Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TIP PHACO I/A TURBO 30KTS

Facility

$325.00

Hospital Charge Code	270600240
Hospital Revenue Code	270
Min. Negotiated Rate	$7.83
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$123.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$65.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$65.00
Rate for Payer: UnitedHealthcare Community & State	$7.83
Rate for Payer: Wellpoint Medicaid Managed Care	$8.61

TIP PHACO I/A TURBO 9MM 30RTS

Facility

$300.00

Hospital Charge Code	270600239
Hospital Revenue Code	270
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

TIP PHACO I/A TURBO 9MM 30RTS

Facility

$300.00

Hospital Charge Code	270600239
Hospital Revenue Code	270
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

TIP PROGEL APPLICTR SPRAY 16CM

Facility

$1,800.00

Service Code	HCPCS C2615
Hospital Charge Code	270662137
Hospital Revenue Code	278
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Community & State	$43.38
Rate for Payer: Wellpoint Medicaid Managed Care	$47.70

TIP PROGEL APPLICTR SPRAY 16CM

Facility

$1,800.00

Service Code	HCPCS C2615
Hospital Charge Code	270662137
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

TIP PROGEL APPLICTR SPRAY 29CM

Facility

$1,800.00

Service Code	HCPCS C2615
Hospital Charge Code	270662138
Hospital Revenue Code	278
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Community & State	$43.38
Rate for Payer: Wellpoint Medicaid Managed Care	$47.70

TIP PROGEL APPLICTR SPRAY 29CM

Facility

$1,800.00

Service Code	HCPCS C2615
Hospital Charge Code	270662138
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

TIP PROTECTOR SMALL ENDO BOOT

Facility

$12.50

Hospital Charge Code	270669846
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

TIP PROTECTOR SMALL ENDO BOOT

Facility

$12.50

Hospital Charge Code	270669846
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$6.25
Rate for Payer: Aetna Commercial	$4.75
Rate for Payer: Aetna Medicare Advantage	$3.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.19
Rate for Payer: Cigna Commercial	$6.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.75
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.88
Rate for Payer: UnitedHealthcare Commercial	$2.50
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

TIP PULSAVAC FAN SPRAY

Facility

$77.65

Hospital Charge Code	270600360
Hospital Revenue Code	272
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$11.65
Rate for Payer: Qualcare PPO/HMO/WC	$11.65

TIP PULSAVAC FAN SPRAY

Facility

$77.65

Hospital Charge Code	270600360
Hospital Revenue Code	272
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$38.83
Rate for Payer: Aetna Commercial	$29.51
Rate for Payer: Aetna Medicare Advantage	$23.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.80
Rate for Payer: Cigna Commercial	$38.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.30
Rate for Payer: Oxford Commercial	$15.53
Rate for Payer: Qualcare PPO/HMO/WC	$11.65
Rate for Payer: UnitedHealthcare Commercial	$15.53
Rate for Payer: UnitedHealthcare Community & State	$1.87
Rate for Payer: Wellpoint Medicaid Managed Care	$2.06

TIP PULSAVAC IM 9

Facility

$129.00

Hospital Charge Code	270600374
Hospital Revenue Code	272
Min. Negotiated Rate	$19.35
Max. Negotiated Rate	$19.35
Rate for Payer: Qualcare PPO/HMO/WC	$19.35

TIP PULSAVAC IM 9

Facility

$129.00

Hospital Charge Code	270600374
Hospital Revenue Code	272
Min. Negotiated Rate	$3.11
Max. Negotiated Rate	$64.50
Rate for Payer: Aetna Commercial	$49.02
Rate for Payer: Aetna Medicare Advantage	$38.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.90
Rate for Payer: Cigna Commercial	$64.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.70
Rate for Payer: Oxford Commercial	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$19.35
Rate for Payer: UnitedHealthcare Commercial	$25.80
Rate for Payer: UnitedHealthcare Community & State	$3.11
Rate for Payer: Wellpoint Medicaid Managed Care	$3.42

TIP ROUND 30 DEG 6/BX

Facility

$225.00

Hospital Charge Code	270650891
Hospital Revenue Code	271
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.50
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$45.00
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

TIP ROUND 30 DEG 6/BX

Facility

$225.00

Hospital Charge Code	270650891
Hospital Revenue Code	271
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

TIP, RUBBER GREY NIPPLES SMAL

Facility

$43.00

Hospital Charge Code	270331539
Hospital Revenue Code	272
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

TIP, RUBBER GREY NIPPLES SMAL

Facility

$43.00

Hospital Charge Code	270331539
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

TIPS BARIUM ENEMA

Facility

$11.87

Hospital Charge Code	270601327
Hospital Revenue Code	270
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$5.93
Rate for Payer: Aetna Commercial	$4.51
Rate for Payer: Aetna Medicare Advantage	$3.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.03
Rate for Payer: Cigna Commercial	$5.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.56
Rate for Payer: Oxford Commercial	$2.37
Rate for Payer: Qualcare PPO/HMO/WC	$1.78
Rate for Payer: UnitedHealthcare Commercial	$2.37
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.31

TIPS BARIUM ENEMA

Facility

$11.87

Hospital Charge Code	270601327
Hospital Revenue Code	270
Min. Negotiated Rate	$1.78
Max. Negotiated Rate	$1.78
Rate for Payer: Qualcare PPO/HMO/WC	$1.78

TIP SCISSOR DISP 3142

Facility

$230.50

Hospital Charge Code	270641064
Hospital Revenue Code	272
Min. Negotiated Rate	$34.58
Max. Negotiated Rate	$34.58
Rate for Payer: Qualcare PPO/HMO/WC	$34.58

TIP SCISSOR DISP 3142

Facility

$230.50

Hospital Charge Code	270641064
Hospital Revenue Code	272
Min. Negotiated Rate	$5.56
Max. Negotiated Rate	$115.25
Rate for Payer: Aetna Commercial	$87.59
Rate for Payer: Aetna Medicare Advantage	$69.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.78
Rate for Payer: Cigna Commercial	$115.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.15
Rate for Payer: Oxford Commercial	$46.10
Rate for Payer: Qualcare PPO/HMO/WC	$34.58
Rate for Payer: UnitedHealthcare Commercial	$46.10
Rate for Payer: UnitedHealthcare Community & State	$5.56
Rate for Payer: Wellpoint Medicaid Managed Care	$6.11

TIP SCISSORS CVD METZ DISP

Facility

$235.00

Hospital Charge Code	270662868
Hospital Revenue Code	270
Min. Negotiated Rate	$5.66
Max. Negotiated Rate	$117.50
Rate for Payer: Aetna Commercial	$89.30
Rate for Payer: Aetna Medicare Advantage	$70.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.92
Rate for Payer: Cigna Commercial	$117.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.50
Rate for Payer: Oxford Commercial	$47.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.25
Rate for Payer: UnitedHealthcare Commercial	$47.00
Rate for Payer: UnitedHealthcare Community & State	$5.66
Rate for Payer: Wellpoint Medicaid Managed Care	$6.23

TIP SCISSORS CVD METZ DISP

Facility

$235.00

Hospital Charge Code	270662868
Hospital Revenue Code	270
Min. Negotiated Rate	$35.25
Max. Negotiated Rate	$35.25
Rate for Payer: Qualcare PPO/HMO/WC	$35.25

TIP SELF SEALING

Facility

$17.92

Hospital Charge Code	270658477
Hospital Revenue Code	270
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$2.69
Rate for Payer: Qualcare PPO/HMO/WC	$2.69

TIP SELF SEALING

Facility

$17.92

Hospital Charge Code	270658477
Hospital Revenue Code	270
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$8.96
Rate for Payer: Aetna Commercial	$6.81
Rate for Payer: Aetna Medicare Advantage	$5.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.57
Rate for Payer: Cigna Commercial	$8.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.38
Rate for Payer: Oxford Commercial	$3.58
Rate for Payer: Qualcare PPO/HMO/WC	$2.69
Rate for Payer: UnitedHealthcare Commercial	$3.58
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.47

Know your out-of-pocket cost for care.

All Charges