Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STOPCOCK 3-WAY PLASTIC

Facility

$23.65

Hospital Charge Code	270601461
Hospital Revenue Code	272
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$3.55
Rate for Payer: Qualcare PPO/HMO/WC	$3.55

STOPCOCK 3 WAY W/SWIVEL MALE

Facility

$2.54

Hospital Charge Code	270649018
Hospital Revenue Code	272
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.27
Rate for Payer: Aetna Commercial	$0.97
Rate for Payer: Aetna Medicare Advantage	$0.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.65
Rate for Payer: Cigna Commercial	$1.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.76
Rate for Payer: Oxford Commercial	$0.51
Rate for Payer: Qualcare PPO/HMO/WC	$0.38
Rate for Payer: UnitedHealthcare Commercial	$0.51
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.07

STOPCOCK 3 WAY W/SWIVEL MALE

Facility

$2.54

Hospital Charge Code	270649018
Hospital Revenue Code	272
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$0.38
Rate for Payer: Qualcare PPO/HMO/WC	$0.38

STOPCOCK ADAPTOR PHD

Facility

$625.00

Hospital Charge Code	270695076S
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

STOPCOCK ADAPTOR PHD

Facility

$625.00

Hospital Charge Code	270695076S
Hospital Revenue Code	272
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

STOPCOCK HIGH PRESSURE H3RRC

Facility

$12.00

Hospital Charge Code	270658301N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

STOPCOCK HIGH PRESSURE H3RRC

Facility

$12.00

Hospital Charge Code	270658301S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

STOPCOCK HIGH PRESSURE H3RRC

Facility

$12.00

Hospital Charge Code	270658301
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

STOPCOCK HIGH PRESSURE H3RRC

Facility

$12.00

Hospital Charge Code	270658301
Hospital Revenue Code	272
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

STOPCOCK HIGH PRESSURE H3RRC

Facility

$12.00

Hospital Charge Code	270658301N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

STOPCOCK HIGH PRESSURE H3RRC

Facility

$12.00

Hospital Charge Code	270658301S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

STOPCOCK LUERLOCK

Facility

$550.00

Hospital Charge Code	270650903
Hospital Revenue Code	272
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

STOPCOCK LUERLOCK

Facility

$550.00

Hospital Charge Code	270650903
Hospital Revenue Code	272
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.00
Rate for Payer: Oxford Commercial	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$110.00
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

STOPCOCK MARQIS 1050 psi H3RLC

Facility

$16.00

Hospital Charge Code	270624382
Hospital Revenue Code	272
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

STOPCOCK MARQIS 1050 psi H3RLC

Facility

$16.00

Hospital Charge Code	270624382
Hospital Revenue Code	272
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$8.00
Rate for Payer: Aetna Commercial	$6.08
Rate for Payer: Aetna Medicare Advantage	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.08
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.80
Rate for Payer: Oxford Commercial	$3.20
Rate for Payer: Qualcare PPO/HMO/WC	$2.40
Rate for Payer: UnitedHealthcare Commercial	$3.20
Rate for Payer: UnitedHealthcare Community & State	$0.39
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

STOPCOCK MICRO 4FT PVC

Facility

$90.00

Hospital Charge Code	270650044
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

STOPCOCK MICRO 4FT PVC

Facility

$90.00

Hospital Charge Code	270650044
Hospital Revenue Code	272
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.00
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$18.00
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

STOPCOCK ROTATION CANNULA 5.8

Facility

$1,575.50

Hospital Charge Code	270689117
Hospital Revenue Code	270
Min. Negotiated Rate	$37.97
Max. Negotiated Rate	$787.75
Rate for Payer: Aetna Commercial	$598.69
Rate for Payer: Aetna Medicare Advantage	$472.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$401.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$401.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$401.75
Rate for Payer: Cigna Commercial	$787.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$472.65
Rate for Payer: Oxford Commercial	$315.10
Rate for Payer: Qualcare PPO/HMO/WC	$236.32
Rate for Payer: UnitedHealthcare Commercial	$315.10
Rate for Payer: UnitedHealthcare Community & State	$37.97
Rate for Payer: Wellpoint Medicaid Managed Care	$41.75

STOPCOCK ROTATION CANNULA 5.8

Facility

$1,575.50

Hospital Charge Code	270689117
Hospital Revenue Code	270
Min. Negotiated Rate	$236.32
Max. Negotiated Rate	$236.32
Rate for Payer: Qualcare PPO/HMO/WC	$236.32

STOP DRILL

Facility

$875.00

Hospital Charge Code	270679988
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

STOP DRILL

Facility

$875.00

Hospital Charge Code	270679988
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

STOP DRILL 2.3x14MM

Facility

$820.00

Hospital Charge Code	270680170
Hospital Revenue Code	272
Min. Negotiated Rate	$123.00
Max. Negotiated Rate	$123.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.00

STOP DRILL 2.3x14MM

Facility

$820.00

Hospital Charge Code	270680170
Hospital Revenue Code	272
Min. Negotiated Rate	$19.76
Max. Negotiated Rate	$410.00
Rate for Payer: Aetna Commercial	$311.60
Rate for Payer: Aetna Medicare Advantage	$246.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.10
Rate for Payer: Cigna Commercial	$410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.00
Rate for Payer: Oxford Commercial	$164.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.00
Rate for Payer: UnitedHealthcare Commercial	$164.00
Rate for Payer: UnitedHealthcare Community & State	$19.76
Rate for Payer: Wellpoint Medicaid Managed Care	$21.73

STOPPER FOR LISS INSERT GUIDES

Facility

$136.50

Hospital Charge Code	270671203
Hospital Revenue Code	272
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$51.87
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.95
Rate for Payer: Oxford Commercial	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$20.48
Rate for Payer: UnitedHealthcare Commercial	$27.30
Rate for Payer: UnitedHealthcare Community & State	$3.29
Rate for Payer: Wellpoint Medicaid Managed Care	$3.62

STOPPER FOR LISS INSERT GUIDES

Facility

$136.50

Hospital Charge Code	270671203
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$20.48
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

Know your out-of-pocket cost for care.

All Charges