Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BANDAGE PLASTER FST SET 5 X 5

Facility

$62.00

Hospital Charge Code	270331278
Hospital Revenue Code	272
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$31.00
Rate for Payer: Aetna Commercial	$23.56
Rate for Payer: Aetna Medicare Advantage	$18.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.81
Rate for Payer: Cigna Commercial	$31.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.60
Rate for Payer: Oxford Commercial	$12.40
Rate for Payer: Qualcare PPO/HMO/WC	$9.30
Rate for Payer: UnitedHealthcare Commercial	$12.40
Rate for Payer: UnitedHealthcare Community & State	$1.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1.64

BANDAGE PLASTER OF PARIS 45YD

Facility

$30.00

Hospital Charge Code	270330849
Hospital Revenue Code	270
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

BANDAGE PLASTER OF PARIS 45YD

Facility

$30.00

Hospital Charge Code	270330849
Hospital Revenue Code	270
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

BANDAGE PLASTER X-FAST 2

Facility

$4.05

Hospital Charge Code	270649479
Hospital Revenue Code	272
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.02
Rate for Payer: Aetna Commercial	$1.54
Rate for Payer: Aetna Medicare Advantage	$1.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.03
Rate for Payer: Cigna Commercial	$2.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.22
Rate for Payer: Oxford Commercial	$0.81
Rate for Payer: Qualcare PPO/HMO/WC	$0.61
Rate for Payer: UnitedHealthcare Commercial	$0.81
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

BANDAGE PLASTER X-FAST 2

Facility

$4.05

Hospital Charge Code	270649479
Hospital Revenue Code	272
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$0.61
Rate for Payer: Qualcare PPO/HMO/WC	$0.61

BANDAGE PLASTER X-FAST 3

Facility

$5.47

Hospital Charge Code	270649480
Hospital Revenue Code	272
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.73
Rate for Payer: Aetna Commercial	$2.08
Rate for Payer: Aetna Medicare Advantage	$1.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.39
Rate for Payer: Cigna Commercial	$2.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.64
Rate for Payer: Oxford Commercial	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$0.82
Rate for Payer: UnitedHealthcare Commercial	$1.09
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

BANDAGE PLASTER X-FAST 3

Facility

$5.47

Hospital Charge Code	270649480
Hospital Revenue Code	272
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.82
Rate for Payer: Qualcare PPO/HMO/WC	$0.82

BANDAGE PLASTER X-FAST 5

Facility

$8.47

Hospital Charge Code	270649481
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$4.24
Rate for Payer: Aetna Commercial	$3.22
Rate for Payer: Aetna Medicare Advantage	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.16
Rate for Payer: Cigna Commercial	$4.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.54
Rate for Payer: Oxford Commercial	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.27
Rate for Payer: UnitedHealthcare Commercial	$1.69
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

BANDAGE PLASTER X-FAST 5

Facility

$8.47

Hospital Charge Code	270649481
Hospital Revenue Code	272
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$1.27
Rate for Payer: Qualcare PPO/HMO/WC	$1.27

BANDAGE PLASTER X-FAST 6

Facility

$9.32

Hospital Charge Code	270649482
Hospital Revenue Code	272
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.40

BANDAGE PLASTER X-FAST 6

Facility

$9.32

Hospital Charge Code	270649482
Hospital Revenue Code	272
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.66
Rate for Payer: Aetna Commercial	$3.54
Rate for Payer: Aetna Medicare Advantage	$2.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.38
Rate for Payer: Cigna Commercial	$4.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.80
Rate for Payer: Oxford Commercial	$1.86
Rate for Payer: Qualcare PPO/HMO/WC	$1.40
Rate for Payer: UnitedHealthcare Commercial	$1.86
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

BANDAGE ROLL

Facility

$9.00

Hospital Charge Code	8000218
Hospital Revenue Code	279
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

BANDAGE ROLL

Facility

$9.00

Hospital Charge Code	8000218
Hospital Revenue Code	279
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

BANDAGE SHEER 1

Facility

$0.08

Hospital Charge Code	270350170
Hospital Revenue Code	272
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Qualcare PPO/HMO/WC	$0.01

BANDAGE SHEER 1

Facility

$0.08

Hospital Charge Code	270350170
Hospital Revenue Code	272
Max. Negotiated Rate	$0.04
Rate for Payer: Aetna Commercial	$0.03
Rate for Payer: Aetna Medicare Advantage	$0.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.02
Rate for Payer: Cigna Commercial	$0.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.02
Rate for Payer: Oxford Commercial	$0.02
Rate for Payer: Qualcare PPO/HMO/WC	$0.01
Rate for Payer: UnitedHealthcare Commercial	$0.02
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

BANDAGE SHEER 1 IN 3583003270

Facility

$2.50

Hospital Charge Code	270350170W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.25
Rate for Payer: Aetna Commercial	$0.95
Rate for Payer: Aetna Medicare Advantage	$0.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.64
Rate for Payer: Cigna Commercial	$1.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.75
Rate for Payer: Oxford Commercial	$0.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.38
Rate for Payer: UnitedHealthcare Commercial	$0.50
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.07

BANDAGE SHEER 1 IN 3583003270

Facility

$2.50

Hospital Charge Code	270350170W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$0.38
Rate for Payer: Qualcare PPO/HMO/WC	$0.38

BANDAGE SHURLOCK W/VELCRO

Facility

$4.77

Hospital Charge Code	270653855
Hospital Revenue Code	272
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.38
Rate for Payer: Aetna Commercial	$1.81
Rate for Payer: Aetna Medicare Advantage	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.22
Rate for Payer: Cigna Commercial	$2.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.43
Rate for Payer: Oxford Commercial	$0.95
Rate for Payer: Qualcare PPO/HMO/WC	$0.72
Rate for Payer: UnitedHealthcare Commercial	$0.95
Rate for Payer: UnitedHealthcare Community & State	$0.11
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

BANDAGE SHURLOCK W/VELCRO

Facility

$4.77

Hospital Charge Code	270653855
Hospital Revenue Code	272
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$0.72
Rate for Payer: Qualcare PPO/HMO/WC	$0.72

BANDAGE SHURLOCK W/VELCRO 4

Facility

$45.75

Hospital Charge Code	270653905
Hospital Revenue Code	272
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$22.88
Rate for Payer: Aetna Commercial	$17.39
Rate for Payer: Aetna Medicare Advantage	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.67
Rate for Payer: Cigna Commercial	$22.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.72
Rate for Payer: Oxford Commercial	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.86
Rate for Payer: UnitedHealthcare Commercial	$9.15
Rate for Payer: UnitedHealthcare Community & State	$1.10
Rate for Payer: Wellpoint Medicaid Managed Care	$1.21

BANDAGE SHURLOCK W/VELCRO 4

Facility

$45.75

Hospital Charge Code	270653905
Hospital Revenue Code	272
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$6.86
Rate for Payer: Qualcare PPO/HMO/WC	$6.86

BANDAGE SPANDAGE DRESSING SZ.

Facility

$38.24

Hospital Charge Code	270658824
Hospital Revenue Code	272
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$5.74
Rate for Payer: Qualcare PPO/HMO/WC	$5.74

BANDAGE SPANDAGE DRESSING SZ.

Facility

$38.24

Hospital Charge Code	270658824
Hospital Revenue Code	272
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$19.12
Rate for Payer: Aetna Commercial	$14.53
Rate for Payer: Aetna Medicare Advantage	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.75
Rate for Payer: Cigna Commercial	$19.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.47
Rate for Payer: Oxford Commercial	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$5.74
Rate for Payer: UnitedHealthcare Commercial	$7.65
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

BANDAGE SPANDAGE SZ 1

Facility

$52.00

Hospital Charge Code	270600768
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

BANDAGE SPANDAGE SZ 1

Facility

$52.00

Hospital Charge Code	270600768
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

Know your out-of-pocket cost for care.

All Charges