89

Hospital Charge Code	270200070
Hospital Revenue Code	270
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.45
Rate for Payer: Aetna Commercial	$4.90
Rate for Payer: Aetna Medicare Advantage	$3.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.29
Rate for Payer: Cigna Commercial	$6.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.87
Rate for Payer: Oxford Commercial	$2.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.93
Rate for Payer: UnitedHealthcare Commercial	$2.58
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

SPIROMETRY PRE AND POST NEB RX

Facility

$36.16

Service Code	HCPCS 94060
Hospital Charge Code	83652375
Hospital Revenue Code	460
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$1,205.83
Rate for Payer: Aetna Medicare Advantage	$1,436.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$443.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,600.25
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: Cigna Medicare Advantage	$443.32
Rate for Payer: Clover Medicare Advantage	$421.15
Rate for Payer: EmblemHealth Commercial	$1,329.96
Rate for Payer: Humana Medicare Advantage	$456.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$443.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.85
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.42
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$443.32
Rate for Payer: Wellcare Medicare Advantage	$443.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.96

SPIROMETRY PRE AND POST NEB RX

Facility

$36.16

Service Code	HCPCS 94060
Hospital Charge Code	83652375
Hospital Revenue Code	460
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$5.42
Rate for Payer: Qualcare PPO/HMO/WC	$5.42

SPIROMETRY PRE & POST NEB RX

Facility

$36.16

Service Code	HCPCS 94060
Hospital Charge Code	87502875
Hospital Revenue Code	460
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$1,205.83
Rate for Payer: Aetna Medicare Advantage	$1,436.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$443.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,600.25
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: Cigna Medicare Advantage	$443.32
Rate for Payer: Clover Medicare Advantage	$421.15
Rate for Payer: EmblemHealth Commercial	$1,329.96
Rate for Payer: Humana Medicare Advantage	$456.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$443.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.85
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.42
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$443.32
Rate for Payer: Wellcare Medicare Advantage	$443.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.96

SPIROMETRY PRE & POST NEB RX

Facility

$36.16

Service Code	HCPCS 94060
Hospital Charge Code	87502875
Hospital Revenue Code	460
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$5.42
Rate for Payer: Qualcare PPO/HMO/WC	$5.42

SPIROMETRY PRE&POST NEB RX

Facility

$36.16

Service Code	HCPCS 94060
Hospital Charge Code	87502730
Hospital Revenue Code	460
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$5.42
Rate for Payer: Qualcare PPO/HMO/WC	$5.42

SPIROMETRY PRE&POST NEB RX

Facility

$36.16

Service Code	HCPCS 94060
Hospital Charge Code	87502730
Hospital Revenue Code	460
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$1,205.83
Rate for Payer: Aetna Medicare Advantage	$1,436.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$443.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,600.25
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: Cigna Medicare Advantage	$443.32
Rate for Payer: Clover Medicare Advantage	$421.15
Rate for Payer: EmblemHealth Commercial	$1,329.96
Rate for Payer: Humana Medicare Advantage	$456.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$443.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.85
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.42
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$443.32
Rate for Payer: Wellcare Medicare Advantage	$443.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.96

SPIROMETRY SIMPLE THERAPHY***

Facility

$201.30

Service Code	HCPCS 94010
Hospital Charge Code	9500570
Hospital Revenue Code	419
Min. Negotiated Rate	$4.85
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$307.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$925.96
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.39
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.20
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$4.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$5.33

SPIROMETRY SIMPLE THERAPHY***

Facility

$201.30

Service Code	HCPCS 94010
Hospital Charge Code	9500570
Hospital Revenue Code	419
Min. Negotiated Rate	$30.20
Max. Negotiated Rate	$30.20
Rate for Payer: Qualcare PPO/HMO/WC	$30.20

Know your out-of-pocket cost for care.

All Charges