Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TONG LOCKING PLASTIC 7****

Facility

$3.55

Hospital Charge Code	270600994
Hospital Revenue Code	270
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$0.53
Rate for Payer: Qualcare PPO/HMO/WC	$0.53

TONOCARD 400/BULK/TAB

Facility

$3.00

Hospital Charge Code	60634690
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

TONOCARD 400/BULK/TAB

Facility

$3.00

Hospital Charge Code	60634690
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

TONOCARD/400MG/TAB

Facility

$6.00

Hospital Charge Code	60634043
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

TONOCARD/400MG/TAB

Facility

$6.00

Hospital Charge Code	60634043
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

TONOCARD/600MG/TAB

Facility

$6.00

Hospital Charge Code	60634235
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

TONOCARD/600MG/TAB

Facility

$6.00

Hospital Charge Code	60634235
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

TONSIL & ADENOID KIT

Facility

$76.00

Hospital Charge Code	270338752
Hospital Revenue Code	272
Min. Negotiated Rate	$11.40
Max. Negotiated Rate	$11.40
Rate for Payer: Qualcare PPO/HMO/WC	$11.40

TONSIL & ADENOID KIT

Facility

$76.00

Hospital Charge Code	270338752
Hospital Revenue Code	272
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$38.00
Rate for Payer: Aetna Commercial	$28.88
Rate for Payer: Aetna Medicare Advantage	$22.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.38
Rate for Payer: Cigna Commercial	$38.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.80
Rate for Payer: Oxford Commercial	$15.20
Rate for Payer: Qualcare PPO/HMO/WC	$11.40
Rate for Payer: UnitedHealthcare Commercial	$15.20
Rate for Payer: UnitedHealthcare Community & State	$1.83
Rate for Payer: Wellpoint Medicaid Managed Care	$2.01

TONSIL AND ADENOID PROCEDURES

Facility

$6,752.49

Service Code	APR-DRG 0971
Min. Negotiated Rate	$6,620.09
Max. Negotiated Rate	$6,752.49
Rate for Payer: UnitedHealthcare Community & State	$6,620.09
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,752.49
Rate for Payer: Wellpoint Medicaid Managed Care	$6,620.09

TONSIL AND ADENOID PROCEDURES

Facility

$9,936.66

Service Code	APR-DRG 0972
Min. Negotiated Rate	$9,741.82
Max. Negotiated Rate	$9,936.66
Rate for Payer: UnitedHealthcare Community & State	$9,741.82
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,936.66
Rate for Payer: Wellpoint Medicaid Managed Care	$9,741.82

TONSIL AND ADENOID PROCEDURES

Facility

$15,803.08

Service Code	APR-DRG 0973
Min. Negotiated Rate	$15,493.22
Max. Negotiated Rate	$15,803.08
Rate for Payer: UnitedHealthcare Community & State	$15,493.22
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,803.08
Rate for Payer: Wellpoint Medicaid Managed Care	$15,493.22

TONSIL AND ADENOID PROCEDURES

Facility

$29,813.73

Service Code	APR-DRG 0974
Min. Negotiated Rate	$29,229.15
Max. Negotiated Rate	$29,813.73
Rate for Payer: UnitedHealthcare Community & State	$29,229.15
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,813.73
Rate for Payer: Wellpoint Medicaid Managed Care	$29,229.15

TONSILLECTOMY - AGE 12 OR MORE

Facility

$22,083.40

Service Code	HCPCS 42826
Hospital Charge Code	1600000282
Hospital Revenue Code	360
Min. Negotiated Rate	$3,312.51
Max. Negotiated Rate	$3,312.51
Rate for Payer: Qualcare PPO/HMO/WC	$3,312.51

TONSILLECTOMY - AGE 12 OR MORE

Facility

$22,083.40

Service Code	HCPCS 42826
Hospital Charge Code	1600000282
Hospital Revenue Code	360
Min. Negotiated Rate	$532.21
Max. Negotiated Rate	$14,218.07
Rate for Payer: Aetna Commercial	$10,713.67
Rate for Payer: Aetna Medicare Advantage	$12,761.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,218.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,218.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,938.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,218.07
Rate for Payer: Cigna Commercial	$7,895.42
Rate for Payer: Cigna Medicare Advantage	$3,938.85
Rate for Payer: Clover Medicare Advantage	$3,741.91
Rate for Payer: EmblemHealth Commercial	$11,816.55
Rate for Payer: Humana Medicare Advantage	$4,057.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,938.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,625.02
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,312.51
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$532.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,938.85
Rate for Payer: Wellcare Medicare Advantage	$3,938.85
Rate for Payer: Wellpoint Medicaid Managed Care	$585.21

TONSILLECTOMY - AGE 12 OR MORE

Facility

$22,083.40

Service Code	HCPCS 42826
Hospital Charge Code	1600000294
Hospital Revenue Code	360
Min. Negotiated Rate	$532.21
Max. Negotiated Rate	$14,218.07
Rate for Payer: Aetna Commercial	$10,713.67
Rate for Payer: Aetna Medicare Advantage	$12,761.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,218.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,218.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,938.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,218.07
Rate for Payer: Cigna Commercial	$7,895.42
Rate for Payer: Cigna Medicare Advantage	$3,938.85
Rate for Payer: Clover Medicare Advantage	$3,741.91
Rate for Payer: EmblemHealth Commercial	$11,816.55
Rate for Payer: Humana Medicare Advantage	$4,057.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,938.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,625.02
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,312.51
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$532.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,938.85
Rate for Payer: Wellcare Medicare Advantage	$3,938.85
Rate for Payer: Wellpoint Medicaid Managed Care	$585.21

TONSILLECTOMY - AGE 12 OR MORE

Facility

$22,083.40

Service Code	HCPCS 42826
Hospital Charge Code	1600000294
Hospital Revenue Code	360
Min. Negotiated Rate	$3,312.51
Max. Negotiated Rate	$3,312.51
Rate for Payer: Qualcare PPO/HMO/WC	$3,312.51

TONSILLECTOMY AGE LESS THAN AG

Facility

$42,339.20

Service Code	HCPCS 42825
Hospital Charge Code	1600000625
Hospital Revenue Code	360
Min. Negotiated Rate	$1,020.37
Max. Negotiated Rate	$25,386.70
Rate for Payer: Aetna Commercial	$19,129.52
Rate for Payer: Aetna Medicare Advantage	$22,786.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,386.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,386.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,032.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,386.70
Rate for Payer: Cigna Commercial	$14,097.46
Rate for Payer: Cigna Medicare Advantage	$7,032.91
Rate for Payer: Clover Medicare Advantage	$6,681.26
Rate for Payer: EmblemHealth Commercial	$21,098.73
Rate for Payer: Humana Medicare Advantage	$7,243.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,032.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,701.76
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,350.88
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$1,020.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,032.91
Rate for Payer: Wellcare Medicare Advantage	$7,032.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1,121.99

TONSILLECTOMY AGE LESS THAN AG

Facility

$42,339.20

Service Code	HCPCS 42825
Hospital Charge Code	1600000625
Hospital Revenue Code	360
Min. Negotiated Rate	$6,350.88
Max. Negotiated Rate	$6,350.88
Rate for Payer: Qualcare PPO/HMO/WC	$6,350.88

TOOL 14CM 5MM BA

Facility

$812.25

Hospital Charge Code	270657312
Hospital Revenue Code	270
Min. Negotiated Rate	$19.58
Max. Negotiated Rate	$406.12
Rate for Payer: Aetna Commercial	$308.65
Rate for Payer: Aetna Medicare Advantage	$243.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.12
Rate for Payer: Cigna Commercial	$406.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.68
Rate for Payer: Oxford Commercial	$162.45
Rate for Payer: Qualcare PPO/HMO/WC	$121.84
Rate for Payer: UnitedHealthcare Commercial	$162.45
Rate for Payer: UnitedHealthcare Community & State	$19.58
Rate for Payer: Wellpoint Medicaid Managed Care	$21.52

TOOL 14CM 5MM BA

Facility

$812.25

Hospital Charge Code	270657312
Hospital Revenue Code	270
Min. Negotiated Rate	$121.84
Max. Negotiated Rate	$121.84
Rate for Payer: Qualcare PPO/HMO/WC	$121.84

TOOL AVENUE INSERTION 0449020

Facility

$14.00

Hospital Charge Code	270632534
Hospital Revenue Code	272
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

TOOL AVENUE INSERTION 0449020

Facility

$14.00

Hospital Charge Code	270632534
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$7.00
Rate for Payer: Aetna Commercial	$5.32
Rate for Payer: Aetna Medicare Advantage	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.57
Rate for Payer: Cigna Commercial	$7.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.20
Rate for Payer: Oxford Commercial	$2.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$2.80
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

TOOL,BALL MIDAS REX LEGEND

Facility

$845.50

Hospital Charge Code	270690928
Hospital Revenue Code	272
Min. Negotiated Rate	$126.83
Max. Negotiated Rate	$126.83
Rate for Payer: Qualcare PPO/HMO/WC	$126.83

TOOL,BALL MIDAS REX LEGEND

Facility

$845.50

Hospital Charge Code	270690928
Hospital Revenue Code	272
Min. Negotiated Rate	$20.38
Max. Negotiated Rate	$422.75
Rate for Payer: Aetna Commercial	$321.29
Rate for Payer: Aetna Medicare Advantage	$253.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$215.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$215.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$215.60
Rate for Payer: Cigna Commercial	$422.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.65
Rate for Payer: Oxford Commercial	$169.10
Rate for Payer: Qualcare PPO/HMO/WC	$126.83
Rate for Payer: UnitedHealthcare Commercial	$169.10
Rate for Payer: UnitedHealthcare Community & State	$20.38
Rate for Payer: Wellpoint Medicaid Managed Care	$22.41

Know your out-of-pocket cost for care.

All Charges