Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BELT RIB WOMEN'S UNIVERSAL

Facility

$32.00

Hospital Charge Code	270302675
Hospital Revenue Code	270
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

BELT RIB WOMENS UNIVERSAL***

Facility

$81.00

Hospital Charge Code	8001372
Hospital Revenue Code	279
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$12.15
Rate for Payer: Qualcare PPO/HMO/WC	$12.15

BELT RIB WOMENS UNIVERSAL***

Facility

$81.00

Hospital Charge Code	8001372
Hospital Revenue Code	279
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$40.50
Rate for Payer: Aetna Commercial	$30.78
Rate for Payer: Aetna Medicare Advantage	$24.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.66
Rate for Payer: Cigna Commercial	$40.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.30
Rate for Payer: Oxford Commercial	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$12.15
Rate for Payer: UnitedHealthcare Commercial	$16.20
Rate for Payer: UnitedHealthcare Community & State	$1.95
Rate for Payer: Wellpoint Medicaid Managed Care	$2.15

BELT ROLL POSEY 1231

Facility

$93.65

Hospital Charge Code	270613230
Hospital Revenue Code	270
Min. Negotiated Rate	$14.05
Max. Negotiated Rate	$14.05
Rate for Payer: Qualcare PPO/HMO/WC	$14.05

BELT ROLL POSEY 1231

Facility

$93.65

Hospital Charge Code	270613230
Hospital Revenue Code	270
Min. Negotiated Rate	$2.26
Max. Negotiated Rate	$46.83
Rate for Payer: Aetna Commercial	$35.59
Rate for Payer: Aetna Medicare Advantage	$28.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.88
Rate for Payer: Cigna Commercial	$46.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.09
Rate for Payer: Oxford Commercial	$18.73
Rate for Payer: Qualcare PPO/HMO/WC	$14.05
Rate for Payer: UnitedHealthcare Commercial	$18.73
Rate for Payer: UnitedHealthcare Community & State	$2.26
Rate for Payer: Wellpoint Medicaid Managed Care	$2.48

BELT ROLL W/Q-RELEASE S/PREP

Facility

$40.00

Hospital Charge Code	270650455
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.00
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

BELT ROLL W/Q-RELEASE S/PREP

Facility

$40.00

Hospital Charge Code	270650455
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

belts gait wipeable 70, blue

Facility

$93.75

Hospital Charge Code	270665773
Hospital Revenue Code	270
Min. Negotiated Rate	$2.26
Max. Negotiated Rate	$46.88
Rate for Payer: Aetna Commercial	$35.62
Rate for Payer: Aetna Medicare Advantage	$28.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.91
Rate for Payer: Cigna Commercial	$46.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.12
Rate for Payer: Oxford Commercial	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$14.06
Rate for Payer: UnitedHealthcare Commercial	$18.75
Rate for Payer: UnitedHealthcare Community & State	$2.26
Rate for Payer: Wellpoint Medicaid Managed Care	$2.48

belts gait wipeable 70, blue

Facility

$93.75

Hospital Charge Code	270665773
Hospital Revenue Code	270
Min. Negotiated Rate	$14.06
Max. Negotiated Rate	$14.06
Rate for Payer: Qualcare PPO/HMO/WC	$14.06

BELT TORSO POSEY 3656

Facility

$108.00

Hospital Charge Code	270613228
Hospital Revenue Code	270
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$16.20

BELT TORSO POSEY 3656

Facility

$108.00

Hospital Charge Code	270613228
Hospital Revenue Code	270
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna Commercial	$41.04
Rate for Payer: Aetna Medicare Advantage	$32.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.54
Rate for Payer: Cigna Commercial	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.40
Rate for Payer: Oxford Commercial	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$16.20
Rate for Payer: UnitedHealthcare Commercial	$21.60
Rate for Payer: UnitedHealthcare Community & State	$2.60
Rate for Payer: Wellpoint Medicaid Managed Care	$2.86

BELT TRACTION TRACTION ZIMCODE

Facility

$86.80

Hospital Charge Code	270654047
Hospital Revenue Code	272
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$43.40
Rate for Payer: Aetna Commercial	$32.98
Rate for Payer: Aetna Medicare Advantage	$26.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.13
Rate for Payer: Cigna Commercial	$43.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.04
Rate for Payer: Oxford Commercial	$17.36
Rate for Payer: Qualcare PPO/HMO/WC	$13.02
Rate for Payer: UnitedHealthcare Commercial	$17.36
Rate for Payer: UnitedHealthcare Community & State	$2.09
Rate for Payer: Wellpoint Medicaid Managed Care	$2.30

BELT TRACTION TRACTION ZIMCODE

Facility

$86.80

Hospital Charge Code	270654047
Hospital Revenue Code	272
Min. Negotiated Rate	$13.02
Max. Negotiated Rate	$13.02
Rate for Payer: Qualcare PPO/HMO/WC	$13.02

BELT UNIV. MEN'S RIB 6 WIDE

Facility

$16.45

Hospital Charge Code	270650449
Hospital Revenue Code	272
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$2.47
Rate for Payer: Qualcare PPO/HMO/WC	$2.47

BELT UNIV. MEN'S RIB 6 WIDE

Facility

$16.45

Hospital Charge Code	270650449
Hospital Revenue Code	272
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$8.22
Rate for Payer: Aetna Commercial	$6.25
Rate for Payer: Aetna Medicare Advantage	$4.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.19
Rate for Payer: Cigna Commercial	$8.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.93
Rate for Payer: Oxford Commercial	$3.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.47
Rate for Payer: UnitedHealthcare Commercial	$3.29
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

BELT UROSTOMY 175507

Facility

$22.15

Hospital Charge Code	270633612
Hospital Revenue Code	272
Min. Negotiated Rate	$3.32
Max. Negotiated Rate	$3.32
Rate for Payer: Qualcare PPO/HMO/WC	$3.32

BELT UROSTOMY 175507

Facility

$22.15

Hospital Charge Code	270633612
Hospital Revenue Code	272
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$11.07
Rate for Payer: Aetna Commercial	$8.42
Rate for Payer: Aetna Medicare Advantage	$6.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.65
Rate for Payer: Cigna Commercial	$11.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.64
Rate for Payer: Oxford Commercial	$4.43
Rate for Payer: Qualcare PPO/HMO/WC	$3.32
Rate for Payer: UnitedHealthcare Commercial	$4.43
Rate for Payer: UnitedHealthcare Community & State	$0.53
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

BELT W/SHOULDER STRAP LG

Facility

$41.50

Hospital Charge Code	270650466
Hospital Revenue Code	272
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$6.22
Rate for Payer: Qualcare PPO/HMO/WC	$6.22

BELT W/SHOULDER STRAP LG

Facility

$41.50

Hospital Charge Code	270650466
Hospital Revenue Code	272
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$20.75
Rate for Payer: Aetna Commercial	$15.77
Rate for Payer: Aetna Medicare Advantage	$12.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.58
Rate for Payer: Cigna Commercial	$20.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.45
Rate for Payer: Oxford Commercial	$8.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.22
Rate for Payer: UnitedHealthcare Commercial	$8.30
Rate for Payer: UnitedHealthcare Community & State	$1.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1.10

BELT W/SHOULDER STRAP MED

Facility

$41.50

Hospital Charge Code	270650473
Hospital Revenue Code	272
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$6.22
Rate for Payer: Qualcare PPO/HMO/WC	$6.22

BELT W/SHOULDER STRAP MED

Facility

$41.50

Hospital Charge Code	270650473
Hospital Revenue Code	272
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$20.75
Rate for Payer: Aetna Commercial	$15.77
Rate for Payer: Aetna Medicare Advantage	$12.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.58
Rate for Payer: Cigna Commercial	$20.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.45
Rate for Payer: Oxford Commercial	$8.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.22
Rate for Payer: UnitedHealthcare Commercial	$8.30
Rate for Payer: UnitedHealthcare Community & State	$1.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1.10

BELT W/SHOULDER STRAP SM

Facility

$41.50

Hospital Charge Code	270650474
Hospital Revenue Code	272
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$20.75
Rate for Payer: Aetna Commercial	$15.77
Rate for Payer: Aetna Medicare Advantage	$12.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.58
Rate for Payer: Cigna Commercial	$20.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.45
Rate for Payer: Oxford Commercial	$8.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.22
Rate for Payer: UnitedHealthcare Commercial	$8.30
Rate for Payer: UnitedHealthcare Community & State	$1.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1.10

BELT W/SHOULDER STRAP SM

Facility

$41.50

Hospital Charge Code	270650474
Hospital Revenue Code	272
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$6.22
Rate for Payer: Qualcare PPO/HMO/WC	$6.22

BELT W/SHOULDER STRAP XL

Facility

$41.50

Hospital Charge Code	270650465
Hospital Revenue Code	272
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$20.75
Rate for Payer: Aetna Commercial	$15.77
Rate for Payer: Aetna Medicare Advantage	$12.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.58
Rate for Payer: Cigna Commercial	$20.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.45
Rate for Payer: Oxford Commercial	$8.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.22
Rate for Payer: UnitedHealthcare Commercial	$8.30
Rate for Payer: UnitedHealthcare Community & State	$1.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1.10

BELT W/SHOULDER STRAP XL

Facility

$41.50

Hospital Charge Code	270650465
Hospital Revenue Code	272
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$6.22
Rate for Payer: Qualcare PPO/HMO/WC	$6.22

Know your out-of-pocket cost for care.

All Charges