Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STER SUPLS-CT FOR V ACCESS

Facility

$150.00

Hospital Charge Code	4800965
Hospital Revenue Code	272
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

STER SUPLS-CT FOR V ACCESS

Facility

$150.00

Hospital Charge Code	4800965
Hospital Revenue Code	272
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.00
Rate for Payer: Oxford Commercial	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$30.00
Rate for Payer: UnitedHealthcare Community & State	$3.62
Rate for Payer: Wellpoint Medicaid Managed Care	$3.98

STE TAX EXP 3.0x12mm 389701230

Facility

$12,500.00

Hospital Charge Code	270637495C
Hospital Revenue Code	278
Min. Negotiated Rate	$301.25
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Community & State	$301.25
Rate for Payer: Wellpoint Medicaid Managed Care	$331.25

STE TAX EXP 3.0x12mm 389701230

Facility

$12,500.00

Hospital Charge Code	270637495C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

STETHOSCOPE ESOPHAGEAL 18FR

Facility

$18.27

Hospital Charge Code	270615341
Hospital Revenue Code	272
Min. Negotiated Rate	$2.74
Max. Negotiated Rate	$2.74
Rate for Payer: Qualcare PPO/HMO/WC	$2.74

STETHOSCOPE ESOPHAGEAL 18FR

Facility

$18.27

Hospital Charge Code	270615341
Hospital Revenue Code	272
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$9.13
Rate for Payer: Aetna Commercial	$6.94
Rate for Payer: Aetna Medicare Advantage	$5.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.66
Rate for Payer: Cigna Commercial	$9.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.48
Rate for Payer: Oxford Commercial	$3.65
Rate for Payer: Qualcare PPO/HMO/WC	$2.74
Rate for Payer: UnitedHealthcare Commercial	$3.65
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

STETHSCOPE ESO 9F W/TEMP 90049

Facility

$13.20

Hospital Charge Code	270615342
Hospital Revenue Code	272
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$1.98
Rate for Payer: Qualcare PPO/HMO/WC	$1.98

STETHSCOPE ESO 9F W/TEMP 90049

Facility

$13.20

Hospital Charge Code	270615342
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$6.60
Rate for Payer: Aetna Commercial	$5.02
Rate for Payer: Aetna Medicare Advantage	$3.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.37
Rate for Payer: Cigna Commercial	$6.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.96
Rate for Payer: Oxford Commercial	$2.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.98
Rate for Payer: UnitedHealthcare Commercial	$2.64
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.35

ST EVAL OF SPEECH SOUND PRODUC

Facility

$2,400.00

Service Code	HCPCS 92522GN
Hospital Charge Code	74204041
Hospital Revenue Code	444
Min. Negotiated Rate	$57.84
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$912.00
Rate for Payer: Aetna Medicare Advantage	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.00
Rate for Payer: Cigna Commercial	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$57.84
Rate for Payer: Wellpoint Medicaid Managed Care	$63.60

ST EVAL OF SPEECH SOUND PRODUC

Facility

$2,400.00

Service Code	HCPCS 92522GN
Hospital Charge Code	74204041
Hospital Revenue Code	444
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$360.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

ST EVAL SPEECH DEV ADD HR

Facility

$130.00

Service Code	HCPCS 92608GN
Hospital Charge Code	74204023
Hospital Revenue Code	480
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$19.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.50

ST EVAL SPEECH DEV ADD HR

Facility

$130.00

Service Code	HCPCS 92608GN
Hospital Charge Code	74204023
Hospital Revenue Code	480
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$49.40
Rate for Payer: Aetna Medicare Advantage	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.15
Rate for Payer: Cigna Commercial	$65.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.50
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$3.13
Rate for Payer: Wellpoint Medicaid Managed Care	$3.44

ST EVAL SPEECH DEVICE 1HR

Facility

$596.00

Service Code	HCPCS 92607GN
Hospital Charge Code	74204021
Hospital Revenue Code	480
Min. Negotiated Rate	$14.36
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$226.48
Rate for Payer: Aetna Medicare Advantage	$178.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.98
Rate for Payer: Cigna Commercial	$298.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.80
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.40
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$14.36
Rate for Payer: Wellpoint Medicaid Managed Care	$15.79

ST EVAL SPEECH DEVICE 1HR

Facility

$596.00

Service Code	HCPCS 92607GN
Hospital Charge Code	74204021
Hospital Revenue Code	480
Min. Negotiated Rate	$89.40
Max. Negotiated Rate	$89.40
Rate for Payer: Qualcare PPO/HMO/WC	$89.40

ST EVAL SP SOUND PROD W LANG C

Facility

$2,400.00

Service Code	HCPCS 92523GN
Hospital Charge Code	74204043
Hospital Revenue Code	444
Min. Negotiated Rate	$57.84
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$912.00
Rate for Payer: Aetna Medicare Advantage	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.00
Rate for Payer: Cigna Commercial	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$57.84
Rate for Payer: Wellpoint Medicaid Managed Care	$63.60

ST EVAL SP SOUND PROD W LANG C

Facility

$2,400.00

Service Code	HCPCS 92523GN
Hospital Charge Code	74204043
Hospital Revenue Code	444
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$360.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

ST EVALUATION OF SPEECH FLUENC

Facility

$2,400.00

Service Code	HCPCS 92521GN
Hospital Charge Code	74204039
Hospital Revenue Code	444
Min. Negotiated Rate	$57.84
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$912.00
Rate for Payer: Aetna Medicare Advantage	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.00
Rate for Payer: Cigna Commercial	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$57.84
Rate for Payer: Wellpoint Medicaid Managed Care	$63.60

ST EVALUATION OF SPEECH FLUENC

Facility

$2,400.00

Service Code	HCPCS 92521GN
Hospital Charge Code	74204039
Hospital Revenue Code	444
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$360.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

STE VIA 7FR 15X120cm VBH061502

Facility

$18,350.00

Hospital Charge Code	270639498C
Hospital Revenue Code	278
Min. Negotiated Rate	$442.24
Max. Negotiated Rate	$9,175.00
Rate for Payer: Aetna Commercial	$6,973.00
Rate for Payer: Aetna Medicare Advantage	$5,505.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,679.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,679.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,679.25
Rate for Payer: Cigna Commercial	$9,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,440.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,037.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,752.50
Rate for Payer: UnitedHealthcare Community & State	$442.24
Rate for Payer: Wellpoint Medicaid Managed Care	$486.27

STE VIA 7FR 15X120cm VBH061502

Facility

$18,350.00

Hospital Charge Code	270639498C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,752.50
Max. Negotiated Rate	$4,440.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,440.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,037.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,752.50

STH PINCLE 7F 65 RSP02

Facility

$585.65

Service Code	HCPCS C1887
Hospital Charge Code	270642217N
Hospital Revenue Code	278
Min. Negotiated Rate	$87.85
Max. Negotiated Rate	$141.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.84
Rate for Payer: Qualcare PPO/HMO/WC	$87.85

STH PINCLE 7F 65 RSP02

Facility

$580.00

Service Code	HCPCS C1887
Hospital Charge Code	270642217C
Hospital Revenue Code	278
Min. Negotiated Rate	$13.98
Max. Negotiated Rate	$290.00
Rate for Payer: Aetna Commercial	$220.40
Rate for Payer: Aetna Medicare Advantage	$174.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.90
Rate for Payer: Cigna Commercial	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.60
Rate for Payer: Qualcare PPO/HMO/WC	$87.00
Rate for Payer: UnitedHealthcare Community & State	$13.98
Rate for Payer: Wellpoint Medicaid Managed Care	$15.37

STH PINCLE 7F 65 RSP02

Facility

$585.65

Service Code	HCPCS C1887
Hospital Charge Code	270642217N
Hospital Revenue Code	278
Min. Negotiated Rate	$14.11
Max. Negotiated Rate	$292.82
Rate for Payer: Aetna Commercial	$222.55
Rate for Payer: Aetna Medicare Advantage	$175.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.34
Rate for Payer: Cigna Commercial	$292.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$128.84
Rate for Payer: Qualcare PPO/HMO/WC	$87.85
Rate for Payer: UnitedHealthcare Community & State	$14.11
Rate for Payer: Wellpoint Medicaid Managed Care	$15.52

STH PINCLE 7F 65 RSP02

Facility

$580.00

Service Code	HCPCS C1887
Hospital Charge Code	270642217C
Hospital Revenue Code	278
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$140.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.60
Rate for Payer: Qualcare PPO/HMO/WC	$87.00

STICK DRESSING THER. A698-5

Facility

$24.85

Hospital Charge Code	270613432
Hospital Revenue Code	279
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$9.44
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.46
Rate for Payer: Oxford Commercial	$4.97
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$4.97
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

Know your out-of-pocket cost for care.

All Charges