Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TRAY LUMBAR PUNCTURE ADULT

Facility

$38.10

Hospital Charge Code	270649762
Hospital Revenue Code	272
Min. Negotiated Rate	$5.71
Max. Negotiated Rate	$5.71
Rate for Payer: Qualcare PPO/HMO/WC	$5.71

TRAY LUMBAR PUNCTURE CHILD

Facility

$55.89

Hospital Charge Code	270649892
Hospital Revenue Code	272
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$27.95
Rate for Payer: Aetna Commercial	$21.24
Rate for Payer: Aetna Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.25
Rate for Payer: Cigna Commercial	$27.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.77
Rate for Payer: Oxford Commercial	$11.18
Rate for Payer: Qualcare PPO/HMO/WC	$8.38
Rate for Payer: UnitedHealthcare Commercial	$11.18
Rate for Payer: UnitedHealthcare Community & State	$1.35
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

TRAY LUMBAR PUNCTURE CHILD

Facility

$55.89

Hospital Charge Code	270649892
Hospital Revenue Code	272
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$8.38
Rate for Payer: Qualcare PPO/HMO/WC	$8.38

TRAY LUMBAR PUNCTURE INFANT

Facility

$49.40

Hospital Charge Code	270649894
Hospital Revenue Code	270
Min. Negotiated Rate	$7.41
Max. Negotiated Rate	$7.41
Rate for Payer: Qualcare PPO/HMO/WC	$7.41

TRAY LUMBAR PUNCTURE INFANT

Facility

$49.40

Hospital Charge Code	270649894
Hospital Revenue Code	270
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$24.70
Rate for Payer: Aetna Commercial	$18.77
Rate for Payer: Aetna Medicare Advantage	$14.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.60
Rate for Payer: Cigna Commercial	$24.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.82
Rate for Payer: Oxford Commercial	$9.88
Rate for Payer: Qualcare PPO/HMO/WC	$7.41
Rate for Payer: UnitedHealthcare Commercial	$9.88
Rate for Payer: UnitedHealthcare Community & State	$1.19
Rate for Payer: Wellpoint Medicaid Managed Care	$1.31

TRAY LUMBAR PUNCTURE/SE

Facility

$114.45

Hospital Charge Code	270603377
Hospital Revenue Code	272
Min. Negotiated Rate	$17.17
Max. Negotiated Rate	$17.17
Rate for Payer: Qualcare PPO/HMO/WC	$17.17

TRAY LUMBAR PUNCTURE/SE

Facility

$114.45

Hospital Charge Code	270603377
Hospital Revenue Code	272
Min. Negotiated Rate	$2.76
Max. Negotiated Rate	$57.23
Rate for Payer: Aetna Commercial	$43.49
Rate for Payer: Aetna Medicare Advantage	$34.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.18
Rate for Payer: Cigna Commercial	$57.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.34
Rate for Payer: Oxford Commercial	$22.89
Rate for Payer: Qualcare PPO/HMO/WC	$17.17
Rate for Payer: UnitedHealthcare Commercial	$22.89
Rate for Payer: UnitedHealthcare Community & State	$2.76
Rate for Payer: Wellpoint Medicaid Managed Care	$3.03

TRAY LUMBAR PUNCT X RX TH INF

Facility

$29.75

Hospital Charge Code	270647910
Hospital Revenue Code	272
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$4.46
Rate for Payer: Qualcare PPO/HMO/WC	$4.46

TRAY LUMBAR PUNCT X RX TH INF

Facility

$29.75

Hospital Charge Code	270647910
Hospital Revenue Code	272
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$14.88
Rate for Payer: Aetna Commercial	$11.30
Rate for Payer: Aetna Medicare Advantage	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.59
Rate for Payer: Cigna Commercial	$14.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.93
Rate for Payer: Oxford Commercial	$5.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.46
Rate for Payer: UnitedHealthcare Commercial	$5.95
Rate for Payer: UnitedHealthcare Community & State	$0.72
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

TRAY MAJOR PROCEDURE

Facility

$322.00

Hospital Charge Code	270654116
Hospital Revenue Code	270
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$161.00
Rate for Payer: Aetna Commercial	$122.36
Rate for Payer: Aetna Medicare Advantage	$96.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.11
Rate for Payer: Cigna Commercial	$161.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.60
Rate for Payer: Oxford Commercial	$64.40
Rate for Payer: Qualcare PPO/HMO/WC	$48.30
Rate for Payer: UnitedHealthcare Commercial	$64.40
Rate for Payer: UnitedHealthcare Community & State	$7.76
Rate for Payer: Wellpoint Medicaid Managed Care	$8.53

TRAY MAJOR PROCEDURE

Facility

$322.00

Hospital Charge Code	270654116
Hospital Revenue Code	270
Min. Negotiated Rate	$48.30
Max. Negotiated Rate	$48.30
Rate for Payer: Qualcare PPO/HMO/WC	$48.30

TRAY MAMMOSITE RTS 4-5 CM 2456

Facility

$11,904.00

Hospital Charge Code	270630230
Hospital Revenue Code	272
Min. Negotiated Rate	$286.89
Max. Negotiated Rate	$5,952.00
Rate for Payer: Aetna Commercial	$4,523.52
Rate for Payer: Aetna Medicare Advantage	$3,571.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,035.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,035.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,035.52
Rate for Payer: Cigna Commercial	$5,952.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,571.20
Rate for Payer: Oxford Commercial	$2,380.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,785.60
Rate for Payer: UnitedHealthcare Commercial	$2,380.80
Rate for Payer: UnitedHealthcare Community & State	$286.89
Rate for Payer: Wellpoint Medicaid Managed Care	$315.46

TRAY MAMMOSITE RTS 4-5 CM 2456

Facility

$11,904.00

Hospital Charge Code	270630230
Hospital Revenue Code	272
Min. Negotiated Rate	$1,785.60
Max. Negotiated Rate	$1,785.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,785.60

TRAY MEDIAL TIBIAL LEFT SIZE B

Facility

$13,740.00

Hospital Charge Code	270645451
Hospital Revenue Code	278
Min. Negotiated Rate	$2,061.00
Max. Negotiated Rate	$3,325.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,748.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,325.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,022.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,061.00

TRAY MEDIAL TIBIAL LEFT SIZE B

Facility

$13,740.00

Hospital Charge Code	270645451
Hospital Revenue Code	278
Min. Negotiated Rate	$331.13
Max. Negotiated Rate	$6,870.00
Rate for Payer: Aetna Commercial	$5,221.20
Rate for Payer: Aetna Medicare Advantage	$4,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,503.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,503.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,748.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,503.70
Rate for Payer: Cigna Commercial	$6,870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,325.08
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,022.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,061.00
Rate for Payer: UnitedHealthcare Community & State	$331.13
Rate for Payer: Wellpoint Medicaid Managed Care	$364.11

TRAY MINOR PROCEDURE

Facility

$162.50

Hospital Charge Code	270654117
Hospital Revenue Code	270
Min. Negotiated Rate	$24.38
Max. Negotiated Rate	$24.38
Rate for Payer: Qualcare PPO/HMO/WC	$24.38

TRAY MINOR PROCEDURE

Facility

$162.50

Hospital Charge Code	270654117
Hospital Revenue Code	270
Min. Negotiated Rate	$3.92
Max. Negotiated Rate	$81.25
Rate for Payer: Aetna Commercial	$61.75
Rate for Payer: Aetna Medicare Advantage	$48.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.44
Rate for Payer: Cigna Commercial	$81.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Oxford Commercial	$32.50
Rate for Payer: Qualcare PPO/HMO/WC	$24.38
Rate for Payer: UnitedHealthcare Commercial	$32.50
Rate for Payer: UnitedHealthcare Community & State	$3.92
Rate for Payer: Wellpoint Medicaid Managed Care	$4.31

TRAY MYELOGRAM 18G

Facility

$220.85

Hospital Charge Code	270601456
Hospital Revenue Code	272
Min. Negotiated Rate	$33.13
Max. Negotiated Rate	$33.13
Rate for Payer: Qualcare PPO/HMO/WC	$33.13

TRAY MYELOGRAM 18G

Facility

$220.85

Hospital Charge Code	270601456
Hospital Revenue Code	272
Min. Negotiated Rate	$5.32
Max. Negotiated Rate	$110.42
Rate for Payer: Aetna Commercial	$83.92
Rate for Payer: Aetna Medicare Advantage	$66.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.32
Rate for Payer: Cigna Commercial	$110.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.25
Rate for Payer: Oxford Commercial	$44.17
Rate for Payer: Qualcare PPO/HMO/WC	$33.13
Rate for Payer: UnitedHealthcare Commercial	$44.17
Rate for Payer: UnitedHealthcare Community & State	$5.32
Rate for Payer: Wellpoint Medicaid Managed Care	$5.85

TRAY MYELOGRAM W/18G NEEDLE

Facility

$64.51

Hospital Charge Code	270601456S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.55
Max. Negotiated Rate	$32.26
Rate for Payer: Aetna Commercial	$24.51
Rate for Payer: Aetna Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.45
Rate for Payer: Cigna Commercial	$32.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.35
Rate for Payer: Oxford Commercial	$12.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.68
Rate for Payer: UnitedHealthcare Commercial	$12.90
Rate for Payer: UnitedHealthcare Community & State	$1.55
Rate for Payer: Wellpoint Medicaid Managed Care	$1.71

TRAY MYELOGRAM W/18G NEEDLE

Facility

$64.51

Hospital Charge Code	270601456S
Hospital Revenue Code	272
Min. Negotiated Rate	$9.68
Max. Negotiated Rate	$9.68
Rate for Payer: Qualcare PPO/HMO/WC	$9.68

TRAY NASAL****

Facility

$166.00

Hospital Charge Code	8002313
Hospital Revenue Code	279
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$83.00
Rate for Payer: Aetna Commercial	$63.08
Rate for Payer: Aetna Medicare Advantage	$49.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.33
Rate for Payer: Cigna Commercial	$83.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.80
Rate for Payer: Oxford Commercial	$33.20
Rate for Payer: Qualcare PPO/HMO/WC	$24.90
Rate for Payer: UnitedHealthcare Commercial	$33.20
Rate for Payer: UnitedHealthcare Community & State	$4.00
Rate for Payer: Wellpoint Medicaid Managed Care	$4.40

TRAY NASAL****

Facility

$166.00

Hospital Charge Code	8002313
Hospital Revenue Code	279
Min. Negotiated Rate	$24.90
Max. Negotiated Rate	$24.90
Rate for Payer: Qualcare PPO/HMO/WC	$24.90

TRAY NASAL NON-DISP

Facility

$235.25

Hospital Charge Code	2708004277
Hospital Revenue Code	272
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$117.62
Rate for Payer: Aetna Commercial	$89.39
Rate for Payer: Aetna Medicare Advantage	$70.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.99
Rate for Payer: Cigna Commercial	$117.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.58
Rate for Payer: Oxford Commercial	$47.05
Rate for Payer: Qualcare PPO/HMO/WC	$35.29
Rate for Payer: UnitedHealthcare Commercial	$47.05
Rate for Payer: UnitedHealthcare Community & State	$5.67
Rate for Payer: Wellpoint Medicaid Managed Care	$6.23

TRAY NASAL NON-DISP

Facility

$235.25

Hospital Charge Code	2708004277
Hospital Revenue Code	272
Min. Negotiated Rate	$35.29
Max. Negotiated Rate	$35.29
Rate for Payer: Qualcare PPO/HMO/WC	$35.29

Know your out-of-pocket cost for care.

All Charges