Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC

Facility

$178,419.57

Service Code	MSDRG 011
Min. Negotiated Rate	$54,326.47
Max. Negotiated Rate	$178,419.57
Rate for Payer: Aetna Medicare Advantage	$178,419.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120,026.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120,026.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$57,185.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120,026.76
Rate for Payer: Cigna Commercial	$102,068.03
Rate for Payer: Cigna Medicare Advantage	$57,185.76
Rate for Payer: Clover Medicare Advantage	$54,326.47
Rate for Payer: EmblemHealth Commercial	$171,557.28
Rate for Payer: Humana Medicare Advantage	$58,901.33
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$57,185.76
Rate for Payer: Oxford Commercial	$73,357.65
Rate for Payer: UnitedHealthcare Commercial	$128,634.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$57,185.76
Rate for Payer: Wellcare Medicare Advantage	$57,185.76

TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC

Facility

$95,278.59

Service Code	MSDRG 013
Min. Negotiated Rate	$29,011.11
Max. Negotiated Rate	$95,278.59
Rate for Payer: Aetna Medicare Advantage	$95,278.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62,572.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62,572.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$30,538.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62,572.09
Rate for Payer: Cigna Commercial	$53,930.01
Rate for Payer: Cigna Medicare Advantage	$30,538.01
Rate for Payer: Clover Medicare Advantage	$29,011.11
Rate for Payer: EmblemHealth Commercial	$91,614.03
Rate for Payer: Humana Medicare Advantage	$31,454.15
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$30,538.01
Rate for Payer: Oxford Commercial	$38,760.21
Rate for Payer: UnitedHealthcare Commercial	$67,967.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$30,538.01
Rate for Payer: Wellcare Medicare Advantage	$30,538.01

TRACHEOSTOMY TUBE #10 FENEST

Facility

$605.00

Hospital Charge Code	270331346
Hospital Revenue Code	272
Min. Negotiated Rate	$14.58
Max. Negotiated Rate	$302.50
Rate for Payer: Aetna Commercial	$229.90
Rate for Payer: Aetna Medicare Advantage	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.28
Rate for Payer: Cigna Commercial	$302.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Oxford Commercial	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.75
Rate for Payer: UnitedHealthcare Commercial	$121.00
Rate for Payer: UnitedHealthcare Community & State	$14.58
Rate for Payer: Wellpoint Medicaid Managed Care	$16.03

TRACHEOSTOMY TUBE #10 FENEST

Facility

$605.00

Hospital Charge Code	270331346
Hospital Revenue Code	272
Min. Negotiated Rate	$90.75
Max. Negotiated Rate	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$90.75

TRACHEOSTOMY TUBE #3, PEDIATR

Facility

$451.00

Hospital Charge Code	270331142
Hospital Revenue Code	272
Min. Negotiated Rate	$10.87
Max. Negotiated Rate	$225.50
Rate for Payer: Aetna Commercial	$171.38
Rate for Payer: Aetna Medicare Advantage	$135.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.00
Rate for Payer: Cigna Commercial	$225.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.30
Rate for Payer: Oxford Commercial	$90.20
Rate for Payer: Qualcare PPO/HMO/WC	$67.65
Rate for Payer: UnitedHealthcare Commercial	$90.20
Rate for Payer: UnitedHealthcare Community & State	$10.87
Rate for Payer: Wellpoint Medicaid Managed Care	$11.95

TRACHEOSTOMY TUBE #3, PEDIATR

Facility

$451.00

Hospital Charge Code	270331142
Hospital Revenue Code	272
Min. Negotiated Rate	$67.65
Max. Negotiated Rate	$67.65
Rate for Payer: Qualcare PPO/HMO/WC	$67.65

TRACHEOSTOMY TUBE SZ.9

Facility

$330.00

Hospital Charge Code	270332362
Hospital Revenue Code	272
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$165.00
Rate for Payer: Aetna Commercial	$125.40
Rate for Payer: Aetna Medicare Advantage	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.15
Rate for Payer: Cigna Commercial	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.00
Rate for Payer: Oxford Commercial	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.50
Rate for Payer: UnitedHealthcare Commercial	$66.00
Rate for Payer: UnitedHealthcare Community & State	$7.95
Rate for Payer: Wellpoint Medicaid Managed Care	$8.74

TRACHEOSTOMY TUBE SZ.9

Facility

$330.00

Hospital Charge Code	270332362
Hospital Revenue Code	272
Min. Negotiated Rate	$49.50
Max. Negotiated Rate	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$49.50

TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES

Facility

$449,834.21

Service Code	MSDRG 004
Min. Negotiated Rate	$136,968.75
Max. Negotiated Rate	$449,834.21
Rate for Payer: Aetna Medicare Advantage	$449,834.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$341,936.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$341,936.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$144,177.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$341,936.70
Rate for Payer: Cigna Commercial	$259,215.10
Rate for Payer: Cigna Medicare Advantage	$144,177.63
Rate for Payer: Clover Medicare Advantage	$136,968.75
Rate for Payer: EmblemHealth Commercial	$432,532.89
Rate for Payer: Humana Medicare Advantage	$148,502.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$144,177.63
Rate for Payer: Oxford Commercial	$186,301.33
Rate for Payer: UnitedHealthcare Commercial	$326,685.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$144,177.63
Rate for Payer: Wellcare Medicare Advantage	$144,177.63

TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$127,665.84

Service Code	APR-DRG 0043
Min. Negotiated Rate	$125,162.59
Max. Negotiated Rate	$127,665.84
Rate for Payer: UnitedHealthcare Community & State	$125,162.59
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$127,665.84
Rate for Payer: Wellpoint Medicaid Managed Care	$125,162.59

TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$60,159.79

Service Code	APR-DRG 0041
Min. Negotiated Rate	$58,980.19
Max. Negotiated Rate	$60,159.79
Rate for Payer: UnitedHealthcare Community & State	$58,980.19
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$60,159.79
Rate for Payer: Wellpoint Medicaid Managed Care	$58,980.19

TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$193,158.47

Service Code	APR-DRG 0044
Min. Negotiated Rate	$189,371.05
Max. Negotiated Rate	$193,158.47
Rate for Payer: UnitedHealthcare Community & State	$189,371.05
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$193,158.47
Rate for Payer: Wellpoint Medicaid Managed Care	$189,371.05

TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$83,117.61

Service Code	APR-DRG 0042
Min. Negotiated Rate	$81,487.85
Max. Negotiated Rate	$83,117.61
Rate for Payer: UnitedHealthcare Community & State	$81,487.85
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$83,117.61
Rate for Payer: Wellpoint Medicaid Managed Care	$81,487.85

TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$62,298.27

Service Code	APR-DRG 0052
Min. Negotiated Rate	$61,076.74
Max. Negotiated Rate	$62,298.27
Rate for Payer: UnitedHealthcare Community & State	$61,076.74
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$62,298.27
Rate for Payer: Wellpoint Medicaid Managed Care	$61,076.74

TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$52,581.28

Service Code	APR-DRG 0051
Min. Negotiated Rate	$51,550.27
Max. Negotiated Rate	$52,581.28
Rate for Payer: UnitedHealthcare Community & State	$51,550.27
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$52,581.28
Rate for Payer: Wellpoint Medicaid Managed Care	$51,550.27

TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$132,624.57

Service Code	APR-DRG 0054
Min. Negotiated Rate	$130,024.09
Max. Negotiated Rate	$132,624.57
Rate for Payer: UnitedHealthcare Community & State	$130,024.09
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$132,624.57
Rate for Payer: Wellpoint Medicaid Managed Care	$130,024.09

TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$93,914.78

Service Code	APR-DRG 0053
Min. Negotiated Rate	$92,073.31
Max. Negotiated Rate	$93,914.78
Rate for Payer: UnitedHealthcare Community & State	$92,073.31
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$93,914.78
Rate for Payer: Wellpoint Medicaid Managed Care	$92,073.31

TRACH INLINE SUCTION CATH

Facility

$42.63

Hospital Charge Code	270600663R
Hospital Revenue Code	272
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$6.39
Rate for Payer: Qualcare PPO/HMO/WC	$6.39

TRACH INLINE SUCTION CATH

Facility

$42.63

Hospital Charge Code	270600663R
Hospital Revenue Code	272
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$21.32
Rate for Payer: Aetna Commercial	$16.20
Rate for Payer: Aetna Medicare Advantage	$12.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.87
Rate for Payer: Cigna Commercial	$21.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.79
Rate for Payer: Oxford Commercial	$8.53
Rate for Payer: Qualcare PPO/HMO/WC	$6.39
Rate for Payer: UnitedHealthcare Commercial	$8.53
Rate for Payer: UnitedHealthcare Community & State	$1.03
Rate for Payer: Wellpoint Medicaid Managed Care	$1.13

TRACH PROX SZ 7 CUFFED 70XLTCP

Facility

$310.00

Hospital Charge Code	270638230
Hospital Revenue Code	272
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$46.50
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

TRACH PROX SZ 7 CUFFED 70XLTCP

Facility

$310.00

Hospital Charge Code	270638230
Hospital Revenue Code	272
Min. Negotiated Rate	$7.47
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$117.80
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.00
Rate for Payer: Oxford Commercial	$62.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Commercial	$62.00
Rate for Payer: UnitedHealthcare Community & State	$7.47
Rate for Payer: Wellpoint Medicaid Managed Care	$8.21

TRACH SYSTEM CLOSED 16FR W/12

Facility

$35.90

Hospital Charge Code	270650096
Hospital Revenue Code	270
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$17.95
Rate for Payer: Aetna Commercial	$13.64
Rate for Payer: Aetna Medicare Advantage	$10.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.15
Rate for Payer: Cigna Commercial	$17.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.77
Rate for Payer: Oxford Commercial	$7.18
Rate for Payer: Qualcare PPO/HMO/WC	$5.38
Rate for Payer: UnitedHealthcare Commercial	$7.18
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

TRACH SYSTEM CLOSED 16FR W/12

Facility

$35.90

Hospital Charge Code	270650096
Hospital Revenue Code	270
Min. Negotiated Rate	$5.38
Max. Negotiated Rate	$5.38
Rate for Payer: Qualcare PPO/HMO/WC	$5.38

TRACH SZ 8 XLT DISTAL CUFFED

Facility

$307.05

Hospital Charge Code	270638227
Hospital Revenue Code	272
Min. Negotiated Rate	$46.06
Max. Negotiated Rate	$46.06
Rate for Payer: Qualcare PPO/HMO/WC	$46.06

TRACH SZ 8 XLT DISTAL CUFFED

Facility

$307.05

Hospital Charge Code	270638227
Hospital Revenue Code	272
Min. Negotiated Rate	$7.40
Max. Negotiated Rate	$153.53
Rate for Payer: Aetna Commercial	$116.68
Rate for Payer: Aetna Medicare Advantage	$92.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.30
Rate for Payer: Cigna Commercial	$153.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.11
Rate for Payer: Oxford Commercial	$61.41
Rate for Payer: Qualcare PPO/HMO/WC	$46.06
Rate for Payer: UnitedHealthcare Commercial	$61.41
Rate for Payer: UnitedHealthcare Community & State	$7.40
Rate for Payer: Wellpoint Medicaid Managed Care	$8.14

Know your out-of-pocket cost for care.

All Charges