Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TRAY ENT/NASAL DISP

Facility

$190.45

Hospital Charge Code	270600758
Hospital Revenue Code	272
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$95.22
Rate for Payer: Aetna Commercial	$72.37
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.13
Rate for Payer: Oxford Commercial	$38.09
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$38.09
Rate for Payer: UnitedHealthcare Community & State	$4.59
Rate for Payer: Wellpoint Medicaid Managed Care	$5.05

TRAY ENT/NASAL - RECYCLABLE***

Facility

$92.00

Hospital Charge Code	8004277
Hospital Revenue Code	272
Min. Negotiated Rate	$2.22
Max. Negotiated Rate	$46.00
Rate for Payer: Aetna Commercial	$34.96
Rate for Payer: Aetna Medicare Advantage	$27.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.46
Rate for Payer: Cigna Commercial	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.60
Rate for Payer: Oxford Commercial	$18.40
Rate for Payer: Qualcare PPO/HMO/WC	$13.80
Rate for Payer: UnitedHealthcare Commercial	$18.40
Rate for Payer: UnitedHealthcare Community & State	$2.22
Rate for Payer: Wellpoint Medicaid Managed Care	$2.44

TRAY ENT/NASAL - RECYCLABLE***

Facility

$92.00

Hospital Charge Code	8004277
Hospital Revenue Code	272
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.80

TRAY EPIDURAL

Facility

$184.00

Hospital Charge Code	270070090
Hospital Revenue Code	272
Min. Negotiated Rate	$4.43
Max. Negotiated Rate	$92.00
Rate for Payer: Aetna Commercial	$69.92
Rate for Payer: Aetna Medicare Advantage	$55.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.92
Rate for Payer: Cigna Commercial	$92.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.20
Rate for Payer: Oxford Commercial	$36.80
Rate for Payer: Qualcare PPO/HMO/WC	$27.60
Rate for Payer: UnitedHealthcare Commercial	$36.80
Rate for Payer: UnitedHealthcare Community & State	$4.43
Rate for Payer: Wellpoint Medicaid Managed Care	$4.88

TRAY EPIDURAL

Facility

$184.00

Hospital Charge Code	270070090
Hospital Revenue Code	272
Min. Negotiated Rate	$27.60
Max. Negotiated Rate	$27.60
Rate for Payer: Qualcare PPO/HMO/WC	$27.60

TRAY EPIDURAL 18G

Facility

$100.44

Hospital Charge Code	270649872
Hospital Revenue Code	272
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$50.22
Rate for Payer: Aetna Commercial	$38.17
Rate for Payer: Aetna Medicare Advantage	$30.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.61
Rate for Payer: Cigna Commercial	$50.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.13
Rate for Payer: Oxford Commercial	$20.09
Rate for Payer: Qualcare PPO/HMO/WC	$15.07
Rate for Payer: UnitedHealthcare Commercial	$20.09
Rate for Payer: UnitedHealthcare Community & State	$2.42
Rate for Payer: Wellpoint Medicaid Managed Care	$2.66

TRAY EPIDURAL 18G

Facility

$100.44

Hospital Charge Code	270649872
Hospital Revenue Code	272
Min. Negotiated Rate	$15.07
Max. Negotiated Rate	$15.07
Rate for Payer: Qualcare PPO/HMO/WC	$15.07

TRAY EPIDURAL AK05502

Facility

$112.70

Hospital Charge Code	270613197
Hospital Revenue Code	272
Min. Negotiated Rate	$2.72
Max. Negotiated Rate	$56.35
Rate for Payer: Aetna Commercial	$42.83
Rate for Payer: Aetna Medicare Advantage	$33.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.74
Rate for Payer: Cigna Commercial	$56.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.81
Rate for Payer: Oxford Commercial	$22.54
Rate for Payer: Qualcare PPO/HMO/WC	$16.91
Rate for Payer: UnitedHealthcare Commercial	$22.54
Rate for Payer: UnitedHealthcare Community & State	$2.72
Rate for Payer: Wellpoint Medicaid Managed Care	$2.99

TRAY EPIDURAL AK05502

Facility

$112.70

Hospital Charge Code	270613197
Hospital Revenue Code	272
Min. Negotiated Rate	$16.91
Max. Negotiated Rate	$16.91
Rate for Payer: Qualcare PPO/HMO/WC	$16.91

TRAY EPIDURAL AK-05502

Facility

$131.00

Hospital Charge Code	270641262
Hospital Revenue Code	272
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$19.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

TRAY EPIDURAL AK-05502

Facility

$131.00

Hospital Charge Code	270641262
Hospital Revenue Code	272
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$65.50
Rate for Payer: Aetna Commercial	$49.78
Rate for Payer: Aetna Medicare Advantage	$39.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.41
Rate for Payer: Cigna Commercial	$65.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.30
Rate for Payer: Oxford Commercial	$26.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.65
Rate for Payer: UnitedHealthcare Commercial	$26.20
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$3.47

TRAY EPIDURAL ANESTHESIA*****

Facility

$78.00

Hospital Charge Code	1800150
Hospital Revenue Code	272
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$11.70
Rate for Payer: Qualcare PPO/HMO/WC	$11.70

TRAY EPIDURAL ANESTHESIA*****

Facility

$78.00

Hospital Charge Code	1800150
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$39.00
Rate for Payer: Aetna Commercial	$29.64
Rate for Payer: Aetna Medicare Advantage	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.89
Rate for Payer: Cigna Commercial	$39.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$11.70
Rate for Payer: UnitedHealthcare Commercial	$15.60
Rate for Payer: UnitedHealthcare Community & State	$1.88
Rate for Payer: Wellpoint Medicaid Managed Care	$2.07

TRAY EPIDURAL CONTINOUS

Facility

$107.48

Hospital Charge Code	270621149
Hospital Revenue Code	272
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$53.74
Rate for Payer: Aetna Commercial	$40.84
Rate for Payer: Aetna Medicare Advantage	$32.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.41
Rate for Payer: Cigna Commercial	$53.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.24
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.12
Rate for Payer: UnitedHealthcare Commercial	$21.50
Rate for Payer: UnitedHealthcare Community & State	$2.59
Rate for Payer: Wellpoint Medicaid Managed Care	$2.85

TRAY EPIDURAL CONTINOUS

Facility

$107.48

Hospital Charge Code	270621149
Hospital Revenue Code	272
Min. Negotiated Rate	$16.12
Max. Negotiated Rate	$16.12
Rate for Payer: Qualcare PPO/HMO/WC	$16.12

TRAY EPIDURAL CONTINOUS

Facility

$97.71

Hospital Charge Code	270650092
Hospital Revenue Code	270
Min. Negotiated Rate	$2.35
Max. Negotiated Rate	$48.85
Rate for Payer: Aetna Commercial	$37.13
Rate for Payer: Aetna Medicare Advantage	$29.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.92
Rate for Payer: Cigna Commercial	$48.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.31
Rate for Payer: Oxford Commercial	$19.54
Rate for Payer: Qualcare PPO/HMO/WC	$14.66
Rate for Payer: UnitedHealthcare Commercial	$19.54
Rate for Payer: UnitedHealthcare Community & State	$2.35
Rate for Payer: Wellpoint Medicaid Managed Care	$2.59

TRAY EPIDURAL CONTINOUS

Facility

$97.71

Hospital Charge Code	270650092
Hospital Revenue Code	270
Min. Negotiated Rate	$14.66
Max. Negotiated Rate	$14.66
Rate for Payer: Qualcare PPO/HMO/WC	$14.66

TRAY EPIDURAL PERIFIX 20G

Facility

$120.59

Hospital Charge Code	270692059
Hospital Revenue Code	272
Min. Negotiated Rate	$2.91
Max. Negotiated Rate	$60.30
Rate for Payer: Aetna Commercial	$45.82
Rate for Payer: Aetna Medicare Advantage	$36.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.75
Rate for Payer: Cigna Commercial	$60.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.18
Rate for Payer: Oxford Commercial	$24.12
Rate for Payer: Qualcare PPO/HMO/WC	$18.09
Rate for Payer: UnitedHealthcare Commercial	$24.12
Rate for Payer: UnitedHealthcare Community & State	$2.91
Rate for Payer: Wellpoint Medicaid Managed Care	$3.20

TRAY EPIDURAL PERIFIX 20G

Facility

$120.59

Hospital Charge Code	270692059
Hospital Revenue Code	272
Min. Negotiated Rate	$18.09
Max. Negotiated Rate	$18.09
Rate for Payer: Qualcare PPO/HMO/WC	$18.09

TRAY EPIDURAL SHOT SINGLE

Facility

$227.32

Hospital Charge Code	270655432
Hospital Revenue Code	270
Min. Negotiated Rate	$34.10
Max. Negotiated Rate	$34.10
Rate for Payer: Qualcare PPO/HMO/WC	$34.10

TRAY EPIDURAL SHOT SINGLE

Facility

$227.32

Hospital Charge Code	270655432
Hospital Revenue Code	270
Min. Negotiated Rate	$5.48
Max. Negotiated Rate	$113.66
Rate for Payer: Aetna Commercial	$86.38
Rate for Payer: Aetna Medicare Advantage	$68.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.97
Rate for Payer: Cigna Commercial	$113.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.20
Rate for Payer: Oxford Commercial	$45.46
Rate for Payer: Qualcare PPO/HMO/WC	$34.10
Rate for Payer: UnitedHealthcare Commercial	$45.46
Rate for Payer: UnitedHealthcare Community & State	$5.48
Rate for Payer: Wellpoint Medicaid Managed Care	$6.02

TRAY EPIDURAL SINGLE SHOT 17G

Facility

$124.00

Hospital Charge Code	270331215
Hospital Revenue Code	272
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$62.00
Rate for Payer: Aetna Commercial	$47.12
Rate for Payer: Aetna Medicare Advantage	$37.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.62
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.20
Rate for Payer: Oxford Commercial	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$24.80
Rate for Payer: UnitedHealthcare Community & State	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

TRAY EPIDURAL SINGLE SHOT 17G

Facility

$124.00

Hospital Charge Code	270331215
Hospital Revenue Code	272
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

TRAY EPIDURAL SNGL SHOT S00201

Facility

$100.85

Hospital Charge Code	270613761
Hospital Revenue Code	272
Min. Negotiated Rate	$15.13
Max. Negotiated Rate	$15.13
Rate for Payer: Qualcare PPO/HMO/WC	$15.13

TRAY EPIDURAL SNGL SHOT S00201

Facility

$100.85

Hospital Charge Code	270613761
Hospital Revenue Code	272
Min. Negotiated Rate	$2.43
Max. Negotiated Rate	$50.42
Rate for Payer: Aetna Commercial	$38.32
Rate for Payer: Aetna Medicare Advantage	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.72
Rate for Payer: Cigna Commercial	$50.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Oxford Commercial	$20.17
Rate for Payer: Qualcare PPO/HMO/WC	$15.13
Rate for Payer: UnitedHealthcare Commercial	$20.17
Rate for Payer: UnitedHealthcare Community & State	$2.43
Rate for Payer: Wellpoint Medicaid Managed Care	$2.67

Know your out-of-pocket cost for care.

All Charges