Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TRAY CHOLANG LAPARO W/TROCAR

Facility

$650.00

Hospital Charge Code	270649267
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

TRAY CHOLANG LAPARO W/TROCAR

Facility

$650.00

Hospital Charge Code	270649267
Hospital Revenue Code	272
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$130.00
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

TRAY COAXIAL BIOPSY 6CM 11G

Facility

$4,091.65

Service Code	HCPCS C1830
Hospital Charge Code	270688549
Hospital Revenue Code	272
Min. Negotiated Rate	$98.61
Max. Negotiated Rate	$2,045.83
Rate for Payer: Aetna Commercial	$1,554.83
Rate for Payer: Aetna Medicare Advantage	$1,227.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,043.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,043.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,043.37
Rate for Payer: Cigna Commercial	$2,045.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,227.49
Rate for Payer: Oxford Commercial	$818.33
Rate for Payer: Qualcare PPO/HMO/WC	$613.75
Rate for Payer: UnitedHealthcare Commercial	$818.33
Rate for Payer: UnitedHealthcare Community & State	$98.61
Rate for Payer: Wellpoint Medicaid Managed Care	$108.43

TRAY COAXIAL BIOPSY 6CM 11G

Facility

$4,091.65

Service Code	HCPCS C1830
Hospital Charge Code	270688549
Hospital Revenue Code	272
Min. Negotiated Rate	$613.75
Max. Negotiated Rate	$613.75
Rate for Payer: Qualcare PPO/HMO/WC	$613.75

TRAY CRANIOTOMY

Facility

$565.60

Hospital Charge Code	270667449
Hospital Revenue Code	270
Min. Negotiated Rate	$84.84
Max. Negotiated Rate	$84.84
Rate for Payer: Qualcare PPO/HMO/WC	$84.84

TRAY CRANIOTOMY

Facility

$565.60

Hospital Charge Code	270667449
Hospital Revenue Code	270
Min. Negotiated Rate	$13.63
Max. Negotiated Rate	$282.80
Rate for Payer: Aetna Commercial	$214.93
Rate for Payer: Aetna Medicare Advantage	$169.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.23
Rate for Payer: Cigna Commercial	$282.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.68
Rate for Payer: Oxford Commercial	$113.12
Rate for Payer: Qualcare PPO/HMO/WC	$84.84
Rate for Payer: UnitedHealthcare Commercial	$113.12
Rate for Payer: UnitedHealthcare Community & State	$13.63
Rate for Payer: Wellpoint Medicaid Managed Care	$14.99

TRAY C-SECTION DELIVERY PK

Facility

$569.53

Hospital Charge Code	270650963
Hospital Revenue Code	272
Min. Negotiated Rate	$85.43
Max. Negotiated Rate	$85.43
Rate for Payer: Qualcare PPO/HMO/WC	$85.43

TRAY C-SECTION DELIVERY PK

Facility

$569.53

Hospital Charge Code	270650963
Hospital Revenue Code	272
Min. Negotiated Rate	$13.73
Max. Negotiated Rate	$284.76
Rate for Payer: Aetna Commercial	$216.42
Rate for Payer: Aetna Medicare Advantage	$170.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.23
Rate for Payer: Cigna Commercial	$284.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.86
Rate for Payer: Oxford Commercial	$113.91
Rate for Payer: Qualcare PPO/HMO/WC	$85.43
Rate for Payer: UnitedHealthcare Commercial	$113.91
Rate for Payer: UnitedHealthcare Community & State	$13.73
Rate for Payer: Wellpoint Medicaid Managed Care	$15.09

TRAY C-SECTION PACK

Facility

$523.25

Hospital Charge Code	270600577
Hospital Revenue Code	272
Min. Negotiated Rate	$78.49
Max. Negotiated Rate	$78.49
Rate for Payer: Qualcare PPO/HMO/WC	$78.49

TRAY C-SECTION PACK

Facility

$523.25

Hospital Charge Code	270600577
Hospital Revenue Code	272
Min. Negotiated Rate	$12.61
Max. Negotiated Rate	$261.62
Rate for Payer: Aetna Commercial	$198.84
Rate for Payer: Aetna Medicare Advantage	$156.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.43
Rate for Payer: Cigna Commercial	$261.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.97
Rate for Payer: Oxford Commercial	$104.65
Rate for Payer: Qualcare PPO/HMO/WC	$78.49
Rate for Payer: UnitedHealthcare Commercial	$104.65
Rate for Payer: UnitedHealthcare Community & State	$12.61
Rate for Payer: Wellpoint Medicaid Managed Care	$13.87

TRAY CUSTOM EYE DR G AS5276-05

Facility

$1,702.45

Hospital Charge Code	270606277
Hospital Revenue Code	276
Min. Negotiated Rate	$255.37
Max. Negotiated Rate	$411.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$374.54
Rate for Payer: Qualcare PPO/HMO/WC	$255.37

TRAY CUSTOM EYE DR G AS5276-05

Facility

$1,702.45

Hospital Charge Code	270606277
Hospital Revenue Code	276
Min. Negotiated Rate	$41.03
Max. Negotiated Rate	$851.23
Rate for Payer: Aetna Commercial	$646.93
Rate for Payer: Aetna Medicare Advantage	$510.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$434.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$434.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$434.12
Rate for Payer: Cigna Commercial	$851.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$374.54
Rate for Payer: Qualcare PPO/HMO/WC	$255.37
Rate for Payer: UnitedHealthcare Community & State	$41.03
Rate for Payer: Wellpoint Medicaid Managed Care	$45.11

TRAY CYSTO

Facility

$90.35

Hospital Charge Code	270654145
Hospital Revenue Code	270
Min. Negotiated Rate	$2.18
Max. Negotiated Rate	$45.17
Rate for Payer: Aetna Commercial	$34.33
Rate for Payer: Aetna Medicare Advantage	$27.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.04
Rate for Payer: Cigna Commercial	$45.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.11
Rate for Payer: Oxford Commercial	$18.07
Rate for Payer: Qualcare PPO/HMO/WC	$13.55
Rate for Payer: UnitedHealthcare Commercial	$18.07
Rate for Payer: UnitedHealthcare Community & State	$2.18
Rate for Payer: Wellpoint Medicaid Managed Care	$2.39

TRAY CYSTO

Facility

$90.35

Hospital Charge Code	270654145
Hospital Revenue Code	270
Min. Negotiated Rate	$13.55
Max. Negotiated Rate	$13.55
Rate for Payer: Qualcare PPO/HMO/WC	$13.55

TRAY DIALYSIS 3 LUMEN CV

Facility

$367.32

Hospital Charge Code	270649140
Hospital Revenue Code	272
Min. Negotiated Rate	$8.85
Max. Negotiated Rate	$183.66
Rate for Payer: Aetna Commercial	$139.58
Rate for Payer: Aetna Medicare Advantage	$110.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.67
Rate for Payer: Cigna Commercial	$183.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.20
Rate for Payer: Oxford Commercial	$73.46
Rate for Payer: Qualcare PPO/HMO/WC	$55.10
Rate for Payer: UnitedHealthcare Commercial	$73.46
Rate for Payer: UnitedHealthcare Community & State	$8.85
Rate for Payer: Wellpoint Medicaid Managed Care	$9.73

TRAY DIALYSIS 3 LUMEN CV

Facility

$367.32

Hospital Charge Code	270649140
Hospital Revenue Code	272
Min. Negotiated Rate	$55.10
Max. Negotiated Rate	$55.10
Rate for Payer: Qualcare PPO/HMO/WC	$55.10

TRAY DOBHOFF FEEDING

Facility

$156.85

Hospital Charge Code	8000788
Hospital Revenue Code	270
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$78.42
Rate for Payer: Aetna Commercial	$59.60
Rate for Payer: Aetna Medicare Advantage	$47.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.00
Rate for Payer: Cigna Commercial	$78.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.05
Rate for Payer: Oxford Commercial	$31.37
Rate for Payer: Qualcare PPO/HMO/WC	$23.53
Rate for Payer: UnitedHealthcare Commercial	$31.37
Rate for Payer: UnitedHealthcare Community & State	$3.78
Rate for Payer: Wellpoint Medicaid Managed Care	$4.16

TRAY DOBHOFF FEEDING

Facility

$156.85

Hospital Charge Code	8000788
Hospital Revenue Code	270
Min. Negotiated Rate	$23.53
Max. Negotiated Rate	$23.53
Rate for Payer: Qualcare PPO/HMO/WC	$23.53

TRAY DRSG CHG CENTRAL LINE

Facility

$20.80

Hospital Charge Code	270302225
Hospital Revenue Code	272
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$3.12
Rate for Payer: Qualcare PPO/HMO/WC	$3.12

TRAY DRSG CHG CENTRAL LINE

Facility

$20.80

Hospital Charge Code	270302225
Hospital Revenue Code	272
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$10.40
Rate for Payer: Aetna Commercial	$7.90
Rate for Payer: Aetna Medicare Advantage	$6.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.30
Rate for Payer: Cigna Commercial	$10.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.24
Rate for Payer: Oxford Commercial	$4.16
Rate for Payer: Qualcare PPO/HMO/WC	$3.12
Rate for Payer: UnitedHealthcare Commercial	$4.16
Rate for Payer: UnitedHealthcare Community & State	$0.50
Rate for Payer: Wellpoint Medicaid Managed Care	$0.55

TRAY EAR IRRIGATION

Facility

$133.65

Hospital Charge Code	2708002248
Hospital Revenue Code	270
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$20.05
Rate for Payer: Qualcare PPO/HMO/WC	$20.05

TRAY EAR IRRIGATION

Facility

$133.65

Hospital Charge Code	2708002248
Hospital Revenue Code	270
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$66.83
Rate for Payer: Aetna Commercial	$50.79
Rate for Payer: Aetna Medicare Advantage	$40.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.08
Rate for Payer: Cigna Commercial	$66.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.09
Rate for Payer: Oxford Commercial	$26.73
Rate for Payer: Qualcare PPO/HMO/WC	$20.05
Rate for Payer: UnitedHealthcare Commercial	$26.73
Rate for Payer: UnitedHealthcare Community & State	$3.22
Rate for Payer: Wellpoint Medicaid Managed Care	$3.54

TRAY EENT

Facility

$247.25

Hospital Charge Code	270654146
Hospital Revenue Code	270
Min. Negotiated Rate	$37.09
Max. Negotiated Rate	$37.09
Rate for Payer: Qualcare PPO/HMO/WC	$37.09

TRAY EENT

Facility

$247.25

Hospital Charge Code	270654146
Hospital Revenue Code	270
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$123.62
Rate for Payer: Aetna Commercial	$93.95
Rate for Payer: Aetna Medicare Advantage	$74.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.05
Rate for Payer: Cigna Commercial	$123.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.17
Rate for Payer: Oxford Commercial	$49.45
Rate for Payer: Qualcare PPO/HMO/WC	$37.09
Rate for Payer: UnitedHealthcare Commercial	$49.45
Rate for Payer: UnitedHealthcare Community & State	$5.96
Rate for Payer: Wellpoint Medicaid Managed Care	$6.55

TRAY ENT/NASAL DISP

Facility

$190.45

Hospital Charge Code	270600758
Hospital Revenue Code	272
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

Know your out-of-pocket cost for care.

All Charges