Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TRACH SZ 8 XLT PROXIMAL CUFFED

Facility

$396.90

Hospital Charge Code	270638229
Hospital Revenue Code	272
Min. Negotiated Rate	$9.57
Max. Negotiated Rate	$198.45
Rate for Payer: Aetna Commercial	$150.82
Rate for Payer: Aetna Medicare Advantage	$119.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.21
Rate for Payer: Cigna Commercial	$198.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.07
Rate for Payer: Oxford Commercial	$79.38
Rate for Payer: Qualcare PPO/HMO/WC	$59.53
Rate for Payer: UnitedHealthcare Commercial	$79.38
Rate for Payer: UnitedHealthcare Community & State	$9.57
Rate for Payer: Wellpoint Medicaid Managed Care	$10.52

TRACH SZ 8 XLT PROXIMAL CUFFED

Facility

$396.90

Hospital Charge Code	270638229
Hospital Revenue Code	272
Min. Negotiated Rate	$59.53
Max. Negotiated Rate	$59.53
Rate for Payer: Qualcare PPO/HMO/WC	$59.53

TRACH TUBE FENESTRATED #8

Facility

$218.00

Hospital Charge Code	270330630
Hospital Revenue Code	272
Min. Negotiated Rate	$32.70
Max. Negotiated Rate	$32.70
Rate for Payer: Qualcare PPO/HMO/WC	$32.70

TRACH TUBE FENESTRATED #8

Facility

$218.00

Hospital Charge Code	270330630
Hospital Revenue Code	272
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$109.00
Rate for Payer: Aetna Commercial	$82.84
Rate for Payer: Aetna Medicare Advantage	$65.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.59
Rate for Payer: Cigna Commercial	$109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.40
Rate for Payer: Oxford Commercial	$43.60
Rate for Payer: Qualcare PPO/HMO/WC	$32.70
Rate for Payer: UnitedHealthcare Commercial	$43.60
Rate for Payer: UnitedHealthcare Community & State	$5.25
Rate for Payer: Wellpoint Medicaid Managed Care	$5.78

TRACH TUBE HOLDER #240 *******

Facility

$3.00

Hospital Charge Code	8003485
Hospital Revenue Code	279
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

TRACH TUBE HOLDER #240 *******

Facility

$3.00

Hospital Charge Code	8003485
Hospital Revenue Code	279
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

TRACH TUBE INNER CANNULA 80MM

Facility

$15.88

Service Code	HCPCS A4623
Hospital Charge Code	270699905
Hospital Revenue Code	272
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$7.94
Rate for Payer: Aetna Commercial	$6.03
Rate for Payer: Aetna Medicare Advantage	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.05
Rate for Payer: Cigna Commercial	$7.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.76
Rate for Payer: Oxford Commercial	$3.18
Rate for Payer: Qualcare PPO/HMO/WC	$2.38
Rate for Payer: UnitedHealthcare Commercial	$3.18
Rate for Payer: UnitedHealthcare Community & State	$0.38
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

TRACH TUBE INNER CANNULA 80MM

Facility

$15.88

Service Code	HCPCS A4623
Hospital Charge Code	270699905
Hospital Revenue Code	272
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$2.38
Rate for Payer: Qualcare PPO/HMO/WC	$2.38

TRACKER INSTRUMENT ENT

Facility

$860.00

Hospital Charge Code	270663282
Hospital Revenue Code	272
Min. Negotiated Rate	$20.73
Max. Negotiated Rate	$430.00
Rate for Payer: Aetna Commercial	$326.80
Rate for Payer: Aetna Medicare Advantage	$258.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.30
Rate for Payer: Cigna Commercial	$430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.00
Rate for Payer: Oxford Commercial	$172.00
Rate for Payer: Qualcare PPO/HMO/WC	$129.00
Rate for Payer: UnitedHealthcare Commercial	$172.00
Rate for Payer: UnitedHealthcare Community & State	$20.73
Rate for Payer: Wellpoint Medicaid Managed Care	$22.79

TRACKER INSTRUMENT ENT

Facility

$860.00

Hospital Charge Code	270663282
Hospital Revenue Code	272
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$129.00
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

TRACKER PATIENT

Facility

$1,300.00

Hospital Charge Code	270703111
Hospital Revenue Code	278
Min. Negotiated Rate	$31.33
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$494.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$286.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00
Rate for Payer: UnitedHealthcare Community & State	$31.33
Rate for Payer: Wellpoint Medicaid Managed Care	$34.45

TRACKER PATIENT

Facility

$1,300.00

Hospital Charge Code	270703111
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$314.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$286.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

TRACKER PATIENT ENT

Facility

$1,025.00

Hospital Charge Code	270663281
Hospital Revenue Code	272
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$153.75
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

TRACKER PATIENT ENT

Facility

$1,025.00

Hospital Charge Code	270663281
Hospital Revenue Code	272
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.50
Rate for Payer: Oxford Commercial	$205.00
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Commercial	$205.00
Rate for Payer: UnitedHealthcare Community & State	$24.70
Rate for Payer: Wellpoint Medicaid Managed Care	$27.16

TRACLEER 125 MG TAB

Facility

$364.00

Hospital Charge Code	60635641
Hospital Revenue Code	250
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

TRACLEER 125 MG TAB

Facility

$364.00

Hospital Charge Code	60635641
Hospital Revenue Code	250
Min. Negotiated Rate	$8.77
Max. Negotiated Rate	$182.00
Rate for Payer: Aetna Commercial	$138.32
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.82
Rate for Payer: Cigna Commercial	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.20
Rate for Payer: Oxford Commercial	$72.80
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Commercial	$72.80
Rate for Payer: UnitedHealthcare Community & State	$8.77
Rate for Payer: Wellpoint Medicaid Managed Care	$9.65

TRACLEER DS 125MG TAB

Facility

$362.00

Hospital Charge Code	60635652
Hospital Revenue Code	250
Min. Negotiated Rate	$54.30
Max. Negotiated Rate	$54.30
Rate for Payer: Qualcare PPO/HMO/WC	$54.30

TRACLEER DS 125MG TAB

Facility

$362.00

Hospital Charge Code	60635652
Hospital Revenue Code	250
Min. Negotiated Rate	$8.72
Max. Negotiated Rate	$181.00
Rate for Payer: Aetna Commercial	$137.56
Rate for Payer: Aetna Medicare Advantage	$108.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.31
Rate for Payer: Cigna Commercial	$181.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.60
Rate for Payer: Oxford Commercial	$72.40
Rate for Payer: Qualcare PPO/HMO/WC	$54.30
Rate for Payer: UnitedHealthcare Commercial	$72.40
Rate for Payer: UnitedHealthcare Community & State	$8.72
Rate for Payer: Wellpoint Medicaid Managed Care	$9.59

T.R.A.C. PAD ONLY M6275051.10

Facility

$122.25

Hospital Charge Code	270633653
Hospital Revenue Code	272
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$61.12
Rate for Payer: Aetna Commercial	$46.45
Rate for Payer: Aetna Medicare Advantage	$36.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.17
Rate for Payer: Cigna Commercial	$61.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.67
Rate for Payer: Oxford Commercial	$24.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.34
Rate for Payer: UnitedHealthcare Commercial	$24.45
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

T.R.A.C. PAD ONLY M6275051.10

Facility

$122.25

Hospital Charge Code	270633653
Hospital Revenue Code	272
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$18.34
Rate for Payer: Qualcare PPO/HMO/WC	$18.34

T.R.A.C. PAD ONLY M6275057S

Facility

$86.95

Hospital Charge Code	270632067
Hospital Revenue Code	272
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$43.48
Rate for Payer: Aetna Commercial	$33.04
Rate for Payer: Aetna Medicare Advantage	$26.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.17
Rate for Payer: Cigna Commercial	$43.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.09
Rate for Payer: Oxford Commercial	$17.39
Rate for Payer: Qualcare PPO/HMO/WC	$13.04
Rate for Payer: UnitedHealthcare Commercial	$17.39
Rate for Payer: UnitedHealthcare Community & State	$2.10
Rate for Payer: Wellpoint Medicaid Managed Care	$2.30

T.R.A.C. PAD ONLY M6275057S

Facility

$86.95

Hospital Charge Code	270632067
Hospital Revenue Code	272
Min. Negotiated Rate	$13.04
Max. Negotiated Rate	$13.04
Rate for Payer: Qualcare PPO/HMO/WC	$13.04

TRACRIUM/10MG/1ML

Facility

$250.00

Hospital Charge Code	60634046
Hospital Revenue Code	250
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.00
Rate for Payer: Oxford Commercial	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$50.00
Rate for Payer: UnitedHealthcare Community & State	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

TRACRIUM/10MG/1ML

Facility

$250.00

Hospital Charge Code	60634046
Hospital Revenue Code	250
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

TRACTION BUCKS *****

Facility

$93.00

Hospital Charge Code	8001877
Hospital Revenue Code	279
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$46.50
Rate for Payer: Aetna Commercial	$35.34
Rate for Payer: Aetna Medicare Advantage	$27.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.71
Rate for Payer: Cigna Commercial	$46.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.90
Rate for Payer: Oxford Commercial	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$13.95
Rate for Payer: UnitedHealthcare Commercial	$18.60
Rate for Payer: UnitedHealthcare Community & State	$2.24
Rate for Payer: Wellpoint Medicaid Managed Care	$2.46

Know your out-of-pocket cost for care.

All Charges