Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TRAY KYPHOPAK

Facility

$14,968.80

Hospital Charge Code	270648849
Hospital Revenue Code	272
Min. Negotiated Rate	$2,245.32
Max. Negotiated Rate	$2,245.32
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.32

TRAY KYPHOPAK

Facility

$14,968.80

Hospital Charge Code	270648849S
Hospital Revenue Code	272
Min. Negotiated Rate	$2,245.32
Max. Negotiated Rate	$2,245.32
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.32

TRAY KYPHOPAK

Facility

$14,968.80

Hospital Charge Code	270648849S
Hospital Revenue Code	272
Min. Negotiated Rate	$360.75
Max. Negotiated Rate	$7,484.40
Rate for Payer: Aetna Commercial	$5,688.14
Rate for Payer: Aetna Medicare Advantage	$4,490.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,817.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,817.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,817.04
Rate for Payer: Cigna Commercial	$7,484.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,490.64
Rate for Payer: Oxford Commercial	$2,993.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.32
Rate for Payer: UnitedHealthcare Commercial	$2,993.76
Rate for Payer: UnitedHealthcare Community & State	$360.75
Rate for Payer: Wellpoint Medicaid Managed Care	$396.67

TRAY KYPHOPAK

Facility

$14,968.80

Hospital Charge Code	270648849
Hospital Revenue Code	272
Min. Negotiated Rate	$360.75
Max. Negotiated Rate	$7,484.40
Rate for Payer: Aetna Commercial	$5,688.14
Rate for Payer: Aetna Medicare Advantage	$4,490.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,817.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,817.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,817.04
Rate for Payer: Cigna Commercial	$7,484.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,490.64
Rate for Payer: Oxford Commercial	$2,993.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.32
Rate for Payer: UnitedHealthcare Commercial	$2,993.76
Rate for Payer: UnitedHealthcare Community & State	$360.75
Rate for Payer: Wellpoint Medicaid Managed Care	$396.67

TRAY KYPHOPAK

Facility

$19,000.00

Hospital Charge Code	270648849N
Hospital Revenue Code	272
Min. Negotiated Rate	$457.90
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$7,220.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,700.00
Rate for Payer: Oxford Commercial	$3,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Commercial	$3,800.00
Rate for Payer: UnitedHealthcare Community & State	$457.90
Rate for Payer: Wellpoint Medicaid Managed Care	$503.50

TRAY KYPHOPAK

Facility

$14,968.80

Hospital Charge Code	270648849C
Hospital Revenue Code	270
Min. Negotiated Rate	$2,245.32
Max. Negotiated Rate	$2,245.32
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.32

TRAY KYPHOPAK

Facility

$14,968.80

Hospital Charge Code	270648849C
Hospital Revenue Code	270
Min. Negotiated Rate	$360.75
Max. Negotiated Rate	$7,484.40
Rate for Payer: Aetna Commercial	$5,688.14
Rate for Payer: Aetna Medicare Advantage	$4,490.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,817.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,817.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,817.04
Rate for Payer: Cigna Commercial	$7,484.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,490.64
Rate for Payer: Oxford Commercial	$2,993.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.32
Rate for Payer: UnitedHealthcare Commercial	$2,993.76
Rate for Payer: UnitedHealthcare Community & State	$360.75
Rate for Payer: Wellpoint Medicaid Managed Care	$396.67

TRAY KYPHOPAK

Facility

$19,000.00

Hospital Charge Code	270648849N
Hospital Revenue Code	272
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

TRAY KYPHOPAK PB

Facility

$14,968.80

Service Code	HCPCS C1713
Hospital Charge Code	270680226
Hospital Revenue Code	278
Min. Negotiated Rate	$2,245.32
Max. Negotiated Rate	$3,622.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,993.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,622.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,293.14
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.32

TRAY KYPHOPAK PB

Facility

$14,968.80

Service Code	HCPCS C1713
Hospital Charge Code	270680226
Hospital Revenue Code	278
Min. Negotiated Rate	$360.75
Max. Negotiated Rate	$7,484.40
Rate for Payer: Aetna Commercial	$5,688.14
Rate for Payer: Aetna Medicare Advantage	$4,490.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,817.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,817.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,993.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,817.04
Rate for Payer: Cigna Commercial	$7,484.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,622.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,293.14
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.32
Rate for Payer: UnitedHealthcare Community & State	$360.75
Rate for Payer: Wellpoint Medicaid Managed Care	$396.67

TRAY LOCAL

Facility

$182.39

Hospital Charge Code	270654147
Hospital Revenue Code	270
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$91.19
Rate for Payer: Aetna Commercial	$69.31
Rate for Payer: Aetna Medicare Advantage	$54.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.51
Rate for Payer: Cigna Commercial	$91.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.72
Rate for Payer: Oxford Commercial	$36.48
Rate for Payer: Qualcare PPO/HMO/WC	$27.36
Rate for Payer: UnitedHealthcare Commercial	$36.48
Rate for Payer: UnitedHealthcare Community & State	$4.40
Rate for Payer: Wellpoint Medicaid Managed Care	$4.83

TRAY LOCAL

Facility

$182.39

Hospital Charge Code	270654147
Hospital Revenue Code	270
Min. Negotiated Rate	$27.36
Max. Negotiated Rate	$27.36
Rate for Payer: Qualcare PPO/HMO/WC	$27.36

TRAY LUMBAR PUNCTURE

Facility

$96.78

Hospital Charge Code	270302245
Hospital Revenue Code	272
Min. Negotiated Rate	$14.52
Max. Negotiated Rate	$14.52
Rate for Payer: Qualcare PPO/HMO/WC	$14.52

TRAY LUMBAR PUNCTURE

Facility

$96.78

Hospital Charge Code	270302245
Hospital Revenue Code	272
Min. Negotiated Rate	$2.33
Max. Negotiated Rate	$48.39
Rate for Payer: Aetna Commercial	$36.78
Rate for Payer: Aetna Medicare Advantage	$29.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.68
Rate for Payer: Cigna Commercial	$48.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.03
Rate for Payer: Oxford Commercial	$19.36
Rate for Payer: Qualcare PPO/HMO/WC	$14.52
Rate for Payer: UnitedHealthcare Commercial	$19.36
Rate for Payer: UnitedHealthcare Community & State	$2.33
Rate for Payer: Wellpoint Medicaid Managed Care	$2.56

TRAY LUMBAR PUNCTURE****

Facility

$45.00

Hospital Charge Code	8004467
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.50
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Commercial	$9.00
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

TRAY LUMBAR PUNCTURE****

Facility

$45.00

Hospital Charge Code	8004467
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

TRAY LUMBAR PUNCTURE 20G

Facility

$66.13

Hospital Charge Code	270649873S
Hospital Revenue Code	272
Min. Negotiated Rate	$9.92
Max. Negotiated Rate	$9.92
Rate for Payer: Qualcare PPO/HMO/WC	$9.92

TRAY LUMBAR PUNCTURE 20G

Facility

$66.13

Hospital Charge Code	270649873
Hospital Revenue Code	272
Min. Negotiated Rate	$9.92
Max. Negotiated Rate	$9.92
Rate for Payer: Qualcare PPO/HMO/WC	$9.92

TRAY LUMBAR PUNCTURE 20G

Facility

$66.13

Hospital Charge Code	270649873S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$33.06
Rate for Payer: Aetna Commercial	$25.13
Rate for Payer: Aetna Medicare Advantage	$19.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.86
Rate for Payer: Cigna Commercial	$33.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.84
Rate for Payer: Oxford Commercial	$13.23
Rate for Payer: Qualcare PPO/HMO/WC	$9.92
Rate for Payer: UnitedHealthcare Commercial	$13.23
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

TRAY LUMBAR PUNCTURE 20G

Facility

$66.13

Hospital Charge Code	270649873
Hospital Revenue Code	272
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$33.06
Rate for Payer: Aetna Commercial	$25.13
Rate for Payer: Aetna Medicare Advantage	$19.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.86
Rate for Payer: Cigna Commercial	$33.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.84
Rate for Payer: Oxford Commercial	$13.23
Rate for Payer: Qualcare PPO/HMO/WC	$9.92
Rate for Payer: UnitedHealthcare Commercial	$13.23
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

TRAY LUMBAR PUNCTURE 20G

Facility

$52.60

Hospital Charge Code	270649873N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$26.30
Rate for Payer: Aetna Commercial	$19.99
Rate for Payer: Aetna Medicare Advantage	$15.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.41
Rate for Payer: Cigna Commercial	$26.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.78
Rate for Payer: Oxford Commercial	$10.52
Rate for Payer: Qualcare PPO/HMO/WC	$7.89
Rate for Payer: UnitedHealthcare Commercial	$10.52
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.39

TRAY LUMBAR PUNCTURE 20G

Facility

$52.60

Hospital Charge Code	270649873N
Hospital Revenue Code	272
Min. Negotiated Rate	$7.89
Max. Negotiated Rate	$7.89
Rate for Payer: Qualcare PPO/HMO/WC	$7.89

TRAY LUMBAR PUNCTURE 22G

Facility

$67.94

Hospital Charge Code	270649875
Hospital Revenue Code	272
Min. Negotiated Rate	$10.19
Max. Negotiated Rate	$10.19
Rate for Payer: Qualcare PPO/HMO/WC	$10.19

TRAY LUMBAR PUNCTURE 22G

Facility

$67.94

Hospital Charge Code	270649875
Hospital Revenue Code	272
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$33.97
Rate for Payer: Aetna Commercial	$25.82
Rate for Payer: Aetna Medicare Advantage	$20.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.32
Rate for Payer: Cigna Commercial	$33.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.38
Rate for Payer: Oxford Commercial	$13.59
Rate for Payer: Qualcare PPO/HMO/WC	$10.19
Rate for Payer: UnitedHealthcare Commercial	$13.59
Rate for Payer: UnitedHealthcare Community & State	$1.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.80

TRAY LUMBAR PUNCTURE ADULT

Facility

$38.10

Hospital Charge Code	270649762
Hospital Revenue Code	272
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$19.05
Rate for Payer: Aetna Commercial	$14.48
Rate for Payer: Aetna Medicare Advantage	$11.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.72
Rate for Payer: Cigna Commercial	$19.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.43
Rate for Payer: Oxford Commercial	$7.62
Rate for Payer: Qualcare PPO/HMO/WC	$5.71
Rate for Payer: UnitedHealthcare Commercial	$7.62
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

Know your out-of-pocket cost for care.

All Charges